Measurement of biomarkers in surveys in developing countries: Opportunities and problems

Reliable and comprehensive data on disease levels, patterns, and trends in populations are required to monitor global and local epidemics and to asses s the effectiveness of public health approaches to disease and injury preve ntion and control. For most developing countries, little is reliably known about causes of mortality or about disease incidence, prevalence, and durat ion. Advances in technology offer the opportunity to collect biomarkers-bio logical and clinical data-in existing large-scale, national sample surveys. Such data on biomarkers could result in significantly better insight into public health problems and more rational and equitable policies leading to improved health. The combination of traditionally collected behavioral data with biological and clinical data affords many possibilities to better ass ess health problems and to develop the most cost-effective set of intervent ions. Careful assessment and discussion of the potential public health bene fits, ethical issues, and logistical challenges should guide the applicatio n of technological advances in population-based surveys.