Protocol: Leveraging a demographic and health surveillance system for Covid-19 Surveillance in rural KwaZulu-Natal

Mark J Siedner^{1

2

3}, Guy Harling^{1

4

5

6}, Anne Derache¹, Theresa Smit¹, Thandeka Khoza¹, Resign Gunda¹, Thobeka Mngomezulu¹, Dickman Gareta¹, Nomathamsanqa Majozi¹, Eugene Ehlers¹, Jaco Dreyer¹, Siyabonga Nxumalo¹, Njabulo Dayi¹, Gregory Ording-Jesperson¹, Nothando Ngwenya¹, Emily Wong^{1

2

3}, Collins Iwuji^{1

7}, Maryam Shahmanesh^{1

4}, Janet Seeley^{1

8}, Tulio De Oliveira^{9

10}, Thumbi Ndung'u^{1

11

12

13}, Willem Hanekom^{1

11}, Kobus Herbst^{1

14}

Affiliations

¹ Africa Health Research Institute, Durban, KwaZulu-Natal, South Africa.
² Massachusetts General Hospital, Boston, MA, USA.
³ Harvard Medical School, Boston, MA, USA.
⁴ Institute for Global Health, University College London, London, UK.
⁵ MRC/Wits Rural Public Health & Health Transitions Research Unit (Agincourt), University of the Witwatersrand, Johannesburg, South Africa.
⁶ Department of Epidemiology and Harvard Center for Population and Development Studies, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
⁷ Department of Global Health and Infection, Brighton and Sussex Medical School, University of Sussex, Brighton, UK.
⁸ Global Health and Development Department, London School of Hygiene & Tropical Medicine, London, UK.
⁹ KwaZulu-Natal Research Innovation and Sequencing Platform (KRISP)), School of Laboratory Medicine and Medical Sciences, University of KwaZulu Natal, Durban, KwaZulu-Natal, South Africa.
¹⁰ Department of Global Health, University of Washington, Seattle, USA.
¹¹ Division of Infection and Immunity, University College London, London, UK.
¹² HIV Pathogenesis Programme, The Doris Duke Medical Research Institute, University of KwaZulu Natal, Durban, KwaZulu-Natal, South Africa.
¹³ Max Planck Institute for Infection Biology, Berlin, Germany.
¹⁴ SAPRIN, South African Medical Research Council, Cape Town, South Africa.

PMID: 32802963
PMCID: PMC7424917
DOI: 10.12688/wellcomeopenres.15949.2

Protocol: Leveraging a demographic and health surveillance system for Covid-19 Surveillance in rural KwaZulu-Natal

Mark J Siedner et al. Wellcome Open Res. 2020.

. 2020 Aug 25:5:109.

doi: 10.12688/wellcomeopenres.15949.2. eCollection 2020.

Authors

Affiliations

¹ Africa Health Research Institute, Durban, KwaZulu-Natal, South Africa.
² Massachusetts General Hospital, Boston, MA, USA.
³ Harvard Medical School, Boston, MA, USA.
⁴ Institute for Global Health, University College London, London, UK.
⁵ MRC/Wits Rural Public Health & Health Transitions Research Unit (Agincourt), University of the Witwatersrand, Johannesburg, South Africa.
⁶ Department of Epidemiology and Harvard Center for Population and Development Studies, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
⁷ Department of Global Health and Infection, Brighton and Sussex Medical School, University of Sussex, Brighton, UK.
⁸ Global Health and Development Department, London School of Hygiene & Tropical Medicine, London, UK.
⁹ KwaZulu-Natal Research Innovation and Sequencing Platform (KRISP)), School of Laboratory Medicine and Medical Sciences, University of KwaZulu Natal, Durban, KwaZulu-Natal, South Africa.
¹⁰ Department of Global Health, University of Washington, Seattle, USA.
¹¹ Division of Infection and Immunity, University College London, London, UK.
¹² HIV Pathogenesis Programme, The Doris Duke Medical Research Institute, University of KwaZulu Natal, Durban, KwaZulu-Natal, South Africa.
¹³ Max Planck Institute for Infection Biology, Berlin, Germany.
¹⁴ SAPRIN, South African Medical Research Council, Cape Town, South Africa.

PMID: 32802963
PMCID: PMC7424917
DOI: 10.12688/wellcomeopenres.15949.2

Abstract

A coordinated system of disease surveillance will be critical to effectively control the coronavirus disease 2019 (Covid-19) pandemic. Such systems enable rapid detection and mapping of epidemics and inform allocation of scarce prevention and intervention resources. Although many lower- and middle-income settings lack infrastructure for optimal disease surveillance, health and demographic surveillance systems (HDSS) provide a unique opportunity for epidemic monitoring. This protocol describes a surveillance program at the Africa Health Research Institute's Population Intervention Platform site in northern KwaZulu-Natal. The program leverages a longstanding HDSS in a rural, resource-limited setting with very high prevalence of HIV and tuberculosis to perform Covid-19 surveillance. Our primary aims include: describing the epidemiology of the Covid-19 epidemic in rural KwaZulu-Natal; determining the impact of the Covid-19 outbreak and non-pharmaceutical control interventions (NPI) on behaviour and wellbeing; determining the impact of HIV and tuberculosis on Covid-19 susceptibility; and using collected data to support the local public-sector health response. The program involves telephone-based interviews with over 20,000 households every four months, plus a sub-study calling 750 households every two weeks. Each call asks a household representative how the epidemic and NPI are affecting the household and conducts a Covid-19 risk screen for all resident members. Any individuals screening positive are invited to a clinical screen, potential test and referral to necessary care - conducted in-person near their home following careful risk minimization procedures. In this protocol we report the details of our cohort design, questionnaires, data and reporting structures, and standard operating procedures in hopes that our project can inform similar efforts elsewhere.

Keywords: Covid-19; Health and Demographic Surveillance System; Screening; South Africa; Surveillance.

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Conflict of interest statement

No competing interests were disclosed.

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References

1. World Health Organisation: Coronavirus disease (COVID-2019) situation reports.2020. Reference Source
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Protocol: Leveraging a demographic and health surveillance system for Covid-19 Surveillance in rural KwaZulu-Natal

Affiliations

Protocol: Leveraging a demographic and health surveillance system for Covid-19 Surveillance in rural KwaZulu-Natal

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

Grants and funding

LinkOut - more resources

Full Text Sources

Miscellaneous