Cambridge Alliance to Protect Bangladesh from Long-term Environmental Hazards (CAPABLE)

Lead Research Organisation: University of Cambridge
Department Name: Public Health and Primary Care

Abstract

In recent decades, Bangladesh has been in the midst of a rapid transition: disease burden has shifted markedly from a profile dominated by infectious diseases, under-nutrition and conditions of childbirth to one increasingly characterised by chronic disease ("non-communicable diseases") such as heart attacks, strokes, diabetes, lung diseases, and cancer. Estimates suggest that at least 60% of adult deaths in Bangladesh today are due to such chronic diseases.

As well as producing profound disabilities and cutting short millions of lives each year, the rise of chronic disease in Bangladesh has created major societal problems, limiting economic advancement, reducing human welfare, and skewing scarce resources toward costly treatments and away from social progress. This situation is unsustainable, especially as Bangladesh's population ages and continues to grow.

The causes of chronic disease in Bangladesh include distinctive social, environmental, and behavioural factors. For example, Bangladesh has one of the world's worst environmental and lifestyle risk profiles, characterised by:

Severe water and air pollution: According to the World Health Organisation (WHO), arsenic-contaminated water in Bangladesh, which affects ~100M people, is "the largest mass poisoning of a human population in history". A 2016 WHO report on ambient air pollution judged Bangladesh to be the fourth worst polluted country worldwide.

Nutritional disorders: Deficiencies of elements (such as iron) required for normal growth and development are widespread. An evolving and complex background of persisting undernutrition and emerging obesity also increase disease risks.

Risk behaviours: "Western" lifestyles (eg, unhealthy diets, physical inactivity) are increasing, and may amplify adverse effects of traditional risk behaviours, augmenting disease risk.

These social, environmental, and behavioural risk factors tend to cluster in households, share antecedents and causes, amplify each other's effects, and depend on one another in complex (and non-obvious) ways. Importantly, they can also exert importantly different effects in differing contexts such as across rural, urban, and slum settings. Hence, approaches that could tackle such chronic disease risk factors in combination rather than in isolation are likely to be more powerful, as well as approaches that can take account of the context in which they occur.

Yet, Bangladesh's research infrastructure is not configured to evaluate the country's multiple risks and multiple settings, perhaps preventing the emergence of evidence that could suggest "joined up" solutions. Our proposal aims to address this grand challenge.

We will mobilise a multidisciplinary team of about 25 leading investigators from seven organisations in Bangladesh and the UK that have a substantial track-record of working together. We will adopt a wide-angle approach, focusing on intertwined risk factors for chronic disease that have not previously been considered in an integrated framework. The plan offers a fundamentally new approach to address this problem because it combines four innovative and inter-linked components:

1) Creation of a 100,000-participant study ("cohort") in urban, rural, and slum areas to enable study of the social, environmental, and behavioural risk factors for chronic diseases.

2) Conduct of cross-disciplinary research projects that will use the new cohort help understand the interplay of risk factors, and how to combat them, drawing on the complementary strengths of sociologists, engineers, behavioural scientists, chemists, biostatisticians, public health scientists and others.

3) Delivery of an integrated programme of research capacity strengthening that targets three inter-linked levels of activity: individual, organisational, and institutional.

4) Mobilisation and deepening of partnerships between Bangladesh and UK centres of excellence.

Technical Summary

In recent decades, Bangladesh has been in the midst of a rapid transition: disease burden has shifted markedly from a profile dominated by infectious diseases, under-nutrition and conditions of childbirth to one increasingly characterised by chronic disease ("non-communicable diseases") such as heart attacks, strokes, diabetes, lung diseases, and cancer. Estimates suggest that at least 60% of adult deaths in Bangladesh today are due to such chronic diseases.

As well as producing profound disabilities and cutting short millions of lives each year, the rise of chronic disease in Bangladesh has created major societal problems, limiting economic advancement, reducing human welfare, and skewing scarce resources toward costly treatments and away from social progress. This situation is unsustainable, especially as Bangladesh's population ages and continues to grow.

The causes of chronic disease in Bangladesh include distinctive social, environmental, and behavioural factors. For example, Bangladesh has one of the world's worst environmental and lifestyle risk profiles, characterised by:

Severe water and air pollution: According to the World Health Organisation (WHO), arsenic-contaminated water in Bangladesh, which affects ~100M people, is "the largest mass poisoning of a human population in history". A 2016 WHO report on ambient air pollution judged Bangladesh to be the fourth worst polluted country worldwide.

Nutritional disorders: Deficiencies of elements (such as iron) required for normal growth and development are widespread. An evolving and complex background of persisting undernutrition and emerging obesity also increase disease risks.

Risk behaviours: "Western" lifestyles (eg, unhealthy diets, physical inactivity) are increasing, and may amplify adverse effects of traditional risk behaviours, augmenting disease risk.

