Chronic Diseases and Urban Health incorporating the TB case-control platform

Changes in environment, nutrition, infrastructure, and epidemics has had profound impacts on the health of people worldwide. The impact in developing countries is even more pronounced due to lack of adequate health systems. The TB platform has demonstrated the importance of active cases finding, monitoring, follow up and analysis of exposed contacts on the overall health of the population. The evolution of the platform to chronic diseases and urban health will allow us to upscale this work and better evaluate the requirements for disease monitoring and prevention in The Gambia. The Chronic Diseases and Urban Health platform will support the planned work on non-communicable diseases and emerging health risks for the Unit. Information will be collected on environment, socio-economic status and risk factors related to lifestyle and will therefore work as a ‘targeted’ urban health surveillance system.

The Chronic Diseases and Urban Health platform will support the planned work on non-communicable diseases and emerging health risks. It will evolve from the current TB Case Contact (TBCC) platform and include existing patients’ cohorts, e.g. rheumatic heart disease, who will be visited at least once a year to collect information on (among others) environment, socio-economic status and risk factors related to lifestyle. This platform will work as a ‘targeted’ urban health surveillance system and possibly develop into an urban HDSS.
The TB case-contact platform was established at MRC in 2001 and allows multi-disciplinary analysis of TB across the spectrum of infection and disease with over 2000 TB cases and 10000 close contacts enrolled to date. The platform has generated over 120 publications including epidemiological, clinical, microbiological, and immunological investigations and is currently recruiting participants for studies on post-TB lung health, a phase III TB vaccine trial, diagnostic and prognostic analysis of TB cases and their contacts and community screening of sub-clinical TB.
The CD&UH platform will include the existing cohorts of TB, chronic liver disease and rheumatic heart disease patients and patients with other chronic diseases such as hypertension, diabetes, and chronic respiratory diseases, e.g. asthma. Patients and their families will be visited at least once a year and data on demographic variables, environment, socio-economic status and risk factors related to lifestyle, health seeking behaviour, etc. will be collected. For each patient in the cohort, we will identify three neighbouring families for which we will collect the same information.