Epidemiology and Impact of the HIV, NCD and Urbanization Syndemic in Africa (Vicinity Study)

This study aims to characterize HIV-related and unrelated risk factors for cardiopulmonary non-communicable diseases (CP-NCDs) in a novel Rural-to-Urban (R2U) African cohort, assess the impact of air pollution and HIV on cardiopulmonary clinical outcomes, and evaluate health services utilization patterns to design an integrated HIV/CP-NCD intervention among R2U migrants.
Objectives
  • Characterize HIV-related and -unrelated risk factors for cardiopulmonary non-communicable diseases (CP-NCDs) in a novel Rural-to-Urban (R2U) African cohort. 
  • Characterize the impact of air pollution and moderating effects of HIV on cardiopulmonary clinical outcomes among R2U migrants. 
  • Assess HIV and CP-NCDs health services utilization patterns among R2U migrants [and design an integrated HIV/CP-NCD intervention. 
Methodology 

The study is nested in RCCS. Rural to urban migrants (Masaka city and Kampala metropolitan) are the indexes. Each index is matched on sex, age, HIV status and community with one rural to rural migrant and two non-migrant participants.

Activities
​1.   Spirometry: done on all eligible participants using NDD software.
2.   Echocardiography: 2,847 participants had echocardiogram done on them during round one of the study.
3.   Air-quality monitoring 
​a) Personal exposure air quality monitoring: Sets of carbon monoxide monitors and ECM monitors are worn and placed in the ​cooking ​area for 48hours to capture carbon monoxide concentration and PM_2.5 data. 
​b) Ambient Air Quality monitoring: we use purple air devices that were placed in various places (17 in RCCS communities, placed at Health facilities, 4 in Masaka and 4 in Kampala metropolitan). One was collocated with BAM at Makerere University weather station and 3 were collocated with Airqo devices. One purple air device was collocated with the E-sampler to RHSP headquarters for data validation.
4.   Ambulatory Blood pressure Monitoring: 24our ABPM is done on a selected group of participants in the VICINITY study.
5.   Daily movement mapping: used GPS logger to map out the routes and locations where participants passed or spent their time in 24hours.

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