ZimNACO Research

Rationale & Justification for setting up an NCD Cohort study

Large prospective epidemiologic studies play an essential role in determining disease aetiology and Zimbabwe does not currently host any such facility for NCD research and long-term follow up of cohort members. The last major surveillance effort that was conducted in Zimbabwe to give a generalizable impression of the prevalence of risk factors and selected NCDs was the WHO STEPwise survey, conducted as far back as 2005, indicating the dire need for current similar and even more informative work to inform policy. Published results from a multi-country pilot conducted in South Africa, Uganda, Nigeria and Tanzania to assess feasibility of introducing a large cohort study in sub-Saharan Africa established this to be an attainable undertaking in comparable environments  (1). Although similar cohort studies have been conducted and continue to be hosted in the Western world (examples: UK biobank, German NAKO study), this facility offers an opportunity for new learning to explore the aetiological linkages between risk factors and NCD outcomes in the unique context of the epidemiological transition in which countries in SSA find themselves during which they are faced with a double burden of NCDs and communicable diseases. A well-established cohort can serve as a research platform that allows flexible research approaches and provides detailed information about populations included, both in terms of prevalence but notably also in terms of risk factor/disease links.

The ZimNaCoIS project would provide dedicated attention to the conduct of prospective epidemiologic studies to inform policy and practice on NCD aetiology and disease pathways in the local context. The facility will be hosted by the Africa University Clinical Research Centre, in collaboration with MOHCC NCDs unit, in receipt of expert support from an A-rated academic institution, the Leibniz-Institute for Prevention Research and Epidemiology – BIPS, that is part of the consortium currently running the German equivalent, the German National Cohort (GNC) as well as a team of multi-disciplinary scientists from Africa University and its relevant partner institutions in Zimbabwe. In addition, an international expert panel of experienced researchers will be engaged to function in a mentorship and advisory capacity for the project.

Roadmap

Below is a road map of envisioned multistage NACO and IS activities over the 10-year period from the time of instituting feasibility pilot in Mutare City to establishing national scale in 10 years: