This technical report presents the results of the 1999 HIV/Syphilis Sentinel Seroprevalence Surve... more This technical report presents the results of the 1999 HIV/Syphilis Sentinel Seroprevalence Survey conducted in two sentinel sites of Nigeria. It highlights the methodology used the results and its limitations and makes an estimate of the number of Nigerians infected with the AIDS virus. The purpose of this report is to determine the magnitude trends and distribution of the HIV epidemic in the country which may be useful for policy and programmatic decisions for the prevention and control of HIV/AIDS. Overall results indicate that 2.6 million adult Nigerians aged 15-49 years are HIV infected and by the year 2003 4.9 million Nigerian adults will be carrying the AIDS virus. This is bound to have major socioeconomic impacts on the Nigerian society including reduced life expectancy increased burden of medical care increase in the number of orphans and declines in economic growth. It is noted that these and other information generated from the Survey should not be an end in itself but a ...
... Asamoah-odei E. HIV/AIDS is endemic in Ghana, with equal proportions of men and women infecte... more ... Asamoah-odei E. HIV/AIDS is endemic in Ghana, with equal proportions of men and women infected. The situation is worsening and prevention and control measures must be intensified. Young people have the highest rate of HIV infection; the highest prevalence among ...
he HIV/AIDS epidemic in sub-Saharan Africa accounts for more than two-thirds of the world's ... more he HIV/AIDS epidemic in sub-Saharan Africa accounts for more than two-thirds of the world's HIV infections, and is commonly referred to as a one-Africa epidemic. Recent trends based on surveillance of pregnant women attending antenatal clinics, however, ...
The Algiers Declaration on Narrowing the Knowledge Gap to Improve Africa's Health was adopte... more The Algiers Declaration on Narrowing the Knowledge Gap to Improve Africa's Health was adopted during a Conference held in Algiers, Algeria, in June 2008. The Conference, which brought Ministers from the African Region together with researchers, nongovernmental organizations, ...
Bulletin of the World Health Organization, Mar 16, 2004
This paper seeks to outline the key elements of the expanded surveillance efforts recommended by ... more This paper seeks to outline the key elements of the expanded surveillance efforts recommended by the second-generation HIV surveillance approach. Second-generation systems focus on improving and expanding existing surveillance methods and combine them in ways that have the greatest explanatory power. The main elements of this approach include: considering biological surveillance - HIV, AIDS, sexually transmitted infections (STIs) - and behavioural surveillance as integral components, targeting surveillance efforts at segments of the population where most new infections are concentrated - which might differ depending on the stage and type of the epidemic - and providing the rationale for the optimal use of data generated for monitoring the HIV epidemic and evaluating national AIDS control programmes. The paper emphasizes improvements in existing surveillance methodologies and discusses in detail crucial issues such as the validity of HIV prevalence data measured in pregnant women and...
This paper seeks to outline the key elements of the expanded surveillance efforts recommended by ... more This paper seeks to outline the key elements of the expanded surveillance efforts recommended by the second- generation HIV surveillance approach. Second-generation systems focus on improving and expanding existing surveillance methods and combine them in ways that have the greatest explanatory power. The main elements of this approach include: considering biological surveillance — HIV, AIDS, sexually transmitted infections (STIs) — and behavioural surveillance as integral components, targeting surveillance efforts at segments of the population where most new infections are concentrated — which might differ depending on the stage and type of the epidemic — and providing the rationale for the optimal use of data generated for monitoring the HIV epidemic and evaluating national AIDS control programmes. The paper emphasizes improvements in existing surveillance methodologies and discusses in detail crucial issues such as the validity of HIV prevalence data measured in pregnant women an...
Following publication of the original article [1], the authors reported the following author name... more Following publication of the original article [1], the authors reported the following author name error is the article:
Background Inadequate access to quality health care services due to weak health systems and recur... more Background Inadequate access to quality health care services due to weak health systems and recurrent public health emergencies are impediments to the attainment of Universal Health Coverage and health security in Africa. To discuss these challenges and deliberate on plausible solutions, the World Health Organization Regional Office for Africa, in collaboration with the Government of Cabo Verde, convened the second Africa Health Forum in Praia, Cabo Verde on 26–28 March 2019, under the theme Achieving Universal Health Coverage and Health Security: The Africa We Want to See. Methods The Forum was conducted through technical sessions consisting of high-level, moderated panel discussions on specific themes, some of them preceded by keynote addresses. There were booth exhibitions by Member States, World Health Organization and other organizations to facilitate information exchanges. A Communiqué highlighting the recommendations of the Forum was issued during the closing ceremony. More t...
