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Health Research Linked to a Demographic Surveillance System

The Kilifi Health and Demographic Surveillance system has been running since 2002, and is distinctive as a DSS in that from inception its primary role was to support health related research. Currently a population of 279,158 are under surveillance within an area of 900km2 centred on Kilifi County hospital.

The long term demographic surveillance provides information on trends in mortality and dynamics of mobility, age-structure, household occupancy and spatial distribution that are of intrinsic interest.  Data on cause of death arise from linked surveillance to the wards of the county hospital but also through Verbal Autopsy undertaken for all deaths.

Hospital admissions can be linked to person years residency to provide highly detailed denominator based incidences of admissions due to disease syndromes (pneumonia, diarrhea, malnutrition) and specific aetiologies (eg malaria, S.pneumoniae, rotavirus).

Similarly, denominators and geographic data are linked to maternity study data (eg KIPMAT) and vaccine records in health facilities throughout the HDSS (PCVIS). This also enables studies on the spatial distribution of diseases (eg malaria hotspots), health interventions (eg H. influenzae type B, S. pneumoniae), and post-discharge mortality or readmission (eg  severe malnutrition cases).

The HDSS provides the frame for sampling,  for example, to identify controls for cases-control studies and participants for household or social epidemiology research, also for evaluation of vaccine intervention (PCVIS and rotavirus vaccination), public health data (eg bednet usage, water and sanitation), and large-scale sampling for prevalence estimation (eg neurological disorders). The KHDSS is part of the INDEPTH network.

Future research The KHDSS will continue to develop as a site to support vaccine trials (eg proposed RSV and Group B Streptococcus vaccine) and interventions, such as rotavirus and, perhaps, malaria vaccination.

 

Investigators : Anthony Scott , Thomas Williams, Jay Berkley, Charles Newton, Philip Bejon, Evasius Bauni