TESSy - The European Surveillance
System
HIV/AIDS Reporting Protocol
and Analysis Plan 2019
Surveillance data for 2018
March 2019
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HIV AIDS Reporting Protocol 2019
Contents
Contents
Introduction ............................................................................................................... 4
How to use this document ..................................................................................................... 4
Finding further information .................................................................................................... 4
Copyright ............................................................................................................................. 4
Reporting to TESSy .................................................................................................... 5
Checking the data collection schedule .................................................................................... 5
Preparing data ...................................................................................................................... 5
Historical HIV/AIDS data .................................................................................................. 6
Checking metadata ............................................................................................................... 6
Checking your data source profile .......................................................................................... 6
Submitting your data ............................................................................................................ 7
Finalising your submission ..................................................................................................... 7
TESSy HelpDesk ................................................................................................................... 7
Changes to current metadata ...................................................................................... 8
Annex 1 HIV/AIDS metadata ....................................................................................... 9
The HIV/AIDS metadata set .................................................................................................. 9
Available record types ...................................................................................................... 9
Current record type versions ............................................................................................. 9
Changes to HIV/AIDS metadata sets .................................................................................... 10
Dataset structure: HIVAIDS case-based record type ............................................................. 10
Description of dataset: HIV case-based record type .............................................................. 26
Description of dataset: AIDS case-base record type .............................................................. 37
Description of dataset: HIV aggregated record type .............................................................. 47
Description of dataset: AIDS aggregated record type ............................................................ 50
Description of dataset: HIVTESTS aggregated record type .................................................... 53
Annex 2 HIV/AIDS specific material ........................................................................... 54
Introduction ....................................................................................................................... 54
HIV/AIDS case definitions ............................................................................................... 54
Analysis plan ...................................................................................................................... 55
Recoding of variables ..................................................................................................... 55
Principles of analysis ...................................................................................................... 55
Creation of derived outputs ............................................................................................ 56
Data presentation .......................................................................................................... 56
Planning materials .............................................................................................................. 56
Draft outline of HIV/AIDS surveillance report ................................................................... 56
List of countries with generalised HIV epidemics .............................................................. 58
3.3 List and codes of AIDS indicative diseases ................................................................. 60
© ECDC March 2019 All rights reserved.
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HIV AIDS Reporting Protocol 2019
Introduction
Introduction
This Reporting Protocol is for the 2019 data call for HIV/AIDS diagnoses made in 2018. This Reporting
Protocol is a joint ECDC/WHO protocol as European level HIV/AIDS surveillance covers the full WHO
European Region, i.e. the 31 European Union/European Economic Area (EU/EEA) countries and 23
countries outside the EU/EEA.
Reporting Protocols are data collection guidelines for reporting countries’ data managers, and the new
Reporting Protocol design is intended to improve user-friendliness by:
Introducing a uniform structure to make it easier for data managers to find data collection
information across different subjects.
Removing information not relevant to data managers.
The TESSy website contains additional generic technical information for each data collection in the
general technical annex and surveillance protocol. Additional information on the HIV and AIDS data
collection is available in
Annex 2 HIV/AIDS specific material.
How to use this document
This Reporting Protocol provides information for reporting countries’ data managers in three main
sections:
Reporting to TESSy – contains guidelines on how to prepare data for submission to TESSy,
deadlines for data submission, subject-specific information (e.g. new changes to metadata),
and links to further information.
Annex 1 HIV/AIDS metadata – contains:
o The metadata set for the subject(s) covered by this Reporting Protocol.
o A history of metadata changes for the subject(s) covered by this Reporting Protocol.
o Dataset descriptions for record types HIVAIDS, HIV case-based, AIDS case-based, HIV
aggregated, AIDS aggregated, and HIV tests aggregated.
Annex 2 HIV/AIDS specific material – contains subject-specific material relevant for distribution
with the Reporting Protocol, for example:
o Case definitions.
o Analysis plan.
Finding further information
Paragraphs denoted by the information icon tell where you can find further information.
Updated links to all the schedules, documentation and training materials mentioned in this Reporting
Protocol are included in the Technical Annex on the TESSy website, including:
Metadata sets and history.
Tutorials for data transformation using respectively Excel and Access.
TESSy user documentation.
CSV and XML transport protocols.
Copyright
© European Centre for Disease Prevention and Control, 2019. Reproduction is authorised, provided
the source is acknowledged. European-level HIV/AIDS surveillance is conducted jointly by ECDC and
the WHO Regional Office for Europe.
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HIV AIDS Reporting Protocol 2019
Reporting to TESSy
Reporting to TESSy
This section provides both an overview of the TESSy reporting process and tips on where you can find
useful information.
The overall process is:
1.
Familiarise yourself with the data collection deadlines.
2.
Prepare (export and transform) your data.
3.
Check that your data comply with the metadata.
4.
Check that your data source profile is up-to-date.
5.
Submit your file(s) to TESSy.
6.
Finalise and approve your submission.
Checking the data col ection schedule
An updated link to the current data collections schedule is provided in the Technical Annex.
The 2016 HIV/AIDS surveillance data collection opens in March 2019 and closes
31 May 2019. Please
inform us as soon as possible if you are unable to meet the 31st May deadline and on a case-
by-case basis we will determine whether countries reporting later can be included in the 2018 data
report planned to be published in November 2019.
Table 1: Timeframe for 2019 HIV/AIDS data collection
Description of process
Date
Data call for submission of HIV/AIDS data
Open from March 2019
Data submission for HIV/AIDS closes
31 May 2019
Validation of data tables
Within two-three weeks of country data upload
Data analysis and report drafting
July-October 2019
Validation of draft report by countries
October-November 2019
Publication of the surveillance report
End November 2019
Preparing data
After you have exported the data from your national database, you need to ensure that the data are in
a format that TESSy can accept. This applies both to the type of file submitted to TESSy (only CSV and
XML files can be submitted) and to the format of the data in certain fields.
Tutorials covering how you can transform your data to the correct TESSy format using Excel or
Access are available on the TESSy documents website. Information on the file formats is available in
the CSV Transport Protocol and XML Transport Protocol.
Annex 1 HIV/AIDS metadata describes the HIV/AIDS variables for reporting to TESSy, including a
detaile
d description of HIV/AIDS variables in the TESSy metadataset.
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Reporting to TESSy
The preferred format of data is case-based and data should be submitted for the entire reporting period,
if available. If case-based data are not available then aggregate data may be reported1. It is important
to only submit either case-based or aggregated data for non-overlapping periods of time.
Historical HIV/AIDS data
It is recommended that historical data are updated every time that data are submitted to TESSy.
Updating historical case-based data provides essential outcome information on parameters such as
treatment, AIDS diagnoses, and death.
Checking metadata
The TESSy metadata define the fields and data formats that are valid as input to TESSy for a given
subject. The metadataset is the set of standard variables that is applied for reporting to TESSy across
all diseases under EU surveillance and hence defines all details of each variable and its coding. New
versions reflect changes in one or more disease areas.
As requirements to the data to be shared among TESSy users change, the data changes needed to
support the new requirements are identified and agreed upon by nominated surveillance contact points
in countries and are then implemented as changes to the TESSy metadata.
In order to ensure that your data can be saved correctly in TESSy, you therefore need to check that
your data are correctly formatted according to the most recent metadata set.
Changes to the metadata for the subject of this Reporting Protocol are described in:
Changes to current HIV/AIDS metadata – changes since the last Reporting Protocol.
It is especially important to focus on:
Field formats
Many fields require that data are formatted in a specific way. For example, dates must be in the
YYYY-MM-DD format; dates in the DD/MM/YYYY format will be rejected.
Coded values
Some fields only permit the use of specific values (coded values). For example,
M,
F,
UNK, or
Other are the
coded values for Gender and any other value in a Gender field will be rejected.
The metadata file contains all the definitions and rules you need to comply with to format your data
correctly for every subject (usually a disease). The file can be downloaded as an Excel file from the
TESSy documents website.
By filtering the fields in the file by subject, you can see the fields required for your subject and the rules
applying to these fields.
The Technical Annex provides an overview of how you work with the metadata file, and the TESSy
user documentation provides in-depth details on metadata.
Checking your data source profile
Before submitting your file(s), please review the profile for your data source(s) in TESSy (go to
Data
Sources), and update the information, if necessary.
1 For details with regard to aggregate reporting for HIV and AIDS refer to Annex 1.
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Reporting to TESSy
Complete and up-to-date data source information for each subject is important for improving
interpretation of data - each surveillance system has different features that need to be taken into
account when comparing data at an international level.
Since 2015, users must have added the new subject
HIVAIDS to the relevant data source in TESSy
to be able to upload HIV/AIDS data using the new combined record type.
If your data source information is out-of-date and you do not have access rights to update it, please
request your National Focal Point for Surveillance or National Coordinator to do so.
In-depth information on the data source variables is available in the TESSy user documentation.
Submitting your data
Data are submitted through the TESSy web interface (go to
Upload).
The
Technical Annex provides an overview of how you submit files to TESSy, and the TESSy user
documentation provides in-depth descriptions of all the upload methods.
Finalising your submission
The compliance of your data with the validation rules in the metadata is checked automatically during
the data upload process.
The result of your upload – i.e. rejected or validated – is displayed immediately after the conclusion of
the check in the
Validation details webpage. Please review the result carefully:
If your file has been rejected, there will be a message explaining each instance of non-
compliance with the metadata that you need to correct.
If your file has been validated, there might be warnings and remarks relating to possible data
quality issues or to potential overwriting of existing records that you should consider.
When you file has been validated and you are satisfied that all corrections have been made, please
ensure prompt approval – unapproved uploads can block for the approval of other uploads.
HIV/AIDS verification reports are available online to check if data in TESSy are the same as the user
has submitted. The data are presented by either date of statistics or date of diagnosis. Information on
the “data source” is displayed as well for countries to keep information on their national surveillance
systems updated.
The TESSy user documentation provides information on reviewing validation results and adjusting
reporting periods to avoid overwriting existing records.
TESSy HelpDesk
Email:
xxxxx@xxxx.xxxxxx.xx
Telephone number:
+46-(0)8-5860 1601
Availability: 9:00 – 16:00 Stockholm time, Monday to Friday (except ECDC
Holidays)
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Changes to current metadata
Changes to current metadata
Changes to the HIVAIDS record type:
Addition of optional variable SiteOfTest
Updated variable RecordTypeVersion from 2 to 3
Changes to the HIV record type
Addition of optional variable SiteOfTest
Updated variable RecordTypeVersion from 6 to 7
There are no changes to the AIDS record type, to the aggregate HIV or AIDS record types or to the
HIVTESTS record type.
The previous metadata changes are described in
Annex 1 HIV/AIDS metadata.
Information on changes to the metadata for other subjects is available on the TESSy documentation
website.
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HIV AIDS Reporting Protocol 2019
Annex 1 HIV/AIDS metadata
Annex 1 HIV/AIDS metadata
This section describes:
The HIV/AIDS metadata set
Changes to the HIV/AIDS metadata
Dataset structure: HIVAIDS case-based record type
Dataset structure: HIV case-based record type
Dataset structure: AIDS case-based record type
Dataset structure: HIV aggregated record type
Dataset structure: AIDS aggregated record type
Dataset structure: HIVTESTS record type
The HIV/AIDS metadata set
Available record types
Different record types are available for European level reporting of HIV/AIDS surveillance data. In 2015
a new combined HIVAIDS record type was introduced to simplify reporting by merging HIV and AIDS
into one dataset and to improve reporting on migrants, transmission, deaths and enable HIV care by
introducing new variables. The new combined HIVAIDS record type is the preferred format for
reporting. However, the previous separate HIV and AIDS case-based record types remain available for
countries whose surveillance systems do not support combined HIVAIDS reporting. Further, aggregated
record types for HIV and AIDS are available for countries that are not able to provide case-based data.
HIV testing data is reported in aggregate in the HIVTESTS record type.
In summary the following record types are available:
HIVAIDS (case-based)
HIV (case-based)
AIDS (case-based)
HIVAGGR (aggregated)
AIDSAGGR (aggregated)
HIVTESTS (aggregated)
The dataset structure for each of the above record types is provided in this section.
Current record type versions
Table 2 shows the record type versions available for reporting 2017 HIV/AIDS surveillance data to
TESSy.
Table 2: HIV/AIDS record version types for 2018 data
Subject
Case-based
Aggregated
record type
record type
version
version
HIVAIDS
HIVAIDS 3
AIDS
AIDS 4
AIDSAGGR 1
HIV
HIV 7
HIVAGGR 1
HIVTESTS
HIVTESTS 1
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Changes to HIV/AIDS metadata sets
Metadata changes for the current year are described below and also in
Changes to current metadata.
Metadata changes prior to 2019 can also be found on the TESSy documents website.
