Trend analysis and short-term forecast of incident HIV infection in Ghana

Towards reliable forecasting of healthcare capacity needs: A scoping review and evidence mapping

BACKGROUND

The COVID-19 pandemic has highlighted the critical importance of robust healthcare capacity planning and preparedness for emerging crises. However, healthcare systems must also adapt to more gradual temporal changes in disease prevalence and demographic composition over time. To support proactive healthcare planning, statistical capacity forecasting models can provide valuable information to healthcare planners. This systematic literature review and evidence mapping aims to identify and describe studies that have used statistical forecasting models to estimate healthcare capacity needs within hospital settings.

METHOD

Studies were identified in the databases MEDLINE and Embase and screened for relevance before items were defined and extracted within the following categories: forecast methodology, measure of capacity, forecast horizon, healthcare setting, target diagnosis, validation methods, and implementation.

RESULTS

84 studies were selected, all focusing on various capacity outcomes, including number of hospital beds/ patients, staffing, and length of stay. The selected studies employed different analytical models grouped in six items; discrete event simulation (N = 13, 15 %), generalized linear models (N = 21, 25 %), rate multiplication (N = 15, 18 %), compartmental models (N = 14, 17 %), time series analysis (N = 22, 26 %), and machine learning not otherwise categorizable (N = 12, 14 %). The review further provides insights into disease areas with infectious diseases (N = 24, 29 %) and cancer (N = 12, 14 %) being predominant, though several studies forecasted healthcare capacity needs in general (N = 24, 29 %). Only about half of the models were validated using either temporal validation (N = 39, 46 %), cross-validation (N = 2, 2 %) or/and geographical validation (N = 4, 5 %).

CONCLUSION

The forecasting models' applicability can serve as a resource for healthcare stakeholders involved in designing future healthcare capacity estimation. The lack of routine performance validation of the used algorithms is concerning. There is very little information on implementation and follow-up validation of capacity planning models.

Trends of HIV indicators in Egypt from 1990 to 2021: time-series analysis and forecast toward UNAIDS 90-90-90 targets

BACKGROUND

Infection with Human immunodeficiency virus (HIV) and the development of acquired immunodeficiency syndrome (AIDS) pose severe threats to public health across the world. This study aimed to describe and forecast the trend of HIV indicators, including progress towards the 90-90-90 targets in Egypt since 1990.

METHODS

The HIV indicators were graphically described, where the X axis is the time in a year and the Y axis is the value of the selected indicator for each year using data retrieved from UNAIDS. We used the Autoregressive Integrated Moving Average (ARIMA) model to forecast different HIV indicators from 2022 to 2024.

RESULTS

Since 1990, HIV prevalence has been < 0.01, the number of people living with HIV (PLHIV) has increased from < 500 to 30,000 with a higher male predominance since 2010, and the number of children living with HIV has increased from < 100 to 1100. The number of pregnant women who needed antiretroviral treatment (ART) to prevent maternofetal HIV transmission increased from < 500 during 2010-2014 to 780 in 2021, the percentage of women who received ART increased from 3% in 2010 to 18% in 2021, the number of children exposed to HIV who did not get infection increased from < 100 in 1990-1991 to 4900 in 2021. The number of AIDS-related deaths increased from < 100 in 1990 to < 1000 in 2021. Based on forecasting, we expect that by 2024 the number of PLHIV will be 39,325(95%CI, 33,236-37,334), 22% (95%CI, 13.0%-32.0%) of pregnant females will have access to ART, 6100(95%CI, 5714-6485) HIV exposed children will not be infected, 77.0%(95% CI 66.0%-86.0%) of the population who knew their HIV status, and 71.0% (95%CI, 61.0%-81.0%) among those who know their HIV status will be on ART.

CONCLUSION

HIV is moving forward fast, however, the Egyptian health authority implements different control measures to control its spread.

The impact of the activities of Ghana AIDS Commission on new HIV infections in Ghana: An intervention time series analysis

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Intervention time series was used to model the impact of the activities of GAC.

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Northern sector HIV/AIDS follows integrated moving average model.

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Southern sector HIV/AIDS follows autoregressive integrated moving average model.

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No significant impact of GAC activities on HIV/AIDS observed in the northern sector.

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Significant impact of GAC activities on HIV/AIDS observed in the southern sector.

The study examines the impact of Ghana AIDS Commission (GAC) activities on new HIV infections. Secondary data from 1 January 1996 to 31 December 2007 were obtained from the Ghana National AIDS Control Programme and Biostatistics Department of the Health Ministry. Intervention time series analysis was applied separately to the data from the northern and southern sectors due to data collection mechanism and location of two tertiary teaching hospitals. The impact of GAC activities is measured by the statistical significance of the coefficients of the intervention variable. The intervention variable is coded as zero (0) for the period before and one (1), the period after the GAC activities commenced. It was shown that the HIV incidence in the northern follows an integrated moving average model, whilst in the southern sectors an autoregressive integrated moving average model was the appropriate model. No significant impact of GAC activities was observed in the northern sector. In contrast the GAC activities in the southern sector were associated with a reduction in new HIV infections (male = −0.20 ± 0.13, p < 0.05; female = 0.14 ± 0.10, p < 0.05), corresponding to a 15% and 18% reduction in male and female new HIV infections respectively in the sector. It can therefore be concluded that the GAC activities were a success. However, greater focus of GAC efforts in the northern sector is required to ensure that its activities have an impact on the incidence there.