These social, environmental, and behavioural risk factors tend to cluster in households, share antecedents and causes, amplify each other's effects, and depend on one another in complex (and non-obvious) ways. Importantly, they can also exert importantly different effects in differing contexts such as across rural, urban, and slum settings. Hence, approaches that could tackle such chronic disease risk factors in combination rather than in isolation are likely to be more powerful, as well as approaches that can take account of the context in which they occur.

Yet, Bangladesh's research infrastructure is not configured to evaluate the country's multiple risks and multiple settings, perhaps preventing the emergence of evidence that could suggest "joined up" solutions. Our proposal aims to address this grand challenge.

We will mobilise a multidisciplinary team of about 25 leading investigators from seven organisations in Bangladesh and the UK that have a substantial track-record of working together. We will adopt a wide-angle approach, focusing on intertwined risk factors for chronic disease that have not previously been considered in an integrated framework. The plan offers a fundamentally new approach to address this problem because it combines four innovative and inter-linked components:

1) Creation of a 100,000-participant study ("cohort") in urban, rural, and slum areas to enable study of the social, environmental, and behavioural risk factors for chronic diseases.

2) Conduct of cross-disciplinary research projects that will use the new cohort help understand the interplay of risk factors, and how to combat them, drawing on the complementary strengths of sociologists, engineers, behavioural scientists, chemists, biostatisticians, public health scientists and others.

3) Delivery of an integrated programme of research capacity strengthening that targets three inter-linked levels of activity: individual, organisational, and institutional.

4) Mobilisation and deepening of partnerships between Bangladesh and UK centres of excellence.

Planned Impact

IMPACT SUMMARIES

The ultimate desired impact of this initiative is a real-word sustainable gain in health (eg, material reduction in disability and/or prolongation of life), leading to improvements in human welfare and economic advancement in Bangladesh.

We acknowledge that such an impact is unrealistic within a 4 year grant period, especially since the funding call requests "feasibility, scoping, exploratory, proof of concept studies" (rather than fullscale implementation trials).

Hence, key "intermediate" impacts to be achieved in the grant period through routes described in the Pathways to Impact statement include:

1) Systematic review, systems modelling, and proof of concept studies of several practicable, scalable and effective interventions that can help protect against NCDs, and understanding of their inter-dependencies, setting the stage for definitive separately-funded studies of interventions

Research findings from this project will be relevant to many aspects of the social, physical, and economic environment
We will contribute to the evidence in these areas and directly influence practice and policies at local, regional, national and international levels

2) A novel partnership between key Bangladeshi and UK organisations that will promote enduring relationships based on shared values and a common research agenda

Policy makers will benefit directly from the results of modelling and through using the models to consider different policy scenarios and assess proposed changes. The models will improve the ability to predict likely effects of interventions before deciding how to invest resources in real interventions, a major benefit for Bangladesh's resource-constrained authorities
We recognise that impact is a 2-way process, with our research priorities shaped by policy and public health needs, encouraging us to pursue a partnership approach, co-producing tools and publications and working closely with policymakers and public health practitioners.

3) A cross-disciplinary network of researchers, policy-makers, and other key stakeholders across the UK and Bangladesh committed to a shared research vision

Civil society organisations, NGOs, and campaigners represent other potential audiences for our evidence outputs and may present research opportunities
Our findings should provide better services and lead to a stronger evidence base for this implementation work (eg, BRAC WASH programmes).

4) Training of a cadre of several dozen applied researchers in Bangladesh and the UK capable of sustaining excellent research and effective action in the face of complexity, to combat adverse health effects of environmental exposures

5) A transformative100,000-participant multi-purpose research platform that can be enriched and harvested on an ongoing basis to inform policy and health practice in Bangladesh

The impact of this cohort could be analogous to the "cohorts/panels" created by the ESRC and MRC in the UK during the past 50 years; several have led to major research and societal advances, such as understanding of the relevance of social determinants of health (Whitehall cohort), the hazards of smoking (British Doctors' Study), and the prevention of cot death (ALSPAC)
This research platform will give the Bangladesh research and policy communities similar advantages to those accruing in other low- and middle-income countries that have created such cohorts suited to national circumstances, including China (500,000-participant Kadoorie Biobank) and Mexico (150,000-participant Mexico City Prospective Study).

Publications

10 25 50

 
Description 1. Member Secretary of Subcommittee on Containment and Epidemiology of COVID-19 including Modelling of National Technical Advisory Committee on COVID-19
Geographic Reach Asia 
Policy Influence Type Participation in a advisory committee
Impact Prof Sohel Chowdhury (Co-Investigator and local Principal Investigator) served as Member Secretary on the Subcommittee on Containment and Epidemiology of COVID-19 including Modelling of National Technical Advisory Committee on COVID-19. This was formed by the Bangladesh Ministry of Health and Family Welfare in April 2020. Its terms of reference were advice on containment of pandemic, epidemiological issues, and apprehension of the disease burden.
 
