Transcript 1. Bauni-Dodowa visit 26_05_2014

Indepth Healthy Transition to
Adulthood study
The Kilifi – Dodowa Workshop
Evasius Bauni
27th – 28th May 2014
The Kemri-wellcome Trust Research Programme
1200
1000
800
600
400
200
DSS
0
1989
Norbert Peshu
Kevin Marsh
Charles Newton
Bob Snow
2000
Malaria
Bacterial disease
Neurology
Genetics
Social science
Public health
2013
Malaria
Bacterial disease
Neurology
Genetics
Social science
Public health
Resp disease
HIV
TB
Malnutrition
Sickle disease
NCD
The Kilifi HDSS
Epidemiology Demography
Department
Kilifi HDSS
Viral Epidemiology & Control
James Nokes
Evasius Bauni
Cluster Support
and management
Tahreni Bwanaali
Human Genetic Factors
Invasive Bacterial Diseases
Tom Williams
Anthony Scott
GPS Receivers
Integrated Surveillance
Systems
Vital status/migration
270,000 population
Home visits every
3-4 months
Clinical case recording
~4,000 inpatients/y
Integrated with DSS on
admission
Laboratory data
From inpatient and
research studies
linked on DSS IDNO
Kilifi IHTAS Staff
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Evasius Bauni
George Mochamah
David Walumbe
Carolyne Ndila
Christopher Nyundo
David Amadi
Gideon Nyutu
Boniface Jibendi
Michael Kinuthia
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Mark Otiende
Alex Mutuku
John Ojal
Jackline Wafula
Pauline Mwatsuma
Paul Musumba
Francis Kombe
Charles Syengo
Elina Kaulu
IHTAS sub-studies
• On-line stakeholders
questionnaire
• Stakeholders workshop
• Focus –group discussions
• Indepth-interviews with
stakeholders
• Systematic literature
review (health
intervetions)
• Systematic literature
review (health problems)
• Systematic literature
review (why young
people do not use health
services)
• Mapping health facilities
• Analysing existing data
• Identifying pilot sites
• IHTAS phase 2
What is the problem? What health
interventions are in place?
What is the problem?
• Substance abuse
• Unprotected sex leading to
unwanted pregnancies,
abortion, STIs and HIV
• Accidents and injuries,
sexual violence, bullying
• Early marriages and,
homosexuality
• Nutrition
Health Interventions
• Provision of health information
(15)
• Screening HIV (5) TB (1)
• Child rights (2)
• Reproductive health
services/YFS (4)
• Economic empowerment (3)
• Malaria control(1)
What is the problem? Systematic Literature Review
Interventions
Anti-helminthic
Hygiene
Malaria prevention
Nutrition
Reproductive health
Voluntary male
circumcision
Other
N
3
7
5
4
10
2
4
Impact
Signifi Mod
2
1
4
1
3
1
2
1
7
3
2
2
0
2
Insignif
0
2
1
1
0
0
0
Age-sex structure and population
density
• Population: 270,000 (2012-
2013 r29)
•
34,000 HH, 900km2
• Males: 47%
• Children <5 years: 19%
• Children 5 -14years: 30%
• 10-24 years: 33%
• Adults 15 – 49 years:39%
• Elderly ≥50+: 12%
What do we know? The 10-24 profile
a) Popn characteristics
b) Health facility survey (n=80)
%
Total Population (10-24yrs)
33
Education status
Out of school
60
All Pregnancies
10-24 yrs
41
13-19 yrs
26
c) Hospital admissions
100
d) Causes of death
Males
Mental and behavioral
Nervous System
Respiratory System
Poisoning by drugs
other
80
percentage
40
60
20
0
Females
Pregnancy related disorders
Infectious & Parasitic
Genitourinary System
Injuries
Blood disorders
Digestive System
0
0
20
20
percentage
40
60
percentage
40
60
80
80
100
Males
100
Females
10-14
15-18
19-24
10-14
15-18
19-24
ot her
HIV/AIDS related death
Malaria
Injuries
Pneumonia
Pulmonary tuberculosis
Maternal causes of death
other
Injuries
HIV/AIDS related death
Pneumonia
Malaria
Pulmonary tuberculosis
Maternal causes of death
other
oth
Timelines
Data
collection
Compiling results
and writing
July – December
2014
January-March
2015
Oct
2013
What we
know
Dec
2013
Jan-June
2014
Proposal to fill the gaps
What we want to
know
April – May 2015
Writing and submitting
trial proposal
Acknowledgements
• IHTAS Staff & Stakeholders Kilifi
• Kemri-Wellcome Trust Research Programme
• Ministry of health
• Dodowa & LSHTM Collaborators
• Hewlett Foundation
www.kilifi-ihtas.com