Profile: Health and Demographic Surveillance System in peri-urban areas of Karachi, Pakistan

Muhammad Ilyas Muhammad Zeb,Imran Ahmed,Fyezah Jehan,Anita K.M Zaidi,Usma Mehmood,Murtaza Ali,Muhammad Imran Nisar,Yasir Shafiq,Urooj Fatima,Abdul Momin Kazi,Komal Naeem,Rashid Ali

doi:10.12688/gatesopenres.12788.1

Abstract

The Aga Khan University’s Health and Demographic Surveillance System (HDSS) in peri urban areas of Karachi was set up in the year 2003 in four low socioeconomic communities and covers an area of 17.6 square kilometres. Its main purpose has been to provide a platform for research projects with the focus on maternal and child health improvement, as well as educational opportunities for trainees. The total population currently under surveillance is 249,128, for which a record of births, deaths, pregnancies and migration events is maintained by two monthly household visits. Verbal autopsies for stillbirths, deaths of children under the age of five years and adult female deaths are conducted. For over a decade, the HDSS has been a platform for a variety of studies including, calculation of the incidence of various infectious diseases like typhoid bacteremia, pneumonia and diarrhea, evaluation of effectiveness of various treatment regimens for neonatal sepsis, assessment of the acceptance of hospitalized care, determination of the etiology of moderate to severe diarrhea, assessment of burden and etiology of neonatal sepsis and a multi-centre cohort study measuring the burden of stillbirths, neonatal and maternal deaths. We have also established a bio-repository of a well-defined maternal and newborn cohort. Through a well-established HDSS rooted in maternal and child health we aim to provide concrete evidence base to guide policy makers to make informed decisions at local, national and international levels.

Highlights

Pakistan has a national database for registering vital events, such as births and deaths, but coverage is sub-optimal with many births and deaths going unrecorded
The Health and Demographic Surveillance System (HDSS) was established in 2003 by the Department of Paediatrics and Child Health of the Aga Khan University, Karachi, Pakistan, in peri urban areas of Karachi, with the mandate to ameliorate some of these gaps
One of these studies was the Young infant clinical signs study (YICSS), which led to the formulation of World Health Organization (WHO) seven sign algorithm for detection of possible serious bacterial infection (PSBI) in young infants

Summary

Peter Byass Sweden

Columbia University, Any reports and responses or comments on the article can be found at the end of the article. Keywords Karachi, Heath and Demographic Surveillance System, HDSS, maternal and child health, longitudinal studies. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Introduction

Discussion

Conclusions

Young Infants Clinical Signs Study Group

13. AMANHI Maternal Morbidity study group

Findings