This study was conducted on the coast of Kenya, within the Kilifi Health and Demographic Surveillance System (KHDSS)
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14 (link). The KHDSS area was defined and mapped for demographic surveillance, clinical and epidemiological research by the KEMRI Wellcome Trust Research Programme (KWTRP) in the year 2000. It is located in Kilifi County along the coastal fringe and covers an area of 891 km
2, 50 km north and south, and 30 km west, of the KCH. The KHDSS monitors a population of around 296,000 residents (2016 census) through household enumeration visits conducted every 4 months. The major economic activity of most residents is subsistence farming of maize, cassava, cashew nuts and coconuts, as well as goats and dairy cattle
14 (link).
The KHDSS area has 21 public health facilities (including the KCH) receiving out-patients, which operate under the Kenya Ministry of Health (MoH). In total, nine of these facilities were selected for this study: Matsangoni, Ngerenya, Mtondia, Sokoke, Mavueni, Jaribuni, Chasimba, Pingilikani and Junju (
Figure 1). The facilities were purposively selected to provide a broad representation across the geographical region, covering major road networks into the location and variation in population density. All specimen processing and testing was carried out at KEMRI-Wellcome Trust Research Programme laboratories in Kilifi.
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