The Haiti cardiovascular disease cohort: study protocol for a population-based longitudinal cohort

• Published in: BMC public health 2020-11, Vol.20 (1), p.1633-11, Article 1633
• Main Authors: Lookens, Jean, Tymejczyk, Olga, Rouzier, Vanessa, Smith, Caleigh, Preval, Fabyola, Joseph, Inddy, Baptiste, Raynold Jean, Victor, Joscar, Severe, Patrice, Apollon, Sandra, Dumont, Emelyne, Forestal, Guyrlaine, St Preux, Stephano, Rivera, Vanessa, Seo, Grace, Charles, Benedict, Ariste, Wilson, Kingery, Justin, Devieux, Jessy, Koenig, Serena, Nash, Denis, Fitzgerald, Daniel, Safford, Monika, Deschamps, Marie Marcelle, Pape, Jean, McNairy, Margaret
• Format: Article
• Language: English
• Subjects: Adult; Adults; Age; Blood pressure; Cardiovascular disease; Cardiovascular diseases; Cardiovascular Diseases - epidemiology; Cardiovascular medicine; Care and treatment; Cerebral infarction; Cohort analysis; Cohort Studies; Consent; Demographic aspects; Diabetes; Diabetes mellitus; Dyslipidemia; Echocardiography; EKG; Electrocardiography; Epidemics; Epidemiology; Food security; Haiti - epidemiology; Health services; Heart diseases; HIV; HIV Infections; Households; Human immunodeficiency virus; Humans; Hypertension; Informed consent; Kidney diseases; Lead content; Mental depression; Mortality; Myocardial infarction; Observational studies; Observational Studies as Topic; Population; Population studies; Population-based studies; Poverty; Prevention; Public health; Questionnaires; Random sampling; Risk analysis; Risk Factors; Social factors; Social interactions; Social isolation; Statistical sampling; Stroke; Study Protocol; Womens health
• ISSN: 1471-2458; 1471-2458
• DOI: 10.1186/s12889-020-09734-x

Cardiovascular disease (CVD) is the leading cause of mortality among Haitians, having surpassed HIV in the last decade. Understanding the natural history of CVD in Haitians, including the age of onset, prevalence, incidence, and role of major risk factors and social determinants, is urgently needed to develop prevention and treatment interventions. Aim 1: Establish a population-based cohort of 3000 adults from Port-au-Prince and assess the prevalence of CVD risk factors and diseases and their association with social and environmental determinants. Aim 2: Determine the incidence of CVD risk factors and CVD during 2-3.5 years of follow-up and their association with social and environmental determinants. The Haiti CVD Cohort is a longitudinal observational study of 3000 adults > 18 years in Port-au-Prince (PAP), Haiti. The study population is recruited using multistage random sampling from census blocks. Adults receive blood pressure (BP) measurements in the community and those with elevated BP are referred to the Groupe Haitien d'Etude Sarcome de Kaposi et des Infections Opportunistes Clinic for care. After informed consent, participants undergo a clinical exam with medical history. BP, electrocardiogram, echocardiogram, a study questionnaire on health behaviors, and laboratory specimens. Every 6 months, BP is remeasured. At 12 and 24 months, clinical exams and questionnaires are repeated. Labs are repeated at 24 months. Adjudicated study outcomes include the prevalence and incidence of CVD risk factors (hypertension, diabetes, obesity, dyslipidemia, kidney disease, inflammation, poor diet, smoking, and physical inactivity) and events (myocardial infarction, heart failure, stroke, and CVD mortality). We also measure social determinants including poverty. Depression, stress, social isolation, food insecurity, and lead exposure. Blood, urine, and stool samples are biobanked at study enrollment. The Haiti CVD Cohort is the largest population-based cohort study evaluating CVD risk factors and CVD among adults in urban Haiti with the goal of understanding the drivers of the CVD epidemic in Haiti. Study outcomes are comparable with existing international cohorts, and the biobank will provide important data for future research. Our goal is to translate findings from this study into pragmatic prevention and treatment interventions to fight the CVD epidemic in Haiti.