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. 2016 Spring;43(1):10-5.

Validating Procedures used to Identify Duplicate Reports in Haiti's National HIV/AIDS Case Surveillance System

Chris Delcher, Nancy Puttkammer, Reginald Arnoux, Kesner Francois, Mark Griswold, Irum Zaidi, Yves Anthony Patrice Joseph, Barbara J Marston

Validating Procedures used to Identify Duplicate Reports in Haiti's National HIV/AIDS Case Surveillance System

Chris Delcher et al. J Registry Manag. 2016 Spring.

Abstract

Objectives: Valid deduplication of human immunodeficiency virus (HIV) case reports is critical to the utility of these data to inform HIV programs. The Haitian Ministry of Health (MSPP) and partners operate a case-based, national HIV/AIDS surveillance system (HASS), using deterministic and probabilistic procedures to identify duplicate records. These procedures are described and validated based on expert classifications.

Methods: Two samples of HASS records identified as duplicates were selected: 100 pairs from deterministic and 100 pairs from probabilistic matching procedures (total: 200 pairs, 400 case reports). Clinical data from the national electronic medical record (iSanté) were reviewed and consensus gold-standard determinations on the status of duplications were made. False positive rates (FPR) were estimated by reviewing these records, while false negative rates were calculated (FNR) by using LinkPlus™ probabilistic linkage software. The effect of deduplication on total HIV case counts was demonstrated.

Results: Review of deterministic matches yielded 99 true positives and 1 false positive (FPR, 1 per 100; 95% CI, 0.71-5.4). Review of probabilistic matches yielded a FPR of 6 per 100 (95% CI, 2.7-12.4). LinkPlus identified 1,491 probable matches among 68,393 records, representing a FNR of 2 per 100 (95% CI, 0.55-7.0). After adjustment, the estimated unique count of reported HIV patients in HASS was 211,885 (95% CI, 207, 293-213, 232) as of December 2013.

Conclusions: Based on application of the established procedures, HASS conforms to the duplication performance standard recommended by the Centers for Disease Control and Prevention for HIV surveillance.

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Figures

Figure 1
Figure 1. Overview of HIV Case Reporting and the Current Validation Study of Patient Identification in Haiti’s National HIV/AIDS Surveillance System
EMR, electronic medical record; HIV, human immunodeficiency virus; HTC, HIV testing and counseling; GHESKIO, Haitian group for the study of Kaposi’s sarcoma and opportunistic infections; PIH, Partners in Health Zanmi Lasante. *Isanté and the Haitian Ministry of Health (MSPP)’s Monitoring, Evaluation and Surveillance Interface (MESI) operate in parallel in most MSPP clinics. **Dashed line indicates that records adjudicated as nonmatches by local Haitian staff were not validated in this study. Rather, these records are in the pool analyzed using LinkPlus.
Figure 2
Figure 2
Comparison of Total Records Submitted to Haiti’s National HIV/AIDS Surveillance System (A) Versus Counts Using (B) the National Code “As Is”, (C) the National Code Cleaned, (D) Deterministic/Probabilistic (D/P) Methods Currently Used, and (E) D/P Methods after this Validation Review
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References

    1. Haiti: HIV and AIDS Estimates. UNAIDS; 2013. website. http://www.unaids.org/en/regionscountries/countries/haiti/
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