CARRS Surveillance study: design and methods to assess burdens from multiple perspectives

• Type of Material: Article
• Authors: Manisha Nair, Public Health Foundation of India (PHFI); Mohammed K Ali, Emory University; Vamadevan S. Ajay, CoE-CARRS, PHFI; Roopa Shivashankar, CoE-CARRS, Public Health Foundation of India & Centre for Chronic Disease Control (CCDC); Viswanathan Mohan, Madras Diabetes Research Foundation (MDRF); Rajendra Pradeepa, Madras Diabetes Research Foundation (MDRF); Mohan Deepa, Madras Diabetes Research Foundation (MDRF); Hassan M. Khan, Aga Khan University; Muhammad M. Kadir, Aga Khan University; Zafar A. Fatmi, Aga Khan University; K. Srinath Reddy, Public Health Foundation of India (PHFI); Nikhil Tandon, All India Institute of Medical Sciences (AIIMS); K.M. Venkat Narayan, Emory University; Dorairaj Prabhakaran, Emory University
• Language: English
• Date: 2012-08-28
• Publisher: BioMed Central
• Publication Version: Final Published Version
• Copyright Statement: © 2012 Nair et al.; licensee BioMed Central Ltd.
• License: Creative Commons Attribution 2.0 Generic
• Final Published Version (URL): http://www.biomedcentral.com/1471-2458/12/701
• Title of Journal or Parent Work: BMC Public Health
• ISSN: 1471-2458
• Volume: 12
• Issue: 701
• Start Page: 1
• End Page: 12
• Grant/Funding Information: However, the contents of this paper are solely the responsibility of the writing group and do not necessarily represent the official views of FIC, Vanderbilt University, Emory University, PHFI, NICHD, or the NIH.; This project is funded in whole or in part by the National Heart, Lung, and Blood Institute, National Institutes of Health (NIH), Department of Health and Human Services, under Contract No. HHSN268200900026C, and the United Health Group, Minneapolis, Mn, USA.; Several members of the research team at PHFI, Emory University, and CCDC were/are supported by the Fogarty International Clinical Research Scholars – Fellows programme (FICRS-F) through Grant Number 5R24TW007988 from NIH, Fogarty International Center (FIC) through Vanderbilt University, Emory’s Global Health Institute, and D43 NCDs in India Training Program through Award Number D43HD05249 from the Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD) and FIC.; We hereby, acknowledge the contributions of the field and research staff of the “CARRS Surveillance Investigators’ Group” (a list of all members is included in the full publication).; This study is coordinated by CoE-CARRS (Center of Excellence - Center for CArdio-metabolic Risk Reduction in South Asia ) based at Public Health Foundation of India (PHFI), New Delhi, India in collaboration with Centre for Chronic Disease Control (CCDC), New Delhi, Emory University, Atlanta, U.S.A, All India Institute of Medical Sciences (AIIMS), New Delhi, Madras Diabetes Research Foundation (MDRF), Chennai, India and Aga Khan University, Karachi, Pakistan.
• Keywords: “Cardio-metabolic diseases”; Surveillance; Risk-factors; South-Asia
• Research Categories: Health Sciences, Public Health

Abstract

Background Cardio-metabolic diseases (CMDs) are a growing public health problem, but data on incidence, trends, and costs in developing countries is scarce. Comprehensive and standardised surveillance for non-communicable diseases was recommended at the United Nations High-level meeting in 2011. Aims: To develop a model surveillance system for CMDs and risk factors that could be adopted for continued assessment of burdens from multiple perspectives in South-Asian countries. Methods Design: Hybrid model with two cross-sectional serial surveys three years apart to monitor trend, with a three-year prospective follow-up of the first cohort. Sites: Three urban settings (Chennai and New Delhi in India; Karachi in Pakistan), 4000 participants in each site stratified by gender and age. Sampling methodology: Multi-stage cluster random sampling; followed by within-household participant selection through a combination of Health Information National Trends Study (HINTS) and Kish methods. Culturally-appropriate and methodologically-relevant data collection instruments were developed to gather information on CMDs and their risk factors; quality of life, health-care utilisation and costs, along with objective measures of anthropometric, clinical and biochemical parameters. The cohort follow-up is designed as a pilot study to understand the feasibility of estimating incidence of risk factors, disease events, morbidity, and mortality. Results The overall participant response rate in the first cross-sectional survey was 94.1% (Chennai 92.4%, n = 4943; Delhi 95.7%, n = 4425; Karachi 94.3%, n = 4016). 51.8% of the participants were females, 61.6% < 45years, 27.5% 45–60years and 10.9% >60 years. Discussion This surveillance model will generate data on prevalence and trends; help study the complex life-course patterns of CMDs, and provide a platform for developing and testing interventions and tools for prevention and control of CMDs in South-Asia. It will also help understanding the challenges and opportunities in establishing a surveillance system across countries.