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					               WHO COLLABORATING CENTRE FOR CAPACITY BUILDING IN
                                  HIV/AIDS SURVEILLANCE
                            Andrija Štampar School of Public Health
                            School of Medicine University of Zagreb
                           Rockefellerova 4, 10 000 Zagreb, Croatia
              Phone: + 385 1 45 90 147/ 45 90 100; Fax: +385 1 46 84 212
                               www.surveillancezagreb.org




               Training Course in Advanced HIV Surveillance
                       12-16 July, 2010, Cavtat (close to Dubrovnik), Croatia

Description
In spite of the improvements in the quantity and quality of HIV surveillance systems in the
past five years, substantial efforts are needed in the countries to implement fully functioning
HIV surveillance. That in particular relates to the need to improve HIV incidence, morbidity,
and mortality surveillance and to more effectively use the data.

HIV surveillance is broad in terms of the content and operations due to the complexity of the
HIV epidemics. In addition to the key surveillance components, comprehensive HIV
surveillance systems have a number of data collection mechanisms in place that provide
information that are crucial for planning a timely and effective HIV response. These are:
      incidence-based HIV surveillance
      surveillance of opportunistic infections (such as tuberculosis) and diseases
         transmitted in similar ways as HIV (particularly hepatitis B and C)
      CD4 T-lymphocyte surveillance which monitors trends in immunosuppression
         associated with HIV infection
      surveillance of AIDS-related mortality
      size estimates of most at-risk groups
      operational research to understand the feasibility of implementation of advanced HIV
         surveillance
      programmatic data that are useful for evaluating the impact of HIV control
         programmes (VCT, PMTCT data)
      data triangulation
      geographic information systems
      surveillance for antiretroviral impact
      surveillance for antiretroviral resistance


 Learning objectives
The aim of the course is to describe the components of an advanced system of HIV
surveillance, in particular new developments in HIV incidence-based surveillance and
assays, surveillance of HIV drug resistance and population size estimates of most-at-risk
groups.

During the group work, participants are expected to develop a protocol for an advanced
component of HIV surveillance, which can be a protocol for an incidence-based HIV survey,
HIV drug resistance surveillance, population size estimates or a proposal on how to better
use programmatic data in HIV surveillance. Participants are encouraged to develop protocols
that will be used in their own countries.

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Key topics of the course are:
    Incidence-based HIV surveillance
    Programmatic data: VCT, PMTCT, ARV coverage, HIV drug resistance data
    Surveillance of co-factors for HIV transmission and co-morbidities
    Trend and cohort data analysis
    Geographic information systems in HIV surveillance
    Population size estimates
    Estimating effectiveness of HIV surveillance

Teaching Methods
The course consists of lectures, presentation of case studies, exercises and group work. The
course is designed to provide participants with practical skills and knowledge in development
of a more effective and comprehensive HIV surveillance systems in their countries.

Target Audience
Epidemiologists, public health professionals, social scientists

Lecturers
Professor George Rutherford, MD, Global Health Sciences, University of California San
Francisco

Ivana Bozicevic, MD, DrPH, WHO Collaborating Centre for Capacity Building in HIV
Surveillance, School of Medicine, University of Zagreb

Willi McFarland, MD, PhD, Global Health Sciences, University of California, San Francisco
and San Francisco Department of Public Health

Jurja-Ivana Cakalo, MD, WHO Collaborating Centre for Capacity Building in HIV
Surveillance, School of Medicine, University of Zagreb

Hillary Spindler, MPH, Global Health Sciences, University of California San Francisco

Course organisers
Danijela Leso and Patricija Jankovic, WHO Collaborating Centre for Capacity Building in HIV
Surveillance


Duration and site:
The course takes place in five days, from 12-16 July 2010 in Cavtat (close to Dubrovnik),
Croatia. The course will take place at the Hotel Croatia in Cavtat ( http://www.hoteli-
croatia.hr/ )

The tuition fee for the course is 750 EUR per participant.