Table 3: Summary of metadata changes for HIV/AIDS 2008-2019
Year Subject
Description
2019 HIVAIDS
Added optional variable: SiteOfTest
HIV
HIVAIDS
Updated variable RecordTypeVersion from 2 to 3
HIV
Updated variable RecordTypeVersion from 6 to 7
2018 HIVAIDS
Update description of the variables:
DateOfDiagnosis, ART, ARTDate– to clarify instructions for the users
HIV
Added mandatory variable: DeathCause to harmonise variables with HIVAIDS
recordtype
HIV
Added optional variables: AgeMonth, AcuteInfection, YearOfArrival,
LastAttendanceDate, ART, ARTDate, VLLatest, VLLatestDate to harmonise variables
with HIVAIDS recordtype
HIV
Dropped
variables
ClinicalCriteria,
LaboratoryResult,
EpiLinked,
PlaceOfNotification, PlaceOfResidence, DateOfOnset, Outcome
HIV
Updated variable RecordTypeVersion from 5 to 6
2017 HIVAIDS
Added optional variable ARTDate
HIVAIDS
Added optional variable AgeMonth
HIVAIDS
Updated variable RecordTypeVersion from 1 to 2
HIVAIDS
Updated coded value list for AcuteInfection: add RECTEST — evidence from
recency testing
2016 HIVAIDS
Update coded value list for AcuteInfection:
remove NOEVINF
HIVAIDS
Update description of the variables:
AcuteInfection, AIDSIndicatorDisease, VLLatest – to clarify instructions for the
users
HIVAIDS
Reduce validation rules – to reduce the number of warnings and the time of the
validation process in TESSy
2015 HIVAIDS
Add new record type HIVAIDS
2008 HIV
New variables: DateOfStatistics, CountryOfBirth, CountryOfNationality,
ProbableCountryOfInfection
Dataset structure: HIVAIDS case-based record type
The dataset for case-based combined HIVAIDS surveillance consists of a set of 36 variables, 17 of which
are mandatory and the remaining 19, optional
(Table 4). The mandatory variables represent a minimum
standard designed to provide an overview of the HIV epidemic and to improve data completeness and
accuracy across Europe. The optional variables are aimed at countries that are able to complete them.
They are also aspirational, with the aim that over the medium term, increasing numbers of countries
will be able to use this dataset to design and enhance national surveillance systems.
Each variable is described in detail in
Description of HIVAIDS variables in the TESSy metadataset
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Table 4: Overview of the revised set of variables for case-based HIVAIDS surveillance
Variable
Report Type
TESSy System Related Variables
1. RecordID
Mandatory
2. RecordType
Mandatory
3. RecordTypeVersion
Optional
4. Subject
Mandatory
5. Status
Optional
6. DataSource
Mandatory
7. ReportingCountry
Mandatory
8. DateUsedForStatistics
Mandatory
Diagnosis Information
9. DateOfDiagnosis
Mandatory
10. DateOfNotification
Mandatory
11. HIVType
Mandatory
12. HIVStatus
Optional
13. Transmission
Mandatory
14. TransmissionPartner
Optional
15. ProbableCountryOfInfection
Optional
16. FirstCD4Count
Mandatory
17. FirstCD4Date
Mandatory
18. AcuteInfection
Optional
Demographics
19. Age
Mandatory
20. AgeMonth
Optional
21. Gender
Mandatory
22. CountryOfBirth
Mandatory
23. RegionOfOrigin
Optional
24. YearOfArrival
Optional
25. SiteOfTest
Optional
Clinical Information
26. LastAttendanceDate
Optional
27. ART
Optional
28. ARTDate
Optional
29. CD4Latest
Optional
30. CD4LatestDate
Optional
31. VLLatest
Optional
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Variable
Report Type
32. VLLatestDate
Optional
33. DateOfAIDSDiagnosis
Optional
34. AIDSIndicatorDisease
Optional
Death
35. DateOfDeath
Mandatory
36. DeathCause
Mandatory
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Annex 1 HIV/AIDS metadata
Description of HIVAIDS variables in the TESSy metadataset
There are 36 variables for HIV case-based reporting, which are divided into system-related variables,
diagnosis information, demographics, clinical information, and variables on death.
In the text the following conventions are used:
VariableName
Literal name of a variable. Does not contain spaces. Case is only used
to improve readability.
Coding
Code as accepted by the system
‘Description of code’
Description of the meaning of a possible value for a specific variable.
Example: The gender of a case is described in the variable
Gender, that can have the possible values
M for ‘Male’,
F for ‘Female’,
O for ‘Other’ and
UNK for ‘Unknown’
Validation rules aim to reduce errors in coding of variables. If validation rules are violated in the data
submission, the system will produce an error report, classifying each violation as a major or minor error.
Major errors will result in the data submission being blocked, while a submission containing minor errors
will be accepted.
The variables are described in detail in the following sections:
System related variables
Diagnosis Variables
Demographic Variables
Clinical Information
Death
System related variables
1.
RecordId (mandatory)
The identifier should be provided by the Member State (MS). It should be unique (within and across
the national surveillance system) and anonymous for each record.
Coding: Text (max 80 characters)
Please note that ID must be unique for all historical cases, if they are derived from the same national
reporting system; records with the same ID will be overwritten.
2.
RecordType (mandatory)
The record type defines the structure and the format of the data reported. The record types are defined
by ECDC. It specifies what data values TESSy expects to receive. The record type is related to the
subject. Only valid combinations of record type, subject and datasource are accepted. For the new
format of combined HIV/AIDS case-based reporting, record type is
HIVAIDS.
3.
RecordTypeVersion (optional)
The version of the record type defines the current structure of the data reported. If the original
dataset for any particular disease is changed, the versioning will change according to increasing
numbering. All record types started at version 1 with the launch of TESSy. This variable can be
omitted if a valid Metadataset is provided.
Coding for the revised HIVAIDS RecordTypeVersion = 2
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4.
Subject (mandatory)
The subject describes the disease associated to the reported case(s); this is
HIVAIDS for all cases.
5.
Status (optional)
The status is used for adding new cases (with new RecordIds) or updating historical data already in
TESSy; the default is
New/Update. By choosing
Delete, the selected record (indicated by the
RecordId) will be marked as inactive, but will remain in TESSy to reconstruct the data for a given date
in the past.
Coding:
NEW/UPDATE
Delete
6.
DataSource (mandatory)
The data source specifies the surveillance system from which the data on this particular disease
originates. The list of available Surveillance Systems per country is an integral part of TESSy and will
be generated and revised/updated in bilateral collaboration with the nominated contact points for
surveillance in each MS.
Coding:
See list of surveillance systems
TESSy currently contains a list of surveillance systems which has been provided by each MS (variable
‘DataSource’). The descriptions of the surveillance systems submitted to TESSy should be kept up-to-
date and will be used to assist with data interpretation. If a MS decides to submit a combined dataset,
this should be specified in the ‘DataSource’ field.
7.
ReportingCountry (mandatory)
This variable identifies the country that reports the case. The list of countries is provided according to
ISO codes. This variable should be included by the MS by default.
Coding:
Country = ISO 3166-1 alpha-2, (two-letter code).
8.
DateUsedForStatistics (mandatory)
This is the date used by the national surveillance institute or organisation in the national HIV/AIDS case
reports and other official statistics. The date used for statistics varies from country to country and could
be either the date of diagnosis or the date of notification or any other date applicable. This date should
be provided as exact date or incomplete date. This is a technical compulsory variable. (E.g. Coding as
‘Unknown’ is not allowed)
Coding:
Date = YYYY-MM-DD
Incomplete date (YYYY-MM, YYYY, YYYY-Www, YYYY-Qq)
Diagnosis Information
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9.
DateOfDiagnosis (mandatory)
The date of first HIV diagnosis; laboratory diagnosis. The exact date is preferred and should be provided
if available; incomplete dates (e.g. quarter, month, year) are allowed if exact date is not available.
Coding:
Date YYYY-MM-DD (preferred)
Incomplete date (YYYY-MM, YYYY, YYYY-Www, YYYY-Qq)
Validation rules:
9.1. (Error) Date of diagnosis (DateOfDiagnosis) must be after 1970.
10.
DateOfNotification (mandatory)
This is the date on which the HIV diagnosis was notified for the first time to the surveillance system in
the reporting country. Date should be provided as exact date, incomplete date or coded as Unknown.
The exact date is preferred and should be provided if available; incomplete dates (e.g. quarter, month,
year) are allowed as well.
Coding:
Date YYYY-MM-DD
Incomplete date (YYYY-MM, YYYY, YYYY-Www, YYYY-Qq)
UNK Unknown (default value)
Note on dates:
Date of diagnosis is used for presentation of HIV/AIDS data
For HIV, the date of diagnosis may not be reported at a national level or may differ from the date
of notification to the surveillance system. Therefore, date of notification to the surveillance system
should be included and reported if available.
11.
HIVType (mandatory)
This variable specifies the type of HIV infection.
Coding:
HIV1
HIV1 only
HIV12
HIV1 and HIV2 (co-infection)
HIV2
HIV2 only
UNK
Unknown
12.
HIVStatus (optional)
This variable provides information on previous positive test results, prior to the current episode of
reporting. This variable allows cases that are "newly diagnosed" to be distinguished from cases who
had a positive HIV test in the past but are tested and/or reported for the first time in the country (ie
transfer of care).
Coding:
NEG
Not known to be previously tested positive
PREVPOS
Previously tested HIV positive
UNK
Unknown (i.e. no previous confirmed test result on record)
13.
Transmission (mandatory)
Describes the most probable route of transmission of HIV. It is classified according to sexual
transmission: sex between men or heterosexual contact. The other categories refer to those
ever
injected drugs, mother-to-child transmission, transfusion recipient, nosocomial. Nosocomial infection
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includes patients infected in health care settings. Case of occupational exposure should be classified as
exposure unknown or undetermined. Cases which are not fully documented should also be coded as
unknown or undetermined.
Coding:
HAEMO
haemophiliac patient
HETERO
heterosexual contact
IDU
ever injected drugs
MSM
MSM/homo or bisexual male
MTCT
mother-to-child-transmission
NOSO
nosocomial
TRANSFU
transfusion recipient
UNK
unknown or undetermined
Validation rules:
13.1. (error) If reported transmission category is men who have sex with men (Transmission=MSM,
then Gender should not be female (F)
13.2. (remark) If transmission category is reported as transfusion of blood or its component due to
haemophilia (Transmission=HAEMO), then Gender is not very often female (F).
13.3. (warning) If the person is younger than 13 years old, transmission is often mother to child
(Transmission = MTCT).
14.
TransmissionPartner (optional)
Describes the most probable route of HIV transmission of the partner in cases where a primary sexual
partner is identified. Does not relate to MTCT or other types of partners.
Coding:
PMSM
Partner MSM
PHETEPI
Partner heterosexual from generalised epidemic country
PHETNEPI
Partner heterosexual from non-generalised epidemic country
PIDU
Partner injecting drug user
PIVER
Partner infected through mother-to-child transmission
PINOSO
Partner infected nosocomially
PHAEMO
Partner haemophiliac
PIBLOOD
Partner infected through blood products
UNK
Partner undetermined or unknown
Countries with generalised HIV epidemics are listed in Annex II.
15.
ProbableCountryOfInfection (optional – repeatable field)
The
country(ies) where infection of the patient is likely to have occurred.
Coding:
Country ISO 3166-1 alpha 2
UNK Unknown
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16.
FirstCD4Count (mandatory)
The first CD4 cell count recorded following HIV diagnosis. The variable specifies the CD4 cells count at
first measurement. Dates during the year following the reporting year are acceptable (i.e., CD4 cell
count in January 2016 for a person diagnosed in November 2015).
Coding:
Numeric value (0-6000)
UNK
Unknown
Validation rules:
16.1. (remark) Usually CD4 cell count varies in a range from 0 to 1,500 and due to rare extremely
high values upper limit is set to 6,000 per cubic millimetre.
17.
FirstCD4Date (mandatory)
Date of first available CD4 cell count. The exact date is preferred and should be provided if available;
incomplete dates (e.g. week, quarter, month, year) are allowed as well.
Coding:
Date YYYY-MM-DD
Incomplete date (YYYY-MM, YYYY, YYYY-Www, YYYY-Qq)
UNK
Unknown
NA
Not applicable
18.
AcuteInfection (optional – repeatable field)
Evidence of recent infection, aside from the recent infection assay result. An infection can be considered
to be recent if a patient presents with seroconversion illness, has a negative HIV test within 6 months
of diagnosis or has evidence from p24 antigen or Western Blot assays. Up to four options can be entered
should more than one apply. For repeatable fields, all empty fields should be filled with “N/A”.
Coding:
SEROILL
Seroconversion illness
NEGTEST
Last negative test within 6 months of HIV diagnosis
EV24ANT
Evidence from p24 antigen
EVWBLOT
Evidence from Western Blot
RECTEST
Evidence from recency testing
UNK
Unknown
NA
Not applicable (not acute infection)
Demographic Variables
19.
Age (mandatory)
This is the age at diagnosis of the person in years as reported in the national system of the MS. If not
available, age can be calculated from the date of birth and the date of diagnosis:
Coding:
Num (0-120)
UNK
Unknown (default value)
Validation rules:
19.1. (warning) If the person is younger than 13 years old, transmission is often mother to child
(Transmission = MTCT).
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19.2 (remark) It is unlikely that the age is more than 80.
20.
AgeMonth (optional)
Age of case in months at diagnosis as reported in the national system for cases with transmission
classified as mother-to-child transmission who are < 2 years of age at the time of diagnosis.
Coding:
Num (0-23)
UNK
Unknown (default value)
20.1. (Error) If Age is greater than 1 and AgeMonth is reported
20.2. (Error) If Age is '0' and AgeMonth is greater than 11
20.3. (Error) If Age is '1' and AgeMonth is less than 12
20.4. (Remark) If Age is greater than 80
20.5. (Warning) If Age is less than 2 and AgeMonth is not reported
20.6. (Warning) If Age is less than 13 and Transmission is not 'MTCT'
21.
