BELIEVE Urban

In South Asia, the burden of cardiovascular and other chronic non-communicable diseases (NCDs) have increased in an unprecedented scale and are expected to be much greater than any other geographical area worldwide. A fifth of the global population are now South Asians, and they currently represent the largest immigrant group in major Western countries (including the United Kingdom). South Asia is also one of the most densely-populated regions with world’s highest rates of urbanisation. There is a growing interest, therefore, in (1) better understanding their risk profile, especially those who live in urban settings, and (2) developing bespoke interventions to prevent NCDs in these populations.

BangladEsh Longitudinal Investigation of Emerging Vascular Events-Urban (BELIEVE-Urban) study, in this regard, has been designed as a large-scale prospective cohort investigation among South Asians living specifically in the urban areas. The study, in collaboration with National Heart Foundation in Bangladesh, aims to recruit up to 75,000 inhabitants (age >18 years) from urban households in Bangladesh (~30,000 participants have so far been recruited by January 2018). The study population will be recruited through a household survey to ensure maximum and generalizable participation, particularly from individuals with shared environmental and genetic background.

The key objectives of the BELIEVE-Urban cohort study are to create a re-callable population and bio-resource involving an urban population to: (1) enable genetic discovery using diverse phenotypes (particularly those related to nutrition such as anaemia, infection, or environment-related aspects such as air and toxic metal pollution), causal evaluation and functional genomics; (2) assess reliably the roles of established and unique locally-relevant risk factors (and their heritability) on incident NCDs such as cardiovascular, cancer, diabetes and kidney diseases (ascertained by clinical records and standardised validation); (3) help study discrepant risk factor patterns over time unique to this population (eg, urbanicity, rural-to-urban migration, patterns of health systems utilization, patterns and barriers of optimal dietary and physical activity practices); and (4) create a well-characterised urban population platform to set-up scalable, cost-effective and context-specific behaviour modification and other interventions, suitable for increasingly urbanised populations of the low- and middle-income countries.

The BELIEVE-Urban study (along with the BELIEVE-Rural 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 Sohel Reza Choudhury, Dr Emanuele Di Angelantonio and Professor John Danesh (co-Principal Investigators)

Dr Fazila-Tun-Nesa Malik, Dr Abdul Malik, Dr Tuhin Haque, Dr M A Rouf, Dr Md Khalequzzaman, Dr Fazal Khan, Dr Meerjadi Sabrina Flora (co-investigators)

Dr Md. Mostafa Monower, Dr Ishrat Tasmin (study coordinators)

Mr Mir Shahadul Islam (project manager)

Ms Catherine Perry, Mr Zahidur Rahman (statistical sciences and data management)

Mr Richard Houghton, Ms Silvia Alonso Rodriguez, Ms Hosne Ara Rekha (Operations)

Contact: believe-urban@capable-bangladesh.org