Bandim Health Project

Experience

Bandim Health Project (BHP) has conducted research on health interventions in Guinea-Bissau since 1978.

BHP grew out of a situation with an under-5 mortality of 500/1000 in 1978. To assure adequate data on early child mortality, BHP has emphasised pregnancy registration in addition to registration of births and deaths, as well as registration of breastfeeding patterns, growth and childhood interventions through home visits. This set-up has provided a unique platform for examining both short-term and long-term effects of health interventions.

BHP consists of an urban study area with a population of approximately 100,000 individuals in suburbs of the capital Bissau. In the study area health promoting interventions to children are monitored daily at the government health centres. Hospital admissions at the pediatric ward and births at the maternity ward are also registered daily.

In a rural surveillance system with regular visits to 258 villages (population ~100,000 individuals) all women of fertile age and all children below the age 5 years are registered.

Disease areas

• Cholera
• HIV
• Malaria
• Newborn Health
• Other
• TB

Available for ebola research

Other information

The population a high TB incidences at 300/100.000)(Lemvik, TMIH 2014) with a high adult mortality (15% at 1 years follow up).
The HIV prevalence is low for sub-saharan Africa, in our latest survey we found a HIV-1 prevalence of 4.6%(2) but HIV-2 is also still a factor although declining. TB incidence among children <15 years is 30/100.000 but likely severely under-diagnosed.
We have enrolled all TB patients living in the study area since the end of 2003, with complete clinical and demographic information. Based on these numbers and the HDSS study database of the background population we find an overall incidence in 2004-12 of TB (smear pos and neg) among 15-24 year old of pulmonary TB to be 288 pr 100.000 person years; the male incidence being 397 pr 100.000 person years, and the female being 198 pr 100.000 person years. The incidence of smear-positive TB was 189 pr. 100.000 person years, the incidence for males was 266 pr 100.000 person years, and the incidence for females was 118 pr 100.000 person years.

BHP has a long experience in intervention trials, in particular among children and we presently run several Randomised Controlled Clinical Trials.
We have now as part of an EDCTP capacity building initiative been able to train two local monitors. The laboratory capacity is limited in terms of human resources, but GLP are in general be implemented for trial related procedures, and SOP’s are available for ELISPOT etc. The necessary registration and storage control of drugs etc has been dealt with but could be improved by standardisation of procedures and allocation of full time staff. Databases have been stored on password secured servers. Regulatory authorities are a committee for research under the ministry of health, no Drug Administration exists and a capacity building effort within this area may also be useful. There is a well functioning Ethics Committee with regular meetings and standard written operating procedures are in place.