Cardiovascular Disease in Russia
Dates: November 2012 – February 2019
Russia has the highest mortality from cardiovascular disease in the world. This project aims to identify key reasons for this very high public health burden which will help inform the development of strategies to improve the situation. A series of detailed studies compares the cardiovascular system of a large sample of the Russian population with that in Norway and other Western countries. It brings together for the first time available high quality data from epidemiological studies in Russia to generate the most authoritative summary of cardiovascular risk factors levels in Russia. Comparative studies of the validity of cause of death in Russia and Norway are also conducted as well as a systematic investigation of the potential contribution of access to and standards of treatment.
Diabetes Management in DRC
Description: This study is carried out in partnership with the Manson Unit of Médecins Sans Frontières (MSF) and will take place in the MSF programme in Mweso, North Kivu in the Democratic Republic of the Congo (DRC). The aim of the study is to assess the feasibility and effectiveness of an intervention to implement treatment and management for diabetes in Mweso. The study objectives are to: measure the effectiveness of care on outcomes for patients with diabetes; assess the baseline prevalence of diabetes and diabetes risk-factors; measure the economic feasibility of implementing care for insulin dependent diabetes; and explore perspectives of health workers and patients on compliance patterns for care for insulin dependent diabetes. Research methods include a cohort of diabetes patients, cross-sectional household surveys, and qualitative research.
PURE Critical Barriers
Description: The goal of this project is to understand inequalities in accessing and continuing effective care for cardiovascular diseases in low-, middle- and high income countries. The objectives of the study are to assess the scale and nature of inequalities in influencing the use of evidence-based CVD prevention measures and treatments for cardiovascular disease (hypertension, stable angina, acute myocardial infarction, heart failure, stroke), and identify the socio-demographic, economic, and community determinants of variation within countries. Research methods include statistical analysis of data from the PURE data.
Description: This project seeks to improve the management of hypertension, a condition that afflicts around a billion people worldwide, nearly three-quarters of whom live in developing countries. The project has several phases: a systematic review of barriers to optimal hypertension management, analysis of those barriers in Colombia and Malaysia, development of a complex intervention including new simplified guidelines for detection and treatment, task shifting, and fixed dose combination therapy (the polypill).
Collaborators: Population Health Research Institute
Khatib R, Schwalm J-D, Yusuf S, Haynes BR, McKee M, Khan M, Nieuwlaat R. Patient and healthcare provider barriers to hypertension awareness, treatment and follow up: A systematic review of qualitative and quantitative studies. PLOS One 2014; 9(1): e84238. doi:10.1371/journal.pone.0084238
Maimaris W, Paty J, Perel P, Legido-Quigley H, Balabanova D, Nieuwlaat R, McKee M. The influence of health systems on hypertension awareness, treatment and control: a systematic literature review. PLOS Med 2013: 10(7): e1001490. doi:10.1371/journal.pmed.1001490
Media: HOPE-4 Video
For further information, please visit: http://www.gacd.org/projects/current-projects/hypertension/project-pages/project2
The CONCORD Programme – Global Surveillance of Cancer Survival
The CONCORD programme for global surveillance of cancer survival is led by the Cancer Survival Group at the London School of Hygiene & Tropical Medicine. The most recent study examined data for over 25 million individual cancer patients diagnosed 1995-2009, provided by 279 population-based cancer registries in 67 countries that are home to two-thirds of the world’s population.
Dr Claudia Allemani was awarded the UK Faculty of Public Health’s inaugural Global Public Health Award in 2016 for her work on the CONCORD programme.
The CONCORD programme is endorsed by 31 national and international agencies, including the Organisation for Economic Co-operation and Development (OECD), the National Cancer Institutes of France and the USA, the US Centers for Disease Control and Prevention, and the World Bank. For more information please see our website.
Community-based Hypertension Improvement Program (ComHIP)
The Centre for Global NCD of the LSHTM is leading the evaluation and cost-effective analysis of a community-based hypertension program (ComHIP) in a district in Ghana as an important contribution to the development of evidence-based innovative approaches to the management of non-communicable diseases in low & middle income countries.
ComHIP is a community based-program that engages both the public and private sectors in the community to improve the management and control of hypertension in the Lower Manya Krobo district. It aims to enhance the capacity of the Ghana Health Service through task shifting and innovative technology solutions to improve access to quality and affordable services for hypertension and other cardiovascular diseases (CVDs). The project also aims to improve the capacity of patients in managing their own conditions and risk factors.
For this project LSHTM is partnering with the Ghana Health Service, FHI360, School of Public Health of the University of Ghana and the Novartis Foundation.
Using computerised clinical data to investigate the links between long-term drug treatments and cancer risk
There are concerns that some widely-used drug treatments might be linked to an increase in the risk of cancer. The aim of the project is to investigate such concerns making use of routinely collected data on large numbers of patients observed over a number of years, recorded in electronic healthcare databases.
