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AMBSO POPULATION HEALTH SURVEILLANCE (APHS) RESEARCH

APHS was established in 2017 and is currently AMBSO's biggest research project. The PHS is a population-based health surveillance Cohort following up ~5000 persons aged 13-80 years in 2 Ugandan districts; Wakiso and Hoima. The main objective of the APHS is to monitor trends for infectious and non-infectious diseases, family and population structures and other health related information; with the goal of informing the design of evidence based prevention, care and treatment programs to reduce morbidity and mortality in the population.

Geographical scope and community characteristics.

The APHS communities in Wakiso and Hoima districts were selected to represent the unique characteristics of the Ugandan population in the context of urban, peri-urban and rural structure. Wakiso district, ‘an urban APHS district’ is located in the central region of Uganda, partly encircling Kampala, Uganda's capital city. The district experiences rapid urbanisation due to the high influx of immigrants and is regarded as  a residence district for the bigger population that works in the city center. The closeness of the district to the city center and being bordered by Lake victoria creates a mixture of large and small scale businesses characterized by increase in risk behaviours that potentially increase morbidity and mortality.  

Hoima district ‘the semi-urban APHS district is very unique due to the richness with oil and mining activities which potentially attracts a huge work force of different ethnicity. Other great potentials such as the recent elevation of the existing urban authority to City status, activities to the ongoing establishment of Hoima international airport and the presence of Lake Albert have attracted many migrant workers, sex workers, and fisher folks which increase the disease burden and mortality. The AMBSO PHS baseline-round HIV prevalence in Wakiso and Hoima has been observed to be as high as 7.7% and 7.3% respectively presumed to be contributed by the presence of key populations such as sex workers, men having sex with men, labour migrants and high rates of alcohol use are among the contributory factors.

Geographical scope and community characteristics.

The main APHS activities are categorised in three components which include census, survey and Health education and  participants followed up annually.

  1. Census: Prior to each survey round, a household census is conducted to determine eligible participants to take part in the survey activities as well as updating information on the resident population in each household in the study communities.
  2. Survey:
  • Inter-survey period: APHS surveys are conducted at approximately 12-month intervals in each community. At each level, persons identified from census data as eligible for the annual survey (Males and females aged 13 -80 years) are notified through home visits to participate in a survey conducted at satellite locations in their communities. Consenting persons are interviewed using baseline questionnaires at the first visit and follow-up questionnaires at follow-up visits to obtain information on socio-demographic, behavioral, health status among others. Participants who consent to store their samples are asked to provide biological specimens for archival and future research. Screening for STIs, HIV, random blood sugar among others is performed. Behavioural measurements such as weight, height, waist and blood pressure measurement to assess other NCDs.    

Mid-round Telephone surveys: Prior to mini telephone surveys, mid-year census is conducted to determine population and family structure, Migrations patterns, death, birth and other vital events. Verbal recorded participant consent is obtained via telephone calling for their participation in the interviews. The data collected helps to determine behavioral trends and other characteristics.

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Study Staff Carrying out Census in one of the Household in the APHS Community.

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Study Staff Conducting an Interview