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. 2025 Jan 22;15(1):e088338.
doi: 10.1136/bmjopen-2024-088338.

Cohort profile: the BangladEsh Longitudinal Investigation of Emerging Vascular and nonvascular Events (BELIEVE) cohort study

Rajiv Chowdhury  1 , Nusrat Khan  2 , Lisa Pennells  3   4 , Maria L C Iurilli  3   4 , Md Taslim Uddin Miah  5 , Md Mostafa Monower  6 , Khan Mohammad Thouhidur Rahman  7 , Sharraf Samin  7   8 , Kazi Nazmus Saqeeb  9 , Ishrat Tasmin  6 , Eleanor Farrow  3   4 , Samantha Farrow  3   10 , Ank Michielsen  3   4 , Catherine Perry  3   4 , Sarah Spackman  3   4 , Charlotte van Coeverden  3   4 , Matthew Walker  3   4 , Tahmeed Ahmed  9   11 , James Ajioka  12 , Khondker Abdul Abdul Awal  13 , Adam S Butterworth  3   4   14   15   16 , Evangelia Chatzidiakou  17 , Jörg Feldmann  18 , Richard Fenner  19 , Meerjady Sabrina Flora  20 , Tuhin Haque  13 , Sarah Hawkes  21 , Syed Shariful Islam  7 , Sirajul Islam  22 , Roderic L Jones  17 , Stephen Kaptoge  3   4 , Kamrul Hasan Khan  7 , Lawrence King  23 , Shammi Luhar  3   4 , Abdul Malik  13 , Fazila-Tun-Nesa Malik  13 , Ruchira T Naved  24 , Aliya Naheed  25 , Olalekan Popoola  17 , Rubhana Raqib  9 , Tahmina Shirin  26 , Stephen Sutton  27 , Kim Robin van Daalen  3   4   28 , Angela Wood  3   4   14   15   16   29 , Simon Griffin  10   30 , Nicholas Mascie Taylor  3   4 , Md Khalequzzaman  7 , Md Alfazal Khan  22 , Sohel Reza Choudhury  6 , Emanuele Di Angelantonio  31   4   14   15   16   32 , John Danesh  3   4   14   15   16   33 ; BELIEVE Study
Collaborators, Affiliations

Cohort profile: the BangladEsh Longitudinal Investigation of Emerging Vascular and nonvascular Events (BELIEVE) cohort study

Rajiv Chowdhury et al. BMJ Open. .

Abstract

Purpose: Bangladesh has experienced a rapid epidemiological transition from communicable to non-communicable diseases (NCDs) in recent decades. There is, however, limited evidence about multidimensional determinants of NCDs in this population. The BangladEsh Longitudinal Investigation of Emerging Vascular and nonvascular Events (BELIEVE) study is a household-based prospective cohort study established to investigate biological, behavioural, environmental and broader determinants of NCDs.

Participants: Between January 2016 and March 2020, 73 883 participants (aged 11 years or older) were recruited from 30 817 households across urban, urban-poor ('slum') and rural settings in Bangladesh. A structured questionnaire was administered by trained personnel recording participants' demographic, socioeconomic, behavioural, medical, environmental and other factors. Anthropometric measurements and blood pressure were recorded for each participant. Biological specimens were collected and aliquoted for long-term storage and analysis.

Findings to date: Of the 73 883 study participants (mean [SD] baseline age: 39 [15] years), 43 470 (59%) were females, and 38 848 (52%) had no or only primary-level education. Focusing only on the 65 822 adult participants aged 20-79 years at baseline, 15 411 (23%) reported being diagnosed with hypertension; 10 578 (16%) with type 2 diabetes and 7624 (12%) with hypercholesterolaemia. Age and sex-standardised prevalences of these conditions were much higher in urban than slum and rural settings. Overall, the mean (SD) body mass index (BMI) was 25 (5) kg/m2, with 10 442 (16%) participants aged 20-79, classified as obese (ie, BMI≥30 kg/m2). Mean BMI was also higher in urban than slum and rural areas.

Future plans: The collection of information during the baseline visit was completed in 2020. Regular longitudinal follow-up is ongoing for ascertainment and adjudication of a range of fatal and non-fatal health outcomes among participants. This cohort will provide a powerful resource to investigate multidimensional determinants of incident NCDs across diverse settings in Bangladesh, helping to advance scientific discovery and public health action in an archetypal low-middle-income country with pressing public health needs.

Keywords: Chronic Disease; EPIDEMIOLOGIC STUDIES; Observational Study.

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Conflict of interest statement

Competing interests: AB reports institutional grants from AstraZeneca, Bayer, Biogen, BioMarin, Bioverativ, Novartis, Regeneron and Sanofi. JD holds a British Heart Foundation Professorship and an NIHR Emeritus Senior Investigator Award (*). JD serves on scientific advisory boards for AstraZeneca, Novartis, Our Future Health and UK Biobank and has received multiple grants from academic, charitable and industry sources outside of the submitted work. EDA holds an NIHR Senior Investigator Award (*). SG has received honoraria from Astra Zeneca and Eli Lilly for contributions to postgraduate education for health professionals in the UK. SS holds an Emeritus NIHR Senior Investigator Award (*). AW is part of the BigData@Heart Consortium, funded by the Innovative Medicines Initiative-2 Joint Undertaking under grant agreement No 116074. *The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care.

Figures

Figure 1
Figure 1. Location of the BELIEVE study sites. BELIEVE, BangladEsh Longitudinal Investigation of Emerging Vascular and nonvascular Events.
Figure 2
Figure 2. Study recruitment and follow-up procedures.
Figure 3
Figure 3. Standardised prevalences of selected chronic conditions at recruitment in BELIEVE for participants aged 20–79. Prevalence was standardised using the sex and age distribution of the Bangladesh 2022 population aged 20–79. BELIEVE, BangladEsh Longitudinal Investigation of Emerging Vascular and nonvascular Events.
See this image and copyright information in PMC

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