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Study, Design, and Rationale of Noncommunicable Diseases in Nepal (NCD Nepal) Study: A Community-Based Prospective Epidemiological and Implementation Study in Rural Nepal

BACKGROUND: Noncommunicable diseases (NCDs) are the leading causes of deaths globally. Currently, there are limited high-quality data on the epidemiology and usefulness of community-based screening and treatment of NCDs in low-to-middle-income countries (LMIC), like Nepal. We describe the protocol o...

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Autores principales: Neupane, Gagan, Acharya, Sameer, Bhattarai, Manoj, Upadhyay, Ashish, Belbase, Bishal, Bhandari, Manoj, Pandeya, Drona, Pokharel, Shatakshi, Ghimire, Sulochana, Thapa, Gorakh, Karmacharya, Biraj, Bhatt, Madan Raj, Spertus, John A, Neupane, Dinesh, Timsina, Lava, Pokharel, Yashashwi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7139172/
https://www.ncbi.nlm.nih.gov/pubmed/32284911
http://dx.doi.org/10.1177/2164956120917379
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author Neupane, Gagan
Acharya, Sameer
Bhattarai, Manoj
Upadhyay, Ashish
Belbase, Bishal
Bhandari, Manoj
Pandeya, Drona
Pokharel, Shatakshi
Ghimire, Sulochana
Thapa, Gorakh
Karmacharya, Biraj
Bhatt, Madan Raj
Spertus, John A
Neupane, Dinesh
Timsina, Lava
Pokharel, Yashashwi
author_facet Neupane, Gagan
Acharya, Sameer
Bhattarai, Manoj
Upadhyay, Ashish
Belbase, Bishal
Bhandari, Manoj
Pandeya, Drona
Pokharel, Shatakshi
Ghimire, Sulochana
Thapa, Gorakh
Karmacharya, Biraj
Bhatt, Madan Raj
Spertus, John A
Neupane, Dinesh
Timsina, Lava
Pokharel, Yashashwi
author_sort Neupane, Gagan
collection PubMed
description BACKGROUND: Noncommunicable diseases (NCDs) are the leading causes of deaths globally. Currently, there are limited high-quality data on the epidemiology and usefulness of community-based screening and treatment of NCDs in low-to-middle-income countries (LMIC), like Nepal. We describe the protocol of a community-based, longitudinal epidemiological study of screening and management of NCDs in rural Nepal. METHODS: We organize monthly mobile health clinics to screen NCDs among 40- to 75-year-old residents from municipal subdivision wards 3, 4, 6, and 7 of Ghorahi submetropolitan city, Dang, Nepal (approximately 406 km west of the capital, Kathmandu). We estimate a total of 7052 eligible participants. After obtaining informed consent, trained personnel will collect sociodemographic and lifestyle data, medical, medication, and family history using validated questionnaires, plus anthropometric measures and capillary glucose levels. We will screen for hypertension, diabetes, obesity, dyslipidemia, tobacco and alcohol use, self-reported physical activity, dietary habits, cardiovascular disease, stroke, chronic lung disease, cancer, and chronic kidney disease. We will also check hemoglobin A1C, lipid panel, serum creatinine, sodium, potassium, urine dipstick, and urine albumin-to-creatinine ratio in high-risk participants. We will offer lifestyle counseling, pharmacotherapy or refer to higher level care, where appropriate; routinely follow participants with NCDs for continuity of care; and follow individuals without NCDs but with elevated glucose, prehypertension or other risk factors every year, and those without risk factors every 2 years. We will monitor participants in the community to reduce attrition and to track all-cause and disease-specific mortality. DISCUSSION: Understanding the community burden of NCDs in resource-limited setting and testing effectiveness of community-based screening and management of NCDs will provide insights to develop national policy to address NCD burden in LMIC like Nepal.
