Profile: Agincourt Health and Socio-demographic Surveillance System

Abstract

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.

The stall in fertility decline in rural, northeast, South Africa: the contribution of a self-settled, Mozambican, refugee sub-population

“…The completeness and accuracy of the Agincourt HDSS data on infants have been noted to be comparable to available national data sources (Kahn et al, 2008). Further details on the study area and the method of data collection are described elsewhere (see for example, Kahn et al 2012).…”

“…The Agincourt health and demographic surveillance system (Agincourt HDSS) site in rural northeast South Africa offers a good prospect to study the relative contribution of the fertility of former refugees to the fertility level and trend of the host community. The Agincourt HDSS is to the west of southern Mozambique border and one-third of its population is made up of people of Mozambican origin, the majority of who entered the neighbouring South African area around the mid-eighties at the height of the Mozambican civil war (Kahn et al , 2012.…”

Evaluation of record linkage of mortality data between a health and demographic surveillance system and national civil registration system in South Africa

“…Information about deaths in the Agincourt HDSS was collected as part of annual updates of vital events in a surveillance population occupying 27 villages in Bushbuckridge municipality, Mpumalanga province, South Africa ( Figure 1) [19,20].The population is largely Tsonga-speaking, and a third are of Mozambican descent who arrived in the study area in the early to mid-1980s as refugees and/or their descendants. The population has been under surveillance since 1992.…”

“…This paper describes the practical steps we took to set up and execute record linkage of mortality data and evaluates the quality of the matched records between the CR system and the longest-running of the three HDSS centers in South Africa, the Agincourt HDSS [19,20]. It describes how we overcame the challenges of bringing together data that are kept in secure databases and environments almost 600 kilometers apart, each governed by data-security policies that prohibit the offsite and non-staff use of unit-record data that contain personal identifiers.…”

Genomic and environmental risk factors for cardiometabolic diseases in Africa: methods used for Phase 1 of the AWI-Gen population cross-sectional study

“…Fortuitously they covered West, East and South Africa and represented rural and urban settings. Six study centres in four SSA countries were involved in Phase 1 of the AWI-Gen study: in South Africa, the MRC/Wits Agincourt HDSS [23], Dikgale HDSS [24] and the Soweto centre located within the MRC/Wits Developmental Pathways for Health Research Unit [20]; in Kenya the African Population and Health Research Center HDSS in Nairobi [25]; in Ghana the Navrongo HDSS in the Navrongo Health Research Centre [26]; and in Burkina Faso the Nanoro HDSS hosted by the Institut de Recherche en Sciences de la Santé Clinical Research Unit [27]. The study is coordinated by the AWI-Gen Collaborative Centre based at the Sydney Brenner Institute for Molecular Bioscience, University of the Witwatersrand in Johannesburg, South Africa.…”