Biomarkers in population based surveys: new evidence for informed policy making

Alfredo L. Fort, Program for Appropriate Technology in Health (PATH)
Dean Garrett, Macro International Inc.
Jasbir K. Sangha, Macro International Inc.
Fred Arnold, Macro International Inc.
Monica Kothari, Program for Appropriate Technology in Health (PATH)

Since inclusion of anthropometry in 1984, Demographic and Health Surveys (DHS) have conducted more than 95 tests and measurements, mostly for anemia, HIV infection and malnutrition. Anthropometric data have allowed governments to fight malnutrition through nutrition education and school food supplementation programs. Anemia testing in 1992 among children and pregnant women has helped implement micronutrient and food supplementation campaigns, distribution of iron and folate pills during antenatal care. HIV testing since 2001 lead countries to down-revise original HIV estimates obtained from surveillance sites, and provides a realistic picture for better targeting of sub-populations, areas most affected. Other biomarkers are being incorporated: rapid diagnostic testing for malaria, retinol-binding protein assay (Vit. A), tetanus toxoid, herpes virus, prostate specific antigen, transferrin (for iron deficiency) and C-reactive protein are a few. Microfluidics will allow a “battery” of tests for chronic and genetic conditions to be performed with a fraction of blood collected currently.