Field-based random sampling without a sampling frame: control selection for a case-control study in rural Africa

Selection bias, particularly of controls, is common in case-control studies and may materially affect the results. Methods of control selection should be tailored both for the risk factors and disease under investigation and for the population being studied. We present here a control selection metho d devised for a case-control study of tuberculosis in rural Africa (Karonga , northern Malawi) that selects an age/ sex frequency-matched random sample of the population, with a geographical distribution in proportion to the p opulation density. We also present an audit of the selection process, and d iscuss the potential of this method in other settings.