OVERVIEW

Marked changes in the prevalence of non-communicable diseases (NCDs), such as obesity, diabetes, and cardiovascular diseases (CVD), have occurred over the past few years in both developed and developing countries. However, the epidemic of chronic NCDs is shifting from developed countries towards developing countries. Approximately 80% of the global cardiovascular disease burden occurs in low- and middle-income countries. The increased proportion of older adults partially explains the increase in CVD. Still, it is also influenced by broader societal factors such as urbanisation and industrialisation, which change job structures, related efforts, and other activities, diet, and psychosocial stressors. Collectively these changes have a significant impact on risk factors.

The PURE (Prospective Urban Rural Epidemiology) study is a large-scale, multi-country epidemiological study that was developed to investigate community-level factors (urban-rural differences, built environment, policy environment, and industrialisation), household-level factors (family structure, income, housing, etc.), and individual-level factors (lifestyle changes, genetic markers, psychological) which lead to the development of obesity, the nine risk factors for CVD (which collectively predict 90% of the global burden), and ultimately to diabetes and CVD.

Currently, 27 countries are involved in this global research program, orchestrated by Prof Salim Yusuf (Population Health Research Institute, Hamilton, CA). South Africa has four participating sites: one urban and one rural site within the North West Province, one urban site in Langa, Western Cape, and one rural site in Mount Frere in the Eastern Cape.

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Researchers from the North-West University that are currently involved in the PURE-SA study: