Bangladesh Prospective Urban and Rural Epidemiological Study (PURE)
Principal Investigator: Professor Omar Rahman
Co-PI: Dr. Rita Yusuf
Research Associates: Mariz Sintaha; Tarzia Choudhury; Dr. Raysul Haque;
In the last few decades, the epidemic of chronic diseases has shifted from the high income countries (HIC) to low income countries (LIC). It is being expected that by 2020 more than 80% of cardiovascular disease (CVD) cases will be in middle and low income countries like Bangladesh. The societal influence in lifestyle is being cited as one of the prime reasons behind this change. Therefore it has become imperative firstly, to understand the societal determinants of biological risk factors and CVD and secondly, to evaluate how these factors are distributed in a given urban and rural population.
The project aims to assess the combined effect of household and societal community level factors on individuals' lifestyles, and thereby on its contribution to the development of biological risk factors for CVD and other chronic diseases. This study in Bangladesh is a part of a larger world wide study in 20 different countries conducted by McMaster University, Canada.
In the worldwide PURE study, 153 996 adults (151 966 aged 35-70 years, 1444 aged < 35 years, and 586 aged > 70 years) were recruited from 628 (348 urban and 280 rural) communities in 17 countries of the world, representing various levels of development and encompassing a large sociocultural diversity. These countries included 3 high-income countries (Canada, Sweden, United Arab Emirates), 7 upper–middle-income (Argentina, Brazil, Chile, Poland, Turkey, Malaysia, South Africa) and 3 low–middle-income (China, Colombia, Iran), and 4 low-income countries (Bangladesh, India, Pakistan, Zimbabwe). Common and standardized approaches were used for the enumeration of households, identification of individuals, recruitment procedures, and data collection.
Supervised by IUB, the Bangladesh portion of the Prospective Urban and Rural Epidemiological (PURE) carried out the baseline survey of around 3000 adults in 2008. Data collection was done by administering questionnaires, collecting urine & blood samples and by taking anthropometric measurements. The data will be analyzed to understand the determinants of chronic diseases (with a particular focus on coronary artery disease) and differences therein between the urban and rural populations.
The baseline survey will be followed up by limited data collection at around 5, 9 and 12 years following the baseline. The first follow-up of the baseline was completed in 2013. The aim of the PURE follow-up study is to document the number of fatal and non-fatal events experienced by the baseline survey respondents since the time of baseline study.
PURE’s research has already been published in highly respected peer-reviewed journals – The Lancet, The Journal of the American Medical Association (JAMA), and The New England Journal of Medicine (NEJM). Most recently, two PURE research articles were published in the same issue of The New England Journal of Medicine. The articles investigated the association of urinary sodium and potassium excretion with blood pressure, mortality, and cardiovascular events.