Comparison of State Prevention of Mother-To-Child Transmission of HIV and National Biennial ANC HIV Sentinel Surveillance Data: Ten Year Experience from Gombe State, North East Nigeria

Abstract
There are significant variations in PMTCT programme implementation in the country. Biennial serosentinel survey among pregnant women attending antenatal clinics provides estimates of HIV and for monitoring the epidemic. The objective of this work was to compare HIV prevalence trend using National ANC HSS data and PMTCT programme data in Gombe state over the last 10 years. Methodology: Cross-sectional comparative study. The HIV prevalence among pregnant women in Gombe State obtained from Gombe State PMTCT programme data from 2004-2014 was compared with the National Biennial sentinel survey for HIV in pregnant women attending ANC in the state over the same period. Results: Women tested for HIV during ANC in Gombe state increased from 4689 in 2004 to 74,737 in 2014. 447,732 women were cumulatively tested for HIV with a positivity rate of 2.1% (9543). ANC HIV positivity rates from PMTCT programme data witnessed a decline from 8.2% (385/4689) in 2004 to 0.6% (497/74,737) in 2014. Conversely, the National biennial HIV sero-prevalence sentinel survey reports for Gombe state in 2005, 2006, 2008, 2010, 2012 and 2014 were 4.9%, 4.4%, 4.0%, 4.2%, 4.1% and 3.4% respectively. The state PMTCT data showed a significant decline in HIV positivity rates among women, paralleled by increased testing, whereas the national sero-prevalence survey averaged 4.2%. Conclusion: While routine yearly Gombe state PMTCT programme data showed a declining HIV trend, biennially conducted seroprevalence in the state was consistent over the period. Implications are unclear to us; accurate estimation of HIV prevalence is a prerequisite for planning.