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/m 2 , with 10 442 (16%) participants aged 20–79, classified as obese (ie, BMI≥30 kg/m 2 ). 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 Medicine · Body mass index · Cohort · Epidemiology · Anthropometry · Cohort study · Socioeconomic status · Epidemiological transition · Demography · Longitudinal study
Cite this paper
Rajiv Chowdhury, Nusrat Khan, Lisa A M Pennells, Maria LC Iurilli, Md Taslim Uddin Miah, Md Mostafa Monower, K M Thouhidur Rahman, Sharraf Samin, Kazi Nazmus Saqeeb, Ishrat Tasmin, Eleanor Farrow, Samantha Farrow, Ank Michielsen, Catherine Perry, Sarah Spackman, Charlotte van Coeverden, Matthew P. Walker, Tahmeed Ahmed, James W. Ajioka, Khondker Abdul Abdul Awal, Adam S. Butterworth, Evangelia Chatzidiakou, Jörg Feldmann, Richard Andrew Fenner, Meerjady Sabrina Flora, Tuhin Haque, Sarah Hawkes, Syed Shariful Islam, Sirajul Islam, Roderic L. Jones, Stephen K. Kaptoge, Kamrul Hasan Khan, LAWRENCE PETER KING, Shammi Luhar, Abdul Malik, Fazila‐Tun‐Nesa Malik, Ruchira Tabassum Naved, Aliya Naheed, Olalekan Popoola, Rubhana Raqib, Tahmina Shirin, Stephen R. Sutton, Kim Robin van Daalen, Angela Wood, Simon Griffin, Nicholas J. Taylor, Md. Khalequzzaman, Md Alfazal Khan, Sohel Reza Choudhury, Emanuele Di Angelantonio, & John Danesh. (2025). Cohort profile: the BangladEsh Longitudinal Investigation of Emerging Vascular and nonvascular Events (BELIEVE) cohort study. BMJ Open, 15(1), e088338. https://doi.org/10.1136/bmjopen-2024-088338
Authors and affiliations
Rajiv Chowdhury
Florida International University
ORCID 0000-0003-4881-5690Nusrat Khan
Newcastle University
ORCID 0000-0003-3928-0022Lisa A M Pennells
University of Cambridge
ORCID 0000-0002-8594-3061Maria LC Iurilli
University of Cambridge
ORCID 0000-0003-0409-1635Md Taslim Uddin Miah
Directorate General of Health Services, Cumilla Medical College, Cumilla, Bangladesh
Md Mostafa Monower
National Heart Foundation Hospital & Research Institute
ORCID 0000-0002-1531-5633K M Thouhidur Rahman
Bangladesh Medical University
ORCID 0000-0002-1471-0797Sharraf Samin
University of South Carolina
Kazi Nazmus Saqeeb
International Centre for Diarrhoeal Disease Research
ORCID 0000-0003-3675-8684Ishrat Tasmin
National Heart Foundation Hospital & Research Institute
ORCID 0009-0009-4663-8601Eleanor Farrow
University of Cambridge
Samantha Farrow
University of Cambridge
Ank Michielsen
University of Cambridge
ORCID 0000-0002-4818-1686Catherine Perry
University of Cambridge
ORCID 0000-0002-8496-6923Sarah Spackman
University of Cambridge
Charlotte van Coeverden
University of Cambridge
Matthew P. Walker
University of Cambridge
ORCID 0000-0002-7839-6389Tahmeed Ahmed
International Centre for Diarrhoeal Disease Research
ORCID 0000-0002-4607-7439James W. Ajioka
University of Cambridge
Khondker Abdul Abdul Awal
National Heart Foundation Hospital & Research Institute
Adam S. Butterworth
University of Cambridge
ORCID 0000-0002-6915-9015Evangelia Chatzidiakou
University of Cambridge
Jörg Feldmann
University of Graz
ORCID 0000-0002-0524-8254Richard Andrew Fenner
University of Cambridge
ORCID 0000-0002-9272-211XMeerjady Sabrina Flora
National Institute of Cardiovascular Diseases
ORCID 0000-0001-5172-1295Tuhin Haque
National Heart Foundation Hospital & Research Institute
Sarah Hawkes
University College London
ORCID 0000-0003-1062-3538Syed Shariful Islam
Bangladesh Medical University
ORCID 0000-0002-3199-1076Sirajul Islam
Bangladesh Medical University
ORCID 0009-0002-5985-9437Roderic L. Jones
University of Cambridge
ORCID 0000-0002-6761-3966Stephen K. Kaptoge
University of Cambridge
ORCID 0000-0002-1155-4872Kamrul Hasan Khan
Bangladesh Medical University
ORCID 0000-0002-9141-6962LAWRENCE PETER KING
University of Massachusetts Amherst
ORCID 0000-0002-5714-406XShammi Luhar
University of Cambridge
ORCID 0000-0002-1080-8893Abdul Malik
National Heart Foundation Hospital & Research Institute
ORCID 0000-0002-9315-0301Fazila‐Tun‐Nesa Malik
National Heart Foundation Hospital & Research Institute
ORCID 0000-0002-8424-439XRuchira Tabassum Naved
International Centre for Diarrhoeal Disease Research
ORCID 0000-0002-0363-5648Aliya Naheed
International Centre for Diarrhoeal Disease Research
ORCID 0000-0002-6016-5603Olalekan Popoola
University of Cambridge
ORCID 0000-0003-2390-8436Rubhana Raqib
International Centre for Diarrhoeal Disease Research
ORCID 0000-0002-8116-4511Tahmina Shirin
Institute of Epidemiology, Disease Control and Research
ORCID 0000-0002-5061-3783Stephen R. Sutton
University of Cambridge
ORCID 0000-0003-1610-0404Kim Robin van Daalen
University of Cambridge
ORCID 0000-0001-6955-9708Angela Wood
University of Cambridge
Simon Griffin
University of Cambridge
Nicholas J. Taylor
University of Cambridge
ORCID 0000-0002-8700-5909Md. Khalequzzaman
Bangladesh Medical University
ORCID 0000-0003-4638-7469Md Alfazal Khan
International Centre for Diarrhoeal Disease Research
ORCID 0000-0002-7916-482XNational Heart Foundation Hospital & Research Institute
ORCID 0000-0002-7498-4634Emanuele Di Angelantonio
University of Cambridge
ORCID 0000-0001-8776-6719John Danesh
University of Cambridge
ORCID 0000-0003-1158-6791