Feasibility of a large cohort study in sub-Saharan Africa assessed through a four-country study.

Journal: Global health action

Volume: 8

Issue: 

Year of Publication: 2016

Affiliated Institutions:  Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA; sdalal@hsph.harvard.edu. Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA. Centre for Evidence-Based Health Care, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa. Department of Community Health, Mbarara University of Science and Technology, Mbarara, Uganda. Department of Epidemiology & Biostatistics, Makerere School of Public Health, Kampala, Uganda. Department of Physiology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania. Institute of Human Virology, Abuja, Nigeria. Department of Internal Medicine, Muhimbili National Hospital, Dar es Salaam, Tanzania. Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria. Department of Medicine, Makerere School of Medicine, Kampala, Uganda. Department of Environmental Health, Harvard School of Public Health, Boston, MA, USA. Department of Health Policy and Management, Harvard School of Public Health, Boston, MA, USA.

Abstract summary 

Large prospective epidemiologic studies are vital in determining disease etiology and forming national health policy. Yet, such studies do not exist in sub-Saharan Africa (SSA) notwithstanding the growing burden of chronic diseases.We explored the feasibility of establishing a large-scale multicountry prospective study at five sites in four sub-Saharan countries.Based on country-specific considerations of feasibility, Nigeria enrolled health care professionals, South Africa and Tanzania enrolled teachers, and Uganda enrolled village residents at one rural and one periurban site each. All sites used a 6-month follow-up period but different approaches for data collection, namely standardized questionnaires filled out by participants or face-to-face interviews.We enrolled 1415 participants from five sites (range 200-489) with a median age of 41 years. Approximately half had access to clean-burning cooking fuel and 70% to piped drinking water, yet 92% had access to a mobile phone. The prevalence of chronic diseases was 49% among 45- to 54-year-olds and was dominated by hypertension (21.7% overall) - ranging from 4.5 to 31.2% across sites - and a serious injury in the past 12 months (12.4% overall). About 80% of participants indicated willingness to provide blood samples. At 6-month follow-up, 68% completed a questionnaire (45 to 96% across sites) with evidence that mobile phones were particularly useful.Our pilot study indicates that a large-scale prospective study in SSA is feasible, and the burden of chronic disease in SSA may already be substantial necessitating urgent etiologic research and primary prevention.

Authors & Co-authors:  Dalal Shona S Holmes Michelle D MD Laurence Carien C Bajunirwe Francis F Guwatudde David D Njelekela Marina M Adebamowo Clement C Nankya-Mutyoba Joan J Chiwanga Faraja S FS Volmink Jimmy J Ajayi Ikeoluwapo I Kalyesubula Robert R Reid Todd G TG Dockery Douglas D Hemenway David D Adami Hans-Olov HO

Study Outcome 

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Statistics
Citations :  Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380:2095–128.
Authors :  16
Identifiers
Doi : 10.3402/gha.v8.27422
SSN : 1654-9880
Study Population
Male,Female
Mesh Terms
Adolescent
Other Terms
Nigeria;South Africa;Tanzania;Uganda;chronic disease;injury;non-communicable
Study Design
Cohort Study,Cross Sectional Study
Study Approach
Country of Study
Uganda
Publication Country
United States