(PMTCT_EID Includes PMTCT_EID_POS) Percentage of infants born to HIV-positive women who had a virologic HIV test done within 12 months of birth

Export Indicator

Percentage of infants born to HIV-positive women who had a virologic HIV test done within 12 months of birth
What it measures

This indicator measures the extent to which infants born to HIV-positive women receive virologic testing to determine their HIV status within the first 2 months and for those not tested by 2 months, how many were tested between 2 and 12 months of age. Additionally, the yield of HIV testing at 2 months of age maybe a useful proxy of early mother-to-child transmission rates if coverage of testing is > 80%. Only the first test for each HIV exposed infant should be counted in this indicator. Even though there is ongoing exposure of infants to HIV (through breastfeeding), this indicator is only measures early access to testing, and not repeat testing of exposed infants. HIV status of infants at the end of the breastfeeding period and the outcomes of the PMTCT program would be measured in PMTCT_FO.

Numerator

Number of infants who had a virologic HIV test within 12 months of birth during the reporting period

Denominator

PMTCT_STAT_POS (see PMTCT_STAT); Denominator is no longer collected as part of indicator, but rather is calculated as PMTCT_STAT_POS

Calculation

Sum results across all reporting periods

Method of measurement

This indicator should be collected from the clinical source (ie. HIV-exposed infant registers or patient records) to assure unduplicated patient counting and receipt of results to inform patient care. HIV-exposed infant registers should be used to count exposed infants and virologic test results. (If available information should come from electronic systems). If the standard report does not contain all the required information, individual patient files should be used. Additional supporting information for this indicator can be obtained from standard laboratory information systems (i.e. DNA PCR log books or electronic systems), but the virologic test results must be able to be linked to a specific patient. Only virologic tests should be included in this indicator. A virologic test is a test used for HIV diagnosis in infants up to 18 months of age. The most commonly used form of virologic testing is HIV DNA PCR on dried blood spots (DBS). Three other types of testing should not be reported: 1) Serologic testing of children should not be reported in this indicator. (See HTS_TST for additional details). 2) Virologic tests conducted with the purpose of confirming the diagnosis of HIV, 3) Virologic tests used for clinical monitoring of children on ART, such as viral load quantification. Additionally, only the first test should be counted for each infant, even if they have had more than one virologic test done during the reporting period. The numerator is divided into tests collected/sent before 2 months of age and those collected/sent between 2 and 12 months of age. Age is documented at the time the DBS is collected and not when the result is returned. It is likely that at the time of reporting there will be tests that have been collected/sent but for which no result is documented in the register or patient record. Partners should report all tests collected/sent even if no result has been recorded in the patient record/register at the time of reporting.

 

How to review for data quality:

 

Review all sites with >100% coverage of testing at 12 months and/or 100% positivity (EID_POS). In general the % tested should not be above 100% at a site, however it is possible that some women identified in PMTCT_STAT_POS might deliver within a reporting period but the infant may not receive virologic test until the following period as there is not always a 1:1 correspondence between POS women identified and infants delivered in a reporting period.

Measurement frequency

Reporting level

Site Level: facility

How often to report:

Quarterly

Disaggregation

Numerator: Number of infants who had a virologic HIV test within 12 months of birth during the reporting period

InfantTest (Required)  Infants who received a virologic test within 2 months of birth; Infants who received their first virologic test between 2 and 12 months of age

Results (sum of postiive disaggregates =PMTCT_EID_ POS) (Required) Infants with a positive virologic test result within 2 months of birth; Infants with a negative virologic test result within 2 months of birth; Infants with a positive virologic test result between 2 and 12 months of birth; Infants with a negative virologic test result between 2 and 12 months of birth; Infants with a test collected/sent but no result recorded within 2 months of birth; Infants with a test collected/sent but no result recorded between 2 and 12 months of birth

Description of Disaggregate

For the numerator to be calculated, implementing partners are required to report: Infants who received a virologic test within 2 months of birth: Age at the time the DBS is collected should be reported. Infants who received their first virologic test between 2 and 12 months of age: Age at the time the DBS is collected should be reported.

For PMTCT_EID_POS to be calculated, implementing partners are required to report: Infants who received a positive/negative virologic test within 2 months of birth: Age at the time the DBS is collected should be reported. Infants who a positive/negative virologic test between 2 and 12 months of age: Age at the time the DBS is collected should be reported.

Explanation of the numerator

Calculated indicator in DATIM, sum of: Infants who received a virologic test within 2 months of birth; Infants who received their first virologic HIV test between 2 and 12 months of age;

Explanation of the denominator

Calculated indicator in DATIM, sum of: 1) Newly Tested Positive, 2) Known Positive at entry (see PMTCT_STAT, Disaggregate Group Positivity Status for more details)

Further information

MER 1.0 to 2.0 Change

Disaggregation language improved to specify 0-2m and 2-12m distinctions. Clarification that 1) PMTCT_STAT_POS is the denominator for this indicator, 2) That the 2 month time point is based on age of collection of dried blood spot, not on date of result return to record. Addition of two new disaggregates: 3) negative results and 4) no result recorded to allow for both the reporting of all tests collected/sent as well as all tests with a final result documented in the patient record at the time of reporting

PEPFAR Support definition

Standard definition of DSD and TA-SDI used. Provision of key staff or commodities for PMTCT include: commodities such as test kits, ARVs, lab commodities, or funding for salaries of health care workers. Ongoing support for PMTCT service delivery improvement includes: training of PMTCT service providers, clinical mentoring and supportive supervision of PTMCT service sites, infrastructure/renovation of facilities, support for PMTCT service data collection, reporting, data quality, QI/QA of PMTCT services support, ARV consumption forecasting and supply management, support of lab clinical monitoring of patients, supporting patient followup/retention, support of mother mentoring programs.

DREAMS SNU Specific Guidance

None