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Drakenstein Child Health Study (DCHS)

Study Overview

The Drakenstein Child Health Study (DCHS) is a multi-year birth cohort study following 1,000 mother child pairs to investigate the epidemiology, aetiology and risk factors for childhood lower respiratory illness and the impact on child health, including the development of chronic respiratory disease. The study aims to investigate the role and interaction of potential risk factors covering 7 areas (environmental, infectious, nutritional, genetic, psychosocial, maternal and immunological risk factors) that may impact on child health (Fig 1). Mothers are enrolled at 20-28 weeks gestation and children followed until they reach five years of age.  This approach will provide an innovative, longitudinal assessment of a range of clinical, molecular, environmental and socioeconomic variables impacting on childhood respiratory illness and the evolution of chronic disease in a low and middle-income country setting.   This study takes place at three sites in the Drakenstein sub-district near Cape Town, South Africa.

Why is the Drakenstein Child Health Study being done?

Childhood pneumonia is the leading cause of mortality and morbidity in children under 5 years of age. Pneumonia accounts for 18% of the approximate 6.6 million child deaths each year, occurring predominantly in low or middle income countries (LMIC). Although African children comprise only about 18% of the global under-5 population, almost 42% of childhood deaths occur on this continent.  Improved availability of the new conjugate vaccines (Haemophilus influenzae type B, Hib, and pneumococcal conjugate vaccine, PCV) may change the burden and aetiology of childhood pneumonia in LMIC. The aetiology of severe pneumonia in LMIC has not been comprehensively studied despite the large burden of pneumonia and unique environmental and host factors.  A number of risk factors for pneumonia or severe disease have been reported, but there is a lack of data on the interaction or cumulative effects of these on the development of pneumonia in LMIC.

Figure 1 Drakenstein Child Health Study Schema

Study Management Team


The Drakenstein Child Health Study is structured to allow for collective ownership of the project across partners while ensuring a functional management system. The co-investigators and expert advisory group members are amongst the leading experts in their respective fields and will ensure a multi-disciplinary collaborative approach to the proposed study.

Heather J. Zar, MBChB, FCPaeds, PhD is the Principal Investigator, providing oversight and direction to the overall project. Prof Zar is located in the Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital, UCT​.

Mark Nicol, MMed, PhD leads the microbiological and laboratory aspects of the project.  He is a specialist clinical microbiologist holding a joint appointment position with the University of Cape Town and the National Health Laboratory Service of South Africa.

Landon Myer, MBChB, PhD is the epidemiologist for the project, providing guidance on study design and analyses.  Prof Myer is an Associate Professor in the School of Public Health & Family Medicine, UCT.

Dan Stein, MBChB, PhD leads the psychosocial aspects of the study.  He is currently the Head of the Department of Psychiatry and Mental Health, UCT.