Performance characteristics of an HIV risk screening tool in Uganda

Introduction: Improving HIV testing efficiency has been documented to save financial and material resources for health.  In October 2019, the Ministry of HealthH Uganda deployed an HIV risk screening tool for use in 24 health facilities targeting clients aged 15 years and above in both outpatient and Voluntary Counselling and Testing departments. Methods: We conducted a retrospective secondary data analysis of routinely collected HIV risk screening program data in Uganda, collected from October to November 2019, to determine the performance characteristics of the adolescent and adult HIV risk screening tool in public health facility settings. Statistical measures for the risk screening tool performance included sensitivity, specificity, positive and negative predictive values, and cost analysis. Results: A total of 19,854 clients were screened for HIV testing eligibility; we excluded 150 records with incomplete testing information. The overall positivity rate (cluster-weighted prevalen..., We conducted a secondary data analysis, of DHIS2 data from 24 health facilities in Uganda, on clients who were screened for HIV testing eligibility using a risk screening tool, and tested for HIV. All clients that were screened were tested irrespective of their screening outcome. The data had been collected and de-identified before being reported in the DHIS2. We received approval from Ministry of Health Uganda to access the DHIS2 data from district Biostatiscians, and we cleaned the dataset by removing entries with missing values, suing the excel sheet, Excel, Stata SPSS Epi info引言：已有研究证实，提升人类免疫缺陷病毒（HIV）检测效率可为医疗卫生系统节省财力与物力资源。2019年10月，乌干达卫生部在24家医疗卫生机构部署了HIV风险筛查工具，服务对象为15岁及以上的门诊患者及自愿咨询检测（Voluntary Counselling and Testing, VCT）科室的就诊者。 方法：本研究对乌干达2019年10月至11月期间常规收集的HIV风险筛查项目数据开展回顾性二次数据分析，旨在评估公共医疗卫生机构环境下针对青少年与成人的HIV风险筛查工具的性能特征。该筛查工具的性能统计指标包括灵敏度、特异度、阳性预测值、阴性预测值及成本分析。 结果：共计19854名就诊者接受了HIV检测资格筛查，我们剔除了150条检测信息不完整的记录。总体阳性率（整群加权患病率……）。本研究同时对乌干达24家医疗卫生机构的DHIS2数据进行二次分析，分析对象为使用风险筛查工具评估HIV检测资格并接受HIV检测的就诊者。所有接受筛查的就诊者均接受了HIV检测，无论其筛查结果如何。该数据在上报至DHIS2前已完成收集与去标识化处理。 本研究已获得乌干达卫生部批准，可通过地区生物统计师获取DHIS2数据；我们使用Excel、Stata、SPSS及Epi Info清理数据集，剔除了存在缺失值的条目。