To apply for the course please contact Ms Patricija Jankovic or Ms Danijela Leso at:
training@snz.hr or apply on-line at www.surveillancezagreb.org

The course is organized by:
WHO Collaborating Centre for Capacity Building in HIV Surveillance
School of Public Health “Andrija Štampar”
School of Medicine, University of Zagreb
Rockefellerova 4
10 000 Zagreb, Croatia
Phone: + 385 1 45 90 142/ 45 90 100
Fax: + 385 1 46 84 212
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Programme: Training course in Advanced HIV Surveillance


 12 July 2010   New updated Second Generation HIV Surveillance Guidelines
                              Tracking new HIV infections

9.00-9.30       Welcome and Introductions

9.30-10.15      Principles of HIV surveillance and new updated 2nd generation
                HIV surveillance guidelines
10.15-10.35     Break
10.35-11.15     Components of an advanced HIV surveillance system

11.15-12.10     Incidence-based HIV surveillance: Part 1
                Implementation of HIV incidence estimation in household
                surveys with case examples

12.10-13.00     Implementation of HIV incidence estimation in sentinel
                surveillance and HIV case reporting

13.00-14.00     Lunch
14.00-15.00     Incidence-based HIV surveillance: Part 2
                Available assays for recent HIV infection

15.00-15.30     Country presentations

15.30-15.50     Break
15.50-16.30     Country presentations


 13 July 2010                    Tracking new HIV infections
                                  Data triangulation and GIS

9.00-9.40       Calculation of HIV incidence

9.40-10.30      Application of HIV incidence estimates

10.30-10.50     Break

10.50-11.50     Thinking out of the box: STI and other co-factor surveillance
                (hepatitis B and C)

11.50-13.00     Exercise: Comparisons of different sampling methods in HIV
                surveillance of high-risk groups
13.00-14.00     Lunch

14.15-15.00     Using data triangulation to understand recent changes in HIV
                transmission
15.00-15.20     Break

15.20-16.30     Use of Geographic Information Systems (GIS) in HIV
                surveillance: examples from data triangulation




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 14 July 2010                Programmatic data and data analysis

9.00-10.10      Programmatic data - VCT, PMTCT, ART coverage

10.10-10.30     Break

10.30-11.30     Principles and components of surveillance of HIV drug
                resistance
11.30-12.45     Data analysis:
                     Trend data analysis
                     Cohort data analysis
12.45-13.00     Introduction to group work on surveillance protocols

13.00-14.00     Lunch
14.00-15.20     Group work: Part 1: Introduction, background and objectives
15.20-15.40     Break
15.40-16.30     Group work Part 2: Methods

 15 July 2010                      Population size estimates
                                 Evaluation of HIV surveillance

9.00-10.00      Population size estimates: Implementation of mapping and
                census, and network scale-up methods
10.00-10.45     Population size estimates: Implementation of capture-recapture

10.45-11.00     Break
11.00-11.40     Population size estimates: Implementation of multiplier method
11.40-12.30     New guidelines on evaluation of HIV surveillance
12.30-13.00     Group work Part 2: Methods
13.00-14.00     Lunch
14.00-15.20     Group work Part 2: Methods
15.20-15.40     Break
15.40-16.30     Group work Part 3: Main indicators and budget

 16 July 2010               Presentations of participants‘ protocols

9.00-10.00      Group work Part 3: Budget and data dissemination

10.00-10.20     Break
10.20-12.30     Final Presentations
12.30-13.00     Evaluations and closure
13.00-14.00     Lunch




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References:

Diaz T, Calleja JMG, Ghys PD, Sabin K. Advances and future directions in HIV surveillance
in low- and middle-income countries. Current Opinion in HIV and AIDS 2009, 4:253–259.

Guy R, Gold J, Calleja JMG, Kim AA, Parekh B, Busch M, Rehle T, Hargrove J, Remis RS,
Kaldor JM, for the WHO Working Group on HIV Incidence Assays. Accuracy of serological
assays for detection of recent infection with HIV and estimation of population incidence: a
systematic review. Lancet Infect Dis 2009; 9: 747–59

Lyerla R, Gouws E, Garcia-Calleja JM. The quality of sero-surveillance in low-level and
middle-income countries: status and trends through 2007. Sex Transm Inf 2008; 84: i85-i91.

Bennett D, Bertagnolio S, Sutherland D, Gilks SF. The World Health Organization’s global
strategy for prevention and assessment of HIV drug resistance. Antiviral Therapy 2008; 13
Suppl 2: 1-13.




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