Description 3. Member, Expert Committee for regulation of Trans Fat level in edible oils and partially hydrogenated vegetable oils (PHO) in Bangladesh.
Geographic Reach Asia 
Policy Influence Type Participation in a advisory committee
Impact Prof. Sohel Chowdhury (Co-Investigator and local Principal Investigator) is a member of an expert committee for the regulation of Trans Fat level in edible oils and partially hydrogenated vegetable oils (PHO) in Bangladesh. This was formed by Bangladesh Food Safety Authority (BFSA), Ministry of Food, Government of Bangladesh in February 2020. Its terms of reference are to advise the BFSA for adoption of trans fat regulation. Draft regulation has now been submitted.
 
Description BELIEVE Covid-19 surveillance data presented to Bangladesh policy-makers
Geographic Reach Asia 
Policy Influence Type Implementation circular/rapid advice/letter to e.g. Ministry of Health
Impact Covid-19 surveillance data has been collected on ~17,000 BELIEVE cohort study participants through the CAPABLE project's infrastructure and staff. These valuable data on symptoms and testing status has been analysed jointly by a Cambridge postdoctoral researcher and a Bangladesh research fellow. Findings have been stratified by age, sex and setting (urban, urban-poor and rural) to identify whether there are differences in infection rate. Additionally this data has been linked with baseline BELIEVE data on demographic, socioeconomic, clinical and lifestyle factors to determine key risk factors for Covid-19 infection and severe outcomes. These findings have been communicated through regular meetings to investigators who are involved in the Covid-19 public health response in Bangladesh e.g. senior epidemiologists sitting on national committees and senior policy-makers working within the Ministry of Health, Government of Bangladesh. These findings will strengthen the evidence base for the Bangladesh Government's response to the Covid-19 pandemic.
 
Description CAPABLE NCD Epidemiology and Biostatistics Training Course
Geographic Reach Asia 
Policy Influence Type Influenced training of practitioners or researchers
Impact CAPABLE's first advanced training course on non-communicable disease epidemiology and biostatistics was held in July 2018. This course provided training for 30 early-career researchers in Bangladesh as part of CAPABLE's capacity building initiative. Three trainees were selected after the course for 12-month research fellowships affiliated with the Institute of Epidemiology, Disease Control and Research in Bangladesh and University of Cambridge in the UK. This course and the fellowship scheme provide valuable individual training and mentorship from senior scientists in the UK and Bangladesh. This will lead to strengthening of population health research capacity in Bangladesh and the ability to produce high quality research.
 
Description CAPABLE NCD Epidemiology and Biostatistics Training Course
Geographic Reach Asia 
Policy Influence Type Influenced training of practitioners or researchers
Impact CAPABLE's second advanced training course on non-communicable disease epidemiology and biostatistics was held in February 2020. This course provided training for 40 early-career researchers in Bangladesh as part of CAPABLE's capacity building initiative. Four trainees were selected after the course for 12-month research fellowships affiliated with the Institute of Epidemiology, Disease Control and Research in Bangladesh and University of Cambridge in the UK. This course and the fellowship scheme provide valuable individual training and mentorship from senior scientists in the UK and Bangladesh. This will lead to strengthening of population health research capacity in Bangladesh and the ability to produce high quality research.
 
Description Member, Technical committee for drafting amendments of Tobacco Control Act.
Geographic Reach Asia 
Policy Influence Type Participation in a advisory committee
Impact Prof Sohel Chowdhury (Co-Investigator and Local Principal Investigator) was a member of the technical committee for drafting amendments to the Bangladesh Tobacco Control Act. This committee was formed by the National Tobacco Control Cell (NTCC), Ministry of Health and Family Welfare in August 2020. Its terms of reference were the drafting of proposals for amendment of current tobacco control act to make it FCTC compliant.
 
Description Cambridge alliance to protect Bangladesh from long0term environmental hazards
Amount £7,946,901 (GBP)
Funding ID MR/P02811X/1 
Organisation Medical Research Council (MRC) 
Sector Public
Country United Kingdom
Start 09/2017 
End 12/2021
 
Description Contribution of gender norms to diabetes prevention and care in Bangladesh: a pilot study based on a patriarchal South Asian population
Amount £79,618 (GBP)
Organisation United Kingdom Research and Innovation 
Department Global Challenges Research Fund
Sector Public
Country United Kingdom
Start 01/2020 
End 07/2020
 
Description Health effects of a large-scale drinking water intervention on arsenic levels in Goalmari, Bangladesh
Amount £79,650 (GBP)
Funding ID G100049 
Organisation United Kingdom Research and Innovation 
Department Global Challenges Research Fund
Sector Public
Country United Kingdom
Start 01/2019 
End 01/2020
 
Description Preparatory work for a trial of tobacco cessation interventions in Bangladesh
Amount £79,778 (GBP)
Organisation University of Cambridge 
Sector Academic/University
Country United Kingdom
Start 01/2019 
End 07/2019
 
Title BELIEVE Blood samples 2020 
Description ~1,000 additional 5ml blood samples were collected from participants of the BELIEVE study in Mirpur, Bauniabadh and Matlab. These blood samples were collected as part of the Covid-19 surveillance efforts and are intended to be used for antibody assays to determine previous infection and immunity in the BELIEVE cohort. These samples are being stored in Bangladesh at CAPABLE's partner institutions leading the three BELIEVE study sites. 
Type Of Material Biological samples 
Year Produced 2020 
Provided To Others? No  
Impact None yet, samples are currently being stored until funding is obtained for analysis. 
 