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spelling pubmed-71391722020-04-13 Study, Design, and Rationale of Noncommunicable Diseases in Nepal (NCD Nepal) Study: A Community-Based Prospective Epidemiological and Implementation Study in Rural Nepal Neupane, Gagan Acharya, Sameer Bhattarai, Manoj Upadhyay, Ashish Belbase, Bishal Bhandari, Manoj Pandeya, Drona Pokharel, Shatakshi Ghimire, Sulochana Thapa, Gorakh Karmacharya, Biraj Bhatt, Madan Raj Spertus, John A Neupane, Dinesh Timsina, Lava Pokharel, Yashashwi Glob Adv Health Med Original Article BACKGROUND: Noncommunicable diseases (NCDs) are the leading causes of deaths globally. Currently, there are limited high-quality data on the epidemiology and usefulness of community-based screening and treatment of NCDs in low-to-middle-income countries (LMIC), like Nepal. We describe the protocol of a community-based, longitudinal epidemiological study of screening and management of NCDs in rural Nepal. METHODS: We organize monthly mobile health clinics to screen NCDs among 40- to 75-year-old residents from municipal subdivision wards 3, 4, 6, and 7 of Ghorahi submetropolitan city, Dang, Nepal (approximately 406 km west of the capital, Kathmandu). We estimate a total of 7052 eligible participants. After obtaining informed consent, trained personnel will collect sociodemographic and lifestyle data, medical, medication, and family history using validated questionnaires, plus anthropometric measures and capillary glucose levels. We will screen for hypertension, diabetes, obesity, dyslipidemia, tobacco and alcohol use, self-reported physical activity, dietary habits, cardiovascular disease, stroke, chronic lung disease, cancer, and chronic kidney disease. We will also check hemoglobin A1C, lipid panel, serum creatinine, sodium, potassium, urine dipstick, and urine albumin-to-creatinine ratio in high-risk participants. We will offer lifestyle counseling, pharmacotherapy or refer to higher level care, where appropriate; routinely follow participants with NCDs for continuity of care; and follow individuals without NCDs but with elevated glucose, prehypertension or other risk factors every year, and those without risk factors every 2 years. We will monitor participants in the community to reduce attrition and to track all-cause and disease-specific mortality. DISCUSSION: Understanding the community burden of NCDs in resource-limited setting and testing effectiveness of community-based screening and management of NCDs will provide insights to develop national policy to address NCD burden in LMIC like Nepal. SAGE Publications 2020-04-07 /pmc/articles/PMC7139172/ /pubmed/32284911 http://dx.doi.org/10.1177/2164956120917379 Text en © The Author(s) 2020 https://creativecommons.org/licenses/by-nc/4.0/ Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Original Article
Neupane, Gagan
Acharya, Sameer
Bhattarai, Manoj
Upadhyay, Ashish
Belbase, Bishal
Bhandari, Manoj
Pandeya, Drona
Pokharel, Shatakshi
Ghimire, Sulochana
Thapa, Gorakh
Karmacharya, Biraj
Bhatt, Madan Raj
Spertus, John A
Neupane, Dinesh
Timsina, Lava
Pokharel, Yashashwi
Study, Design, and Rationale of Noncommunicable Diseases in Nepal (NCD Nepal) Study: A Community-Based Prospective Epidemiological and Implementation Study in Rural Nepal
title Study, Design, and Rationale of Noncommunicable Diseases in Nepal (NCD Nepal) Study: A Community-Based Prospective Epidemiological and Implementation Study in Rural Nepal
title_full Study, Design, and Rationale of Noncommunicable Diseases in Nepal (NCD Nepal) Study: A Community-Based Prospective Epidemiological and Implementation Study in Rural Nepal
title_fullStr Study, Design, and Rationale of Noncommunicable Diseases in Nepal (NCD Nepal) Study: A Community-Based Prospective Epidemiological and Implementation Study in Rural Nepal
title_full_unstemmed Study, Design, and Rationale of Noncommunicable Diseases in Nepal (NCD Nepal) Study: A Community-Based Prospective Epidemiological and Implementation Study in Rural Nepal
title_short Study, Design, and Rationale of Noncommunicable Diseases in Nepal (NCD Nepal) Study: A Community-Based Prospective Epidemiological and Implementation Study in Rural Nepal
title_sort study, design, and rationale of noncommunicable diseases in nepal (ncd nepal) study: a community-based prospective epidemiological and implementation study in rural nepal
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7139172/
https://www.ncbi.nlm.nih.gov/pubmed/32284911
http://dx.doi.org/10.1177/2164956120917379
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