Gender (mandatory)
Gender of the infected person. Transsexual persons should be coded as
O ‘Other’.
Coding:
M
Male
F
Female
O
Other (e.g., transsexual)
UNK
Unknown (default value)
Validation rules:
21.1. (Error) If reported transmission category is men who have sex with men
(Transmission=MSM), then Gender should not be female (F).
21.2. (Warning or Remark) If transmission category is reported as transfusion of blood or its
component due to haemophilia (Transmission=HAEMO), then Gender is not very often female
(F).
22.
CountryOfBirth (mandatory)
Country of birth of patient. Defines the country of birth as country level, the ISO list of countries is
provided.
Coding: Country ISO 3166-1 alpha 2
UNK
Unknown
23.
RegionOfOrigin (optional)
Region from which the case originates. If the case is from the reporting country, it should be coded as
REPCOUNTRY. CountryOfBirth is the preferred variable. If this is not available, then submit
RegionOfOrigin. If both are submitted, CountryOfBirth should match RegionOfOrigin.
Coding:
ABROAD
Abroad but specific region unknown
AUSTNZ
Australia and New Zealand
CAR
Caribbean
CENTEUR
Central Europe
EASTASIAPAC
East Asia and Pacific
EASTEUR
East Europe
EUROPE
If a case cannot be classified as West, Central or
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Eastern Europe, report as Europe, sub-region unknown
LATAM
Latin America
NORTHAFRMIDEAST North Africa and Middle East
NORTHAM
North America
REPCOUNTRY
Same as country of report
SOUTHASIA
South and South East Asia
SUBAFR
Sub Sahara Africa
UNK
Unknown
WESTEUR
West Europe
24.
YearOfArrival (optional)
Year patient arrived in the reporting country.
Coding:
Date YYYY
NA
Not Applicable
UNK Unknown
25.
SiteOfTest (optional)
Describes the site of the first HIV reactive test for persons newly diagnosed with HIV, including
screening tests prior to confirmatory testing performed outside of healthcare settings.
Coding:
CBT = Community-based testing programme
INFDIS = Infectious disease clinic
SEXHEAL = Sexual health or STI clinic
EMERG= Accident and emergency department
ANS = Antenatal screening
PHC = Primary health care
OTHHOSP = Other hospital setting
BLOOD = Blood donation screening
SELFTEST = Self-testing
SELFSAMP=Self-sampling
PHARM=pharmacy
PWID = Harm reduction site/drug services
PRIS = Prison or remand services
ABROAD=tested abroad prior to arrival to reporting country
OTHER=other setting
UNK = Undetermined or unknown
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Clinical Information
26.
LastAttendanceDate (optional)
Date the patient was last seen for HIV-related care (can be a date prior to the reporting year). The
exact date is preferred and should be provided if available; incomplete dates (e.g. week, quarter,
month, year) are allowed as well.
Coding:
Date YYYY-MM-DD
Incomplete date (YYYY-MM, YYYY, YYYY-Www, YYYY-Qq)
UNK
Unknown
Validation rules:
25.1. (Remark) If ART is
Y (Yes), last attendance date should be reported.
27.
ART (optional)
Whether person was on ART at the time of the last attendance date.?
Coding:
Y
Yes
N
No
UNK Unknown
Validation rule:
26.1. (Remark) If ART is
Y (Yes), last attendance date should be reported.
28.
ARTDate (optional)
Date that ART was initiated. The exact date is preferred and should be provided if available; incomplete
dates (e.g. week, quarter, month, year) are allowed as well.
Coding:
Date YYYY-MM-DD
Incomplete date (YYYY-MM, YYYY, YYYY-Www, YYYY-Qq)
UNK
Unknown
29.
CD4Latest (optional)
Numeric value of last known CD4 count. If latest CD4 is not available, enter UNK.
Coding:
Numeric value (0-6000)
UNK
Unknown
Validation rules:
28.1. (remark) Usually CD4 cell count varies in a range from 0 to 1,500 and due to rare extremely
high values upper limit is set to 6,000 per cubic millimetre.
28.2. (Remark) if CD4Latest is known then CD4LatestDate should be reported.
30.
CD4LatestDate (optional)
Date of last CD4 count assessment. The exact date is preferred and should be provided if available;
incomplete dates (e.g. week, quarter, month, year) are allowed as well.
Coding:
Date YYYY-MM-DD
Incomplete date (YYYY-MM, YYYY, YYYY-Www, YYYY-Qq)
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NA
Not applicable
UNK
Unknown
31.
VLLatest (optional)
Last known viral load. Enter the numeric value of the last viral load. If viral load is ‘undetectable’ (ie no
numeric value is provided by the test) please code as ‘0’. If the latest viral load is unknown code as
‘UNK’.
Coding:
Numeric value (up to 7 digits)
0
Low or Undetectable
UNK Unknown
32.
VLLatestDate (optional)
Date of last known viral load assessment (date of blood test where available). The exact date is
preferred and should be provided if available; incomplete dates (e.g. week, quarter, month, year) are
allowed as well.
Coding:
Date YYYY-MM-DD
Incomplete date (YYYY-MM, YYYY, YYYY-Www, YYYY-Qq);
NA
Not applicable
UNK
Unknown
33.
DateOfAIDSDiagnosis (optional)
The date of first AIDS diagnosis; clinical or laboratory diagnosis. Date should be provided as exact date,
incomplete date. The exact date is preferred and should be provided if available; incomplete dates (e.g.
week, quarter, month, year) are allowed as well.
Coding: Date YYYY-MM-DD
Incomplete: YYYY-MM, YYYY, YYYY-Www, YYYY-Qq;
NA
Not applicable (no AIDS diagnosis)
UNK
Unknown
Validation rules:
32.1. (error) Date of AIDS diagnosis (DateOfAIDSDiagnosis) must be after 1970.
32.2. (remark) If death due to AIDS is reported (DeathCause=DAIDS), patient should also have a
DateOfAIDSDiagnosis.
34.
AIDSIndicatorDisease (optional –repeatable field)
AIDS indicator disease at the time of AIDS diagnosis occurring within two consecutive months from
the date of AIDS diagnosis. The list of AIDS Indicator Diseases is provided (see
Table 7: AIDS
indicator disease codes). This is a repeatable field for up to 4 diagnoses. In case the indicator disease
is not known, the code 30
Opportunistic infection(s), not specified should be used. For
repeatable fields, all empty fields should be filled with “N/A”.
Coding:
Numeric value (1-31)
Validation rule:
34.1. (warning) If AIDS indicator disease (AIDSIndicatorDisease) is reported, DateOfAIDSDiagnosis
should be reported.
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Death
35.
DateOfDeath (mandatory)
Date of death due to any cause. The exact date is preferred to obtain more accurate information and
to allow better comparison and grouping. Incomplete dates (quarter, month, year) are permissible. All
cases that are still alive or where the outcome (i.e., whether the case is alive or dead) is unknown are
to be coded as ‘NA’.
Coding:
Date YYYY-MM-DD (preferred)
Incomplete date = YYYY-MM, YYYY, YYYY-Www, YYYY-Qq
NA
Not applicable (Alive or unknown status)
UNK Unknown date of death
Validation rules:
34.1. (warning) If it is known that a person died, it is usually expected that the DateOfDeath is
reported.
36.
DeathCause (mandatory)
Information on whether the case is alive or deceased (due to AIDS-related and non-AIDS related
causes).
Coding:
DAIDS
Death due to AIDS (or an AIDS defining-illness)
DNOAIDS
Non AIDS-related death
DUNK
Died of unknown cause
A
Alive
UNK
Unknown status
Validation rules:
35.1. (remark) If death due to AIDS is reported (DeathCause=DAIDS), patient should also have a
DateOfAIDSDiagnosis.
35.2. (warning) If it is known that a person died, it is usually expected that the DateOfDeath is
reported.
35.3. (warning) If DateOfDeath is known, DeathCause should be coded as DAIDS or DNOAIDS or
DUNK.
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Structure of older HIV and AIDS record types for surveillance
This section describes the variables that are included in the case-based and aggregated record types
for separate HIV and AIDS reporting. Datasets for HIV/AIDS surveillance consist of two sets of variables:
the common set of system related variables and the disease-specific set of epidemiological variables.
The common set applies to all diseases under EU surveillance. For HIV and AIDS case-based reporting,
the common set consists of 20 variables with an additional 14 (HIV) and 13 (AIDS) which are disease-
specific. The aggregated format for HIV reporting consists of 10 common variables and two which are
disease-specific (see Table 5). The mandatory variables for all datasets represent a minimum standard
designed to improve data completeness and accuracy across Europe. If it is not possible to provide
information for all variables using the aggregate format, the hierarchy for aggregate reporting is as
follows: 1) transmission; 2) age class 3) gender.
Table 5: Overview of the enhanced set of variables for case-based HIVAIDS surveillance, aggregated
HIV/AIDS surveillance and for HIV tests
AIDS AGGREGATE
HIVTESTS
HIV CASE BASED
AIDS CASE BASED
HIV AGGREGATE
(aggregate)
Common set of system-related variables
1. RecordID*
1. RecordId*
1. RecordType*
1. RecordType*
1. RecordType*
2.
2.
2.
2. RecordType*
2. RecordType*
RecordTypeVersion
RecordTypeVersion
RecordTypeVersion
3.
3. RecordTypeVersion
3. Subject *
3. Subject *
3. Subject *
RecordTypeVersion
4. Subject*
4. Subject*
4. DataSource*
4. DataSource*
4. DataSource*
5.
5. Status
5. Status
5. AgeClass*
5. AgeClass*
DateUsedForStatistic
s*
6.
6. DataSource*
6. DataSource*
6. Gender*
6. Gender*
ReportingCountry*
7.
7.
7.
7. ReportingCountry*
7. NumberOfTests*
ReportingCountry*
ReportingCountry*
ReportingCountry*
8.
8. DateUsedForStatistics*
8.DateUsedForStatist
8.DateUsedForStatist
DateUsedForStatistic
ics*
ics*
s*
9. Age*
9. Age*
9. Classification*
10. NumberOfCases*
10. AgeMonth
10. Gender*
10. NumberOfCases*
11. Gender*
11. DeathCause*
12. DateOfOnset
13.
12. DateOfDiagnosis*
DateOfDiagnosis*
14.
13. DateOfNotification
DateOfNotification
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14. Classification*
15. Classification*
16. ClinicalCriteria*
17. LaboratoryResult
18. EpiLinked
19.
PlaceOfNotification
20.
PlaceOfResidence
Disease-specific epidemiological variables
15. HIVType*
21. HIVType*
11. Transmission*
16. Stage
-
12. DateSpecified*
17 AcuteInfection
22. ARTTreatment*
18. Transmission*
23. Transmission*
24.
19. TransmissionHetero
TransmissionHetero
25.
20. TransmissionMTCT
TransmissionMTCT
21. HIVStatus
-
22. DateOfAIDSDiagnosis
-
26.
23. DateOfDeath
DateOfHIVDiagnosis
24. DeathCause
27. DateOfDeath*
28.
25 YearOfArrival
DateOfReportDeath
26. CountryOfBirth
29. CountryOfBirth
30.
27.CountryOfNationality
CountryOfNationality
28. RegionOfOrigin*
31. RegionOfOrigin*
29. CD4Cel s
-
32.
30. FirstCD4Date*
AIDSIndicatorDiseas
e*
31.ProbableCountryOfInfec
33. AgeClass
tion
32. LastAttendance
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33. ART
34. ARTDate
35. VLLatest
36. VLLatestDate
37. SiteOfTest
*Mandatory variables: If not uploaded some mandatory variables prompt a warning, but data can be uploaded anyway
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Description of dataset: HIV case-based record type
There are 37 variables for case-based reporting using the older HIV record type. These are divided in
a common set of variables and disease specific variables.
In the text the following conventions are used:
VariableName
Literal name of a variable. Does not contain spaces. Case is only used
to improve readability.
Coding
Code as accepted by the system
‘Description of code’
Description of the meaning of a possible value for a specific variable.
Example: The gender of a case is described in the variable
Gender, that can have the possible values
M for ‘Male’,
F for ‘Female’,
O for ‘Other’ and
Unk for ‘Unknown’
System related variables (mandatory unless otherwise indicated)
1 RecordId (mandatory)
The identifier should be provided by the MS. It should be unique (within and across the national
surveillance system) and anonymous for each record.
Coding: Text (max 80 characters)
Please note that ID must be unique across the HIV and AIDS, if they are derived from the same national
reporting system; records with the same ID will be overwritten.
2. RecordType (mandatory)
The record type defines the structure and the format of the data reported. The record types are defined
by ECDC. It specifies what data values TESSy expects to receive. The record type is related to the
subject. Only valid combinations of record type, subject and data source are accepted. For HIV case
based reporting, record type is “HIV”.
3. RecordTypeVersion (not mandatory)
The version of the record type defines the current structure of the data reported. If the original dataset
for any particular disease is changed, the versioning will change according to increasing numbering. All
record types started at version 1 with the launch of TESSy. This variable can be omitted if a valid
Metadataset is provided.
Coding for HIV value = 6
4 Subject
The subject describes the disease associated to the reported case(s); this is
HIV.