Title BELIEVE Covid-19 Electronic Questionnaire Applications 
Description The Cambridge project hub have developed three new 'apps' to collect Covid-19 symptom data & sample collection data and to schedule sample collection appointments. These apps have enabled paperless collection of data over the telephone by data collectors in Bangladesh. The apps have built in quality control checks to ensure that data is recorded accurately and that data quality is high, as well as integrated transfer, export and cleaning of these data in Cambridge. These apps were created, tested, translated into Bengali and implemented in April-June 2020. 
Type Of Material Improvements to research infrastructure 
Year Produced 2020 
Provided To Others? No  
Impact These apps ensure that Covid-19 surveillance data collected is of the highest possible quality and that data is collected, transferred and cleaned ready for analysis as efficiently as possible. These apps also provide good value for money as they were created internally by the project hub using a free platform and free server space, which meant the project team did not need to hire an expensive external app developer. 
 
Title BELIEVE Electronic Questionnaire Application 
Description As part of the BELIEVE study, three bespoke electronic questionnaire applications have been developed to collect baseline and follow-up data during cohort recruitment. These apps enable paperless collection of data on household factors, lifestyle, socioeconomic factors, medical history and physical measurements. The apps have built in quality control checks to ensure that data is recorded accurately and that data quality is high. 
Type Of Material Improvements to research infrastructure 
Year Produced 2018 
Provided To Others? No  
Impact The use of the BELIEVE electronic apps instead of paper has led to a reduction in paper use by the study team and improvements in data quality and data security. 
 
Title BELIEVE Mirpur, Bauniabadh and Matlab Samples 
Description Collection of blood and nail samples from the BELIEVE (BangladEsh Longitudinal Investigation of Emerging Vascular and Non-Vascular Events) Study across three settings; Mirpur (urban), Bauniabadh (urban slum) and Matlab (rural). These three study sites are managed in collaboration with three Bangladeshi partner institutions; the National Heart Foundation, Bangabandhu Sheikh Mujib Medical University and the International Centre for Diarrhoeal Disease Research, Bangladesh. This study aims to recruit up to 150,000 community-based individuals (age >5 years) through a household survey to ensure maximum and generalisable participation, particularly from individuals with shared environmental and genetic background. The key objectives of the BELIEVE prospective cohort study are to create a re-callable population and bio-resource involving a general South Asian population to: (1) enable genetic discovery using diverse phenotypes (particularly those related to nutrition such as anaemia, infection, or environment-related aspects such as air and toxic metal pollution), causal evaluation and functional genomics; (2) assess reliably the roles of established and unique locally-relevant risk factors on incident NCDs such as cardiovascular, cancer, diabetes and kidney diseases (ascertained by clinical records and standardised validation); (3) help study discrepant risk factor patterns unique to this population (eg, unusually high tobacco usage, lowest average body mass index, highest physical inactivity rates) over time, in various age groups as a life-course approach; and their heritability; and (4) create a well-characterised population base to set-up innovative and cost-effective behaviour modification and pharmaceutical interventions, suitable from a South-Asian context. 
Type Of Material Biological samples 
Year Produced 2017 
Provided To Others? No  
Impact None yet, samples and data still being collected and analysed. 
 
Title Participant Follow-up Electronic Questionnaire Applications 
Description The Cambridge project hub has developed a new app for periodic follow-up of the cohort participants using xls forms and a free online available platform. These apps have enabled paperless collection of follow-up data over the telephone by data collectors in Bangladesh. The apps have built-in quality control checks to ensure that data is recorded accurately and that data quality is high, as well as integrated transfer, export and cleaning of these data in Cambridge. The states of creation, testing, translation into Bengali, implementation and further amendments happened between March-September 2021. 
Type Of Material Improvements to research infrastructure 
Year Produced 2021 
Provided To Others? No  
Impact This app ensures that the participant follow-up surveillance data collected is of the highest possible quality and that data is captured, transferred and cleaned ready for analysis as efficiently as possible. This app enabled the periodic BELIEVE participant follow-up to be done over the phone during the pandemic restrictions, replacing the costly, time and resource consuming household visits that were previously used in this process. The app is good value for money, since it was created internally by the project hub using a free online platform with a free server space, which meant the project team did not ened to hire an expensive external app developer. Furthermore, it has enabled the group to have a more cost-effective and longer-term follow-up process: it will allow the continuation of the project after the granting is over using contingency budget until new funding is secured. Moreover, the development of this app served as an important capacity building tool for our hub, as it required the developer to learn from scratch how to develop apps using xls forms. 
 
