What is Third Generation Surveillance?

• 
  Who has the conditions?
  
• 
  When did they get them?
  
• 
  Where do they live?
  
• 
  How have they put themselves at risk of contracting HIV and STIs?
  
• 
  How many reported cases need treatment?
  

HIV/STI surveillance systems should be based on scientifically sound and well-known case definitions and well-established indicators for monitoring the epidemic and evaluating impact of interventions. They should also include orderly consolidation and evaluation (Quality Assurance) of data, and prompt dissemination to those who need to know.

comprehensive

surveillance

system

• 
  collects, analyses and publishes accurate and timely epidemiological, behavioural and care information
  
• 
  monitors the spread (incidence, prevalence and underlying behaviours and factors) and the impact (health and social) of these conditions
  
• 
  contributes to a better understanding of the magnitude of diseases, risk behaviours, and the care and treatment coverage for individuals suffering from these conditions
  
• 
  contributes to a better understanding of the disease trends in different vulnerable groups and in different socio-economic strata and geographic areas
  
• 
  provides timely and accurate data for public health planning
  
• 
  supports health planners and decision-makers to plan and evaluate the impact of interventions and programmes (such as safer sex practises, reduction in incidence or prevalence of diseases, quality of care)
  
• 
  enhances interventions to treat and decrease spread of infection.
  

The surveillance strategy should address core epidemiological, behavioural and care information systems. These systems should be responsive to the country’s data needs for priority conditions such as HIV and other STIs.

Levels of

surveillance

systems

Table 4.1 Components of basic, intermediate and advanced surveillance systems.

What this section

is about

This section provides an overview of the history, purpose and importance of HIV case surveillance. It explains:

• 
  the natural history of HIV disease and the points in the course of disease that are important to monitor for surveillance purposes
  
• 
  the history of case reporting and how changes in HIV testing methods and HIV treatments have affected reporting recommendations and practises
  
• 
  the purpose of HIV case surveillance
  
• 
  how other types of HIV programmes can provide data for surveillance purposes.
  

Warm-up

1. 
   What are the key differences between HIV sero-surveillance and HIV case surveillance?
   

2. 
   True or false? Reporting of all HIV tests performed on women coming in for antenatal care is a component of AIDS case reporting.
   

3. 
   Which of the following is NOT a purpose of advanced HIV disease/AIDS case reporting?
   

1. 
   Determining the burden of disease attributable to advanced HIV disease/AIDS in the region
   
2. 
   Assessing trends in advanced HIV disease/AIDS cases
   
3. 
   Providing information on the opportunistic infections associated with AIDS cases
   
4. 
   Measuring HIV incidence
   

4. 
   List four stages in the natural history of HIV disease that are target points for HIV case surveillance.
   

5. 
   List three reasons for conducting HIV case surveillance.
   

6. 
   Which stage in the life cycle of HIV requires use of special (not routine) laboratory tests?