5. Status
The status is used for updating data; the default is
New/Update. By choosing
Delete, the selected
record (indicated by the
RecordId) will be marked as inactive, but will remain in TESSy to reconstruct
the data for a given date in the past.
Coding:
NEW/UPDATE
Delete
6. DataSource (mandatory)
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The data source specifies the surveillance system from which the data on this particular disease
originates. The list of available Surveillance Systems per country is an integral part of TESSy and will
be generated and revised/updated in bilateral collaboration with the nominated contact points for
surveillance in each MS.
Coding: See list of surveillance systems
TESSy currently contains a list of surveillance systems which has been provided by each MS (variable
‘DataSource’). The descriptions of the surveillance systems submitted to TESSy should be kept up to
date and will be used to assist with data interpretation. If a MS decides to submit a combined dataset,
this should be specified in the ‘DataSource’ field.
7. ReportingCountry (mandatory)
This variable identifies the country that reports the case. The list of countries is provided according to
ISO codes. This variable should be included by the MS by default.
Coding: Country = ISO 3166-1 alpha-2, (two-letter code).
8. DateUsedForStatistics
This is the date used by the national surveillance institute or organisation in the national HIV/AIDS
case-reports and other official statistics. The date used for statistics varies from country to country and
could be either the date of diagnosis or the date of notification or any other date applicable. This date
should be provided as exact date or incomplete date. This is a technical compulsory variable. (e.g.
Coding as ‘Unknown’ is not allowed)
Coding: Date = YYYY-MM-DD or incomplete date ( YYYY-MM, YYYY, YYYY-Www, YYYY-Qq).
Epidemiological variables
9. Age (mandatory)
This is the age of the person in years as reported in the national system of the MS. For HIV, if not
available, age can be calculated from the date of birth and the date of diagnosis:
Coding:
Age
Num (0-120)
UNK
Unknown (default value)
Validation rule: a warning will be sent for a person older than 80 years.
If the person is younger than 13 years old, transmission should be mother to child (Transmission =
MTCT).
If transmission subcategory mother to child transmission (TransmissionMTCT) is reported, then age is
usually less than 13 years.
10. AgeMonth
Age of case in months at diagnosis as reported in the national system for cases with transmission
classified as mother-to-child transmission who are < 2 years of age at the time of diagnosis.
Coding:
Num (0-23)
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UNK
Unknown (default value)
20.1. (Error) If Age is greater than 1 and AgeMonth is reported
20.2. (Error) If Age is '0' and AgeMonth is greater than 11
20.3. (Error) If Age is '1' and AgeMonth is less than 12
20.4. (Remark) If Age is greater than 80
20.5. (Warning) If Age is less than 2 and AgeMonth is not reported
20.6. (Warning) If Age is less than 13 and Transmission is not 'MTCT'
11. Gender (mandatory)
Gender of the infected person. Transgender persons should be coded as
O ‘Other’.
Coding:
F
Female
M
Male
O
Other (e.g., transgender)
UNK Unknown (default value)
Validation rules:
If reported transmission category is men who have sex with men (Transmission=MSM), then Gender
should not be female (F).
If transmission category is reported as transfusion of blood or its component due to haemophilia
(Transmission=HAEMO), then Gender is not very often female (F).
If transmission subcategory TransmissionHetero is reported as sex with a bisexual male
(TransmissionHetero=SEXBI), then gender should not be reported as male (Gender=M).
12. DateOfDiagnosis (mandatory)
The date of first HIV diagnosis; lab diagnosis. The exact date is preferred and should be provided if
available; incomplete dates (e.g. quarter, month, year) are allowed as well.
Coding: Date YYYY-MM-DD or YYYY-MM, YYYY, YYYY-Www, YYYY-Qq
Validation rules:
DateOfDiagnosis of HIV should not be later that DateOfDeath.
Date of diagnosis (DateOfDiagnosis) must be after 1970.
If DateOfOnset is reported, then DateOfDiagnosis should also be reported.
If Stage is reported as acute infection (Stage=ACUTE), then DateOfDiagnosis should be reported.
If Stage is not reported as AIDS, then DateOfDiagnosis should not be later than DateOfAIDSDiagnosis.
13. DateOfNotification
The date when the HIV case is notified for the first time to the place of notification. Date should be
provided as exact date, incomplete date or coded as ‘Unknown’. The exact date is preferred and should
be provided if available; incomplete dates (e.g. quarter, month, year) are allowed as well.
Coding:
Date YYYY-MM-DD or Incomplete date (YYYY-MM-DD, YYYY-MM, YYYY, YYYY-
Www, YYYY-Qq),
UNK Unknown (default value)
Validation rules:
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If DateOfOnset is reported, then DateOfNotification should also be reported.
DateOfNotification should not be later than DateOfAIDSDiagnosis.
Note on dates:
Date of diagnosis is used for presentation of HIV/AIDS data. From the 2011 data collection, Date
of Diagnosis has become a mandatory variable.
Not all dates are reported at the national level. For HIV, the date of diagnosis may not be reported
at a national level. Therefore, all dates available should be included and reported.
14. Classification
This variable indicates the case classification according to the EU case definition. For HIV, only
‘Confirmed’ cases
CONF are reportable at European level. The only exception is in the case when MTCT
cases <18 month are not confirmed, they should be reported as probable “
PROB”.
Coding:
CONF
Confirmed
PROB
Probable
UNK
Unknown(default value)
POSS
Possible
Disease specific set of variables for HIV (all mandatory unless otherwise specified)
15. HIVType (mandatory) This variable specifies the type of HIV infection.
Coding:
HIV1
HIV1 only
HIV12
HIV1 and HIV2 (co-infection)
HIV2
HIV2 only
UNK
Unknown
16. Stage
This variable specifies the clinical stage at the time of HIV diagnosis. In case of acute infection
(
Stage=
ACUTE) the
DateOfOnset should be provided.
Coding:
ACUTE
Acute HIV infection
AIDS
AIDS
ASYMP
Asymptomatic
NONAIDS
Non-AIDS, not further specified
SYMPNONAIDS
Symptomatic non-AIDS
UNK
Unknown (default value)
Validation rules:
If stage of disease is reported as AIDS (Stage=AIDS), then DateOfAIDSDiagnosis should be reported.
Remark, if Stage is not reported
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If Stage is reported as acute infection (Stage=ACUTE), then DateOfOnset should be reported.
If Stage is reported as acute infection (Stage=ACUTE), then DateOfDiagnosis should be reported.
If Stage is reported as AIDS (Stage=AIDS), then DateOfAIDSDiagnosis should be reported.
If Stage is not reported as AIDS, then DateOfDiagnosis should not be later than DateOfAIDSDiagnosis.
If transmission category is reported as MTCT (Transmission=MTCT), stage cannot be acute HIV
infection (Stage=ACUTE).
If transmission subcategory TransmissionMTCT is reported, then reported stage should not be ACUTE
(Stage= ACUTE).
Note on clinical stage:
Cases with a previous (unreported) AIDS diagnosis should be classified as AIDS, even if they no
longer have clinical signs of AIDS.
In countries with both laboratory and clinician reports, the latter may be delayed and the clinical
stage may evolve in the meantime. In such cases, the clinical stage should be that one provided
by the clinician.
Note on “acute”: For cases with acute HIV infection, the date of infection is probably close to the
date of HIV diagnosis.
17. AcuteInfection (optional – repeatable field)
Evidence of recent infection, aside from the recent infection assay result. An infection can be considered
to be recent if a patient presents with seroconversion illness, has a negative HIV test within 6 months
of diagnosis or has evidence from p24 antigen or Western Blot assays. Up to four options can be entered
should more than one apply. For repeatable fields, all empty fields should be filled with “N/A”.
Coding:
SEROILL
Seroconversion illness
NEGTEST
Last negative test within 6 months of HIV diagnosis
EV24ANT
Evidence from p24 antigen
EVWBLOT
Evidence from Western Blot
RECTEST
Evidence from recency testing
UNK
Unknown
NA
Not applicable (not acute infection)
18. Transmission (mandatory)
Describes the most probable route of transmission of HIV. It is classified according to sexual
transmission,
MSM ‘MSM/homo or bisexual male’ and
HETERO ‘heterosexual contact’. ‘Heterosexual
contact’ is used for cases for which heterosexual transmission is highly probable, and do not fit into
another category. The other categories refer to
IDU ‘ever injected drugs’,
MTCT ‘mother-to-child
transmission’,
HAEMO ‘haemophiliac patient or patient with coagulation’,
TRANSFU ‘transfusion
recipient’,
NOSO ‘nosocomial’. Nosocomial infection includes patients infected in health care settings.
Case of occupational exposure should be classified as
UNK ‘Unknown or undetermined’. Cases which
are not fully documented should be coded as
UNK.
Coding:
HAEMO
haemophiliac patient
HETERO
heterosexual contact
IDU
ever injected drugs
MSM
MSM/homo or bisexual male
MTCT
mother-to-child transmission
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NOSO
Nosocomial
TRANSFU
transfusion recipient
UNK
Unknown or undetermined (default value)
Validation rules:
If a person comes from Sub Saharan Africa (RegionOfOrigin=SUBAFR), then transmission category
should not be unknown (Transmission=Unk).
If reported transmission category is men who have sex with men (Transmission=MSM), then Gender
should not be female (F).
If transmission category is reported as transfusion of blood or its component due to haemophilia
(Transmission=HAEMO), then Gender is not very often female (F).
If the person is younger than 13 years old, transmission should be mother to child (Transmission =
MTCT).
If transmission category is reported as MTCT (Transmission=MTCT), stage cannot be acute HIV
infection (Stage=ACUTE).
Transmission subcategory TransmissionHetero should be reported if transmission category is HETERO
(Transmission=HETERO).
Transmission subcategory TransmissionHetero cannot be reported as not applicable
(TransmissionHetero=NA) if transmission category is reported as HETERO (Transmission =
HETERO).
If transmission category is not reported as HETERO (Transmission=HETERO), then transmission
subcategory TransmissionHetero should be coded not applicable (NA).
If transmission category is reported as mother-to-child (Transmission=MTCT), then transmission
subcategory TransmissionMTCT should be also reported(as other than not applicable).
19. TransmissionHetero
This allows to specify the heterosexual route of transmission and this should be provided if
Transmission=
HETERO; in other cases the variable is coded as default
NA ‘not applicable’.
Heterosexual contact refers to a person for who risk factors for HIV infection other than heterosexual
contact have not been identified and who either originates from a country with generalized epidemic
(HIV prevalence in pregnant women>1%) or has had sex with: bisexual male, IDU, haemophiliac -
recipient, a person from a country with generalized epidemic, a person known to be HIV positive and
not known to belong to one of the above mentioned or is strongly believed to have been infected
through sexual transmission, information on risk factors and HIV status of partner(s) not available.
Coding:
NA
not applicable
ORIGINHP
Originating from a country with generalized epidemic
SEXBI
Sex with a bisexual male
SEXHAEMO
Sex with a haemophiliac
SEXHIVPOS
Sex with a person known to be infected and not know to belong to
any of categories above
SEXHP
Sex with a person originating or living in a country with a generalized
epidemic
SEXIDU
Sex with an injecting drug user
SEXUNK
Strongly believed to have been infected through heterosexual contact,
information on risk factor and partner not available
Validation rules:
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Transmission subcategory TransmissionHetero should be reported if transmission category is HETERO
(Transmission=HETERO).
Transmisison subcategory TransmissionHetero cannot be reported as not applicable
(TransmissionHetero=NA) if transmission category is reported as HETERO (Transmission =
HETERO).
If transmission category is not reported as HETERO (Transmission=HETERO), then transmission
subcategory TransmissionHetero should be coded not applicable (NA).
If transmission subcategory TransmissionHetero is reported as sex with a bisexual male
(TransmissionHetero=SEXBI), then gender should not be reported as male (Gender=M).
If transmission subcategory TransmissionHetero is reported as heterosexual transmission from country
with generalised epidemic (TransmissionHetero=ORIGINHP), then it is highly probable that
region of origin of the person is Sub Saharan Africa (RegionOfOrigin=SUBAFR).
Note on TransmissionHetero:
The sub-variable heterosexual transmission includes not only information on the reported case itself
but also on the origin as well as risk exposure. The sub-variable ORIGINHP should match variable
RegionOfOrigin, if country of nationality or country of birth is not reported.
20. TransmissionMTCT
This allows to specify the transmission categories for mother to child cases and this should be provided
if Transmission=MTCT (variable 21); in other cases the variable is coded as default
NA ‘not applicable’.
Coding:
MOTHHET
Infected through heterosexual contact and not known to belong to
category above
MOTHHP
Originating from a country with generalized epidemic
MOTHIDU
Injecting drug use
MOTHTRANSFU
Transfusion recipient
NA
not applicable
UNK
Other/undetermined
Validation rules:
If transmission category is reported as mother-to-child (Transmission=MTCT), then transmission
subcategory TransmissionMTCT should be also reported.
If transmission subcategory mother to child transmission (TransmissionMTCT) is reported, then age is
usually less than 13 years.
If transmission category is reported as mother-to-child (Transmission=MTCT), then transmission
subcategory TransmissionMTCT should also be reported (as other than not applicable).
If transmission category is not equal to mother to child (Transmission is other than MTCT), then
transmission subcategory TransmisisonMTCT should be coded NA.
If transmission subcategory TransmissionMTCT is reported, then reported stage should not be ACUTE
(Stage= ACUTE).
