Title: Developing Capacity for Tuberculosis (TB) Surveillance in Health and Demographic Surveillance System (HDSS) Settings

Period: 1st February to 30th September 2011.

Grant Number, if any: IND/001/20f1

Collaborators: Bandim HDSS, Karonga HDSS

Sponsor: INDEPTH:

Investigator/s: Dr. Shivaji Karad , Md. Hanif Shaikh

Rationale: Health and demographic surveillance systems are ideal platforms to collect TB burden data, risk factors for TB, and TB health seeking characteristics. Strengths of conducting this type of analysis in the HDSS include the ability to follow each individual longitudinally, the availability of existing data, known population denominators, and the ability to measure endpoints such as mortality. Knowledge of the factors that are associated with TB disease is important for the design of TB control activities in the community, and data-driven health policies.

Aim/s and objectives: The overall aim of this study is to strengthen the capacity of Asia/Africa HDSS sites to evaluate the TB burden and associated TB risk factors. Further, we will evaluate the characteristics of TB patients who seek TB care.


  • To collect TB burden data on patients residing in the HDSS using the TB registers
  • To collect information on TB risk factors using data collected in the HDSS and link to TB burden and TB treatment outcome data
  • To characterize TB patients who seek (and do not seek) TB care
  • To compare these data across all participating HDSS sites
  • To build capacity in collecting, managing and analyzing tuberculosis surveillance data

Population and Study Design: The entire HDSS population, which is followed longitudinally, will serve as the sampling frame for this study. The entire HDSS who does not have TB/is a suspect will serve as the comparison population to the TB cases/suspects from the HDSS.

Data collection: All data will comprise existing data in the TB registers or HDSS databases. If BCG scar is recorded in the resisters, prevalence of BCG scar and any associations will be assessed. Risk factors which are currently available for measurement are listed below.

Outcome: The main outcome of this study is the capacity to describe TB burden, TB risk factors, characteristics of TB patient care seeking across HDSS sites and risk factors associated with poor TB treatment outcomes. With the knowledge of risk factors associated with TB across sites, researchers in each site will be able to identify areas of TB related interventions for the future.

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