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Improving Sampling Efficiency for Determining Pediatric HIV Prevalence in National Surveys: Evidence from Eight Sub-Saharan African Countries
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8 01 2021
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Source: J Acquir Immune Defic Syndr. 87(Suppl 1):S43-S51
[PDF-132.02 KB]
Details:
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Alternative Title:J Acquir Immune Defic Syndr
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Personal Author:
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Description:Background
Measurement of mother to child HIV transmission through population-based surveys requires large sample sizes because of low HIV prevalence among children. We estimate potential improvements in sampling efficiency resulting from a targeted sample design.
Setting
Eight countries in sub-Saharan Africa with completed Population-based HIV Impact Assessment (PHIA) surveys as of 2017.
Methods
The PHIA surveys used a geographically stratified two-stage sample design with households sampled from randomly selected census enumeration areas. Children (0–14 years of age) were eligible for HIV testing within a random subsample of households (usually 50%). Estimates of child HIV prevalence in each country were calculated using jackknife replicate weights. We compared sample sizes and precision achieved using this design to a two-phase disproportionate sample design applied to strata defined by maternal HIV status and mortality.
Results
HIV prevalence among children ranged from 0.4% (95% CI: 0.2–0.6) in Tanzania to 2.8% (95% CI: 2.2–3.4) in Eswatini with achieved relative standard errors (RSEs) between 11–21%. The expected precision improved in the targeted design in all countries included in the analysis, with proportionate reductions in mean squared error (MSE) ranging from 27% in Eswatini to 61% in Tanzania, assuming an equal sample size.
Conclusions
Population-based surveys of adult HIV prevalence that also measure child HIV prevalence should consider targeted sampling of children to reduce required sample size, increase precision, and increase the number of positive children tested. The findings from the PHIA surveys can be used as baseline data for informing future sample designs.
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Pubmed ID:34166312
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Pubmed Central ID:PMC8588417
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Volume:87
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