21. HIVStatus
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This variable provides information on previous positive test results, prior to the first time of reporting.
This variable allows cases "newly diagnosed" to be distinguished from case who had positive HIV test
in the past but are reported for the first time in the country.
Codes:
NEG
Negative
PREVPOS
previous HIV positive
UNK
Unknown (default value)
22. DateOfAIDSDiagnosis
For HIV cases initially reported at a pre-AIDS stage, the date of AIDS diagnosis is 'follow-up'
information, which necessitates updating of the record. The exact date is preferred to obtain more
accurate information and to allow better comparison and grouping. Incomplete dates (quarter, month,
year) are allowed as well.
Coding:
Date = YYYY-MM-DD (preferred), incomplete date = YYYY-Qq, YYYY-MM, YYYY
Unk
Unknown
NA
not applicable
Validation rules:
If stage of disease is reported as AIDS (Stage=AIDS), then DateOfAIDSDiagnosis should be reported.
If Stage is reported as AIDS (Stage=AIDS), then DateOfAIDSDiagnosis should be reported.
If Stage is not reported as AIDS, then DateOfDiagnosis should not be later than DateOfAIDSDiagnosis.
DateOfNotification should not be later than DateOfAIDSDiagnosis.
23 DateOfDeath
Date of death due to any cause. The exact date is preferred to obtain more accurate information and
to allow better comparison and grouping. Incomplete dates (quarter, month, year) are permissible. All
cases that are still alive or where the outcome (i.e., whether the case is alive or dead) is unknown are
to be coded as ‘NA’.
Coding:
Date YYYY-MM-DD (preferred)
Incomplete date = YYYY-MM, YYYY, YYYY-Www, YYYY-Qq
NA
Not applicable (Alive or unknown status)
UNK Unknown date of death
Validation rules:
(warning) If it is known that a person died, it is usually expected that the DateOfDeath is reported.
24. DeathCause (mandatory)
Information on whether the case is alive or deceased (due to AIDS-related and non-AIDS related
causes).
Coding:
DAIDS
Death due to AIDS (or an AIDS defining-illness)
DNOAIDS
Non AIDS-related death
DUNK
Died of unknown cause
A
Alive
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UNK
Unknown status
Validation rules:
(remark) If death due to AIDS is reported (DeathCause=DAIDS), patient should also have a
DateOfAIDSDiagnosis.
(warning) If it is known that a person died, it is usually expected that the DateOfDeath is reported.
(warning) If DateOfDeath is known, DeathCause should be coded as DAIDS or DNOAIDS or DUNK.
25. YearOfArrival
Year patient arrived in the reporting country.
Coding:
Date YYYY
NA
Not Applicable
UNK Unknown
26. CountryOfBirth
Country of birth of patient. Defines the country of birth as country level, the ISO list of countries is
provided in the metadataset.
Coding:Country ISO 3166-1 alpha 2
UNK
Unknown
Validation rules:
Either country of birth (CountryOfBirth) or country of nationality (CountryOfNationality) must be
reported.
27. CountryOfNationality
Country of nationality of person defines the country of nationality as country level, the ISO list of
countries is provided in the metadataset.
Coding:
Country ISO 3166-1 alpha 2
UNK
Unknown
Validation rule:
Either country of birth (CountryOfBirth) or country of nationality (CountryOfNationality) must be
reported.
28. RegionOfOrigin (mandatory)
This variable describes region of origin of patient. It is preferred to use country of birth or country of
nationality. It is recommended to derive this information from nationality or country of birth. If both
nationality and country of birth are available, it is recommended to use country of birth.
Coding:
ABROAD
Abroad but sub-continent unknown
AUSTNZ
Australia and New Zealand
CAR
Caribbean
CENTEUR
Central Europe
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EASTASIAPAC
East Asia and Pacific
EASTEUR
East Europe
EUROPE
If a case cannot be reported in West, central or Eastern Europe, than
Europe (sub-continent unknown) should be reported.
LATAM
Latin America
NORTHAFRMIDEAST North Africa and Middle East
NORTHAM
North America
REPCOUNTRY
Same as country of report
SOUTHASIA
South and South East Asia
SUBAFR
Sub Sahara Africa
WESTEUR
West Europe
UNK
Unknown (default value)
For list of countries see ANNEX I.
Validation rules:
If a person comes from Sub Saharan Africa (RegionOfOrigin=SUBAFR), than transmission category
should not be unknown (Transmission=Unk).
If transmission subcategory TransmissionHetero is reported as heterosexual transmission from country
with generalised epidemic (TransmissionHetero=ORIGINHP), than it is highly probable that
region of origin of the person is Sub Saharan Africa (RegionOfOrigin=SUBAFR).
Note on geographical information:
In the process of improving the comparability of reporting and harmonising the variables and coding
of variables, the country (from ISO list) is the preferred format for geographical information if it is
available. Information at country level (rather than region or continent) provides more accurate
information and allows better comparison and grouping across diseases.
For HIV/AIDS, country of birth and country of nationality are preferred above the less accurate ‘region
of origin’.
29. CD4cells (mandatory)
CD4 cell count at time of diagnosis. The variable specifies the CD4 cells count at the time of HIV
diagnosis.
Coding:
Numeric value (0-6000)
NA
Not applicable
UNK
Unknown
Validation rule:
Usually CD4 cell count varies in a range from 0 to 1,500 and due to rare extremely high values upper
limit is set to 6,000 per cubic millimetre.
30. FirstCD4Date (mandatory)
Date of first available CD4 cell count at time of diagnosis. The exact date is preferred and should be
provided if available; incomplete dates (e.g. week, quarter, month, year) are allowed as well.
Coding:
Date YYYY-MM-DD
Incomplete date (YYYY-MM, YYYY, YYYY-Www, YYYY-Qq)
UNK
Unknown
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NA
Not applicable
31. ProbableCountryOfInfection
The country(ies) where infection of the patient is likely to have occurred.
Coding:
Country ISO 3166-1 alpha 2
UNK
Unknown
32. LastAttendanceDate (optional)
Date the patient was last seen for HIV-related care (can be a date prior to the reporting year). The
exact date is preferred and should be provided if available; incomplete dates (e.g. week, quarter,
month, year) are allowed as well.
Coding:
Date YYYY-MM-DD
Incomplete date (YYYY-MM, YYYY, YYYY-Www, YYYY-Qq)
UNK
Unknown
Validation rules:
(Remark) If ART is
Y (Yes), last attendance date should be reported.
33. ART
Whether person was on ART at the time of the last attendance date.?
Coding:
Y
Yes
N
No
UNK Unknown
Validation rule:
(Remark) If ART is
Y (Yes), last attendance date should be reported.
34. ARTDate
Date that ART was initiated. The exact date is preferred and should be provided if available; incomplete
dates (e.g. week, quarter, month, year) are allowed as well.
Coding:
Date YYYY-MM-DD
Incomplete date (YYYY-MM, YYYY, YYYY-Www, YYYY-Qq)
UNK
Unknown
35. VLLatest (optional)
Last known viral load. Enter the numeric value of the last viral load. If viral load is ‘undetectable’ (ie no
numeric value is provided by the test) please code as ‘0’. If the latest viral load is unknown code as
‘UNK’.
Coding:
Numeric value (up to 7 digits)
0
Low or Undetectable
UNK Unknown
36. VLLatestDate (optional)
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Date of last known viral load assessment (date of blood test where available). The exact date is
preferred and should be provided if available; incomplete dates (e.g. week, quarter, month, year) are
allowed as well.
Coding:
Date YYYY-MM-DD
Incomplete date (YYYY-MM, YYYY, YYYY-Www, YYYY-Qq);
NA
Not applicable
UNK
Unknown
37. SiteOfTest (optional)
Describes the site of the first HIV reactive test for persons newly diagnosed with HIV, including
screening tests prior to confirmatory testing performed outside of healthcare settings.
Coding:
CBT = Community-based testing programme
INFDIS = Infectious disease clinic
SEXHEAL = Sexual health or STI clinic
EMERG= Accident and emergency department
ANS = Antenatal screening
PHC = Primary health care
OTHHOSP = Other hospital setting
BLOOD = Blood donation screening
SELFTEST = Self-testing
SELFSAMP=Self-sampling
PHARM=pharmacy
PWID = Harm reduction site/drug services
PRIS = Prison or remand services
ABROAD=tested abroad prior to arrival to reporting country
OTHER=other setting
UNK = Undetermined or unknown
Description of dataset: AIDS case-base record type
There are 33 variables for AIDS case based reporting: which are divided in common set of variables
and disease specific variables.
System related variables (all mandatory)
1. RecordId
The identifier should be provided by the MS. It should be unique (within and across the national
surveillance system) and anonymous for each record.
2. RecordType
The record type defines the structure and the format of the data reported. The record types are defined
by ECDC. It specifies what data values TESSy expects to receive. The record type is related with the
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‘subject’. Only valid combinations of record type, subject and datasource will be accepted. For AIDS,
record type is
AIDS.
3. RecordTypeVersion (not mandatory)
The version of the record type defines the current structure of the data reported. If the original dataset
for any particular disease is changed, the versioning will change according to increasing numbering. All
record types started at version 1 with the launch of TESSy. This variable can be omitted if a valid
Metadataset is provided.
Coding for AIDS value = 4
4. Subject
The subject describes the disease associated to the reported case; this is
AIDS.
5. Status (not mandatory)
The status is used for updating data; the default is
New/Update. By choosing
Delete, the selected
record (indicated by the
RecordId) will be marked as inactive, but will remain in TESSy to reconstruct
the data for a given date in the past.
Coding:
NEW/UPDATE
Delete
6. DataSource
The data source specifies the surveillance system from which the data on this particular disease
originates. The list of available Surveillance Systems per country is an integral part of TESSy and will
be generated and revised/updated in bilateral collaboration with the nominated contact points for
surveillance in each MS.
Coding: See list of surveillance systems
TESSy currently contains a list of surveillance systems which has been provided by each MS (variable
‘DataSource’). The descriptions of the surveillance systems submitted to TESSy should be kept up to
date and will be used to assist with data interpretation. If a MS decides to submit a combined dataset,
this should be specified in the ‘DataSource’ field.
7. ReportingCountry
This variable identifies the country that reports the case. The list of countries is provided according to
ISO codes. This variable should be included by the MS by default.
Coding: Country = ISO 3166-1 alpha-2, (two-letter code).
8. DateUsedForStatistics
This is the date used by the national surveillance institute/organisation in the national case-reports and
other official statistics. The date used for statistics varies from country to country and could be either
the date of diagnosis or the date of notification or any other date applicable. This date should be
provided as exact date or incomplete date. This is a technical compulsory variable. (e.g. Coding as
‘Unknown’ is not allowed).
Coding:
Date = YYYY-MM-DD or
Incomplete date (YYYY-MM, YYYY, YYYY-Www, YYYY-Qq)
Epidemiological variables
9. Age
This is the age of the person in years as reported in the national system of the MS. For AIDS, if not
available, age can be calculated from date of birth at time of AIDS diagnosis.
Coding: Num (0-120) Age
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UNK
Unknown (default value)
Validation rules:
9.1.
If the age is not reported, then age class should be provided.
9.2.
If the person is younger than 13 years old, transmission should be mother to child
(Transmission = MTCT).
9.3.
If transmission subcategory mother to child transmission (TransmissionMTCT) is reported, then
age is usually less than 13 years.
10. Gender
Gender of the infected person. Transgender persons should be coded as O ‘Other’.
Coding:
F
Female
M
Male
O
Other (e.g., transgender)
Unk
Unknown (default value)
Validation rules:
10.1. If transmission mode (Transmission) is selected as men who have sex with men (MSM), then
the gender should not be female (F).
10.2. If transmission mode (Transmission) selected is transfusion of blood or its component due to
haemophilia (HAEMO), then it is very rare that the gender is Female (F).
10.3. If transmission subcategory (TransmissionHetero) equals sex with a bisexual male (SEXBI) than
gender should not be Male (M).
11. DeathCause (mandatory)
Information on whether the case is alive or deceased (due to AIDS-related and non-AIDS related
causes). This variable was called “Outcome” in previous metadata and has been changed to harmonise
across record types. Values are slightly different.
Coding:
DAIDS
Death due to AIDS (or an AIDS defining-illness)
DNOAIDS
Non AIDS-related death
DUNK
Died of unknown cause
A
Alive
UNK
Unknown status
Validation rules:
11.1. (Warning) If DateOfDeath is 'UNK' and DeathCause is not 'A' and DeathCause is not 'UNK' and
DeathCause is reported
11.2. (Warning) If DateOfDeath is not 'UNK' and DateOfDeath is reported and DeathCause is not
'DAIDS' and DeathCause is not 'DNOAIDS' and DeathCause is not 'DUNK'
11.3. (Warning) If DateOfDeath is not reported and DeathCause is not 'A' and DeathCause is not 'UNK'
and DeathCause is reported
11.4. (Warning) If DateOfReportDeath is not reported and DeathCause is not 'A' and DeathCause is not
'UNK' and DeathCause is reported
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12. DateOfOnset (not mandatory)
The date of onset of disease is the day that first symptoms appeared. For AIDS, this should be coded
as
Unk ‘Unknown’ except for acute primo-infection or proven seroconversion by laboratory
confirmation.
