Journal
INTERNATIONAL JOURNAL OF EPIDEMIOLOGY
Volume 41, Issue 4, Pages 988-1001Publisher
OXFORD UNIV PRESS
DOI: 10.1093/ije/dys115
Keywords
Sub-Saharan Africa; population pyramids; health transition; mortality; morbidity; cause of death; fertility; migration; census; HIV; tuberculosis; non-communicable diseases; households
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Funding
- Wellcome Trust, UK [058893/Z/99/A, 069683/Z/02/Z, 085477/Z/08/Z]
- National Institute on Ageing of the NIH [1R24AG032112-01, 5R24AG032112-03]
- William and Flora Hewlett Foundation [2008-1840]
- Andrew W Mellon Foundation, USA
- University of the Witwatersrand and Medical Research Council, South Africa
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The Agincourt health and socio-demographic surveillance system (HDSS), located in rural northeast South Africa close to the Mozambique border, was established in 1992 to support district health systems development led by the post-apartheid ministry of health. The HDSS (90 000 people), based on an annual update of resident status and vital events, now supports multiple investigations into the causes and consequences of complex health, population and social transitions. Observational work includes cohorts focusing on different stages along the life course, evaluation of national policy at population, household and individual levels and examination of household responses to shocks and stresses and the resulting pathways influencing health and well-being. Trials target children and adolescents, including promoting psycho-social well-being, preventing HIV transmission and reducing metabolic disease risk. Efforts to enhance the research platform include using automated measurement techniques to estimate cause of death by verbal autopsy, full 'reconciliation' of in- and out-migrations, follow-up of migrants departing the study area, recording of extra-household social connections and linkage of individual HDSS records with those from sub-district clinics. Fostering effective collaborations (including INDEPTH multi-centre work in adult health and ageing and migration and urbanization), ensuring cross-site compatibility of common variables and optimizing public access to HDSS data are priorities.
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