How complete is AIDS surveillance in Europe? An eagle eye comparison with mortality data

Objectives-Preliminary assessment of the adequacy of AIDS surveillance effo rts in Europe by comparing data from two official sources-AIDS surveillance and mortality statistics. Methods-The study used ENAADS (European Non-Aggregate AIDS Data Set) data c ompiled by the European Centre for the Epidemiological Monitoring of AIDS i n St Maurice, France, and mortality statistics from WHO. As ENAADS provides information about AIDS incidence as well as AIDS mortality; both series we re compared with WHO mortality data. Western European countries with more t han 1000 adult AIDS cases as of July 1997 were included in the cross countr y comparative analyses. Results-AIDS surveillance and mortality statistics in Europe depict four di fferent patterns: (1) high overall concordance (Austria, Italy, Switzerland ); (2) concordance between incidence by ENAADS and mortality by WHO, but a delay in mortality reporting in ENAADS (France, Spain); (3) more cases in W HO mortality data than in ENAADS data (Germany, Portugal); (4) more cases i n ENAADS data than in WHO mortality data (Sweden, United Kingdom, Greece, B elgium). Conclusions-National AIDS surveillance systems in Europe exhibit important differences in terms of completeness and functionality. New challenges such as the introduction of effective but expensive and complex treatments will exert demands on surveillance efforts. Countries with discrepant AIDS and mortality data should try to improve and update their surveillance systems.