/**
* Library: HIV.IND.42 Logic
* Ref No: VER.6
* Short Name: Final outcome of PMTCT
*
* Definition: % of HIV-exposed infants whose final HIV outcome status is known
*
* Numerator: HIV-exposed infants born within the past 12 months (or 24 months in breastfeeding settings) who have known final HIV outcome status
* Numerator Calculation: COUNT of infants who are an "HIV-exposed infant or child" AND [(with an "Infant date of birth" in past 12 months) OR (with an "Infant date of birth" in past 24 months IF mothers are "Breastfeeding")] AND "Registered in birth cohort"=True AND with a "Final diagnosis of HIV-exposed infant" of NOT NULL
* Numerator Exclusions:
*
* Denominator: a) Programme-based/service delivery denominator | Number of HIV-exposed infants who were born within the 12 months (or 24 months in breastfeeding settings) prior to the reporting period and registered in the birth cohort | For example, for the reporting period January to December 2021 the denominator would be the number of HIV-exposed infants born between January to December 2020 in non-breast feeding settings and January to December 2019 in breastfeeding settings. | | b) Population-based denominator | Estimated number of HIV-positive women who delivered within the past 12 months | (or 24 months in breastfeeding settings)
* Denominator Calculation: COUNT of infants who are an "HIV-exposed infant or child" AND [(with an "Infant date of birth" within past 12 months) OR (with an "Infant date of birth" within past 24 months IF mothers are "Breastfeeding")] AND "Registered in birth cohort"=True
* Denominator Exclusions:
*
* Disaggregations:
* • Outcome status (HIV-positive, HIV-negative, no longer breastfeeding)
* • Cities and other administrative regions of epidemiologic importance
*
* Disaggregation Elements: Infant HIV status
*
* Numerator and Denominator Elements:
* Breastfeeding
* Final diagnosis of HIV-exposed infant
* HIV-exposed infant or child
* Infant date of birth
* Registered in birth cohort
*
* Reference: Consolidated guidelines on person-centred HIV strategic information: strengthening routine data for impact. Geneva: World Health Organization; 2022
*
* Data Concepts:
* HIV.B.DE32: Breastfeeding | Infant is being breastfed by mother
* HIV.D.DE32: Breastfeeding | Client is giving infant breast milk
* HIV.E.DE87: Infant date of birth | The infant's date of birth (DOB) if known
* HIV.E.DE112: HIV-exposed infant or child | Whether the infant or child was determined to have had HIV exposure
* HIV.E.DE179: Registered in birth cohort | Whether the infant has been registered in a birth cohort
* HIV.E.DE225: Infant HIV status | HIV status reported after applying the HIV testing algorithm. No single HIV test can provide an HIV-positive diagnosis.
* HIV.E.DE226: HIV-positive | Infant is HIV-positive
* HIV.E.DE227: HIV-negative | Infant is HIV-negative
* HIV.E.DE228: Unknown | Infant has unknown HIV status
* HIV.E.DE230: Final diagnosis of HIV-exposed infant | HIV-exposed infant final status at 18 months or 3 months after cessation of breastfeeding (whichever is later).
* HIV.E.DE231: HIV-positive | The infant is HIV-positive
* HIV.E.DE232: HIV-negative and no longer breastfeeding | The infant is HIV-negative and the mother has quit breastfeeding
* HIV.E.DE233: HIV status unknown | The final HIV status of the child is unknown because the infant died, was lost to follow-up or transferred out without ever having an HIV-positive diagnosis or is active in care but was not tested at 18 months
* HIV.SRV.DE20: HIV-exposed infant or child | Whether the infant or child was determined to have had HIV exposure
* HIV.SRV.DE22: Final diagnosis of HIV-exposed infant | HIV-exposed infant final status at 18 months or 3 months after cessation of breastfeeding (whichever is later).
*
* Additional Context
* - what it measures: This indicator measures quality of programme follow-up to track exposed infants and ascertain final HIV status.
* - rationale: • Effective PMTCT programmes must follow HIV-exposed infants until the end of the breastfeeding period to ensure that the full cascade of services and support is provided to HIV-positive mothers and their infants. | • The ability to ascertain final outcome status through routine programme data across multiple points of care is a key challenge.
* - method: This indicator measures quality of programme follow-up to track exposed infants and ascertain final HIV status.
*
* Suggested Scoring Method: proportion | http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/proportion-measure-cqfm
*/
library HIVIND42Logic
// Included Libraries
using FHIR version '4.0.1'
include HIVCommon version '0.0.1' called HIC
include FHIRHelpers version '4.0.1'
include WHOCommon called WCom
include HIVElements called HE
include HIVIndicatorElements called HIE
// Indicator Definition
parameter "Measurement Period" Interval<Date> default Interval[@2023-01-01, @2023-01-30]
context Patient
/* Populations */
/*
*Initial Population
*/
define "Initial Population":
true
/**
* Numerator
*
* Definition: HIV-exposed infants born within the past 12 months (or 24 months in breastfeeding settings) who have known final HIV outcome status
* Calculation: COUNT of infants who are an "HIV-exposed infant or child" AND [(with an "Infant date of birth" in past 12 months) OR (with an "Infant date of birth" in past 24 months IF mothers are "Breastfeeding")] AND "Registered in birth cohort"=True AND with a "Final diagnosis of HIV-exposed infant" of NOT NULL
*/
define "Numerator":
HIE."is HIV-exposed infant or child E.DE112"
and
(exists(HIE."Live Birth Delivery" B where months between end of B.effective.toInterval() and end of "Measurement Period" < 12 months)
or
(
exists(HIE."Breastfeeding B.DE32" B) and
exists(HIE."Live Birth Delivery" B where months between end of B.effective.toInterval() and end of "Measurement Period" < 24 months)
)
)
and HIE."Registered in birth cohort"
and HE."Final diagnosis of HIV-exposed infant E.DE230" is not null
/**
* Denominator
*
* Definition: a) Programme-based/service delivery denominator | Number of HIV-exposed infants who were born within the 12 months (or 24 months in breastfeeding settings) prior to the reporting period and registered in the birth cohort | For example, for the reporting period January to December 2021 the denominator would be the number of HIV-exposed infants born between January to December 2020 in non-breast feeding settings and January to December 2019 in breastfeeding settings. | | b) Population-based denominator | Estimated number of HIV-positive women who delivered within the past 12 months | (or 24 months in breastfeeding settings)
* Calculation: COUNT of infants who are an "HIV-exposed infant or child" AND [(with an "Infant date of birth" within past 12 months) OR (with an "Infant date of birth" within past 24 months IF mothers are "Breastfeeding")] AND "Registered in birth cohort"=True
*/
define "Denominator":
HIE."is HIV-exposed infant or child E.DE112"
and
(exists(HIE."Live Birth Delivery" B where months between end of B.effective.toInterval() and end of "Measurement Period" < 12 months)
or
(
exists(HIE."Breastfeeding B.DE32" B) and
exists(HIE."Live Birth Delivery" B where months between end of B.effective.toInterval() and end of "Measurement Period" < 24 months)
)
)
and HIE."Registered in birth cohort"
/* end Populations */
/*
* Disaggregators
*/
define "Geographic Region Stratifier":
HIE."By Geographic Region Stratifier"
define "HIV Status Stratifier infant":
HIE."HIV Status Stratifier infant"
define "Stratification":
HIE."HIV Status Stratifier infant".code
+ ':' + HIE."By Geographic Region Stratifier"
|