IJID regions · 2026
Strengthening human immunodeficiency virus surveillance through systematic data cleaning: a national retrospective validation of the human immunodeficiency virus treatment and care registry in Guyana, 2025.
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Jagnarine Tariq, Chalmers Murvin
Аннотация
BACKGROUND: Accurate human immunodeficiency virus (HIV) surveillance is essential for achieving the Joint United Nations Programme on HIV/acquired immunodeficiency syndrome (AIDS) (UNAIDS) 95-95-95 targets. Historically, Guyana's HIV datasets contained duplicate entries, silent mortality, and unverified migration, resulting in inflated denominators and under-reported viral suppression. In 2025, the National AIDS Programme Secretariat conducted the first national HIV data-cleaning and verification exercise to establish a validated treatment cohort.
OBJECTIVES: 1. To verify and clean historical HIV treatment records.2. To quantify duplicate, deceased, migrated, and defaulter cases.3. To distinguish long- vs short-term defaulters.4. To assess the impact on UNAIDS cascade indicators.5. To model viral suppression gains through re-engagement.
METHODS: A national retrospective review of 12,824 records included deduplication, outcome verification, and cohort classification. Analytical outputs included Wilson 95% confidence intervals, chi-square distribution testing, and standardized residuals. Re-engagement modeling simulated suppression gains across 15-60% scenarios.
RESULTS: We identified 401 duplicates (3.1%), 1308 deaths (10.2%), and 454 migrations (3.5%), producing a validated eligible cohort of 10,661 people living with HIV, correcting 13.7% denominator inflation. Of eligible clients, 7268 (68.2%) were active, 2071 (19.4%) long-term defaulters, and 1322 (12.4%) short-term defaulters. Re-engagement modeling showed improvements of +2.6 percentage points at 25% return and +6.3 percentage points at 60%, indicating strong potential for accelerating the third 95.
CONCLUSION: National data validation substantially improved surveillance precision and clarified programmatic gaps. Re-engagement of short-term defaulters is a high-impact strategy for increasing viral suppression. Guyana's 2025 exercise provides a replicable model for improving regional HIV monitoring and advancing progress toward epidemic control.
OBJECTIVES: 1. To verify and clean historical HIV treatment records.2. To quantify duplicate, deceased, migrated, and defaulter cases.3. To distinguish long- vs short-term defaulters.4. To assess the impact on UNAIDS cascade indicators.5. To model viral suppression gains through re-engagement.
METHODS: A national retrospective review of 12,824 records included deduplication, outcome verification, and cohort classification. Analytical outputs included Wilson 95% confidence intervals, chi-square distribution testing, and standardized residuals. Re-engagement modeling simulated suppression gains across 15-60% scenarios.
RESULTS: We identified 401 duplicates (3.1%), 1308 deaths (10.2%), and 454 migrations (3.5%), producing a validated eligible cohort of 10,661 people living with HIV, correcting 13.7% denominator inflation. Of eligible clients, 7268 (68.2%) were active, 2071 (19.4%) long-term defaulters, and 1322 (12.4%) short-term defaulters. Re-engagement modeling showed improvements of +2.6 percentage points at 25% return and +6.3 percentage points at 60%, indicating strong potential for accelerating the third 95.
CONCLUSION: National data validation substantially improved surveillance precision and clarified programmatic gaps. Re-engagement of short-term defaulters is a high-impact strategy for increasing viral suppression. Guyana's 2025 exercise provides a replicable model for improving regional HIV monitoring and advancing progress toward epidemic control.