Title BELIEVE Covid-19 Dataset 
Description Data on Covid-19 symptoms and testing status was collected in ~17,000 participants of the BELIEVE cohort study (urban, urban-poor and rural sites) by three Bangladeshi partner institutions; the National Heart Foundation, Bangabandhu Sheikh Mujib Medical University and the International Centre for Diarrhoeal Disease Research, Bangladesh, in collaboration with the project hub at Cambridge University. These data on symptoms and testing status are being analysed jointly by a Cambridge postdoctoral researcher and a Bangladesh research fellow. Findings have been stratified by age, sex and setting (urban, urban-poor and rural) to identify whether there are differences in infection rate. Additionally this data has been linked with baseline BELIEVE data on demographic, socioeconomic, clinical and lifestyle factors to determine key risk factors for Covid-19 infection and severe outcomes. Several CAPABLE research fellows are working on these analyses. 
Type Of Material Database/Collection of data 
Year Produced 2020 
Provided To Others? No  
Impact Preliminary findings based on this BELIEVE Covid-19 dataset have been communicated through regular meetings to investigators who are involved in the Covid-19 public health response in Bangladesh e.g. senior epidemiologists sitting on national committees and senior policy-makers working within the Ministry of Health, Government of Bangladesh. These findings will strengthen the evidence base for the Bangladesh Government's response to the Covid-19 pandemic. 
 
Title BELIEVE Mirpur (Urban), Bauniabadh (Urban Slum) and Matlab (Rural) 
Description Collection of data from the BELIEVE (BangladEsh Longitudinal Investigation of Emerging Vascular and Non-Vascular Events) Study across three settings; Mirpur (urban), Bauniabadh (urban slum) and Matlab (rural). These three study sites are managed in collaboration with three Bangladeshi partner institutions; the National Heart Foundation, Bangabandhu Sheikh Mujib Medical University and the International Centre for Diarrhoeal Disease Research, Bangladesh. This study aims to recruit up to 150,000 community-based individuals (age >5 years) through a household survey to ensure maximum and generalisable participation, particularly from individuals with shared environmental and genetic background. The key objectives of the BELIEVE prospective cohort study are to create a re-callable population and bio-resource involving a general South Asian population to: (1) enable genetic discovery using diverse phenotypes (particularly those related to nutrition such as anaemia, infection, or environment-related aspects such as air and toxic metal pollution), causal evaluation and functional genomics; (2) assess reliably the roles of established and unique locally-relevant risk factors on incident NCDs such as cardiovascular, cancer, diabetes and kidney diseases (ascertained by clinical records and standardised validation); (3) help study discrepant risk factor patterns unique to this population (eg, unusually high tobacco usage, lowest average body mass index, highest physical inactivity rates) over time, in various age groups as a life-course approach; and their heritability; and (4) create a well-characterised population base to set-up innovative and cost-effective behaviour modification and pharmaceutical interventions, suitable from a South-Asian context. 
Type Of Material Database/Collection of data 
Year Produced 2017 
Provided To Others? No  
Impact None yet, samples and data still being collected and analysed. 
URL https://www.capable-bangladesh.org/cohorts/
 
Description BELIEVE 
Organisation National Heart Foundation of Bangladesh
Country Bangladesh 
Sector Charity/Non Profit 
PI Contribution Funding, protocol design and implementation support; analysis of data and publication manuscript preparation. Scientific leadership.
Collaborator Contribution Conduct of the protocol, use of resources and sample/data transport
Impact N/A - commenced 2016
Start Year 2016
 
Description CAPABLE - BSMMU 
Organisation Bangabandhu Sheikh Mujib Medical University
Country Bangladesh 
Sector Academic/University 
PI Contribution Intellectual input and scientific direction/coordination to help set up a research cohort to better understand disease and environmental risks in Bangladesh. Coordinating centre for the CAPABLE programme under which this collaboration sits.
Collaborator Contribution Intellectual input and scientific direction/coordination to help set up a research cohort to better understand disease and environmental risks in Bangladesh. Provision of staff, resources, space.
Impact No outputs yet.
Start Year 2017
 
Description CAPABLE - Department of Genetics, Cambridge 
Organisation University of Cambridge
Department Department of Genetics
Country United Kingdom 
Sector Academic/University 
PI Contribution The Cambridge project hub have brought together experts from multiple different disciplines to regular meetings where CAPABLE's Covid-19 surveillance strategy, study design, data collection, analysis and dissemination have been discussed. Cambridge have provided coordination, data management and data analysis support for these efforts.
Collaborator Contribution Dr Henrik Salje at the Department of Genetics, who has expertise in infectious disease epidemiology and modelling, has provided guidance to investigators in Cambridge and Bangladesh. This has ensured that CAPABLE's Covid-19 surveillance strategy and data collection tools used (e.g. questionnaires) are scientifically robust and will generate useful findings that are actionable for policy-makers in Bangladesh. Dr Salje has attended regular meetings of the CAPABLE project team to provide valuable input, and he presented his research at the annual general assembly meeting to the whole project consortium. He is now attending monthly meetings of the BELIEVE Covid-19 data analysis working group where data analysis and dissemination strategy are discussed by investigators, analysts and research fellows in Cambridge and Bangladesh.
Impact This partnership has ensured that the Covid-19 surveillance data collected through the CAPABLE project is scientifically robust and relevant, and will be actionable for policy-makers in Bangladesh.
Start Year 2020
 
