Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, Fajara, The Gambia.
Department of Women and Children's Health, King's College, London, United Kingdom.
PLoS One. 2022 Jul 13;17(7):e0271464. doi: 10.1371/journal.pone.0271464. eCollection 2022.
To assess whether an adapted Demographic and Health Survey (DHS) like cross-sectional household survey with full pregnancy histories can demonstrate the validity of health and demographic surveillance (HDSS) data by producing similar population structural characteristics and childhood mortality indicators at two HDSS sites in The Gambia-Farafenni and Basse.
A DHS-type survey was conducted of 2,580 households in the Farafenni HDSS, and 2,907 in the Basse HDSS. Household members were listed and pregnancy histories obtained for all women aged 15-49. HDSS datasets were extracted for the same households including residency episodes for all current and former members and compared with the survey data. Neonatal (0-28 days), infant (<1 year), child (1-4 years) and under-5 (< 5 years) mortality rates were derived from each source by site and five-year periods from 2001-2015 and by calendar year between 2011 and 2015 using Kaplan-Meier failure probabilities. Survey-HDSS rate ratios were determined using the Mantel-Haenszel method.
The selected households in Farafenni comprised a total population of 27,646 in the HDSS, compared to 26,109 captured in the household survey, implying higher coverage of 94.4% (95% CI: 94.1-94.7; p<0.0001) against a hypothesised proportion of 90% in the HDSS. All population subgroups were equally covered by the HDSS except for the Wollof ethnic group. In Basse, the total HDSS population was 49,287, compared to 43,538 enumerated in the survey, representing an undercount of the HDSS by the survey with a coverage of 88.3% (95% CI: 88.0-88.6; p = 1). All sub-population groups were also under-represented by the survey. Except for the neonatal mortality rate for Farafenni, the childhood mortality indicators derived from pregnancy histories and HDSS data compare reasonably well by 5-year periods from 2001-2015. Annual estimates from the two data sources for the most recent quinquennium, 2011-2015, were similar in both sites, except for an excessively high neonatal mortality rate for Farafenni in 2015.
Overall, the adapted DHS-type survey has reasonably represented the Farafenni HDSS database using population size and structure; and both databases using childhood mortality indicators. If the hypothetical proportion is lowered to 85%, the survey would adequately validate both HDSS databases in all considered aspects. The adapted DHS-type sample household survey therefore has potential for validation of HDSS data.
评估经过改编的人口与健康动态调查（DHS），如包含完整妊娠史的横断面家庭调查，能否通过在冈比亚的法非尼和巴萨两个卫生和人口监测（HDSS）站点产生相似的人口结构特征和儿童死亡率指标，证明其 HDSS 数据的有效性。
在法非尼 HDSS 中进行了一项类似于 DHS 类型的调查，共涉及 2580 户家庭，在巴萨 HDSS 中进行了一项类似的调查，共涉及 2907 户家庭。对所有 15-49 岁的女性家庭成员进行了登记，并获得了她们的妊娠史。从同一家庭中提取了 HDSS 数据集，包括所有当前和以前成员的居住事件，并与调查数据进行了比较。通过每个来源（按地点和 2001-2015 年的 5 年期间以及 2011-2015 年的日历年），使用 Kaplan-Meier 失败概率，分别从新生儿（0-28 天）、婴儿（<1 岁）、儿童（1-4 岁）和 5 岁以下儿童（<5 岁）死亡率得出了数据。使用 Mantel-Haenszel 方法确定了调查-HDSS 率比。
在法非尼选择的家庭中，HDSS 的总人口为 27646 人，而家庭调查中捕获的人数为 26109 人，这意味着调查的覆盖率为 94.4%（95%CI：94.1-94.7；p<0.0001），而假设的 HDSS 覆盖率为 90%。除了沃洛夫族外，所有人口亚组都被 HDSS 平等覆盖。在巴萨，HDSS 的总人口为 49287 人，而在调查中记录的人数为 43538 人，这意味着调查对 HDSS 的统计存在低估，覆盖率为 88.3%（95%CI：88.0-88.6；p=1）。所有亚人群组也都被调查低估。除了法非尼的新生儿死亡率外，2001-2015 年期间，来自妊娠史和 HDSS 数据的儿童死亡率指标都相当吻合。2011-2015 年最近五年期间，来自这两个数据源的年度估计值在两个地点都相似，除了法非尼 2015 年的新生儿死亡率过高。
总体而言，改编后的 DHS 类型调查使用人口规模和结构合理地代表了法非尼 HDSS 数据库；使用儿童死亡率指标也是如此。如果假设比例降低到 85%，调查将在所有考虑的方面充分验证这两个 HDSS 数据库。因此，改编后的 DHS 类型抽样家庭调查具有验证 HDSS 数据的潜力。
