Completeness and concordance of TB and HIV surveillance systems for TB-HIV co-infected patients in South Africa

Setting South Africa currently maintains separate surveillance systems for tuberculosis (TB) and human immunodeficiency virus (HIV). There are future plans for integration of these systems; however, the consistency of information across the existing systems has not previously been assessed. Objective To determine the completeness and concordance of data in the TB and HIV surveillance systems for TB-HIV co-infected patients. Design In a retrospective cohort evaluation of the records of TB-HIV co-infected patients in the Eden District of the Western Cape, data were abstracted from paper-based and electronic TB and HIV surveillance sources. Concordance was measured using Fleiss' kappa coefficient. Results Demographic variables had high completeness and concordance across the TB and HIV systems. Completeness and concordance for clinical variables was somewhat lower, particularly for TB variables in the HIV systems and HIV variables in the TB systems. Conclusion Varying levels of completeness and concordance of surveillance data for TB-HIV co-infected patients highlight challenges in the current TB and HIV surveillance systems. Future integration of TB and HIV programs in this region will need to support more accurate data collection at all levels.