Evaluation of the Human Immunodeficiency Virus viral load surveillance system, national perspective in Tanzania: A descriptive cross-sectional study

Abstract

Introduction: Human immunodeficiency virus (HIV) infection is still a global public health problem. The number of HIV-positive individuals was estimated to be 38.0 million worldwide in 2020, with 2.78 million being children and adolescents aged 0 to 19 years. The evaluation findings will influence HIV care policy and resource allocation. We aimed to assess the usefulness and system attributes of the HIV Viral Load (HVL) surveillance system in Tanzania and determine whether it meets its objectives. Methods: This descriptive cross-sectional analysis was conducted to describe the attributes and usefulness of the HVL surveillance system. We extracted HVL data from January to December 2022. The system description, case definition, and eligibility criteria were obtained from the system guidelines. We used updated guidelines for evaluating public health surveillance systems from the Centre for Disease Control and Prevention (CDC) to evaluate system attributes. We observed the data entry to determine the simplicity and time spent entering data into the system. Turnaround time (TAT) was calculated from the sample collection to the result returned to the clients. Results: The HVL surveillance system is implemented by 90.6% (4314/4764) of facilities in the country. The overall national data completeness was 97.4%. The system's sensitivity was 84.4%, with a predictive value positive (PVP) of 52% and a national data accuracy of 97%. Of eight data clerks interviewed, 100% (8/8) said the system was simple to use. The observed time for data entry for one request was an average of two minutes and an average of three minutes by laboratory data clerks and CTC2 data clerks respectively. We found the mean and median TAT were 14.9±9.1 and 13 (IQR: 9-17.4) days, respectively. Conclusion: The system's overall performance in achieving its goals was satisfactory. The system was representative, simple, flexible, and sensitive. Turnaround time was at a median of 13 (IQR: 9-17.4) days.