Monitoring the Demographic, Epidemiological, SocioCultural and Economic Impacts of Non-Communicable Diseases, Reproductive, Maternal, New-Born Child and Adolescent Health, and COVID-19: A Community-Based Urban Cohort in Addis Ababa, Ethiopia (COMBAT)

Abstract

Background: The dynamics of demographics and health of urban populations, such as in Addis Ababa, are continuously influenced by a  range of biological, social, and environmental factors. Non-communicable diseases (NCDs), reproductive, maternal, newborn child, and  adolescent health (RMNCAH), and emerging infections like coronavirus disease (COVID-19) are major health challenges for urban  residents. Updated and comprehensive evidence is crucial for policymakers and practitioners to make evidence-based decisions and to  build a resilient health system for these complex issues and their effects on an urban Ethiopian population. However, there is limited  contemporary evidence about these changing demographics and medical conditions. Therefore, we aimed to assess the demographic,  epidemiological, socio-cultural, and economic impacts of non-communicable diseases; reproductive, maternal, newborn, child, and  adolescent health, and COVID-19 over three years. Accordingly, we established COMBAT the first community-based urban cohort with  multidisciplinary experts. Through epidemiologic and socioeconomic lenses, this first community-based urban cohort, involving an  interdisciplinary team, will help in longitudinally monitoring for NCDs, RMNCAH, and COVID-19. It will also produce important policy  options and community-based public health evidence in Addis Ababa. Additionally, it will serve as a foundation for other researchers,  including PhD and MSc students, who are interested in assessing and tracking potential future issues about public health.

Methods: The  study is being conducted in Addis Ababa from January 2023 to January 2025, with the possibility of continuation based on funding  availability, employing an explanatory sequential mixed study design. The quantitative prospective cohort (open cohort where new  subjects meeting the selection criteria will be included at any time) will be conducted at the household (HH) level, with 4020 households  randomly chosen from Addis Ababa's lowest administrative unit (Ketena) to serve as the cohort's foundation. Subsequent home visits will  occur at six-month intervals to re-interview the households' economic situation, chronic non-communicable diseases, RMNCAH  indicators, and any COVID-19 or new health issues that have emerged since the previous visit, and anthropometric and biophysical  measurements (weight, height, hip and waist circumference, blood glucose, and blood pressure monitoring). Additionally, in-depth and  key informant interviews with purposefully chosen household heads and other stakeholders will be undertaken to examine the socio- cultural determinants and economic implications of NCDs, RMNCAH, and COVID-19.