The BHDSS is a longitudinal population-based study designed to monitor demographic and health trends and support research on infectious diseases and public health interventions in rural Gambia. As of December 2022, the cohort includes over 213,000 participants from 224 villages in the southern half of the Upper River Region (URR). Participants were recruited from 2007 through a full census of the region, with all residents enumerated and assigned unique identifiers. The cohort is predominantly rural and ethnically diverse, with major groups including Serahule, Fula, and Mandinka. The population has grown from almost 142,000 individuals in 2007 through natural demographic changes and continued inclusion of new residents. Participants are followed up every four months through household visits that collect data on births, deaths, pregnancies, migrations, vaccinations, and education.

Recruitment is ongoing