Use of Health and Demographic Surveillance Site Data for Secondary Analyses: Guidance for Researchers Using Examples from Existing Analyses

Estelle McLean, London School of Hygiene and Tropical Medicine (LSHTM)
Rebecca Sear, London School of Hygiene and Tropical Medicine (LSHTM)
Emma Slaymaker, London School of Hygiene and Tropical Medicine (LSHTM)

Health and Demographic Surveillance Sites (HDSS) are geographic open cohorts in low and middle-income countries, including many across Africa. Data on demographic events, socio-demographic and health indicators are regularly gathered on the whole population, often for decades, and, while most HDSSs operate independently, data collected in different sites are often similar. This results in opportunities for complex, comparative or pooled longitudinal analyses which may take household and familial contexts into account. HDSSs also have issues which can make interpretation of data challenging: lack of data on migrants when they are outside the area may cause bias, and data repeatedly collected may result in inconsistencies and/or more reliable data for participants present in the HDSS for longer. This paper uses an in-depth review of published complex HDSS analyses to demonstrate the utility of using HDSS data for secondary analyses, and to provide guidance on the conduct and reporting of these analyses.