Cohort profile: the BangladEsh Longitudinal Investigation of Emerging Vascular and nonvascular Events (BELIEVE) cohort study

Rajiv Chowdhury ¹, Nusrat Khan ², Lisa Pennells ^3,4

¹Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA.
²Population Health Sciences Institute, Newcastle University Population Health Sciences Institute, Newcastle upon Tyne, UK.
³British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
⁴Victor Phillip Dahdaleh Heart and Lung Research Institute, University of Cambridge, Cambridge, UK.
⁵Directorate General of Health Services, Cumilla Medical College, Cumilla, Bangladesh.
⁶Deapartment of Epidemiology & Research, National Heart Foundation Hospital and Research Institute, Dhaka, Bangladesh.
⁷Department of Public Health and Informatics, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.
⁸Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA.
⁹Nutrition Research Division, International Centre for Diarrhoeal Disease Research Bangladesh (icddr,b), Dhaka, Bangladesh.
¹⁰Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
¹¹Office of the Executive Director, International Centre for Diarrhoeal Disease Research Bangladesh (icddr,b), Dhaka, Bangladesh.
¹²Department of Pathology, University of Cambridge, Cambridge, UK.
¹³National Heart Foundation Hospital and Research Institute, Dhaka, Bangladesh.
¹⁴British Heart Foundation Centre of Research Excellence, University of Cambridge, Cambridge, UK.
¹⁵National Institute for Health and Care Research Blood and Transplant Research Unit in Donor Health and Behaviour, University of Cambridge, Cambridge, UK.
¹⁶Health Data Research UK Cambridge, Wellcome Genome Campus and University of Cambridge, Cambridge, UK.
¹⁷Yusuf Hamied Department of Chemistry, University of Cambridge, Cambridge, UK.
¹⁸TESLA-Analytical Chemistry, Institute of Chemistry, University of Graz, Graz, Austria.
¹⁹Centre for Sustainable Development, Department of Engineering, University of Cambridge, Cambridge, UK.
²⁰National Institute of Preventive and Social Medicine, Dhaka, Bangladesh.
²¹Institute for Global Health, University College London, London, UK.
²²Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research Bangladesh (icddr,b), Dhaka, Bangladesh.
²³Department of Economics, University of Massachusetts Amherst, Amherst, Massachusetts, USA.
²⁴Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research Bangladesh (icddr,b), Dhaka, Bangladesh.
²⁵Non Communicable Diseases, Nutrition Research Division, International Centre for Diarrhoeal Disease Research Bangladesh (icddr,b), Dhaka, Bangladesh.
²⁶Institute of Epidemiology, Disease Control and Research (IEDCR), Dhaka, Bangladesh.
²⁷Behavioural Science Group, Department of Public Health and Primary Care, University of Cambridge, Cambridge, Cambridgeshire, UK.
²⁸Global Health Resilience Group, Barcelona Supercomputing Center, Barcelona, Spain.
²⁹Cambridge Centre of Artificial Intelligence in Medicine, University of Cambridge, Cambridge, UK.
³⁰MRC Epidemiology Unit, University of Cambridge, Cambridge, UK.
³¹British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK ed303@medschl.cam.ac.uk.
³²Health Data Science Centre, Human Technopole, Milan, Italy.
³³Department of Human Genetics, Wellcome Sanger Institute, Hinxton, UK.

⁰Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA.

Bmj Open +

|

January 22, 2025

View abstract on PubMed

Summary

Bangladesh is shifting towards non-communicable diseases (NCDs). The BELIEVE study investigates NCD determinants, finding higher prevalences of hypertension, diabetes, and obesity in urban settings.

Area Of Science

Epidemiology
Public Health
Chronic Disease Research

Background

Bangladesh is undergoing an epidemiological transition, with a rise in non-communicable diseases (NCDs).
Limited understanding exists regarding the multidimensional factors influencing NCDs in the Bangladeshi population.
The BangladEsh Longitudinal Investigation of Emerging Vascular and nonvascular Events (BELIEVE) study was established to address this knowledge gap.

Purpose Of The Study

To investigate the biological, behavioral, environmental, and broader determinants of NCDs in Bangladesh.
To establish a household-based prospective cohort for long-term NCD research.
To provide insights into the epidemiological transition of diseases in a low-middle-income country.

Main Methods

Recruited 73,883 participants aged 11+ from 30,817 households across urban, slum, and rural settings between January 2016 and March 2020.
Administered structured questionnaires covering demographic, socioeconomic, behavioral, medical, and environmental factors.
Collected anthropometric measurements, blood pressure, and biological specimens for analysis.

Main Results

Among 65,822 adults (20-79 years), prevalences were 23% for hypertension, 16% for type 2 diabetes, and 12% for hypercholesterolemia.
Age and sex-standardized prevalences of these NCDs were significantly higher in urban settings compared to slum and rural areas.
Mean Body Mass Index (BMI) was 25 kg/m², with 16% classified as obese (BMI≥30 kg/m²), and higher in urban areas.

Conclusions

The BELIEVE cohort provides a robust resource for studying NCD determinants in Bangladesh.
Findings highlight significant urban-rural disparities in NCD prevalence and obesity.
This research is crucial for advancing scientific discovery and informing public health strategies in low-middle-income countries.

Keywords:

Chronic Disease EPIDEMIOLOGIC STUDIES Observational Study

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