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

Abstract

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-tomiddle-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,

Difficulties in Accessing Cancer Care in a Small Island State: A Community-Based Pilot Study of Cancer Survivors in Saint Lucia

“…These knowledge gaps cannot be addressed locally using the same approach as previous studies from high-income countries [ 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 ] given the limited research capacity on the island, which is a common issue among SIDS [ 26 ]. On the other hand, community-based approaches in research have been successfully implemented in some LMICs to generate responsive and patient-centered insights into cancer prevention [ 27 , 28 , 29 ]. A study of this type is novel for Saint Lucia.…”

Proposed ‘Healthy Lifestyle Center’ model utilizing integrated primary care for non-communicable diseases’ prevention and management in rural Nepal

“…12 However, many areas of the country still lack baseline information on the prevalence of NCDs and underlying risk factors. 9,10,13 Nepal's PHC model provides services centered on treating infectious diseases, with NCDs identified primarily through health facility-based screenings. 9,10,14 These centers are ill-equipped to manage the long-term chronic care needs and comorbidities associated with NCDs.…”

“…9,10,13 Nepal's PHC model provides services centered on treating infectious diseases, with NCDs identified primarily through health facility-based screenings. 9,10,14 These centers are ill-equipped to manage the long-term chronic care needs and comorbidities associated with NCDs. 14 A 2020 report projected that on the current course, NCDs will contribute to the highest proportion of deaths in Nepal by the year 2040.…”