This paper seeks to outline the key elements of the expanded surveillance efforts recommended by ... more This paper seeks to outline the key elements of the expanded surveillance efforts recommended by the second-generation HIV surveillance approach. Second-generation systems focus on improving and expanding existing surveillance methods and combine them in ways that have the greatest explanatory power. The main elements of this approach include: considering biological surveillance - HIV, AIDS, sexually transmitted infections (STIs) - and behavioural surveillance as integral components, targeting surveillance efforts at segments of the population where most new infections are concentrated - which might differ depending on the stage and type of the epidemic - and providing the rationale for the optimal use of data generated for monitoring the HIV epidemic and evaluating national AIDS control programmes. The paper emphasizes improvements in existing surveillance methodologies and discusses in detail crucial issues such as the validity of HIV prevalence data measured in pregnant women and...
Expansion of HIV surveillance systems in sub-Saharan Africa is leading to downward adjustments to... more Expansion of HIV surveillance systems in sub-Saharan Africa is leading to downward adjustments to the size of the AIDS epidemic. However, only analysis of surveillance data from the same populations over time can provide insight into trends of HIV prevalence. We have used data from the same antenatal clinics to document recent empirical trends. We collated data from antenatal clinics on HIV prevalence between 1997 and 2003. Data were obtained from 140?000 pregnant women attending more than 300 antenatal clinics in 22 countries in sub-Saharan Africa. Additionally, long-term trend data are available for 57 urban areas and provinces. Median HIV prevalence in 148 antenatal clinic sites in southern Africa increased from 21.3% (IQR 11.5-28.2%) in 1997/98 to 23.8% (15.6-29.2%) in 2002. At more than half the sites (58%) an increase of at least one-tenth was noted, but at a fifth of sites, prevalence dropped by at least one-tenth. In eastern Africa, median HIV prevalence decreased from 12.9% (7.0-16.9%) in 1997/98 to 8.5% (5.3-13.0%) in 2002, with prevalence rising in four (7%) sites, but falling at 25 (43%) sites. In west Africa, median HIV prevalence was 3.5% (2.2-5.9%) and 3.2% (2.3-6.1%) for 1997/98 and 2002, respectively, with reductions and increases in prevalence being noted in equal proportions. The long-term trends in urban areas in sub-Saharan Africa show a similar pattern, with increasing evidence of stabilisation during the past 2-3 years compared with the previous decade. Evidence from surveillance of mostly urban antenatal clinic attendees indicates that the growth in the AIDS epidemic in sub-Saharan Africa has levelled off since the late 1990s but only eastern Africa shows a decline in HIV prevalence. Very large differences persist between subregions. Workers planning a response to the AIDS epidemic must take more careful consideration of these variations to allow locally appropriate responses to the epidemic.
Expansion of HIV surveillance systems in sub-Saharan Africa is leading to downward adjustments to... more Expansion of HIV surveillance systems in sub-Saharan Africa is leading to downward adjustments to the size of the AIDS epidemic. However, only analysis of surveillance data from the same populations over time can provide insight into trends of HIV prevalence. We have used data from the same antenatal clinics to document recent empirical trends. We collated data from antenatal clinics on HIV prevalence between 1997 and 2003. Data were obtained from 140?000 pregnant women attending more than 300 antenatal clinics in 22 countries in sub-Saharan Africa. Additionally, long-term trend data are available for 57 urban areas and provinces. Median HIV prevalence in 148 antenatal clinic sites in southern Africa increased from 21.3% (IQR 11.5-28.2%) in 1997/98 to 23.8% (15.6-29.2%) in 2002. At more than half the sites (58%) an increase of at least one-tenth was noted, but at a fifth of sites, prevalence dropped by at least one-tenth. In eastern Africa, median HIV prevalence decreased from 12.9% (7.0-16.9%) in 1997/98 to 8.5% (5.3-13.0%) in 2002, with prevalence rising in four (7%) sites, but falling at 25 (43%) sites. In west Africa, median HIV prevalence was 3.5% (2.2-5.9%) and 3.2% (2.3-6.1%) for 1997/98 and 2002, respectively, with reductions and increases in prevalence being noted in equal proportions. The long-term trends in urban areas in sub-Saharan Africa show a similar pattern, with increasing evidence of stabilisation during the past 2-3 years compared with the previous decade. Evidence from surveillance of mostly urban antenatal clinic attendees indicates that the growth in the AIDS epidemic in sub-Saharan Africa has levelled off since the late 1990s but only eastern Africa shows a decline in HIV prevalence. Very large differences persist between subregions. Workers planning a response to the AIDS epidemic must take more careful consideration of these variations to allow locally appropriate responses to the epidemic.