Coding:
Date
YYYY-MM-DD or
Incomplete date: YYYY, YYYY-Qq, YYYY-MM
UNK
Unknown (default value)
Validation rules:
12.1. DateOfDeath should be after DateOfOnset and DateOfDiagnosis.
12.2. Usually DateOfOnset should not be later than DateOfNotification or DateOfDiagnosis.
12.3. If DateOfOnset is known then DateOfDiagnosis should also be known.
12.4. If DateOfOnset is known then DateOfNotification should also be known.
12.5. DateOfOnset cannot be later than DateOfDiagnosis; DateOfOnset will be set to [Default value].
13. DateOfDiagnosis
The date of first AIDS diagnosis; clinical or lab diagnosis. Date should be provided as exact date,
incomplete date . The exact date is preferred and should be provided if available; incomplete dates
(e.g. week, quarter, month, year) are allowed as well.
Coding:
Date
YYYY-MM-DD or
Incomplete:
YYYY-MM, YYYY, YYYY-Www, YYYY-Qq
Validation rule:
13.1.
Date of diagnosis (DateOfDiagnosis) must be after 1970.
13.2.
If DateOfOnset is known then DateOfDiagnosis should also be known.
14. DateOfNotification (not mandatory)
The date when the AIDS case is notified for the first time to the place of notification. Date should be
provided as exact date, incomplete date or coded as Unknown. The exact date is preferred and should
be provided if available; incomplete dates (e.g. week, quarter, month, year) are allowed as well.
Coding:
Date
YYYY-MM-DD or
Incomplete date: YYYY-MM, YYYY, YYYY-Www, YYYY-Qq
UNK
Unknown (default value)
Validation rules:
14.1. If DateOfOnset is known then DateOfNotification should also be known.
Note on dates:
Not all dates are reported at the national level. Therefore, all dates available should be included
and reported.
In the process of improving the comparability of reporting and harmonising the variables and coding
of variables, the exact dates (YYYY-MM-DD) are the preferred format for dates. Exact dates provide
more accurate information and allow better comparison and grouping across diseases. Incomplete
dates are allowed as well (quarters, months, years) in case the exact date is not available.
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15. Classification
This variable indicates the case classification according to the EU case definition. For AIDS, only
‘Confirmed’ cases
CONF are reportable at European level.
Coding:
CONF Confirmed
PROB
POSS
UNK Unknown (default value)
16. ClinicalCriteria
The criteria for the clinical picture of the disease are met according to the EU case definition. For AIDS,
only cases meeting the clinical criteria should be reported to the European level.
Coding:
N
No
NA
Not applicable
Unk
Unknown (default value)
Y
Yes
17. LaboratoryResult (not mandatory)
The criteria for the laboratory diagnosis of the disease are met according to the EU case definition.
According to the European AIDS case definition 2008, only lab confirmed cases are reportable at
European level. Confirmed cases are coded as
CONF. For historical data, case definition of appropriate
period should be used.
Coding:
CONF
Confirmed
PROB
Probable
NA
Not applicable
UNK
Unknown(default value)
18. EpiLinked (not mandatory)
The criteria for the epidemiological link of the disease (e.g. human-to-human transmission, exposure
to common source, environmental exposure) are met according to the EU case definition. For AIDS,
this is not applicable and should be coded as ‘Not Applicable’
NA.
Coding:
NA
not applicable
Y
Yes
N
No
UNK
Unknown (default value)
19. PlaceOfNotification (not mandatory)
Place of the first notification of the case to a regional authority. Select the most detailed NUTS level.
Coding:
NUTS
UNK
Unknown
20. PlaceOfResidence (not mandatory)
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Place of residence of patient at the time of disease onset. Select the most detailed NUTS level possible.
Coding:
NUTS
UNK
Unknown
Disease-specific set of variables for AIDS (all mandatory unless indicated)
21. HIVType
This variable specifies the type of HIV infection. It should be coded as
HIV1 (only infected with HIV
type 1) or
HIV2 (only infected with HIV type 2) or
HIV12 (infected with both types 1 and 2). Coding
as ‘Undetermined/unknown’ is not allowed.
Coding:
HIV1
HIV1 only
HIV12
HIV1 and HIV2 (co-infection)
HIV2
HIV2 only
UNK
Unknown
22. ARTTreatment
This variable indicates if the patient receives any kind of antiretroviral treatment at any time prior to
AIDS diagnosis. There is no minimum duration and no restriction on timing.
Coding
Y
Yes
N
No
UNK Unknown (default value)
23. Transmission
Describes the most probable route of transmission of HIV. It is classified according to sexual
transmission,
MSM ‘MSM/homo or bisexual male’ and
HETERO ‘heterosexual contact’. ‘Heterosexual
contact’ is used for cases for which heterosexual transmission is highly probable, and do not fit into
another category. The other categories refer to
IDU ‘ever injected drugs’,
MTCT ‘mother-to-child
transmission’,
HAEMO ‘haemophiliac patient or patient with coagulation’,
TRANSFU ‘transfusion
recipient’,
NOSO ‘nosocomial’. Nosocomial infection includes patients infected in health care settings.
Case of occupational exposure should be classified as
UNK ‘Unknown or undetermined’. Cases which
are not fully documented should be coded as
UNK.
Coding:
HAEMO
haemophiliac patient
HETERO
heterosexual contact
IDU
ever injected drugs
MSM
MSM/homo or bisexual male
MTCT
mother-to-child-transmission
NOSO
Nosocomial
TRANSFU
transfusion recipient
UNK
Unknown or undetermined (default value)
Validation rules:
23.1. If transmission mode (Transmission) is selected as men who have sex with men (MSM), then
the gender should not be female (F).
23.2. If transmission mode (Transmission) selected is transfusion of blood or its component due to
haemophilia (HAEMO), then it is very rare that the gender is Female (F).
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23.3. If the person is younger than 13 years old, transmission should be mother to child
(Transmission = MTCT).
23.4. If transmission category HETERO is selected (Transmission=HETERO), then any transmission
subcategory other than NA can be reported.
23.5. If transmission category does not equal hetero (Transmission is other than HETERO), then
transmission subcategory TransmisisonHetero should be coded NA.
23.6. If transmission subcategory Mother to child transmission (TransmissionMTCT ) is not reported,
then transmission category of Mother to Child (Transmission=MTCT) should not be selected.
23.7. If transmission subcategory Mother to child transmission is non applicable
(TransmissionMTCT=NA), then transmission category should not be equal to mother to child
transmission (Transmission should not be MTCT).
23.8. If transmission category is not equal to mother to child (Transmission is other than MTCT),
then transmission subcategory TransmisisonMTCT should be coded NA.
24. TransmissionHetero
This allows to specify the heterosexual route of transmission and this should be provided if
Transmission=
HETERO (variable 23); in other cases the variable is coded as default
NA ‘not
applicable’. Heterosexual contact refers to a person for whom risk factors for HIV infection other than
heterosexual contact have not been identified and who either originates from a country with generalized
epidemic (HIV prevalence in pregnant women>1%, see list of countries in the Annex 3) or has had sex
with: bisexual male, IDU, haemophiliac - recipient, a person from a country with generalized epidemic,
a person known to be HIV positive and not known to belong to one of the above mentioned or is
strongly believed to have been infected through sexual transmission, information on risk factors and
HIV status of partner(s) not available.
Coding:
NA
not applicable
ORIGINHP
Originating from a country with generalized epidemic
SEXBI
Sex with a bisexual male
SEXHAEMO
Sex with a haemophiliac
SEXHIVPOS
Sex with a person known to be infected and not know to belong to
any of categories above
SEXHP
Sex with a person originating or living in a country with a generalized
epidemic
SEXIDU
Sex with an injecting drug user
SEXUNK
Strongly believed to have been infected through heterosexual contact,
information on risk factor and partner not available
Validation rules:
24.1. Transmission subcategory TransmissionHetero is mandatory if transmission category is
reported as HETERO (Transmission = HETERO).
24.2. If transmission category HETERO is selected (Transmission=HETERO), then any transmission
subcategory other than NA can be reported.
24.3. If transmission category does not equal hetero (Transmission is other than HETERO), then
transmission subcategory TransmisisonHetero should be coded NA.
24.4. If transmission subcategory (TransmissionHetero) equals sex with a bisexual male (SEXBI) than
gender should not be Male (M).
24.5. If heterosexually infected person comes from a country or a region with generalised HIV
epidemic (TransmissionHetero=ORIGINHP), then there is high probability that region of origin
is Sub Saharan Africa (RegionOfOrigin=SUBAFR).
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25. TransmissionMTCT (not mandatory)
This allows to specify the transmission categories for mother to child cases and this should be provided
if Transmission=MTCT (variable 21); in other cases the variable is coded as default
NA ‘not applicable’.
Coding:
MOTHHET
Infected through heterosexual contact and not known to belong to
category above
MOTHHP
Originating from a country with generalized epidemic
MOTHIDU
Injecting drug use
MOTHTRANSFU
Transfusion recipient
NA
not applicable
UNK
Other/undetermined
Validation rules:
25.1. If transmission subcategory Mother to child transmission (TransmissionMTCT ) is not reported,
then transmission category of Mother to Child (Transmission=MTCT) should not be selected.
25.2. If transmission subcategory mother to child transmission (TransmissionMTCT) is reported, then
age is usually less than 13 years.
25.3. If transmission subcategory Mother to child transmission is non applicable
(TransmissionMTCT=NA) , then transmission category should not be equal to mother to child
transmission (Transmission should not be MTCT).
25.4. If transmission category is not equal to mother to child (Transmission is other than MTCT),
then transmission subcategory TransmisisonMTCT should be coded NA.
26. DateOfHIVDiagnosis (not mandatory)
Date of first HIV positive HIV test.
Coding:
Date
YYYY-MM-DD or
Incomplete date: YYYY-MM, YYYY, YYYY-Qq
UNK
Unknown (default value)
Validation rule:
26.1. A patient should usually have HIV diagnosed preceding AIDS.
27. DateOfDeath (mandatory)
Date of death due to any cause. The exact date is preferred to obtain more accurate information and
to allow better comparison and grouping. Incomplete dates (quarter, month, year) are permissible. All
cases that are still alive or where the outcome (i.e., whether the case is alive or dead) is unknown are
to be coded as 'NA'. The exact date is preferred to obtain more accurate information and to allow better
comparison and grouping.
Coding:
Date
YYYY-MM-DD or
Incomplete date: YYYY-MM, YYYY, , YYYY-Qq
NA
Not applicable
UNK
Unknown (default value)
Validation rules:
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27.1. (Warning) If DateOfDeath is 'UNK' and DeathCause is not 'A' and DeathCause is not 'UNK' and
DeathCause is reported
27.2. (Warning) If DateOfDeath is before DateOfDiagnosis or DateOfDeath is before DateOfOnset
27.3. (Warning) If DateOfDeath is not 'UNK' and DateOfDeath is reported and DeathCause is not
'DAIDS' and DeathCause is not 'DNOAIDS' and DeathCause is not 'DUNK'
27.4. (Warning) If DateOfDeath is not reported and DeathCause is not 'A' and DeathCause is not 'UNK'
and DeathCause is reported
28. DateOfReportDeath (not mandatory)
Date of death report to national HIV/AIDS surveillance.The exact date is preferred to obtain more
accurate information and to allow better comparison and grouping. Incomplete dates (quarter, month,
year) are allowed as well. Previously only quarter or year was provided.
Coding:
Date
YYYY-MM-DD or
Incomplete date: YYYY-MM, YYYY, YYYY-Qq
NA
Not applicable
UNK
Unknown (default value)
Validation rules
28.1. The DateOfReportDeath should not precede the DateOfDeath.
28.2. If it is known that a person has died, then DateOfReportDeath should be known.
29. CountryOfBirth (not mandatory)
Country of birth of patient. Defines the country of birth at country level, the ISO list of countries is
provided.
Coding:
Country
ISO 3166-1 alpha 2
UNK
Unknown
Validation rules
28.1. CountryOfBirth is mandatory if CountryOfNationality is not reported - otherwise CountryOfBirth
will be set to [Default value]
30. CountryOfNationality (not mandatory)
Country of nationality of patient. Defines the country of nationality at country level, the ISO list of
countries is provided.
Coding:
Country
ISO 3166-1 alpha 2
UNK
Unknown
31. RegionOfOrigin
Region of origin of patient. It is recommended to derive this information from nationality or country of
birth. If both nationality and country of birth are available, it is recommended to use nationality.
Coding
ABROAD
Abroad but sub-continent unknown
AUSTNZ
Australia and New Zealand
CAR
Caribbean
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CENTEUR
Central Europe
EASTASIAPAC
East Asia and Pacific
EASTEUR
East Europe
EUROPE
If a case cannot be reported in West, central or Eastern Europe, he/she
should be reported in Europe (sub-continent unknown).
LATAM
Latin America
NORTHAFRMIDEAST North Africa and Middle East
NORTHAM
North America
REPCOUNTRY
Same as country of report
SOUTHASIA
South and South East Asia
SUBAFR
Sub Sahara Africa
WESTEUR
West Europe
UNK
Unknown (default value)
For list of countries see ANNEX I
Validation rule:
31.1. If heterosexually infected person comes from a country or a region with generalised HIV
epidemic (TransmissionHetero=ORIGINHP), then there is high probability that region of origin
is Sub Saharan Africa (RegionOfOrigin=SUBAFR).
