Magu HDSS INDEPTH Network 8 th Annual General Meeting 8 th Annual - - PowerPoint PPT Presentation

Magu HDSS

INDEPTH Network 8th Annual General Meeting 8th Annual General Meeting 22nd -26th September, 2008 Dar es Salaam, Tanzania

MAGU HDSS

WELCOME YOU ALL TO TANZANIA

Structure of presentation

1.

Introduction to Magu HDSS

2.

Methods: Data collection & Data collection and

2.

Methods: Data collection & Data collection and Innovations

3.

Verbal Autopsy: Data collection and innovations

4.

Future of Magu HDSS

5.

INDEPTH’s added Value

History

Started in 1994 by the Tanzania Netherlands

Support Program on HIV Control (TANESA) Project

– Collaborators:

National Institute for Medical Research (NIMR), Mwanza Regional Medical Office, Mwanza and Bugando Medical Centre, Mwanza

In December, 2002 Research activities were handed over to

NIMR, Mwanza

Administrative divisions: Six villages

HDSS population

Population

– Currently about 28,000 – Ethnicity: 95% are Sukuma – Ethnicity: 95% are Sukuma – Religion: 74% Christian, 23% traditional religions, 3% Islam – Education: Fourteen primary schools (11 public & 3 private)

and three secondary schools (2 public and 1 private)

– Health: Seven health facilities (four public and three private)

Economy

– Per capita income below $120 per year – Farming is main source of income, petty trading common

Population pyramid, 2007

55-59 60-64 65-69 70-74 75-79 80+

• 20
• 10

10 20 0-4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 Percent of Population

Female Males

Objectives of the HDSS & cohort study

• To measure child and adult mortality and fertility in the general

population and by HIV status

• To asses the leading causes of death through verbal autopsy

To asses changes in the family structure due to HIV epidemic

• To asses changes in the family structure due to HIV epidemic
• To facilitate understanding of the dynamics of the HIV epidemic
• To facilitate assessment the demographic, social and economic

impacts of the HIV/AIDS epidemic

• To facilitate evaluate the effects of national prevention, treatment and

care interventions as implemented in the HDSS area

• To provide reliable data for planning at different administrative levels

Types of research

1

Demographic surveys

• house to house, whole pop
• keep track of births, deaths

and movements

2

Serological surveys

• adults invited to village clinics
• HIV & other lab tests

and movements

• 2 or 3 times per year
• simple, quick questions
• HIV & other lab tests
• every 3 years
• long questionnaire about

behaviour & other risks

3

In depth enquiries

• specially selected individuals
• sensitive topics
• timing as required
• some open-ended questions &/or

qualitative interviews

4

Operations research

• community groups, village

leaders, health services

• help national surveillance
• timing as required
• IEC activities and feedback

Demography Serology ANC surveillance VCT service

Timing of the Research Activities

Jan-94 Jan-95 Jan-96 Jan-97 Jan-98 Jan-99 Jan-00 Jan-01 Jan-02 Jan-03 Jan-04 Jan-05 Jan-06 Jan-07 Jan-08 Jan-0

HDSS: Data collection

Visit every household and collect information from

household head or other adult members

Ask about births, pregnancies, deaths, moves in or out Ask about births, pregnancies, deaths, moves in or out

and update information on schooling

Link children to parents and adults to their spouses

using line numbers

Follow-up death reports with special verbal autopsy

interviews

Completed 21 rounds since 1994 HDSS Round 22 is currently going on

HDSS data collection form

Verbal Autopsy Interviews

Part of the HDSS activities Started in 1994 after the HDSS baseline census Started in 1994 after the HDSS baseline census For deaths in DSS round 1-18 focus was only for

death of individuals under 60 years

Starting from round 19,20&21, VA carried out for

all deaths

So far VA has been carried out for all deaths

listed in DSS round 1-21.

Updating VA Instruments

Prior to doing VA interviews for deaths listed

in DSS 19&20

Looked at existing VA Instruments Looked at existing VA Instruments

(INDEPTH’s, HMN & Our old ones)

Contacted WHO’s Health Matrix Network Adapted both INDEPTH.s and Health Matrix

VA instrument

New tool used for VA for deaths from HDSS

round 19,20,21

VA data collection & processing

Interviews conducted by clinicians Questionnaires: Three types: Neonates 0-4

years, children 5-13 years and adults 14+ years, children 5-13 years and adults 14+

Interview Clinician assign causes of death in the field Two independent clinician assign cause of death When the three assessments agrees the cause is

taken as the cause of death

When they disagree it is considered in-determine

(unknown)

Prediction of HIV/AIDS associated death

In areas of generalised epidemics verbal autopsy

can consistently measure AIDS mortality. It can predict AIDS death up to 88%

Reliable estimate obtained for people 15-44 years VA tools for estimating AIDS mortality should collect

information to single out symptoms like; herpes zoster, oral candidiasis, abscesses/sores or vaginal tumours.

INDEPTH’s added Value

• Magu HDSS-Member site
• Benefits

–

Capacity building;

Data management (2006 & 2008) Data management (2006 & 2008) VA Coding (Accra 2003) VA training-Rufiji (April, 2008) Writing skills (Workshop Accra Aug., 2008) –

Publications

Fertility monograph (on going) Facilitating Developing multi-site proposals (currently – ’cost of

illness’)

–

Sharing of data/information with other sites

–

Scientific advancement through the Scientific conference during AGMs

Future

Increase frequency of HDSS data collection to

three rounds per annum

Start using PDAs (small hand held computers)

for data collection

Carry out VA interview soon after the death

has been registered