The objective of this paper was to analyse the quality of HIV/AIDS sentinel surveillance systems ... more The objective of this paper was to analyse the quality of HIV/AIDS sentinel surveillance systems in countries and the resulting quality of the data used to make estimates of HIV/AIDS prevalence and mortality. Available data on sero-surveillance of HIV/AIDS in countries were compiled in the process of making the end of 1999 estimates of HIV/AIDS. These data came primarily from the HIV/AIDS Surveillance Database developed by the United States Census Bureau, from a database maintained by the European Centre for the Epidemiological Monitoring of AIDS and all country reports on sentinel surveillance that had been provided to World Health Organization or UNAIDS. Procedures were developed to score quality of surveillance systems based on four dimensions of quality: timeliness and frequency; appropriateness of groups; consistency of sites over time; and coverage provided by the system. In total, the surveillance systems from 167 countries were analysed. Forty-seven of the 167 countries whose surveillance systems were rated were judged to have fully implemented sentinel surveillance systems; 51 were judged to have systems that had some or most aspects of a good HIV surveillance system in place and 69 were rated as having poorly functioning or non-existent surveillance systems. This analysis suggests that the quality of HIV surveillance varies considerably. The majority of countries most affected by HIV/AIDS have systems that are providing sufficient sero-prevalence data for tracking the epidemic and making reasonable estimates of HIV prevalence. However, many countries have poor systems and strengthening these is an urgent priority.
This technical report presents the results of the 1999 HIV/Syphilis Sentinel Seroprevalence Surve... more This technical report presents the results of the 1999 HIV/Syphilis Sentinel Seroprevalence Survey conducted in two sentinel sites of Nigeria. It highlights the methodology used the results and its limitations and makes an estimate of the number of Nigerians infected with the AIDS virus. The purpose of this report is to determine the magnitude trends and distribution of the HIV epidemic in the country which may be useful for policy and programmatic decisions for the prevention and control of HIV/AIDS. Overall results indicate that 2.6 million adult Nigerians aged 15-49 years are HIV infected and by the year 2003 4.9 million Nigerian adults will be carrying the AIDS virus. This is bound to have major socioeconomic impacts on the Nigerian society including reduced life expectancy increased burden of medical care increase in the number of orphans and declines in economic growth. It is noted that these and other information generated from the Survey should not be an end in itself but a ...
... Asamoah-odei E. HIV/AIDS is endemic in Ghana, with equal proportions of men and women infecte... more ... Asamoah-odei E. HIV/AIDS is endemic in Ghana, with equal proportions of men and women infected. The situation is worsening and prevention and control measures must be intensified. Young people have the highest rate of HIV infection; the highest prevalence among ...
he HIV/AIDS epidemic in sub-Saharan Africa accounts for more than two-thirds of the world's ... more he HIV/AIDS epidemic in sub-Saharan Africa accounts for more than two-thirds of the world's HIV infections, and is commonly referred to as a one-Africa epidemic. Recent trends based on surveillance of pregnant women attending antenatal clinics, however, ...
The Algiers Declaration on Narrowing the Knowledge Gap to Improve Africa's Health was adopte... more The Algiers Declaration on Narrowing the Knowledge Gap to Improve Africa's Health was adopted during a Conference held in Algiers, Algeria, in June 2008. The Conference, which brought Ministers from the African Region together with researchers, nongovernmental organizations, ...
