The rapidly rising epidemic of non-communicable diseases (NCDs) in sub-Saharan Africa, in the presence of the long-standing burden of infectious diseases and constrained health care resources, represents an enormous challenge to the region. The causes, determinants and potential trajectory of the NCD epidemic are poorly understood. There is an urgent need for local research to inform an effective response to these changing health needs.
Responding to the call from Malawi Ministry of Health, MEIRU has broadened the scope of research, and a major focus in the future will be studies to prevent and control the high-burden NCDs. MEIRU has also expanded geographically to develop research activities in Lilongwe (the capital city) to complement those in Karonga, and enable rural-urban comparison of research findings. We are conducting one of the largest studies on NCDs in Africa (surveying nearly 18,000 and 25,000 adults ≥18-years old in Karonga and in Area 25 Lilongwe, respectively) to address some of the critical questions, such as:
- What is driving the high rates of hypertension and diabetes?
- What is the nature/natural history of hypertension and diabetes in this setting; how many people have complications (eg stroke, kidney disease, eye disease) and when do they get them?
- Do early nutritional insults increase later risk of NCDs?
- What is the link between HIV and NCDs?
- How much does genetics contribute to the risk of diabetes/hypertension or their complications?
- What are the barriers to accessing care?
- How should we intervene?
MEIRU has extensive collaborations with other academic/research institutions within Malawi and internationally. In particular, we have strong links with LSHTM – notably with the Department of NCD Epidemiology & Centre for Global NCDs. Our ambition is to build a strong multidisciplinary team with epidemiological, clinical and social science expertise. Leveraging the enabling local environment (the infrastructure in Karonga and Lilongwe) and support from our partners, MEIRU is uniquely placed to stimulate the development of a vibrant and sustainable capacity in NCD research and training in Malawi and the region.
Current studies (2012-2016)
- Ongoing population based NCD survey, and associated sub-studies (see above)
- Establishing a model for community-level stroke surveillance in sub-Saharan Africa – funded by the Wellcome Trust through a Clinical Fellowship (Alison Price)
- Trial development study (funded by the MRC) to design a cluster randomised controlled trial of sodium reduction to reduce hypertension in Malawi.
- A trial to examine the effect of mobile phone text-messaging on treatment of patients with type 2 diabetes in sub-Saharan Africa – funded by the MRC
- A collaborative study to investigate the burden, spectrum and aetiology of type 2 diabetes in sub-Saharan Africa – funded by the Wellcome Trust, through the H3 Africa initiative
- Identification and characterisation of chronic kidney disease in Uganda and Malawi – Funded by GSK through the Africa Open Lab initiative.