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

Gagan Neupane, Sameer Acharya, Manoj Bhattarai, Ashish Upadhyay, Bishal Belbase, Manoj Bhandari, Drona Pandeya, Shatakshi Pokharel, Sulochana Ghimire, Gorakh Thapa, Biraj Karmacharya, Madan Raj Bhatt, John A. Spertus, Dinesh Neupane, Lava Timsina, Yashashwi Pokharel

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

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-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.

Original languageEnglish (US)
JournalGlobal Advances In Health and Medicine
Volume9
DOIs
StatePublished - 2020
Externally publishedYes

Keywords

  • Nepal
  • cardiovascular disease
  • community-based intervention
  • diabetes
  • disparity
  • hypertension
  • low- and middle-income countries
  • noncommunicable diseases
  • rural health
  • tobacco use

ASJC Scopus subject areas

  • Medicine(all)

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