The course and outcome of alcohol use disorders (AUD): A population based cohort study in Goa, India
Exploring early and life-course determinants of chronic kidney disease
Epidemiology of infections amongst people with chronic kidney disease and diabetes
Using routine health records, this project investigates whether people with diabetes who also have chronic kidney disease are at a higher risk of infections than those without kidney disease, and whether people with kidney disease receive vaccinations for vaccine-preventable diseases.
Nutritional challenges, abdominal adiposity and type 2 diabetes in Indians
Lead: Hannah Kuper
This study was undertaken in Hyderabad, India, to assess the impact of early life nutritional supplementation and later life rural-urban migration on diabetes and other chronic diseases.
Improving the assessment and treatment of childhood obesity
As part of the PROMISE Programme, two projects based at LSHTM aim to:
1. Scope the impact of the National Child Measurement Programme feedback on the child obesity pathway; and 2. Develop a new electronic tool to improve childhood obesity management in primary care.
REPAIR and ERICCA trials
Lead: Tim Clayton
The REPAIR trial aims (Renal protection against ischaemia reperfusion injury in transplantation) to determine if remote ischaemic preconditioning (RIPC) improves renal function after transplantation. The ERICCA trial (Effect of Remote Ischaemic preConditioning on clinical outcomes in patients undergoing Coronary Artery Bypass Graft surgery) aims to determine whether remote ischaemic preconditioning (RIC) improves clinical outcomes after cardiac surgery.
Leverhulme centre for integrative research on agriculture and health
The determinants of international and socio-economic variations in female breast cancer survival
Lead: Laura Woods
This research examines the determinants of low survival amongst women with breast cancer in England in comparison to Australia, and in poorer women in comparison to richer women in the United Kingdom.
Timely diagnosis and inequalities in breast cancer survival
Lead: Laura Woods
The purpose of this research is to provide robust, quantitative evidence of the effectiveness of mammographic screening for reducing inequalities in survival between women of different socio-economic groups and of different ethnicities.
STRENGTHS – mental health care for Syrian refugees
Funder: European Commission
ECOHOST staff involved: Bayard Roberts
Description: ECOHOST is a partner in a new five-year European Commission funded research project called STRENGTHS led by Vrije Universiteit Amsterdam which seeks to strengthen mental health care for Syrian refugees in Europe and in countries neighbouring Syria.
The current refugee crisis across Europe and the Middle East effects refugees’ psychological well-being, as they face extreme stressors in their flight from their home country and lives in new countries, but also has large effects on the healthcare systems of countries housing refugees. In response to this crisis, STRENGTHS aims to provide a framework for scaling-up the delivery and uptake of effective community-based mental health strategies to address the specific needs of refugees within and outside Europe’s borders. STRENGTHS will outline necessary steps to integrate evidence-based low-intensity psychological interventions (PM+) with refugees for common mental disorders into health systems in Syria’s surrounding countries (Turkey, Lebanon, Jordan) and Europe (Germany, Switzerland, the Netherlands and Sweden).
The programme of work includes conducting randomised control trials of PM+, and associated implementation science and economic evaluation of scaling-up PM+. The consortium is a unique partnership between academics, NGOs, international agencies and local partners with the responsibility to provide and scale-up evidence-based mental health and psychosocial support interventions for refugees. Bayard Roberts (ECOHOST) is leading a work package examining the responsiveness of health systems to the scaling-up of PM+ across the study countries. Research methods include rapid appraisals of health systems, cross-sectional population-level surveys, and in-depth qualitative research.
For further information contact: Bayard Roberts
[Photo credit: Russell Watkins/Department for International Development,
licensed under CC-Attribution 2.0]
Treatment and control of NCDs in Malaysia and the Philippines
Creating the building blocks for better treatment and control of non-communicable diseases among poor and vulnerable households in Malaysia and the Philippines
Description: The project will provide the knowledge needed to overcome health system barriers to optimal management of hypertension in Malaysia and the Philippines, which is now a major cause of disability and premature death despite being easily detected and treated. Yet although evidence on its clinical management is universal, to overcome the health systems barriers, especially those faced by the poor, local knowledge is needed. This, in turn, requires local capacity in health systems research and knowledge transfer. The project will use a mix of quantitative and qualitative methods to understand barriers to hypertension control faced by low-income households. We will use innovative open-source mobile technology to capture participant-generated content (audio, text, video, etc.) on their lived experience in real-time, coupled with panel surveys of households, and assessment of formal and informal providers.
Collaborators: University of the Philippines – Manila, College of Medicine and UCSI University (Malaysia)
TOwards imProved screening for breast, cervical and colorectal cancer In All of Europe
The EU-TOPIA study is carried out in partnership with: Erasmus University, Netherlands; Cancer Society of Finland; City of Health and Science University Hospital of Turin, Italy; The Institute of Oncology Ljubljana, Slovenia; Health Development Institute, Estonia; and Syreon Clinical Research, Hungary.
