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Project Topic
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Background: Non communicable diseases (NCDs) and Infectious diseases (IDs), such as malaria and intestinal parasites are highly prevalent in sub-Saharan Africa. Their dual burden, associated risk factors and impact are poorly studied in Central Africa. Objectives: The ParCaM study will estimate and compare the frequency of cardio-metabolic diseases risk factors (CMDRF), including metabolic syndrome, hypertension, and inflammatory biomarkers in individuals with or without intestinal parasite infection (IPIs). Differences between specific age groups, type of parasitism (protozoa, helminths) and geographical (urban versus rural) areas will be emphasized. In addition, risk groups will be identified. Methods: A two phase prospective and analytical study will be conducted in two urban (Libreville and Melen) and two rural (Koulamoutou and Bitam) cities in Gabon. Phase 1 will be a cross-sectional survey during which young adults aged between 18 and 49 years will be randomly included in the 4 sites. A standardized World Health Organization STEPwise NCDs surveillance questionnaire will be used to obtain demographic characteristics, lifestyle and risk factors. Blood pressure, height, weight, BMI and waist circumference will be measured. A parasitological analysis will identify intestinal protozoa, soil-transmitted helminths including urinary and intestinal schistosomiasis. Clinical chemistry and immunological tests will allow to identify the metabolic syndrome (which involves glucose, insulin, lipids levels) and the chronic inflammation biomarkers (IL-6, TNF-?, sCD14, hsCRP). The Framingham score will determine the 10-year cardiovascular risk at the beginning and the end of the follow-up. In the Phase 2, selected participants will be included in 18-month prospective cohort study to estimate the frequency of occurrence of any CMD event or risk factor. Statistical analysis will include the estimation of the prevalence of IPIs and logistic regression analysis to assess the association between the presence of IPIs and CMDRF. Covariates such as study area, age, sex, area of residency and type of parasitism will be introduced within the model. Conclusion: The prevalence of IPIs and CMDRF will be described globally and according to the study area (urban and rural areas). Also, the impact of IPIs on the occurrence of CMDRF will be estimated adjusted to the westernized or rural life style. The results of this study will emphasize the need of collaborative multi-country assessment of NCD and neglected infectious diseases burden estimation and co-management, as well as their prevention through the reduction of risk factors in urban, but also in remote areas.
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