32. AIDSIndicatorDisease
AIDS indicator disease at the time of AIDS diagnosis occurring within two consecutive months from the
date of AIDS diagnosis. The list of AIDS Indicator Diseases is provided (see Table 7, Annex II). In case
the indicator disease is not known, the code 30
Opportunistic infection(s), not specified should
be used. This is a repeatable field for up to 4 diagnoses. For repeatable fields, all empty fields should
be filled with “N/A”.
Coding: 28,30,31
Validation rule:
32.1
The clinical criteria (ClinicalCriteria) must be yes if an indicator disease is given
(AIDSIndicatorDisease).
33. AgeClass (not mandatory)
This is the age of the person in years as reported in the national system of the MS. Age can be calculated
from date of birth and the date of AIDS diagnosis. The preferred age grouping is the following: <4; 5-
14, 15-19, 20-24, 25-29, 30-39, 40-49, 50-59, 60+. For AIDS case based reporting, the exact age is
preferred (variable 9) but aggregate age classes are allowed. The previously used age grouping is
provided in the list of age groups.
1_00
Less than 1
2_00-14 0 to 14 4_00
Less
5_00-04 0 to 4
year
than 1
yr
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1_01-04 1 to 4
2_15-19 15 to 19 4_01-04 1 to 4
5_05-14 5 to 14
1_05-09 5 to 9
2_20-24 20 to 24 4_05-09 5 to 9
5_15-19 15 to 19
1_10-12 10 to 12
2_25-29 25 to 29 4_10-12 10 to 12 5_20-24 20 to 24
1_13-14 13 to 14
2_30-39 30 to 39 4_13-14 13 to 14 5_25-34 25 to 34
1_15-19 15 to 19
2_40-49 40 to 49 4_15-19 15 to 19 5_35-44 35 to 44
1_20-24 20 to 24
2_50+
50
or 4_20-24 20 to 24 5_45-64 45 to 64
over
1_25-29 25 to 29
3_00-14 0 to 14
4_25-29 25 to 29 5_65+
65
or
over
1_30-34 30 to 34
3_15-19 15 to 19 4_30-34 30 to 34
1_35-39 35 to 39
3_20-29 20 to 24 4_35-39 35 to 39
1_40-49 40 to 49
3_30-39 30 to 39 4_40-49 40 to 49
1_50-59 50 to 59
3_40-49 40 to 49 4_50-59 50 to 59
1_60+
60 years or 3_50+
50
or 4_60-64 60 to 64
over
over
4_65+
65
or
over
UNK
Unknown
Validation rule:
32.1. If the age is not reported, then age class should be provided
Description of dataset: HIV aggregated record type
The variables used for reporting data according to aggregated format include age class, gender, case
classification, date used for statistics, reporting country and the number of cases. All variables are
mandatory unless otherwise specified.
1. RecordType
The record type defines the structure and the format of the data reported. The record types are defined
by ECDC. It specifies what data values TESSy expects to receive. The record type is related with the
‘subject’. Only valid combinations of record type, subject and datasource will be accepted. For
aggregated HIV data, record type is
HIVAGGR.
2. RecordTypeVersion (not mandatory)
The version of the record typedefines the current structure of the data reported. If the original dataset
for any particular disease is changed, the versioning will change according to increasing numbering. All
record types started at version 1 with the launch of TESSy. This variable can be omitted if a valid
Metadataset is provided.
Coding for HIVAGGR value =
1.
3. Subject
The subject describes the disease associated to the aggregate reporting,
HIV.
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4. DataSource
The data source specifies the surveillance system from which the data on this particular disease
originates. The list of available Surveillance Systems per country is an integral part of TESSy and will
be generated and revised/updated in bilateral collaboration with the nominated contact points for
surveillance in each MS.
5. Ageclass
This is the age of the person in years as reported in the national system of the MS. Age can be calculated
from date of birth and the date of diagnosis. The preferred age grouping is the following: <4; 5-14,
15-19, 20-24, 25-29, 30-39, 40-49, 50-59, 60+. For aggregate HIV, the previously used age grouping
is provided.
Coding:
4_00 Less than
1_00 Less than 1 2_00-14 0 to 14
1year
5_00-04 0 to 4
1_01-04 1 to 4
2_15-19 15 to 19
4_01-04 1 to 4
5_05-14 5 to 14
1_05-09 5 to 9
2_20-24 20 to 24 4_05-09 5 to 9
5_15-19 15 to 19
1_10-12 10 to 12
2_25-29 25 to 29 4_10-12 10 to 12 5_20-24 20 to 24
1_13-14 13 to 14
2_30-39 30 to 39
4_13-14 13 to 14
5_25-34 25 to 34
1_15-19 15 to 19
2_40-49 40 to 49
4_15-19 15 to 19
5_35-44 35 to 44
1_20-24 20 to 24 2_50+ 50 years +
4_20-24 20 to 24 5_45-64 45 to 64
5_65+ 65 years
UNK
Unknown(default
1_25-29 25 to 29
4_25-29 25 to 29
value)
1_30-34 30 to 34 3_00-14 0 to 14
4_30-34 30 to 34
1_35-39 35 to 39
3_15-19 15 to 19 4_35-39 35 to 39
1_40-49 40 to 49
3_20-29 20 to 24 4_40-49 40 to 49
1_50-59 50 to 59 3_30-39 30 to 39 4_50-59 50 to 59
1_60+ 60 years >
3_40-49 40 to 49 4_60-64 60 to 64
3_50+ 50 years or
over
4_65+ 65 years
6. Gender
Gender of the infected person.
Coding:
F
Female
M
Male
O
Other (e.g., transgender)
Unk
Unknown (default value)
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7. ReportingCountry
The country reporting the record.
Coding: Country = ISO 3166-1 alpha-2, (two-letter code).
8. DateUsedForStatistics
This is the date used by the national surveillance institute or organisation in the national case-reports
and other official statistics. The date used for statistics varies from country to country and could be
either the date of diagnosis or the date of notification. Please specify in DateSpecified which date is
actually used.
Coding:
Date =
Incomplete date: YYYY-MM, YYYY, YYYY-Qq
9. Classification
This variable indicates the case classification according to the EU case definition. For HIV, only
‘Confirmed’ cases
CONF are reportable at European level.
Coding:
CONF
Confirmed
POSS
PROB
UNK
Unknown (default value)
10. NumberOfCases
Total number of cases during the reported period for the specified disease.
Coding:
Number = Min:0 Max:999999999
11. Transmission
Describes the most probable route of transmission of HIV. It is classified according to sexual
transmission,
MSM ‘MSM/homo or bisexual male’ and
HETERO ‘heterosexual contact’. ‘Heterosexual
contact’ is used for cases for which heterosexual transmission is highly probable, and do not fit into
another category. The other categories refer to
IDU ‘ever injected drugs’,
MTCT ‘mother-to-child
transmission’,
HAEMO ‘haemophiliac patient or patient with coagulation’,
TRANSFU ‘transfusion
recipient’,
NOSO ‘nosocomial’. Nosocomial infection includes patients infected in health care settings.
Case of occupational exposure should be classified as
UNK ‘Unknown or undetermined’. Cases which
are not fully documented should be coded as
UNK.
Coding:
HAEMO
haemophiliac patient
HETERO
heterosexual contact
IDU
ever injected drugs
MSM
MSM/homo or bisexual male
MTCT
mother-to-child-transmisison
NOSO
Nosocomial
TRANSFU
transfusion recipient
UNK
Unknown or undetermined (default value)
11. DateSpecified
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Indicates which date was used in the
DateUsedForStatistics. In case it was the ‘DateOfDiagnosis’,
indicate
DIAG (PREFERRED). In case it was the ‘DateOfNotification’, indicate
NOTI.
The reference date used for standard reports that is compared to the reporting period. The date used
for statistics can be any date that the reporting country finds applicable, e.g. date of notification, date
of diagnosis or any other date.
Coding:
DIAG Date of diagnosis
NOTI Date of notification
Description of dataset: AIDS aggregated record type
The variables used for reporting data according to aggregated format include age class, gender, case
classification, date used for statistics, reporting country and the number of cases. All variables are
mandatory unless otherwise specified.
1. RecordType
The record type defines the structure and the format of the data reported. The record types are defined
by ECDC. It specifies what data values TESSy expects to receive. The record type is related with the
‘subject’. Only valid combinations of record type, subject and datasource will be accepted. For
aggregated HIV data, record type is
AIDSAGGR.
2. RecordTypeVersion (not mandatory)
The version of the record typedefines the current structure of the data reported. If the original dataset
for any particular disease is changed, the versioning will change according to increasing numbering. All
record types started at version 1 with the launch of TESSy. This variable can be omitted if a valid
Metadataset is provided.
Coding for AIDSAGGR value =
1.
3. Subject
The subject describes the disease associated to the aggregate reporting,
AIDS.
4. DataSource
The data source specifies the surveillance system from which the data on this particular disease
originates. The list of available Surveillance Systems per country is an integral part of TESSy and will
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be generated and revised/updated in bilateral collaboration with the nominated contact points for
surveillance in each MS.
5. Ageclass
This is the age of the person in years as reported in the national system of the MS. Age can be calculated
from date of birth and the date of diagnosis. The preferred age grouping is the following: <4; 5-14,
15-19, 20-24, 25-29, 30-39, 40-49, 50-59, 60+. For aggregate HIV, the previously used age grouping
is provided.
Coding:
1_00 Less than 1
2_00-14 0 to 14
4_00 Less than 1year
5_00-04 0 to 4
1_01-04 1 to 4
2_15-19 15 to 19
4_01-04 1 to 4
5_05-14 5 to 14
1_05-09 5 to 9
2_20-24 20 to 24
4_05-09 5 to 9
5_15-19 15 to 19
1_10-12 10 to 12
2_25-29 25 to 29
4_10-12 10 to 12
5_20-24 20 to 24
1_13-14 13 to 14
2_30-39 30 to 39
4_13-14 13 to 14
5_25-34 25 to 34
1_15-19 15 to 19
2_40-49 40 to 49
4_15-19 15 to 19
5_35-44 35 to 44
1_20-24 20 to 24
2_50+ 50 years +
4_20-24 20 to 24
5_45-64 45 to 64
5_65+ 65 years
1_25-29 25 to 29
4_25-29 25 to 29
UNK Unknown(default
1_30-34 30 to 34
3_00-14 0 to 14
4_30-34 30 to 34
value)
1_35-39 35 to 39
3_15-19 15 to 19
4_35-39 35 to 39
1_40-49 40 to 49
3_20-29 20 to 24
4_40-49 40 to 49
1_50-59 50 to 59
3_30-39 30 to 39
4_50-59 50 to 59
1_60+ 60 years >
3_40-49 40 to 49
4_60-64 60 to 64
3_50+ 50 years or
over
4_65+ 65 years
6. Gender
Gender of the infected person.
Coding:
F
Female
M
Male
O
Other (e.g., transgender)
Unk
Unknown (default value)
7. ReportingCountry
The country reporting the record.
Coding: Country = ISO 3166-1 alpha-2, (two-letter code).
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8. DateUsedForStatistics
This is the date used by the national surveillance institute or organisation in the national case-reports
and other official statistics. The date used for statistics varies from country to country and could be
either the date of diagnosis or the date of notification. Please specify in DateSpecified which date is
actually used.
Coding:
Date =
Incomplete date: YYYY-MM, YYYY, YYYY-Qq
9. NumberOfCases
Total number of cases during the reported period for the specified disease.
Coding:
Number = Min:0 Max:999999999
10. Transmission
Describes the most probable route of transmission of HIV. It is classified according to sexual
transmission,
MSM ‘MSM/homo or bisexual male’ and
HETERO ‘heterosexual contact’. ‘Heterosexual
contact’ is used for cases for which heterosexual transmission is highly probable, and do not fit into
another category. The other categories refer to
IDU ‘ever injected drugs’,
MTCT ‘mother-to-child
transmission’,
HAEMO ‘haemophiliac patient or patient with coagulation’,
TRANSFU ‘transfusion
recipient’,
NOSO ‘nosocomial’. Nosocomial infection includes patients infected in health care settings.
Case of occupational exposure should be classified as
UNK ‘Unknown or undetermined’. Cases which
are not fully documented should be coded as
UNK.
Coding:
HAEMO
haemophiliac patient
HETERO
heterosexual contact
IDU
ever injected drugs
MSM
MSM/homo or bisexual male
MTCT
mother-to-child-transmisison
NOSO
Nosocomial
TRANSFU
transfusion recipient
UNK
Unknown or undetermined (default value)
12. DateSpecified
Indicates which date was used in the
DateUsedForStatistics. In case it was the ‘DateOfDiagnosis’,
indicate
DIAG (PREFERRED). In case it was the ‘DateOfNotification’, indicate
NOTI.
The reference date used for standard reports that is compared to the reporting period. The date used
for statistics can be any date that the reporting country finds applicable, e.g. date of notification, date
of diagnosis or any other date.
Coding:
DIAG Date of diagnosis
NOTI Date of notification
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Description of dataset: HIVTESTS aggregated record type
The variables used for reporting data according to aggregated format include number of HIV tests
performed, excluding tests used for screening of blood donations and for unlinked anonymous tests,
date used for statistics, reporting country and the number of cases. The data can be uploaded as file
or typed manually. All variables are mandatory unless otherwise specified.
