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Approaches to Developing National Estimates
UNAIDS Reference Group on Estimates, Models and
Projections
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Approaches to Developing National Estimates
Estimate should be owned by the National AIDS Control Program
National consensus workshop• Involve key experts• Bring all expertise about surveillance
data• Improve surveillance system
Release of estimate can be advocacy opportunity
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National Workshop
Surveillance methodology Surveillance data Discussion and agreement on
methodology Agreement on major trends Review of results How to use results Key dissemination messages Public seminar
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Methodology Generalized epidemics
• Urban/rural• Province• Site specific with district mapping• Consider characteristics of sites
Concentrated epidemics• National or provincial• Risk groups to include• Estimation of risk group size
Range of estimates
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Kaporo
Mbalachanda HC
St. John’s Hosp.
Rumphi DH
NkhataBay DH
St. Anne’s Hosp.Kamboni HC
Mchinji DH
Lilongwe CH
Ntcheu DH
Thonje HC
Kasina HC
Mangochi DH
Nsanje DH
Mianga HC
QECH
Gawanani HC
Milepa HC
Mulanje M. Hosp.
HIV Sentinel Sites
Urban
Semi-urban
Rural
HIV Sentinel Sites in Malawi
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Region District Urban site Rural siteNorth Chitipa Kasoba/Kaporo Mbalachanda-Kaporo
Karonga Nkhata Bay Kasoba/KaporoRumphi Rumphi MbalachandaNkhata Bay Nkhata Bay Mbalachanda-KaporoMzimba Rumphi MbalachandaMzuzu City St. John's St. John'sLikoma Nkhata Bay-Kaporo Nkhata Bay-Kaporo
Central Kasungu Mchinji KamboniNkhotakota Nkhotakota KamboniNtchisi Thonje-Mchinji ThonjeDowa Mchinji ThonjeSalima Mchinji-Nkhotakota Nkhata Bay-KaporoLilongwe Lilongwe KasinaMchinji Mchinji KamboniDedza Ntcheu KasinaNtcheu Ntcheu Kasina
South Mangochi Mangochi GawananiMachinga Mangochi GawananiBalaka Mangochi-Ntcheu GawananiZomba Blantyre Gawanani-MilepaChiradzulu Mulanje MilepaBlantyre Blantyre Milepa-MiangaMwanza Mchinji GawananiThyolo Mulanje MiangaMulanje Mulanje MiangaPhalombe Milepa MilepaChikwawa Nsanje Milepa-MiangaNsanje Nsanje Milepa-Mianga
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Agreement on Trends
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
1990 1995 2000
Nyeri
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Agreement on Trends
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
1990 1995 2000
MeruNyeriThikaMaraguaNjambini
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Is prevalence declining?
0
5
10
15
20
25
30
35
Phi=1.49; SSQ=0.013096 Data
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Is prevalence declining?
0
5
10
15
20
25
30
35
1980 1983 1986 1989 1992 1995 1998 2001 2004 2007
Phi=1.49; SSQ=0.013096 PHI=100; SSQ=.013466 Data
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New Sites
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