Patient Characteristics Associated with Lack of Reporting of Viral Load Test Date and Clinic Attendance Date:
General Material Designation
[Thesis]
First Statement of Responsibility
Adjei, Paul C.
Title Proper by Another Author
Country-Specific Analyses of Data Reported to the European Surveillance System Database
Subsequent Statement of Responsibility
Jordan, Michael R.
.PUBLICATION, DISTRIBUTION, ETC
Name of Publisher, Distributor, etc.
Sackler School of Graduate Biomedical Sciences (Tufts University)
Date of Publication, Distribution, etc.
2020
PHYSICAL DESCRIPTION
Specific Material Designation and Extent of Item
60
DISSERTATION (THESIS) NOTE
Dissertation or thesis details and type of degree
M.S.
Body granting the degree
Sackler School of Graduate Biomedical Sciences (Tufts University)
Text preceding or following the note
2020
SUMMARY OR ABSTRACT
Text of Note
Background: Surveillance data on HIV/AIDS from all 53 countries within the WHO European region are reported by countries to the European Surveillance System (TESSy). However, to date, no country-specific analyses have examined: 1) country- and regional-level viral load (VL) coverage and 2) the completeness of data reported to TESSy. Methods: An analysis was performed of data reported to TESSy between 2017 and 2019 with two aims: 1) identification of country-specific patient-factors associated with having no VL test date reported, and 2) identification of country-specific patient-factors associated with having no last clinic attendance date. All analyses were restricted to persons reported to be receiving ART. Separate multivariable logistic regression models were built for each country included in the analysis. In addition, the prevalence of missing data in key clinical and virologic outcomes variables was determined. Results: The VL test cohort had a sample size of 98,097 with cases from 22 countries. The clinic attendance cohort had 94,630 individuals from 17 countries. For the first outcome (VL test date not reported), transmission via injection drug use (IDU) was associated with increased odds in the Netherlands, Tajikistan, Ukraine while being a man who has sex with other men (MSM) was associated with decreased odds in Belarus, Kazakhstan, Ukraine; male gender was associated with increased odds in Belarus, Kazakhstan, Tajikistan, Ukraine; advanced age was associated with decreased odds in Kyrgyzstan and increased odds in Ukraine; a more recent year of diagnosis was associated with increased odds in Azerbaijan, Kazakhstan, Moldova, Tajikistan and decreased odds in Ukraine.; not having a first CD4 cell count test reported was associated with increased odds in Azerbaijan, Belarus, Kazakhstan, Netherlands, Tajikistan, Ukraine. For the second outcome (clinic attendance date not reported), IDU was associated with increased odds in Armenia, Azerbaijan, Kyrgyzstan, Tajikistan and decreased odds in Moldova, Ukraine while MSM was associated with decreased odds in Netherlands, Ukraine and increased odds in Albania; male gender was associated with increased odds in Netherlands, Tajikistan, Ukraine; advanced age was associated with decreased odds in Netherlands, Tajikistan, Ukraine and increased odds in Belarus, Kazakhstan; a more recent year of diagnosis was associated with decreased odds Armenia, Azerbaijan, Czech Republic, Israel, Kazakhstan, Moldova, Netherlands, Slovakia, Tajikistan; not having a first CD4 cell count test reported was associated with increased odds in Albania, Azerbaijan, Belarus, Netherlands, Tajikistan and decreased odds in Kyrgyzstan, Ukraine; being a migrant was associated with decreased odds in Kazakhstan, Netherlands, Tajikistan. We found high proportion of missing data in reporting of: VL load test date (83%), clinic attendance date (82%) and ART status (receiving ART or not) (46%). Conclusion: Among HIV-infected persons receiving ART in the WHO European region with data reported to TESSy, patient factors associated with reporting of VL testing and clinic attendance dates vary by country. We also found very low reporting of ART status, VL testing date and clinic attendance date; all of which are important metrics in measuring progress towards attainment of the 90-90-90 targets. These findings should be helpful in improving data reporting to TESSy to ensure that data reported to TESSy can support important public health decisions