Bulletin of the World Health Organization, Mar 16, 2004
This paper seeks to outline the key elements of the expanded surveillance efforts recommended by ... more This paper seeks to outline the key elements of the expanded surveillance efforts recommended by the second-generation HIV surveillance approach. Second-generation systems focus on improving and expanding existing surveillance methods and combine them in ways that have the greatest explanatory power. The main elements of this approach include: considering biological surveillance - HIV, AIDS, sexually transmitted infections (STIs) - and behavioural surveillance as integral components, targeting surveillance efforts at segments of the population where most new infections are concentrated - which might differ depending on the stage and type of the epidemic - and providing the rationale for the optimal use of data generated for monitoring the HIV epidemic and evaluating national AIDS control programmes. The paper emphasizes improvements in existing surveillance methodologies and discusses in detail crucial issues such as the validity of HIV prevalence data measured in pregnant women and...
This paper seeks to outline the key elements of the expanded surveillance efforts recommended by ... more This paper seeks to outline the key elements of the expanded surveillance efforts recommended by the second- generation HIV surveillance approach. Second-generation systems focus on improving and expanding existing surveillance methods and combine them in ways that have the greatest explanatory power. The main elements of this approach include: considering biological surveillance — HIV, AIDS, sexually transmitted infections (STIs) — and behavioural surveillance as integral components, targeting surveillance efforts at segments of the population where most new infections are concentrated — which might differ depending on the stage and type of the epidemic — and providing the rationale for the optimal use of data generated for monitoring the HIV epidemic and evaluating national AIDS control programmes. The paper emphasizes improvements in existing surveillance methodologies and discusses in detail crucial issues such as the validity of HIV prevalence data measured in pregnant women an...
Following publication of the original article [1], the authors reported the following author name... more Following publication of the original article [1], the authors reported the following author name error is the article:
Background Inadequate access to quality health care services due to weak health systems and recur... more Background Inadequate access to quality health care services due to weak health systems and recurrent public health emergencies are impediments to the attainment of Universal Health Coverage and health security in Africa. To discuss these challenges and deliberate on plausible solutions, the World Health Organization Regional Office for Africa, in collaboration with the Government of Cabo Verde, convened the second Africa Health Forum in Praia, Cabo Verde on 26–28 March 2019, under the theme Achieving Universal Health Coverage and Health Security: The Africa We Want to See. Methods The Forum was conducted through technical sessions consisting of high-level, moderated panel discussions on specific themes, some of them preceded by keynote addresses. There were booth exhibitions by Member States, World Health Organization and other organizations to facilitate information exchanges. A Communiqué highlighting the recommendations of the Forum was issued during the closing ceremony. More t...
This paper seeks to outline the key elements of the expanded surveillance efforts recommended by ... more This paper seeks to outline the key elements of the expanded surveillance efforts recommended by the second-generation HIV surveillance approach. Second-generation systems focus on improving and expanding existing surveillance methods and combine them in ways that have the greatest explanatory power. The main elements of this approach include: considering biological surveillance - HIV, AIDS, sexually transmitted infections (STIs) - and behavioural surveillance as integral components, targeting surveillance efforts at segments of the population where most new infections are concentrated - which might differ depending on the stage and type of the epidemic - and providing the rationale for the optimal use of data generated for monitoring the HIV epidemic and evaluating national AIDS control programmes. The paper emphasizes improvements in existing surveillance methodologies and discusses in detail crucial issues such as the validity of HIV prevalence data measured in pregnant women and...
Expansion of HIV surveillance systems in sub-Saharan Africa is leading to downward adjustments to... more Expansion of HIV surveillance systems in sub-Saharan Africa is leading to downward adjustments to the size of the AIDS epidemic. However, only analysis of surveillance data from the same populations over time can provide insight into trends of HIV prevalence. We have used data from the same antenatal clinics to document recent empirical trends. We collated data from antenatal clinics on HIV prevalence between 1997 and 2003. Data were obtained from 140?000 pregnant women attending more than 300 antenatal clinics in 22 countries in sub-Saharan Africa. Additionally, long-term trend data are available for 57 urban areas and provinces. Median HIV prevalence in 148 antenatal clinic sites in southern Africa increased from 21.3% (IQR 11.5-28.2%) in 1997/98 to 23.8% (15.6-29.2%) in 2002. At more than half the sites (58%) an increase of at least one-tenth was noted, but at a fifth of sites, prevalence dropped by at least one-tenth. In eastern Africa, median HIV prevalence decreased from 12.9% (7.0-16.9%) in 1997/98 to 8.5% (5.3-13.0%) in 2002, with prevalence rising in four (7%) sites, but falling at 25 (43%) sites. In west Africa, median HIV prevalence was 3.5% (2.2-5.9%) and 3.2% (2.3-6.1%) for 1997/98 and 2002, respectively, with reductions and increases in prevalence being noted in equal proportions. The long-term trends in urban areas in sub-Saharan Africa show a similar pattern, with increasing evidence of stabilisation during the past 2-3 years compared with the previous decade. Evidence from surveillance of mostly urban antenatal clinic attendees indicates that the growth in the AIDS epidemic in sub-Saharan Africa has levelled off since the late 1990s but only eastern Africa shows a decline in HIV prevalence. Very large differences persist between subregions. Workers planning a response to the AIDS epidemic must take more careful consideration of these variations to allow locally appropriate responses to the epidemic.
