OBJECTIVES The capture-recapture method was applied to estimate the number of human immunodeficiency virus (HIV)-positive individuals not registered with any data sources.
METHODS
This cross-sectional study was conducted in Lorestan Province, in the west of Iran, in 2016. Three incomplete sources of HIV-positive individuals, with partially overlapping data, were used, including: (a) transfusion center, (b) volunteer counseling and testing centers (VCTCs), and (c) prison. The 3-source capture-recapture method, using a log-linear model, was applied for data analysis. The Akaike information criterion and the Bayesian information criterion were used for model selection.
RESULTS
Of the 2,456 HIV-positive patients registered in these 3 data sources, 1,175 (47.8%) were identified in transfusion center, 867 (35.3%) in VCTCs, and 414 (16.8%) in prison. After the exclusion of duplicate entries, 2,281 HIV-positive patients remained. Based on the capture-recapture method, 14,868 (95% confidence interval, 9,923 to 23,427) HIV-positive individuals were not identified in any of the registries. Therefore, the real number of HIV-positive individuals was estimated to be 17,149, and the overall completeness of the 3 registries was estimated to be around 13.3%.
CONCLUSIONS
Based on capture-recapture estimates, a huge number of HIV-positive individuals are not registered with any of the provincial data sources. This is an urgent message for policymakers who plan and provide health care services for HIV-positive patients. Although the capture-recapture method is a useful statistical approach for estimating unknown populations, due to the assumptions and limitations of the method, the population size may be overestimated as it seems possible in our results.
Summary
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OBJECTIVES This study investigated changes in hepatitis B seroprevalence from 1998 to 2013, and to identify differences in epidemiologic characteristics between hepatitis B surface antigen (HBsAg)-positive and HBsAg-negative people.
METHODS
HBsAg seropositive rates were compared by year, sex, and age using the blood test data from the periods I to VI (1998-2013) of the Korea National Health and Nutrition Examination Survey. Interviews and self-administered surveys were conducted to collect data on health behavior, quality of life, comorbidities, and health care utilization.
RESULTS
HBsAg seropositive rates in the Republic of Korea decreased from 4.6% in 1998 to 2.9% in 2008, and then remained the same for the next five years. While seropositive rates by age were the highest at 35 to 39 years of age in 1998, it peaked at 50 to 54 years of age in 2013. HBsAg-positive people showed high values from two liver function tests, including glutamic-oxaloacetic transaminase and glutamic-pyruvic transaminase, and the prevalence rates of liver cirrhosis and liver cancer were also significantly high. Indices for health behavior and quality of life showed no significant differences between HBsAg-positive and HBsAg-negative people.
CONCLUSIONS
While HBsAg seropositive rates tended to decline after 1998, there have been no significant changes over the most recent five years. We should focus on treatment of existing hepatitis B patients along with immunization programmes to prevent new hepatitis B infections. In addition, it may be necessary to encourage HBsAg-positive people to follow healthier life-styles in order to prevent further progression of hepatitis B to liver cirrhosis and liver cancer.
Summary
Korean summary
한국 국민건강영양조사 자료로 본 HBsAg 양성률은 1998 년 4.6%에서 2008 년에 2.9%로 감소한 이후 5 년간 증감없이 2013 년에 2.9%로 나타났다. 한국 HBsAg 양성률을 더욱 감소시키기 위해서는 예방접종사업뿐 아니라 B형 간염 환자 치료를 보다 적극적으로 해야 될 것으로 보인다. 또한 HBsAg 양성자는 간경화나 간암 예방을 위해 건강한 생활습관을 가지도록 노력하는 것이 필요하다.
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