Description CAPABLE - Directorate General of Health Services, Bangladesh 
Organisation Government of Bangladesh
Department Directorate General of Health Services, MOHFW
Country Bangladesh 
Sector Public 
PI Contribution This partnership has been formed through the existing partnership between Cambridge and another branch of the Government of Bangladesh; the Institute of Epidemiology, Disease Control and Research. Cambridge are providing valuable Covid-19 surveillance data to Bangladesh policy-makers and senior scientists, including Professor Sabrina Flora, the Additional Director General of the Directorate General of Health Services. Cambridge has provided study coordination, data management and data analysis support.
Collaborator Contribution The Directorate General of Health Services have provided guidance and expertise to ensure that the Covid-19 surveillance data being collected through the CAPABLE project is relevant and actionable in terms of public health policy. The Additional Director General Professor Flora has attended CAPABLE's most recent steering committee meeting and general assembly meeting in late 2020 to provide input on the project's strategy regarding the Covid-19 response.
Impact This partnership has enhanced the collection of valuable Covid-19 surveillance data which will feed into public health policy in Bangladesh.
Start Year 2020
 
Description CAPABLE - IEDCR 
Organisation Institute of Epidemiology Disease Control And Research
Country Bangladesh 
Sector Public 
PI Contribution Intellectual input to the research into environmental and lifestyle risk factors in Bangladesh with respect to non-communicable diseases, as well as the planning and coordination of capacity building and training in the programme. Coordinating centre responsible for the CAPABLE consortium under which this collaboration sits.
Collaborator Contribution Intellectual input to the research into environmental and lifestyle risk factors in Bangladesh with respect to non-communicable diseases, as well as the planning and coordination of capacity building and training in the programme. Provision of space and resources for capacity building elements of the programme.
Impact Not outputs yet.
Start Year 2017
 
Description CAPABLE - University of Dhaka 
Organisation University of Dhaka
Country Bangladesh 
Sector Academic/University 
PI Contribution Cambridge have provided expertise in terms of epidemiology and population health research, to complement the environmental research expertise which University of Dhaka have. Cambridge have provided research coordination and administrative support for the environmental determinants work plan of CAPABLE. Cambridge have provided resources for the purchase of equipment to measure air quality and for supporting two 12 month research fellowships at the University of Dhaka.
Collaborator Contribution The University of Dhaka have provided expertise in air pollution monitoring, which has been key in developing scientific plans to investigate the environmental determinants of non-communicable diseases within CAPABLE. University of Dhaka have provided use of their internationally accredited facilities for measuring air quality and environmental pollution. Two members of staff at University of Dhaka are in 12 month research fellowships as part of the CAPABLE programme. University of Dhaka provide supervision for these fellows and have taught on CAPABLE'S Advanced Short Course in Dhaka.
Impact No outcomes yet. This is a multi-disciplinary collaboration; University of Cambridge provide expertise in population health and epidemiology, and University of Dhaka provide expertise in environmental science, specifically the measurements of air quality.
Start Year 2019
 
Description CAPABLE-University College London 
Organisation University College London
Department Institute For Global Health
Country United Kingdom 
Sector Academic/University 
PI Contribution Intellectual input and scientific direction/coordination to help set up a work stream on social determinants and better understand disease and environmental risks in Bangladesh.
Collaborator Contribution Intellectual input and scientific direction/coordination to help set up a work stream on social determinants, policy and gender studies to better understand disease and environmental risks in Bangladesh. Supervision of fellows, capacity building.
Impact No outcomes yet
Start Year 2017
 
Description CAPABLE-University of Aberdeen 
Organisation University of Aberdeen
Country United Kingdom 
Sector Academic/University 
PI Contribution Intellectual input and scientific direction/coordination for studying arsenic and other environmental toxic metals. Coordinating centre for analytical analyses in biological and non-biological samples.
Collaborator Contribution Intellectual input and scientific direction/coordination to better understand disease and environmental risks in Bangladesh. Provision of staff, resources, space, capacity building, development of novel analytical methods to study the concentration of toxic metals in biological and non-biological samples.
Impact No outputs yet
Start Year 2017
 
Description Human Technopole Collaboration 
Organisation Human Technopole
Country Italy 
Sector Charity/Non Profit 
PI Contribution Providing samples from UK and Asian cohorts
Collaborator Contribution proteomic assays
Impact None yet
Start Year 2021
 