Expansion of HIV surveillance systems in sub-Saharan Africa is leading to downward adjustments to... more Expansion of HIV surveillance systems in sub-Saharan Africa is leading to downward adjustments to the size of the AIDS epidemic. However, only analysis of surveillance data from the same populations over time can provide insight into trends of HIV prevalence. We have used data from the same antenatal clinics to document recent empirical trends. We collated data from antenatal clinics on HIV prevalence between 1997 and 2003. Data were obtained from 140?000 pregnant women attending more than 300 antenatal clinics in 22 countries in sub-Saharan Africa. Additionally, long-term trend data are available for 57 urban areas and provinces. Median HIV prevalence in 148 antenatal clinic sites in southern Africa increased from 21.3% (IQR 11.5-28.2%) in 1997/98 to 23.8% (15.6-29.2%) in 2002. At more than half the sites (58%) an increase of at least one-tenth was noted, but at a fifth of sites, prevalence dropped by at least one-tenth. In eastern Africa, median HIV prevalence decreased from 12.9% (7.0-16.9%) in 1997/98 to 8.5% (5.3-13.0%) in 2002, with prevalence rising in four (7%) sites, but falling at 25 (43%) sites. In west Africa, median HIV prevalence was 3.5% (2.2-5.9%) and 3.2% (2.3-6.1%) for 1997/98 and 2002, respectively, with reductions and increases in prevalence being noted in equal proportions. The long-term trends in urban areas in sub-Saharan Africa show a similar pattern, with increasing evidence of stabilisation during the past 2-3 years compared with the previous decade. Evidence from surveillance of mostly urban antenatal clinic attendees indicates that the growth in the AIDS epidemic in sub-Saharan Africa has levelled off since the late 1990s but only eastern Africa shows a decline in HIV prevalence. Very large differences persist between subregions. Workers planning a response to the AIDS epidemic must take more careful consideration of these variations to allow locally appropriate responses to the epidemic.
The objective of this paper was to analyse the quality of HIV/AIDS sentinel surveillance systems ... more The objective of this paper was to analyse the quality of HIV/AIDS sentinel surveillance systems in countries and the resulting quality of the data used to make estimates of HIV/AIDS prevalence and mortality. Available data on sero-surveillance of HIV/AIDS in countries were compiled in the process of making the end of 1999 estimates of HIV/AIDS. These data came primarily from the HIV/AIDS Surveillance Database developed by the United States Census Bureau, from a database maintained by the European Centre for the Epidemiological Monitoring of AIDS and all country reports on sentinel surveillance that had been provided to World Health Organization or UNAIDS. Procedures were developed to score quality of surveillance systems based on four dimensions of quality: timeliness and frequency; appropriateness of groups; consistency of sites over time; and coverage provided by the system. In total, the surveillance systems from 167 countries were analysed. Forty-seven of the 167 countries whose surveillance systems were rated were judged to have fully implemented sentinel surveillance systems; 51 were judged to have systems that had some or most aspects of a good HIV surveillance system in place and 69 were rated as having poorly functioning or non-existent surveillance systems. This analysis suggests that the quality of HIV surveillance varies considerably. The majority of countries most affected by HIV/AIDS have systems that are providing sufficient sero-prevalence data for tracking the epidemic and making reasonable estimates of HIV prevalence. However, many countries have poor systems and strengthening these is an urgent priority.
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Papers by Emil Asamoah-Odei