Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine Faculty of Epidemiology and Population Health, London, UK
National Institute of Nutrition, Hyderabad, Telangana, India.
BMJ Open. 2023 Nov 27;13(11):e073897. doi: 10.1136/bmjopen-2023-073897.
The epidemiological and demographic transitions are leading to a rising burden of multimorbidity (co-occurrence of two or more chronic conditions) worldwide. Evidence on the burden, determinants, consequences and care of multimorbidity in rural and urbanising India is limited, partly due to a lack of longitudinal and objectively measured data on chronic health conditions. We will conduct a mixed-methods study nested in the prospective Andhra Pradesh Children and Parents' Study (APCAPS) cohort to develop a data resource for understanding the epidemiology of multimorbidity in rural and urbanising India and developing interventions to improve the prevention and care of multimorbidity.
We aim to recruit 2100 APCAPS cohort members aged 45+ who have clinical and lifestyle data collected during a previous cohort follow-up (2010-2012). We will screen for locally prevalent non-communicable, infectious and mental health conditions, alongside cognitive impairments, disabilities and frailty, using a combination of self-reported clinical diagnosis, symptom-based questionnaires, physical examinations and biochemical assays. We will conduct in-depth interviews with people with varying multimorbidity clusters, their informal carers and local healthcare providers. Deidentified data will be made available to external researchers.
The study has received approval from the ethics committees of the National Institute of Nutrition and Indian Institute of Public Health Hyderabad, India and the London School of Hygiene and Tropical Medicine, UK. Meta-data and data collection instruments will be published on the APCAPS website alongside details of existing APCAPS data and the data access process (www.lshtm.ac.uk/research/centres-projects-groups/apcaps).
流行病学和人口结构转型正在导致全球范围内多种疾病（两种或多种慢性疾病同时发生）负担的增加。关于农村和城市化印度多种疾病的负担、决定因素、后果和护理的证据有限，部分原因是缺乏关于慢性健康状况的纵向和客观测量数据。我们将在前瞻性安得拉邦儿童和父母研究（APCAPS）队列中进行一项嵌套的混合方法研究，为了解农村和城市化印度多种疾病的流行病学和开发改善多种疾病预防和护理的干预措施，开发一个数据资源。
我们的目标是招募 2100 名年龄在 45 岁以上的 APCAPS 队列成员，他们在之前的队列随访期间（2010-2012 年）有临床和生活方式数据。我们将使用自我报告的临床诊断、基于症状的问卷、身体检查和生化分析相结合，筛查当地流行的非传染性、传染性和精神健康状况，以及认知障碍、残疾和虚弱。我们将对具有不同多种疾病群的人、他们的非正式照顾者和当地医疗保健提供者进行深入访谈。将向外部研究人员提供去识别数据。
该研究已获得印度国家营养研究所和印度公共卫生学院和英国伦敦卫生与热带医学院的伦理委员会的批准。元数据和数据收集工具将在 APCAPS 网站上与现有的 APCAPS 数据和数据访问流程的详细信息一起发布（www.lshtm.ac.uk/research/centres-projects-groups/apcaps）。
