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Location of the Bandim HDSS Centre, Guinea-Bissau

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Location of the Bandim HDSS Centre, Guinea-Bissau G U I N E A - B I S S A U Guinea-BissauGuinea-Bissau BissauBissau CityCity BissauBissau CityCity BissauBissau CityCity BandimBandim DSSDSS areaarea 00 2.52.5 55 00 5050 100100 KilometreKilometre KilometreKilometre Location of the Bandim HDSS centre, Guinea-Bissau The Bandim Health Project (http:// www.bandim.org ) was initiated in 1978 with the aim of improving child survival in Guinea Bissau. The Bandim Health Project is part of the National Institute of Health (INASA) in Guinea-Bissau and supported by a research group at the Statens Serum Institut, Copenhagen. The research station in Guinea-Bissau currently employs several Guinean physicians and epidemiologists involved in research training and a few expatriates, medical doctors, statistician, immunologist, medical and public health students. The field station registers the basic demographic and health-related data for approximately 102,000 inhabitants in the capital Bissau and 182 randomly selected clusters of villages are followed in the interior of Guinea-Bissau. More than 180 Guineans are employed for the continuous collection of surveillance data and for data collection linked to specific trials. Part of the research training, data analyses and writing of papers takes place at Statens Serum Institut, Copenhagen, and the potential implications of findings in Guinea-Bissau for Danish children are explored. Seven Guineans have obtained a PhD at University of Copenhagen. Objectives • To follow long-term consequences of various infections, health conditions and interventions. • To conduct research on determinants of measles mortality and evaluation of various measles vaccination schemes. • To study the non-specific immune training effects of vaccinations, vitamin A supplementation and other interventions. • To examine systematically the possibility that interventions have sex-differential effects. • To investigate management and health system problems in relation to diseases with a major impact on child mortality in low-income countries • To conduct clinical trials to assess both specific and non-specific effects of health interventions and interactions between interventions. • To facilitate research training Priority Research Areas The Bandim Health Project’s main focal areas are vaccinations and vitamin A supplementation in childhood and their impact on public health, in particular their non-specific effects. We are emphasising that these interventions often have sex-differential effects. We have shown in several randomised trials that the non-specific beneficial effects of BCG and measles vaccine are more important for child survival than the specific effects of these vaccines. To strengthen this area Bandim has received funding from DANIDA to organise a PhD training network focusing on the real-life assessment of major interventions. Though our research question many assumptions underlying current immunization policies, WHO is currently evaluating the potential non-specific effects of vaccines. Other focal areas include studies of the epidemiology, treatment or prevention of measles, varicella, acute respiratory infections (including RSV), diarrhoea (including rotavirus, cryptosporidium, enterotoxigenic Escherichia coli , and cholera), malaria, tuberculosis, retrovirus infections (HIV-1, HIV-2, HTLV), and maternal mortality as well as studies of quality of care, humanitarian aid and the consequences of war, child nutrition, vitamin A and micronutrient supplementation, and management of TB and HIV treatment. Funders • DANIDA • Danish National Research Foundation • Novo Nordisk Foundation • Danish Research Councils • EU Collaborators The Bandim Health project collaborates with • Many INDEPTH Centres including Navrongo, Nouna, Niakhar, Nairobi, Kintampo, Chakaria, Matlab and Vadu Health and Demographic Surveillance System. • Medical Research Council Laboratories in the Gambia • Aarhus University, Denmark, • Southern Danish University, Denmark • Nijmegen University and Leiden University, Holland Key Publications 1. Aaby P,Jensen H, Samb B, Cisse B, Sodeman M, Jakobsen M, Poulsen A, Rodrigues A, Lisse IM, Simondon F, Whittle H. Differences in female-male mortality after high-titre measles vaccine and association with subsequent vaccination with diphtheria-tetanus- pertussis and inactivated poliovirus: reanalysis of West African studies. Lancet 2003;361: 2183-88 2. Benn CS, Bale C, Sommerfelt H, Friis H, Aaby P. Vitamin A supplementation and childhood mortality: Amplification of the non-specific effects of vaccines? Int J Epidemiol 2003:32: 822-8 3. Jensen H, Benn CS, Nielsen J, Lisse IM, Rodrigues A, Andersen PK, Aaby P. Survival bias in observational studies of the impact of routine vaccinations on childhood survival. TMIH 2007;12:5-14 4. Sodemann M, Benn CS, Aaby P. Improving child survival. Bandim Health Project 2003- 2008. Copenhagen, 2008 5. Benn CS, Diness BR, Roth A, Nante E, Fisker AB, Lisse IM, Whittle H, Rodrigues A, Yazdanbakhsh M, Aaby P. Randomised trial of the effect on mortality of 50,000 IU vitamin A given with BCG vaccine to infants in Guinea-Bissau, West-Africa. BMJ 2008;336:1416-20 6. Benn CS, Aaby P, Nielsen J, Binka FN, Ross DA. Does vitamin A supplementation interact with routine vaccinations? An analysis of the Ghana vitamin A supplementation trial. AJCN 2009;epub 7. Roth A, Benn CB, Ravn H, Rodrigues A, Lisse IM, Yazdanbakhsh M, Whittle H, Aaby P. A randomised trial of the effect of revaccination with BCG in early childhood and mortality. BMJ 2010;340:c671 8. Benn CS, Fisker A, Roth A, Diness BR, Lausch KR, Ravn H, Yazdanbakhsh M, Rodrigues A, Whittle H, Aaby P. Randomised trial of vitamin A supplementation and BCG vaccination at birth to low-birth-weight children. BMJ 2010;340:c1101 9. Aaby P, Martins CL, Garly ML, Bale C, Andersen A, Rodrigues A, Ravn H, Lisse IM, Benn CS, Whittle H. Non-specific effects of standard measles vaccine at 4.5 and 9 months of age on childhood mortality: Randomised controlled trial. BMJ 2010;341:c6495 10. Aaby P, Roth A, Ravn H, Napirna BM, Rodrigues A, Lisse IM, Stensballe L, Diness BR, Lausch KR, Lund N, Biering-Sørensen S, Whittle H, Benn CS. Randomised trial of BCG vaccination at birth to low-birth-weight children: Beneficial non-specific effects in the neonatal period? JID 2011:204:245-51 11. Aaby P, Whittle HC, Benn CS. Vaccine programmes must consider their effect on general resistance. BMJ 2012;344:e3769 12. Aaby P, Benn CS, Nielsen J, Lisse IM, Rodrigues A, Ravn H. Testing the hypothesis that diphtheria-tetanus-pertussis vaccine has negative non-specific and sex-differential effects on child survival in high-mortality countries. BMJ Open 2012;2:e000707. 13. Aaby P, Martins CL, Garly ML, Rodrigues A, Benn CS, Whittle HC. The optimal age of measles immunization in low-income countries: a secondary analysis of the assumptions underlying the current policy. BMJ Open 2012;2:e000761 .
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