About Bandim Health Project
Bandim Health Project (BHP) is a health and demographic surveillance system (HDSS) site situated in Guinea-Bissau.
BHP is formally placed under the National Institute of Public Health in Guinea-Bissau (INASA). BHP is a member of the Indepth Network, a global network of health and demographic surveillance system (HDSS) field sites in Africa, Asia and Oceania. Read more about Indepth Network.
BHP follows a population of more than 200,000 individuals in urban and rural Guinea-Bissau. This provides a Unique platform for conducting health research. One of the major research areas is to study the real life effects of vaccines, vitamin A and other health interventions. Based on BHP's research, in 2012, the Danish National Research Foundation funded the establishment of a Center of Excellence, Research Center for Vitamins and Vaccines (CVIVA) at Statens Serum Institut in Denmark. Read more about CVIVA.
Research at BHP
Research from the project has shown that vaccines not only protect against the target disease, but also modifies susceptibility to unrelated infections. These so-called “non-specific effects” have major consequences for child survival. The results indicate that the international community can save millions of children in the world’s poorest countries, if the vaccination programs are optimized to take into account both specific and non-specific effects of vaccines. Read more about our research.
Since the BHP began working in Bissau in 1978, studies have been carried out in measles epidemiology routine vaccinations, HIV-2, diarrhoea (aetiology and prevention), tuberculosis, maternal mortality, nutrition, breast-feeding, vitamin A supple-mentation, respiratory diseases, twin studies, malaria, immunological determinants, and mortality.
Unique registration and surveillance
The backbone of the BHP project is the continuous health and demographic surveillance system (HDSS) initiated in 1978. This demographic and health surveillance system enables BHP to follow all children who have received a vaccine, a drug, or having passed a specific infectious disease.
Since the BHP inception in 1978, there have been numerous studies of measles epidemiology, routine vaccinations, HIV-1 and HIV-2, tuberculosis, malaria, maternal mortality, nutrition, breast-feeding, vitamin A supplementation, respiratory diseases, twins, immunological determinants, and mortality. Many randomised trials testing health interventions, in particular vaccines and vitamin A, have also been carried out.
Urban study area
The urban study area consists of six suburban areas of the capital Bissau: Bandim 1, Bandim 2, Belem, Mindará, Cuntum 1 and Cuntum 2.
BHP carries out regular censuses of the entire population in the study area about every three years. All houses in the area are divided into groups of houses called zones, and every house within each zone has been given a number.
Every month, all households with women in the fertile age are visited to register new pregnancies. All newborns are registered and an interview on the pregnancy, the delivery and on household factors is carried out. All children are followed every 3 months, until they're three years of age. At the routine follow-up visits, information on nutritional status, vaccinations, morbidity and hospitalisations is collected.
In the study area BHP registers every newborn and follows all children below three years of age. The BHP registers morbidity, nutritional status, vaccinations, and collection of information on social background factors.
In addition, BHP registers the routine vaccinations, monitors consultations and treatment of TB and HIV at three health centres within the study area. BHP registers all births at the maternity ward and all hospitalisations at the paediatric ward at the national Hospital Simão Mendes two kilometres outside the study area.
Rural study area
In rural Bissau, BHP follows 182 clusters of 100 women in the fertile age and all their children below five years of age. Four mobile teams visit the villages closest to Bissau every month and villages furthest away every six months registering pregnancies, births and deaths among previously registered women and all children below the age of five. Information on antenatal care, socioeconomic indicators and immunisations, hospitalisations and nutritional status is collected.
The project collaborates closely with the three local health centres in the study area, and a number of other health institutions, including the national laboratory, LNSP, the national hospital, Hospital National Simão Mendes, HNSM, the national tuberculosis hospital and INASA, the National Public Health Institute.
One of Guinea-Bissau’s biggest employers
More than 150 local assistants, nurses, doctors and supervisors work for BHP, making it one of Guinea-Bissau’s biggest employers. Most people in the city of Bissau know the project and someone who has a relation to it.
BHP has a good reputation in the local community and at the institutions, which collaborates with the project.
Over the years, a group of Guinean health scientists have completed formal training overseas in epidemiology, and have obtained a Master degree or PhD.