Evaluation of the HIV/AIDS Epidemiological Surveillance System, Nouakchott Outpatient Treatment Center, Mauritania

Background: HIV/AIDS continues to be a public health problem and a major global concern. West and Central Africa had 4.9 million cases in 2019, including 240,000 new cases and about 140,000 deaths related to HIV/AIDS. In Mauritania, in 2019, according to WHO estimates, the prevalence of HIV/AIDS is estimated at 0.2%. We evaluated the HIV/AIDS surveillance system in the Nouakchott region to describe its organization and functioning, determine its usefulness, and assess its attributes according to the updated guidelines of the Center for Disease Control and Prevention for the evaluation of public health surveillance systems. Methods: This descriptive cross-sectional study was conducted from May 1st, 2020, to December 2020 and involved data from January 2019 to December 2019. The study population consisted of actors directly involved in surveillance at all levels of the country's surveillance system. Data were collected through document review and semi-structured interviews. Data analysis was done using Epi Info® 7.2.5.6 and Excel®2020. Proportions and rates were calculated. The characteristics were assessed by estimating the average of the results obtained on each variable. Results: The monitoring system is complex but useful, achieving its objectives. An average utility level of 52% was noted, with a 95% confidence interval (CI) [16 – 85%]. The average simplicity was 64%, CI [33-94%]. The performance level in terms of flexibility was 47%, CI [16 - 77%]. Similarly, the level of performance regarding acceptability was 47%, CI [21 – 70%]. Average responsiveness was 65%, CI [39 – 89%]. The Positive Predictive Value (96.24%) was high in 2019. Conclusions: The monitoring system was found to be useful and met its objectives. Flexibility and acceptability need to be improved. We recommend to the national AIDS program to establish other HIV/AIDS testing centers and outpatient treatment centers at the districts and regional levels, at the DRS, it is recommended to regularly supervise surveillance activities in the districts and to organize quarterly health training. For the CTA of Nouakchott, it is advisable to strengthen collaboration with the DRS and INRSP for the screening of suspected cases of HIV/AIDS in non-hospitalized patients.