Description Regeneron 
Organisation Regeneron Pharmaceuticals, Inc.
Country United States 
Sector Private 
PI Contribution Providing samples from Asian cohorts
Collaborator Contribution Whole exome genotyping on samples from Asian cohorts.
Impact none yet
Start Year 2019
 
Description University of Massachusetts - Larry King 
Organisation University of Massachusetts
Country United States 
Sector Academic/University 
PI Contribution Prof. King is a co-PI on the CAPABLE programme funded by UKRI.
Collaborator Contribution Take part in operational and scientific meetings, provide scientific inputs, write project proposals, contribute in scientific papers, and other activities as requested by the CAPABLE Executive Committee. Co-lead the work of analysing social determinants of risk factors in the CAPABLE programme.
Impact none yet
Start Year 2018
 
Description BangladEsh Longitudinal Investigation of Emerging Vascular Events (BELIEVE) community engagement meetings (Sophie Weston) 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact Regular community engagement meetings are held in all three BELIEVE cohort study sites. Community advisory boards, made up of local community leaders, have been created specifically for the study. The purpose is to form a strong positive relationship with the community, to gather feedback on recruitment approaches/interactions with the study team and encourage participation in the BELIEVE studies. These meetings have led to changes in study procedure based on community feedback and improved recruitment and retention rates.
Year(s) Of Engagement Activity 2019
URL https://www.phpc.cam.ac.uk/ceu/international-vascular-health/believe
 
Description CAPABLE Annual General Assembly Meeting 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact CAPABLE's annual meeting was held virtually in 2020 due to Covid-19 travel restrictions. The purpose of this meeting is to share updates on the progress on cohort recruitment, capacity building and targeted studies and to discuss scientific plans. The outcome was further strengthening of CAPABLE consortium, making decisions on future scientific plans including the Covid-19 response and taking on board feedback obtained from consortium and advisory board.
Year(s) Of Engagement Activity 2020
 
Description CAPABLE Bangladesh Launch 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Policymakers/politicians
Results and Impact Bangladesh launch of CAPABLE programme, talks given, press spoken to and site visited. Generated lots of debate and in country press articles.
Year(s) Of Engagement Activity 2018
 
Description CAPABLE Cambridge Team visit to Bangladesh 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Study participants or study members
Results and Impact Cambridge hub team (PI, co-investigators and coordination team) visited Dhaka to meet with all four Bangladeshi partner organisations in the CAPABLE consortium. The purpose of this was to share updates on programme progress and to discuss scientific plans. The Cambridge hub team also met with community advisory groups to hear feedback from them directly. These meetings strengthened partnerships and collaboration, led to challenges being identified and resolved, and allowed scientific working groups to be further developed. During this visit, the Cambridge hub team also coordinated and taught on the second short course on non-communicable disease epidemiology and biostatistics.
Year(s) Of Engagement Activity 2020
 
Description CAPABLE General Assembly (John Danesh) 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Annual general assembly of CAPABLE programme, gathering of all collaborators, staff members, supporters, extended network, donors and other stakeholders. Talks, debates, working groups.
This was a talk and discussion between Cambridge and Dhaka for a working collaboration to help improve the lives of the Bangladeshi people (2019).
Year(s) Of Engagement Activity 2018,2019
URL http://www.capable-bangladesh.org/capable-in-popular-media/meeting-september-2018-uk/
 
Description CAPABLE workshop in Bangladesh (Emanuele Di Angelantonio) 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Travel to Dhaka to plan implementation of CAPABLE study, with Scientific Planning Committee Meeting, site visits and meeting collaborators
Year(s) Of Engagement Activity 2018
 
Description Cambridge Festival of Ideas (Sophie Weston) 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Public/other audiences
Results and Impact Talk as part of the Cambridge Festival of Ideas by two Cambridge PhD students working on BELIEVE. The purpose was to inform the general public about the role of air pollution, arsenic and climate change on NCDs and health in general (with examples from Bangladesh). Several members of the audience got in touch after the talk to give positive feedback and ask further questions.
Year(s) Of Engagement Activity 2019
URL https://www.festivalofideas.cam.ac.uk
 
Description Cambridge GCRF launch event 
Form Of Engagement Activity Participation in an open day or visit at my research institution
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact Visit by politicians (Joe Johnson) and RCUK representatives to promote the GCRF projects funded at the University of Cambridge, including presentations to these stakeholders.
Year(s) Of Engagement Activity 2017
 
Description Cambridge Programme to Assist Bangladesh in Lifestyle and Environmental Risk Reduction (CAPABLE) General Assemby Meeting (Sophie Weston) 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact CAPABLE's annual meeting in Cambridge. The purpose is to share updates on the progress on cohort recruitment, capacity building and targeted studies and to discuss scientific plans. The outcome was further strengthening of CAPABLE consortium, making decisions on future scientific plans and taking on board feedback obtained from consortium and advisory board.
Year(s) Of Engagement Activity 2019
 