The study will systematically evaluate and quantify the harms and benefits of current programmes for breast, cervical, and colorectal cancer in all European countries, and identify ways to improve health outcomes and equity. Using quality indicators, outcomes and cost-effectiveness of existing cancer screening programmes in 2015 will be estimated. Models of the natural history of the cancers will be constructed using country-specific data, and barriers to implementation identified. Road maps for change with capacity for self-evaluation of screening will be built using web-based tools. The project aims to reduce inequity, number of cancer deaths and over-diagnosed cases, and increase life years gained and improve cost-effectiveness by 2025.
Dates: December 2016 – 2019
Staff: Neil Pearce
Description: Chronic kidney disease of an undetermined cause (CKDu) is estimated to have led to the premature deaths of hundreds of thousands of young men and women in low and middle income countries over the last two decades. It has been primarily linked to an epidemic of fatal illness among sugar cane workers in Central America but there is currently no standardised data to enable comparison and understanding of the causes and common factors compared with other parts of the world. DEGREE provides a simple set of tools which researchers can use anywhere to quantify the distribution of estimated Glomerular Filtrate Rate (eGFR) – an estimate of kidney function – using cross-sectional surveys in a representative sample from populations thought to be at risk of disease.
Collaborators: London School of Hygiene & Tropical Medicine, La Isla Foundation (La Isla Network)
The BRAIN Study
Staff: Neil Pearce
Description: There is growing evidence on the possible increased risks of neurodegenerative diseases including Dementia, Amyotrophic Lateral Sclerosis (ALS), Parkinson’s disease (PD), and Chronic Traumatic Encephalopathy (CTE) in former contact sport athletes. Different sports expose players to different types of injuries and while several studies have suggested an increased risk of various neurological disorders, this has not yet been established. The research is gathering data on the retired players’ quality of life and social circumstances, with an extensive set of tests capturing physical and cognitive capabilities – including grip strength, memory and reasoning – and a neurological clinical examination to look for signs of disease. There will also be face-to-face assessments as well as blood and urine samples taken for future analysis. The same tests and procedures will be used in a separate ongoing 1946 Birth Cohort Study which will provide a general population comparison.
Collaborators: London School of Hygiene & Tropical Medicine, Rugby Football Union, Queen Mary University of London, Institute of Occupational Medicine, University College London and Oxford University
World Asthma Phenotypes Study (WASP)
Staff: Neil Pearce
Description: This work is needed to better understand the aetiological mechanisms of asthma and to identify new causes and new treatments. Five centres are involved in the study; Bristol (UK), Wellington (New Zealand), Salvador (Brazil), Esmeraldas Province (Ecuador), Entebbe (Uganda). Detailed information will be collected from 200 asthmatics and 50 non-asthmatics in each centre, including sputum and nasal samples, blood samples, lung function and skin prick testing. Children and adolescents will be enrolled in all centres except Bristol where participants will be 26-27 years old. The key features of this study are the inclusion of both high and low prevalence centres in both high income and low-and-middle income countries, more detailed biomarker information compared to previous studies and new bioinformatics methods for integrating and analysing data.
CO-CREATE: Young people tackling obesity in Europe
Dates: May 2018 – April 2023
European Union Horizon 2020
CO-CREATE is using a complex systems approach to understand how different societal factors, stakeholders and institutions associated with obesity interact at various levels, and the implications these have on policy and young people. The researchers will work with adolescents to create, inform and disseminate proposals for policies to tackle obesity among their peers. This will be done through a participatory process of identifying and formulating relevant policies, assessing the options with other actors, promoting relevant policy actions and developing tools and strategies for implementation. LSHTM is working across the whole project, and responsible in particular for running one of the core fieldwork packages: generating systems maps with adolescents, policy-makers and other experts on the drivers of obesity, using tools from complex systems science.
FOLKEHELSEINSTITUTTET (Norway), UNIVERSITEIT VAN AMSTERDAM (Netherlands), UNIVERSITETET I OSLO (Norway), WORLD OBESITY FEDERATION (United Kingdom), LONDON SCHOOL OF HYGIENE AND TROPICAL MEDICINE (United Kingdom), UNIVERSITY OF CAPE TOWN (South Africa), Centro de Estudos e Investigação em Dinamicas Sociais e Saúde (Portugal), World Cancer Research Fund International (Belgium), EAT Stockholm Food Forum AS (Norway), University of Texas Health Science Center at Houson (United States), Press (Norway), UNIVERSITETET I BERGEN (Norway), SWPS UNIWERSYTET HUMANISTYCZNOSPOLECZNY (Poland), DEAKIN UNIVERSITY (Australia)
The CO-CREATE project has received funding from the European Union’s Horizon 2020 research and innovation programme for Sustainable Food Security under grant agreement No 774210.