1. RecordType
The record type defines the structure and the format of the data reported. The record types are defined
by ECDC. It specifies what data values TESSy expects to receive. The record type is related with the
‘subject’. Only valid combinations of record type, subject and datasource will be accepted. For HIV
number of test, record type is HIVTESTS.
2. RecordTypeVersion (not mandatory)
The version of the record typedefines the current structure of the data reported. If the original dataset
for any particular disease is changed, the versioning will change according to increasing numbering. All
record types started at version 1 with the launch of TESSy. This variable can be omitted if a valid
Metadataset is provided.
Coding for HIVTESTS value = 1.
3. Subject
The subject describes the disease associated to the aggregate reporting HIV test, Subject is HIVTESTS.
4. DataSource
The data source specifies the surveillance system from which the data on this particular disease
originates. The list of available Surveillance Systems per country is an integral part of TESSy and will
be generated and revised/updated in bilateral collaboration with the nominated contact points for
surveillance in each MS.
5. DateUsedForStatistics
This is the date used by the national surveillance institute or organisation in the national and other
official statistics to indicate the period for which number of tests is available. The date is expressed as
a year and following format is allowed:
Coding: YYYY
6. ReportingCountry
This variable identifies the country that reports the case. The list of countries is provided according to
ISO codes. This variable should be included by the MS by default.
Coding: Country = ISO 3166-1 alpha-2, (two-letter code).
7. NumberOfTests
Total number of tests during the reported period for the specified disease. If exact numbers are not
available, provide estimates.
Coding: min=0 ; max=99999999
UNK Unknown
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Introduction
Robust surveillance data are critical to monitor and inform the public health response to the European
HIV epidemic in an accurate and timely fashion. HIV surveillance within Europe has been coordinated
jointly by the European Centres for Disease Prevention and Control (ECDC) and the WHO Regional
Office for Europe since 2008. ECDC and WHO work together to achieve full coverage and high quality
HIV and AIDS case surveillance data from the 53 countries of the WHO European Region, which include
the 28 countries of the European Union (EU) and the additional three countries2 of the European
Economic Area (EEA).
HIV/AIDS surveillance data are submitted to a joint database using The European Surveillance System
(TESSy); this platform enables countries to upload and test their data and also performs an automated
validation to improve data quality.
This document is a practical reference guide for countries reporting HIV and AIDS data to ECDC and
WHO for European HIV/AIDS surveillance. It specifies the recommende
d dataset for HIV/AIDS reporting
at the European level, and provides detailed definitions and guidelines for coding for each variable,
including their relevant validation rules. It also provides an
analysis plan to show how the data will be
used.
Starting in reporting year 2015 (for 2014 data), HIV and AIDS data was collected in a new combined
HIVAIDS record type via TESSy3. This new way of submitting data was piloted in 2013-2014 in 10
countries and was discussed in detail at the European HIV Surveillance Network meeting in Dubrovnik,
Croatia on 22nd May 2014. The record type was reviewed at the HIV network meeting in Bratislava,
Slovakia on 10-11th March 2016 and was found to be functioning well among countries that could
implement it.
If countries are unable to report the mandatory fields using the new format described here, they can
submit data using the separate older
HIV and
AIDS record types. For countries without the possibility
to report case-based data, aggregated HIV and AIDS record types remain available. Countries using
either the older record types or the aggregate record types may not be included in some of the analyses
included in the European HIV/AIDS Surveillance report.
Each country should examine the contents of the dataset in detail. The dataset is divided into mandatory
and optional fields. While we encourage the reporting of the optional fields, the mandatory fields must
be completed, even if the information is ‘unknown’.
HIV/AIDS case definitions
The implementation of WHO and EU case definitions for HIV/AIDS reporting means that only confirmed
cases of HIV/AIDS should be reported at the European level.
The EU case definitions for HIV/AIDS should be followed for EU countries reporting to the European
level. It is recognised that the case definitions currently used in a number of countries for HIV/AIDS
may differ in the WHO European region.
The latest version of the published EU case definition is available on pages 6 and 7 at:
http://eur-
lex.europa.eu/LexUriServ/LexUriServ.do?uri=CONSLEG:2002D0253:20120927:EN:PDF The WHO case definition of HIV surveillance is available at:
http://www.who.int/hiv/pub/vct/hivstaging/en/index.html
2 Of which Liechtenstein is not included in the 53 WHO European Member States
3 The metadataset is the set of standard variables that is applied for reporting to TESSy across all diseases under EU surveillance and
hence defines all details of each variable and its coding. New versions reflect changes in one or more disease areas.
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Since 2012, the EU and WHO case definitions have been compatible for surveillance purposes.
TESSy contains a menu named
Data Source that specifies details of the national HIV and AIDS
surveillance system. Each Member State should edit the properties of their Data Source information
and indicate which case definition is used for reporting to the European level (page 8 for more details).
Analysis plan
This chapter describes the process through which the national surveillance data reported to TESSy are
converted into the datasets that are used to produce European-wide tables, figures and graphs for
presentation in the annual surveillance report. It also describes the main principles of data analysis
including the recoding of certain variables, preparation of additional datasets, reporting delay
adjustment and description of outputs.
Recoding of variables
Preparation of the datasets consists of the following:
Present the data by age, gender and mode of transmission.
Present the data by regional grouping of countries
The steps below describe the recoding of submitted variables or the creation of additional variables:
Convert age into age group: <15, 15-19, 20-24, 25-29, 30-39, 40-49, 50+; if data on age are
unavailable, the country will be excluded from the analysis in age specific tables
Each country will be grouped as EU/EEA or non-EU and as located in the East, Centre or West
of WHO European Region.
Dates:
The ‘date used for statistics’ is a variable that is included in the TESSy dataset for all
communicable diseases under EU surveillance. This date accords with the date that is used for
national reports concerning all diseases. In some countries, a subset of cases has missing
values for date of HIV diagnosis. In these instances, the date used for statistics is used.
o If for any date field a country provides an incomplete date the following default values
may be assigned for some analyses.
Month and year provided: 15/MM/YYYY
Year provided: 01/07/YYYY
Principles of analysis
Geographical grouping of countries
Data are presented for the entire WHO European Region and for the European Union (EU) and European
Economic area (EEA) countries: the EU consists of 28 Member States and the EEA consists of Norway,
Liechtenstein, and Iceland. The rest of the countries are classified as non-EU/EEA countries. For the
WHO European Region, data are subdivided into three geographical/epidemiological areas: West (23
countries), Centre (15 countries) and East (15 countries).
Absolute numbers and rates per hundred thousand
Data are presented in absolute numbers and as rates per hundred thousand population (rounded to
one decimal place in tables and in the text) where appropriate.
Data are presented by year and also as a cumulative total per country. The cumulative total
includes all data reported by that particular country and does not confine to the selected
number of years presented in each table.
Population estimates are derived from Eurostat for all EU/EEA countries and from the United
Nations (UN) Population Division for all non-EU/EEA countries. The Eurostat data are based
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on end-year estimate
s (www.eurostat.europa.eu) while the UN population estimates are as of
1 July of the year indicated.
Reporting delays
Data presented are provisional because of reporting delays, and because previously reported data are
subject to regular updates (e.g. detection and deletion of duplicate cases, inclusion of new information
about cases already reported).
Reporting delays refer to the time between diagnosis (or death) and formal notification at the national
level. Overall, around 50% of AIDS cases and 65% of AIDS deaths are reported within 6 months of the
event; around 10% are reported after more than 1 year. Reporting delays vary widely between
countries, and thus recent trends in HIV, AIDS incidence and AIDS mortality are best assessed by
analysing data by year of diagnosis and by year of death with adjustments for reporting delays rather
than by year of report. In the annual surveillance report, presentation of overall trends and trends by
transmission mode are adjusted by ECDC for reporting delay4.
Creation of derived outputs
Probable country of infection output
Probable country of infection will be as presented as reported. However, a new method of assigning
country of infection for those born abroad (not in reporting country) has been published that utilises
models of CD4 decline, incorporating data on CD4 count at diagnosis, year of arrival and country of
birth5. This may be adopted in future analyses once there is a better understanding of migration in
Europe.
Late HIV diagnoses
For newly diagnoses cases who have a valid FirstCD4Count and a FirstCD4Date, a late diagnosis is
defined as a first CD4 count <350 cells/mm3 within three months of HIV diagnosis.
Data presentation
The analyses describe core epidemiological information on the occurrence of HIV by time, transmission
mode, age, gender (including female proportion) and CD4 cell counts as well as specific derived outputs
described above. The report will include the tables, figures, maps, annexes outlined in
Draft outline of
HIV/AIDS surveillance report.
Planning materials
Draft outline of HIV/AIDS surveillance report
Below is an overview of the chapters, tables, maps, figures and annexes plan to be included in the
2018 HIV/AIDS surveillance in Europe report.
Overview of HIV and AIDS in Europe
European Union and European Economic Area
WHO European Region
Conclusions
4 Quinten C., Likatavicius G., van de Laar M. Adjusting HIV surveillance data for reporting delays. 2012. Stockholm, European Centre for
Disease Prevention and Control.
5 Rice BD, Elford J, Yin Z, Delpech VC. A new method to assign country of HIV infection among heterosexuals born abroad and diagnosed
with HIV. AIDS 2012 Sep 24;26(15):1961-6.
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1 HIV and AIDS in the European Union and European Economic Area
1.1 HIV diagnoses
1.2 Trends in HIV diagnoses
1.3 AIDS cases, morbidity and mortality
1.4 Conclusions
2 HIV and AIDS in the WHO European Region
2.1 HIV and AIDS diagnoses in the WHO European Region
2.2 HIV and AIDS diagnoses in the East
2.3 HIV and AIDS diagnoses in the Centre
2.4 HIV and AIDS diagnoses in the West
2.5 Number of HIV tests performed
2.6 Conclusions
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List of countries with generalised HIV epidemics
Table 6: countries with generalised HIV epidemics6
Country
Country Code
Africa
Angola
AO
Burundi
BI
Benin
BJ
Botswana
BW
Congo, the Democratic Republic of the
CD
Central African Republic
CF
Chad
TD
Congo
CG
Cote d'Ivoire
CI
Cameroon
CM
Ethiopia
ET
Gabon
GA
Ghana
GH
Gambia
GM
Guinea
GN
Equatorial Guinea
GQ
Liberia
LR
Guinea-Bissau
GW
Kenya
KE
Lesotho
LS
Malawi
MW
Mozambique
MZ
Namibia
NA
Nigeria
NG
Rwanda
RW
Sierra Leone
SL
South Africa
ZA
South Sudan
SS
Swaziland
SZ
Togo
TG
Tanzania, United Republic of
TZ
Uganda
UG
6 Updated to list countries with generalised HIV epidemics (HIV prevalence in adult population >1%) as per UNAIDS 2014
(http://www.unaids.org/sites/default/files/media_asset/UNAIDS_Gap_report_en.pdf) Removed: Barbados, Burkina Faso, Djibouti,
Dominican Republic, Eritrea, Mali, Papua New Guinea, Suriname; Added (since 2012 estimates): South Sudan, Gambia, Thailand,
Jamaica, Trinidad and Tobago, Belize, Guyana
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Country
Country Code
Zambia
ZM
Zimbabwe
ZW
South and Southeast Asia
Thailand
TH
Caribbean
Bahamas
BS
Haiti
HT
Jamaica
JM
Trinidad and Tobago
TT
Latin America
Belize
BZ
Guyana
GY
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3.3 List and codes of AIDS indicator diseases
Table 7: AIDS indicator disease codes
1
Bacterial infections, multiple or recurrent in a child under 13 years of age
2
Candidiasis of bronchi, trachea, or lungs
3
Candidiasis, oesophageal
4
Coccidioidomycosis, disseminated or extrapulmonary
5
Cryptococcosis, extrapulmonary
6
Cryptosporidiosis, intestinal with diarrhoea (>1 months duration)
7
Cytomegalovirus disease (other than liver, spleen, or nodes) in a patient over one month of age
8
Cytomegalovirus retinitis (with loss of vision)
9
Herpes simplex: chronic ulcer(s) (>1 months duration); or bronchitis, pneumonitis, or oesophagitis in a
patient over one month of age
10 Histoplasmosis, disseminated or extrapulmonary
11 Isosporiasis, intestinal with diarrhoea (>1 months duration)
12 Mycobacterium avium complex or M. kansasii, disseminated or extrapulmonary
13 Mycobacterium tuberculosis, pulmonary in an adult or an adolescent (aged 13 years or over)
14 Mycobacterium tuberculosis, extrapulmonary
15 Mycobacterium, other species or unidentified species, disseminated or extrapulmonary
16 Pneumocystis carinii pneumonia
17 Pneumonia, recurrent in an adult or an adolescent (aged 13 years or over)
18 Progressive multifocal leukoencephalopathy
19 Salmonella (non-typhoid) septicaemia, recurrent
20 Toxoplasmosis of brain in a patient over one month of age
21 Cervical cancer, invasive in an adult or an adolescent (aged 13 years or over)
22 Encephalopathy, HIV-related
23 Kaposi s sarcoma
24 Lymphoid interstitial pneumonia in a child under 13 years of age
25 Lymphoma, Burkitt s (or equivalent term)
26 Lymphoma, immunoblastic (or equivalent term)
27 Lymphoma, primary, of brain
28 Wasting syndrome due to HIV
30
Opportunistic infection(s), not specified
31
Lymphoma(s), not specified
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