NCD and Environmental Research Strengthening Training (NErST)

December 26, 2024| Ongoing Project | Reading time: 8 min

Introduction

The Kintampo Health Research Centre (KHRC) is implementing this research training programme in collaboration with the University of Ghana School of Public Health, Columbia University (CU, USA), and the Icahn School of Medicine at Mount Sinai (ISMMS, USA,) to train Ghanaian researchers to address critical public health challenges through epidemiological research on environmental exposures and Non-Communicable Diseases (NCD). This programme is funded by the National Institute with Health (NIH).

Investigators
Dr Kwaku Poku Asante, Japhet Anim, Solomon Nyame, Yvette Eyram Avorgbedor.

Background

Forty-one million people die every year from NCDs, accounting for >70% of all global deaths. Cardiovascular diseases (CVDs) affect nearly 18 million people each year; chronic respiratory diseases and metabolic disease also carry a high burden (>4 million and 1.5 million, respectively). In Ghana, the burden of NCDs is high - about 94,000 NCD deaths are estimated to occur per year, and stroke and ischemic heart disease form about 50% of all NCD deaths.

Metabolic factors (high blood pressure, high body mass index, high fasting blood sugar) and environmental (air pollution) are among the top 10 risk factors for mortality. Evidence-based strategies to address the growing NCD burden are urgently needed. To sustainably move this agenda forward, a training pipeline must be developed to provide Ghanaian scientists with expertise in public health-relevant research and to build institutional research capacity.

Objectives
The programme has the following objectives:

1.To strengthen the capacity of LMIC institutions to conduct NCD research and train a cadre of experts such that KHRC and UGSPH partners will become a national, regional and international center of expertise in NCD research.

2.To support NCD multidisciplinary research training and implementation science.

3.To develop NCD research experts that will directly affect public health policy and care implementation in Ghana, particularly given that NCDs are a demonstrated public health priority.

4.Build critical research infrastructure that will support research capabilities, for example program and grants administration; grant and scientific manuscript writing; data management and information technologies.

5.Build networks for research training within Ghana, with a forward view of expanding to West Africa.

Methodology
The programme will leverage the extant well-characterized, longitudinal cohorts operationally led by KHRC provide robust data and sample repositories for mentored research opportunities. The programme will leverage four main cohorts:

1.the well-characterized Ghana Randomized Air Pollution and Health Study (GRAPHS), a continuously funded pregnancy cohort initiated in 2010 with extensive mother-child dyad health assessments and environmental exposure data and specimen repository.

2. the actively enrolling Pregnancy Risk Stratification Innovation and Measurement Alliance (PRiSMA) study which is enrolling n=3000 pregnant persons with funded longitudinal mother-child follow-up.

Informed consent was sought from parents or guardians before all study activities begun. After consultations and health evaluations, qualified children were enrolled in the trial and closely monitored by study staff from KHRC during treatment.

3. The Kintampo Hypertension Program (KHP), a program that identified the burden of hypertension In 2015 and has currently screened ~10,000 community members to identify, educate and refer hypertension cases for further management using an implementation science approach (TASSH -Task Strengthening Strategy for Hypertension).

4. the Kintampo Health and Demographic Surveillance System (KHDSS), a progressive surveillance cohort started in 2003 that currently follows 540,000 individuals with 6-month morbidity and mortality surveillance.

Taken together, these cohorts provide an opportunity to take a life course approach and examine how environmental exposures beginning prenatally shape future NCD risk (GRAPHS, PRISMA); how, once risk factors develop, environmental exposures accelerate NCD progression (KHP, GRAPHS mothers cohort); and finally, how environmental exposures are associated with all-cause and cause-specific mortality (KHDSS).

Expected Outcomes
This programme is expected to strengthen core research skills in Ghana and develop a pipeline of experts focused on life-course non-communicable disease (NCD) risks. These experts will work on creating and implementing evidence-based solutions to tackle the rising NCD burden in Ghana and other West African countries.

Collaborating Institutions

University of Ghana School of Public Health (UGSPH).
Icahn School of Medicine at Mount Sinai (ISMMS).
The Trustees of Columbia University in the City of New York.
Lamont Doherty Earth Observatory

Study Duration

Five (5) Years
Start Date: 2024
End Date: 2029