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BMC Public Health. 2012; 12: 701.
Published online Aug 28, 2012. doi:  10.1186/1471-2458-12-701
PMCID: PMC3491014
CARRS Surveillance study: design and methods to assess burdens from multiple perspectives
Manisha Nair,1 Mohammed K Ali,2 Vamadevan S Ajay,3 Roopa Shivashankar,4 Viswanathan Mohan,5 Rajendra Pradeepa,6 Mohan Deepa,6 Hassan M Khan,7 Muhammad M Kadir,7 Zafar A Fatmi,7 K Srinath Reddy,8 Nikhil Tandon,9 KM Venkat Narayan,10 and Dorairaj Prabhakarancorresponding author4
1Public Health Foundation of India (PHFI), New Delhi & CoE-CARRS, PHFI, New Delhi, India
2Emory University, Atlanta, USA
3CoE-CARRS, PHFI, New Delhi, India
4CoE-CARRS, Public Health Foundation of India & Centre for Chronic Disease Control (CCDC), Tower No. 4, Commercial Complex, Sector-C, Pocket-9, Vasant Kunj, New Delhi, 110070, India
5Madras Diabetes Research Foundation (MDRF), Chennai, India
6MDRF, Chennai, India
7Aga Khan University, Karachi, Pakistan
8PHFI, New Delhi, India
9All India Institute of Medical Sciences (AIIMS), New Delhi, India
10Emory University, Atlanta, USA
corresponding authorCorresponding author.
Manisha Nair: manisha.nair/at/; Mohammed K Ali: mkali/at/; Vamadevan S Ajay: ajay/at/; Roopa Shivashankar: roopa/at/; Viswanathan Mohan: drmohans/at/; Rajendra Pradeepa: guhapradeepa/at/; Mohan Deepa: deepa.mohan1/at/; Hassan M Khan: hassan.daudzai/at/; Muhammad M Kadir: masood.kadir/at/; Zafar A Fatmi: zafar.fatmi/at/; K Srinath Reddy: ksrinath.reddy/at/; Nikhil Tandon: nikhil_tandon/at/; KM Venkat Narayan: KNARAYA/at/; Dorairaj Prabhakaran: dprabhakaran/at/
Received June 27, 2012; Accepted August 13, 2012.
Cardio-metabolic diseases (CMDs) are a growing public health problem, but data on incidence, trends, and costs in developing countries is scarce. Comprehensive and standardised surveillance for non-communicable diseases was recommended at the United Nations High-level meeting in 2011.
Aims: To develop a model surveillance system for CMDs and risk factors that could be adopted for continued assessment of burdens from multiple perspectives in South-Asian countries.
Design: Hybrid model with two cross-sectional serial surveys three years apart to monitor trend, with a three-year prospective follow-up of the first cohort.
Sites: Three urban settings (Chennai and New Delhi in India; Karachi in Pakistan), 4000 participants in each site stratified by gender and age.
Sampling methodology: Multi-stage cluster random sampling; followed by within-household participant selection through a combination of Health Information National Trends Study (HINTS) and Kish methods.
Culturally-appropriate and methodologically-relevant data collection instruments were developed to gather information on CMDs and their risk factors; quality of life, health-care utilisation and costs, along with objective measures of anthropometric, clinical and biochemical parameters. The cohort follow-up is designed as a pilot study to understand the feasibility of estimating incidence of risk factors, disease events, morbidity, and mortality.
The overall participant response rate in the first cross-sectional survey was 94.1% (Chennai 92.4%, n = 4943; Delhi 95.7%, n = 4425; Karachi 94.3%, n = 4016). 51.8% of the participants were females, 61.6% < 45years, 27.5% 45–60years and 10.9% >60 years.
This surveillance model will generate data on prevalence and trends; help study the complex life-course patterns of CMDs, and provide a platform for developing and testing interventions and tools for prevention and control of CMDs in South-Asia. It will also help understanding the challenges and opportunities in establishing a surveillance system across countries.
Keywords: “Cardio-metabolic diseases”, Surveillance, Risk-factors, South-Asia
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