Skip to content
DraconiticResearch
Search Sources API
182,469 studies31 sourcesUpdated 21 min ago
Peer-reviewedCC BY 4.0Frontiers in Public Health

A narrative review of HIV surveillance strategies used in selected sub-Saharan African countries

  • Marriott Nliwasa1,2
  • Beth A. Tippett Barr3,4
  • Fumbani Chigawa3
  • Michael G. Chipeta5
  • McEwen Khundi5
  • Themba Mzembe5
  • Brewster Moyo3
  • Chikondi Mafaiti3
  • Takondwa Msosa3
  • Jeffrey W. Imai-Eaton6,7
  • Victor Mwapasa3
7 affiliations
  1. 1School of Medicine and Oral Health, Kamuzu University of Health Sciences
  2. 2Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand
  3. 3School of Global and Public Health, Kamuzu University of Health Sciences
  4. 4Nyanja Health Research Institute
  5. 5African Institute for Development Policy
  6. 6Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard T.H. Chan School of Public Health
  7. 7MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London
Open at sourcePDFDOICite

Abstract

Background: Over the last two decades, new HIV infections and AIDS-related deaths have declined significantly through expansion of access to HIV testing, treatment, and prevention services. Data to monitor epidemic trends and program coverage have been central to driving progress. We describe HIV surveillance indicators and methods that countries use to monitor the HIV epidemic and impact of programs in selected African countries.

Methods: We conducted a review of global and national HIV surveillance guidelines. We extracted information on (1) indicators used to monitor HIV epidemic changes, and (2) activities countries conduct to measure these. We conducted an in-depth document analysis for five selected African countries: Ghana, Kenya, Lesotho, Malawi, and Zimbabwe.

Results: We identified 66 documents that inform HIV surveillance plans at national or global levels. Documents from the five selected countries reflected a range of 80 to 103 HIV indicators per country compared to 128 from a consolidated list of indicators in global guidance documents. The largest proportion of reported national indicators was for integrated services and non-biomedical measures such as HIV stigma and knowledge, with these accounting for a range of 22.8% (21/92) in Ghana to 64.1% (66/103) in Lesotho. Measuring incidence and mortality relied predominantly on mathematical modeling. Activities such as community and facility-based mortality surveillance, HIV drug resistance surveys and bio-behavioral surveys were specified in strategic plans but were partially implemented or not documented.

Conclusion: HIV surveillance among selected African countries primarily used mathematical models for estimating HIV incidence and mortality and heavily depended on infrequent household surveys for quantifying epidemic burden. Strategy documents named many HIV indicators and surveillance activities, which were inconsistently implemented. Countries could reassess suitability of current indicators and activities and streamline these for efficient estimation of HIV burden.

Related

  1. Hepatitis B vaccination coverage and factors associated with higher uptake among children aged 5–35 months in eight selected sub-Saharan African countries: a multilevel ordinal logistic regression analysis
    Victor A. Ochagu, Michael Ekholuenetale, Amadou Barrow +1
    BMC Public HealthPeer-reviewedCC BY-NC-ND 4.0Epidemiology & public healthCrossref
  2. Access to and use of improved water and sanitation facilities in Sub-Saharan Africa: Analysis of Demographic and Health Survey Data from 30 countries
    Joyce Aputere Ndago, Paul Adjorlolo, Martin Nyaaba Adokiya +1
    PLOS Global Public HealthPeer-reviewedCC BY 4.0Full textEnvironmental science & pollutionEpidemiology & public healthPLOS
  3. Management of HIV-Associated Cancers in Sub-Saharan Africa: A Scoping Review of Treatment Outcomes, Challenges, and Strategies for Enhancing Care
    Emmanuel O. Oisakede, Daniel Asogun, Ayobami T. Adegbenro +5
    Infectious disease reportsPeer-reviewedCC BYFull textGeneral medicineEurope PMC
  4. The impact of male circumcision on risk of HIV infection in sub-Saharan Africa: a household fixed-effects analysis of 279,351 men from 29 countries.
    Caroline A Bulstra, Xiaochen Dai, Kenneth Ngure +6
    Frontiers in public healthPeer-reviewedCC BYFull textSurgery & anaesthesiaEurope PMC
  5. Continental-scale genomic surveillance of Plasmodium falciparum malaria across sub-Saharan Africa with rapid nanopore sequencing
    Mulenga Mwenda, Karolina Mosler, Bernd Bohmeier +46
    Nature CommunicationsPeer-reviewedCC BY11 citedEpidemiology & public healthOpenAlex

Cite

BibTeXRIS
BibTeX
@article{nliwasa2026narrative,
  title = {{A narrative review of HIV surveillance strategies used in selected sub-Saharan African countries}},
  author = {Marriott Nliwasa and Beth A. Tippett Barr and Fumbani Chigawa and Michael G. Chipeta and McEwen Khundi and Themba Mzembe and Brewster Moyo and Chikondi Mafaiti and Takondwa Msosa and Jeffrey W. Imai-Eaton and Victor Mwapasa},
  journal = {Frontiers in Public Health},
  year = {2026},
  month = oct,
  doi = {10.3389/fpubh.2026.1887244},
  url = {https://www.frontiersin.org/articles/10.3389/fpubh.2026.1887244/full},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - A narrative review of HIV surveillance strategies used in selected sub-Saharan African countries
AU  - Marriott Nliwasa
AU  - Beth A. Tippett Barr
AU  - Fumbani Chigawa
AU  - Michael G. Chipeta
AU  - McEwen Khundi
AU  - Themba Mzembe
AU  - Brewster Moyo
AU  - Chikondi Mafaiti
AU  - Takondwa Msosa
AU  - Jeffrey W. Imai-Eaton
AU  - Victor Mwapasa
PY  - 2026
DA  - 2026/10/27
JO  - Frontiers in Public Health
DO  - 10.3389/fpubh.2026.1887244
UR  - https://www.frontiersin.org/articles/10.3389/fpubh.2026.1887244/full
AB  - Background: Over the last two decades, new HIV infections and AIDS-related deaths have declined significantly through expansion of access to HIV testing, treatment, and prevention services. Data to monitor epidemic trends and program coverage have been central to driving progress. We describe HIV surveillance indicators and methods that countries use to monitor the HIV epidemic and impact of programs in selected African countries.  Methods: We conducted a review of global and national HIV surveillance guidelines. We extracted information on (1) indicators used to monitor HIV epidemic changes, and (2) activities countries conduct to measure these. We conducted an in-depth document analysis for five selected African countries: Ghana, Kenya, Lesotho, Malawi, and Zimbabwe.  Results: We identified 66 documents that inform HIV surveillance plans at national or global levels. Documents from the five selected countries reflected a range of 80 to 103 HIV indicators per country compared to 128 from a consolidated list of indicators in global guidance documents. The largest proportion of reported national indicators was for integrated services and non-biomedical measures such as HIV stigma and knowledge, with these accounting for a range of 22.8% (21/92) in Ghana to 64.1% (66/103) in Lesotho. Measuring incidence and mortality relied predominantly on mathematical modeling. Activities such as community and facility-based mortality surveillance, HIV drug resistance surveys and bio-behavioral surveys were specified in strategic plans but were partially implemented or not documented.  Conclusion: HIV surveillance among selected African countries primarily used mathematical models for estimating HIV incidence and mortality and heavily depended on infrequent household surveys for quantifying epidemic burden. Strategy documents named many HIV indicators and surveillance activities, which were inconsistently implemented. Countries could reassess suitability of current indicators and activities and streamline these for efficient estimation of HIV burden.
SN  - 2296-2565
ER  -