Kisesa observational HIV cohort study

Background

The Tanzania National Institute for Medical Research (NIMR) is a parastatal service organization (under the Ministry of Health) established by the act of Parliament No. 23 of 1979 and became operational in 1980.  The institute was established to generate scientific data and information required in the development of better methods and techniques of enhancing disease management, prevention, control and informing policy makers at different levels of the country. The Institution has centres located in the Country’s zones. Mwanza Medical Research Centre is one of the six constituent centres of NIMR.

Kisesa observational HIV cohort

The cohort (now with population of 34,000) has been in operation since 1994 and is the second long serving HIV cohort in Africa (after Masaka in Uganda) and the only one in Tanzania. The cohort is located in Kisesa Ward[1] part of Magu District, Mwanza Region, North Western Tanzania. The Ward lie 20kms East of Mwanza City, the Region’s Capital.

Kisesa Observational HIV cohort is based on specific research undertakings which include: population monitoring through Demographic Surveillance System (DSS). DSS involves registering of residents of the cohort area with their names, age, sex and relation to household head and follow-up rounds to document mortality (and causes), fertility and mobility (so far 31 rounds have been completed); HIV monitoring through Epidemiological Sero-surveys. The sero-surveys involve individuals 15 years and over and once at the survey clinic, participants are interviewed, provide blood for unanimous HIV testing and are offered with services like HIV Testing and Counseling (so far 8 rounds have been completed); Antenatal Clinic Surveillance has also been implemented in the cohort area(four rounds completed) as well as other research activities to assess uptake & impact of roll-out of ART in the cohort area. Of recently, cohort work has included support for HTC and Care and Treatment services as well as an innovative Real Time Record Linkage (RTRL) work which is linking community and health facility based records for patients using CTC services.

Secondary data potentials

Over the 24 year of operation the cohort kept a very rich data set which has provided opportunities for the cohort to support academics (MSc & PhDs) and working with varied partners and International Networks (INDEPTH Network, ALPHA Network, IeDEA Network, and recently ANDLA Network  interested in working with the secondary data under the cohort study.  Analysis of the data has also enabled the cohort research work to be disseminated widely including over 60 publications in peer reviewed journals. The data set still offers great opportunity for analysis especially analyses focusing on trends in mortality, fertility, survival, sexual behavior during the past 23 years.

Primary data potentials

The routine data collection at the cohort study is ongoing and therefore there is great potentials for new types of data collection in the site. Support is being extended to the Government’s based health facilities offering HIV Counseling and Testing (HTC) and HIV care services.

Interest in the ANDLA work/Mandate

Non-communicable diseases are a growing problem in urban and rural Sub-Saharan Africa. ANDLA Network has come at right time as it will allow for more NCD work in the sites either on data analysis of secondary data or collection of new data to address varied issues of the NCDs. Therefore Kisesa as a site and its mother Institution i.e. the Tanzania National Institute for Medical Research, Mwanza centre is highly interested in the ANDLA agenda and the NCD research in general.