Non-communicable diseases (NCDs) are already the commonest cause of death in the rural areas of South Asia. A rise in the prevalence of cardiovascular and cardio-metabolic disease among rural populations has important public health implications, since, notwithstanding the rapid urbanization, two-thirds of the South Asian population still lives in rural areas; therefore, characterising NCD risk in the context of urban-rural disparities in environmental and lifestyle risk factors is critical.

BangladEsh Longitudinal Investigation of Emerging Vascular Events-Rural (BELIEVE-Rural) study aims to create a large-scale prospective cohort study in the rural Matlab area in Bangladesh. The principal partner collaborator of BELIEVE Rural’s is icddr,b, an internationally renowned organization that maintains in Matlab one of the developing world’s longest-running Health and Demographic Surveillance Systems (HDSS) in ~140 villages, encompassing ~230,000 individuals in Matlab area. The 30,000-person BELIEVE-rural cohort study will provide information regarding environmental (e.g. air pollution, water pollution, iron deficiency) and biological risk factors (e.g. lipids, hypertension, genetics).

The key objectives of the BELIEVE-Rural cohort study are to establish an NCD long-lasting and multi-purpose population platform to 1) study the role played by context-specific environmental hazards, such as exposure to toxic metals linked to supply water provisions (eg, arsenic), and air pollution (eg, indoor air pollution owing to traditional cooking methods); 2) assess how the characteristics of the communities and households may vary in the urban-rural context ; 3) study the association of complex and unresolved issues such as the role of gene-environment interactions in the cardiovascular pathogenesis of rural-distinctive phenotypes; 4) understand the interplay of NCD anthropometric and biochemical risk factors together with health-related behaviours specific for the rural setting (eg, cigarette smoking, physical inactivity, lipids profile, BMI); 5) assist the health-service research to tackle health systems challenges for a population that may be underserved; 6) develop and evaluate practicable, feasible and acceptable interventions applicable for the large and underrepresented rural populations worldwide.

The BELIEVE-Rural study (along with the BELIEVE-Urban and BELIEVE-Slum studies) has been underpinned by the Global Challenges Research Funds from the Research Councils UK.

Key people involved in the study:

Dr Rajiv Chowdhury (lead Principal Investigator)

Dr Fazal Khan, Dr Emanuele Di Angelantonio and Professor John Danesh (co-Principal Investigators)

Dr Rubhana Raqib, Dr Anisur Rahman, Dr Sirajul Islam, Dr. Ruchira Tabassum Naved, Dr Sohel Choudhury, Dr Md Khalequzzaman, Dr Meerjadi Sabrina Flora, Dr Tahmeed Ahmed (co-investigators)

Ms Giulia Loffreda (Scientific Study Coordinator)

Ms Catherine Perry (data management)

Ms Silvia Alonso Rodriguez (laboratory sciences coordinator)

Mr Richard Houghton (Head of operations)