Description Cambridge Science Festival 
Form Of Engagement Activity Participation in an open day or visit at my research institution
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact Helping out at the "Hands On" stall by the Division of Cardiovascular Medicine, giving a talk with 'Out-thinkers' and running a live action game event aimed at teaching 30 school children about the complexity of dealing with emerging epidemics.
Year(s) Of Engagement Activity 2018
URL https://www.sciencefestival.cam.ac.uk/about/past-festivals/2018-festival
 
Description Cambridge team visit to Bangladesh for the Cambridge Programme to Assist Bangladesh in Lifestyle and Environmental Risk Reduction (CAPABLE) (Sophie Weston) 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact Cambridge hub team (PI, co-investigators and coordination team) visited Dhaka to meet with all four Bangladeshi partner organisations in CAPABLE consortium. The purpose of this was to share updates on programme progress and to discuss scientific plans. The Cambridge hub team also met with community advisory groups to hear feedback from them directly. These meetings strengthened partnerships and collaboration, led to challenges being identified and resolved, and allowed scientific working groups to be further developed.
Year(s) Of Engagement Activity 2019
URL https://www.iph.cam.ac.uk/global-public-health/projects/bangladesh
 
Description Community engagement meetings in Belabo, Bangladesh for BELIEVE 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact During the visit of the Cambridge project hub to Bangladesh, the team visited Belabo, where a new rural BELIEVE study site will begin participant recruitment in 2021. The Cambridge team were given a tour of local health facilities, met with local senior health administrators and led a meeting with the community to outline the BELIEVE study objectives, procedures and what participation in the study would entail. The community reacted very positively to this visit and the engagement meeting. The meeting led to enthusiasm for participation in the study and provided the opportunity for community leaders to ask questions and give valuable feedback to the project hub team. The final outcome of the meeting was that the local community gave their approval for the study to proceed in the local area.
Year(s) Of Engagement Activity 2020
 
Description East London Genes & Health (ELGH) Cardiovascular Workshop (Professor John Danesh) 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Other audiences
Results and Impact Updates on research conducted and future plans.
Year(s) Of Engagement Activity 2019
 
Description Newsletter to update CAPABLE consortium members on project progress (Sophie Weston) 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Newsletter sent to members of the CAPABLE study consortium, updating with project progress and future plans.
Year(s) Of Engagement Activity 2019,2020
 
Description Presentation on BELIEVE Covid-19 Surveillance at Cambridge Scientific Meeting 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Three presentations by CAPABLE's Scientific Director, Senior Scientific Coordinator and Study Coordinator were given on the BELIEVE Covid-19 surveillance efforts at quarterly scientific meetings of the Cardiovascular Epidemiology Unit, University of Cambridge. The audience for these presentations were senior scientists, postdoctoral researchers and postgraduate students. These presentations informed others working in similar areas of population health and Covid-19 related research and gave the opportunity for these individuals to provide feedback so that the Covid-19 efforts within BELIEVE could be further enhanced.
Year(s) Of Engagement Activity 2020
 
Description Presentation on BELIEVE Covid-19 Surveillance at GCRF workshop 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact CAPABLE's Senior Scientific Coordinator gave a presentation on the BELIEVE Covid-19 surveillance efforts at a Covid-19 themed workshop organised by UKRI for GCRF projects. This virtual workshop was attended by other project managers and study coordinators working on other GCRF funded projects. This workshop provided the opportunity to engage with individuals working on similar projects facing similar challenges due to the Covid-19 pandemic and provided inspiration for how to respond to these challenges.
Year(s) Of Engagement Activity 2020
 
Description Teaching a Short Course in Poznan, Poland (Professor Nick Mascie-Taylor) 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Teaching Short Course on epidemiology and biostatistics in Poznan, Poland organised by European Association
Year(s) Of Engagement Activity 2018,2019
 
Description Teaching a Short Course in Vilnius, Lithuania (Professor Nick Mascie-Taylor) 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Teaching on Short Course on epidemiology and biostatistics in Poznan, Poland organised by European Association.
Year(s) Of Engagement Activity 2019
 
Description Teaching at Short Course in Dhaka, Bangladesh (Emanuele Di Angelantonio) 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Teaching on Short Course in Dhaka, Bangladesh organised by UK Universities to extend knowledge and educate as part of CAPABLE study
Year(s) Of Engagement Activity 2018,2019,2020
 
Description Teaching at Short Course in Dhaka, Bangladesh (Professor Nick Mascie-Taylor) 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Teaching on Short Course in Dhaka, Bangladesh, organised by UK universities to extend knowledge and educate as part of CAPABLE study.
Year(s) Of Engagement Activity 2018,2019,2020
 
Description Teaching at Short Course in Warsaw, Poland (Professor Nick Mascie-Taylor) 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Teaching on Short Course on epidemiology and biostatistics in Poznan, Poland organised by European Association
Year(s) Of Engagement Activity 2020