ArticleEpidemiology and infection2018
The importance of accounting for testing and positivity in surveillance by time and place: an illustration from HIV surveillance in Japan.
Article in Epidemiology and infection, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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4 citing papers in PubMed.
- Patient Perceptions of Sensitive Genetic and Other Medical Information: Findings from a Cancer Survivors Survey in Japan.JMA journal · 2026Article
- Comprehensive epidemiological analysis of severe fever with thrombocytopenia syndrome in Japan, 2013-2023: descriptive observational study.The Lancet regional health. Western Pacific · 2025Article
- Epidemiology of Coronavirus Disease 2019 in Japan: Descriptive Findings and Lessons Learned through Surveillance during the First Three Waves.JMA journal · 2021Article
- Letter to the Editor: Pathogens detected from patients with acute respiratory infections negative for SARS-CoV-2, Saitama, Japan, 2020.Western Pacific surveillance and response journal : WPSARArticle
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10 authors.
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Abstract
The number of tests performed is an important surveillance indicator. We illustrate this point using HIV surveillance data, focusing on Tokyo and Okinawa, two prefectures with high HIV notification rates in Japan. Restricting to data reported from local public health centres and affiliate centres where testing data are accessible, we assessed HIV surveillance data during 2007-2014, based on the annual HIV notification rate (per 100 000 population), HIV testing rate (per 100 000 population) and proportion testing HIV-positive (positivity). Nationally, testing activity and positivity showed an inverse relationship; in 2008, the testing rate peaked, but positivity was lowest. While notification rates were higher for Tokyo (median = 0.98, range = 0.89-1.33) than Okinawa (median = 0.61, range = 0.42-1.09), Okinawa had slightly higher testing rates (median = 187, range = 158-274) relative to Tokyo (median = 172, range = 163-210). Positivity was substantially lower in Okinawa (median = 0.34%, range = 0.24-0.45%) compared with Tokyo (median = 0.57%, range = 0.46-0.67%). Relative to the national testing rate (median = 85, range = 80-115) and positivity (median = 0.34%, range = 0.28-0.36%), Tokyo had higher positivity, despite more testing. In 2014 in Okinawa, all three indicators increased, providing a strong reason to be concerned as positivity increased despite more testing. Together with other information, accounting for testing and positivity improve interpretation of surveillance data to guide public health assessments.
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