Why we need a study on ‘birth cohort’ in Rwanda
Wednesday, September 28, 2022

The month of August was inundated with the tragic loss of renowned Rwandan sensation Yvan Burabyo, commonly known as Buravan. What stood out was the relatively young age at which he passed; 27. He died of cancer.

While this was a high profile case, at least in Rwanda, dangerously little attention has been paid to the increasing number of individuals suffering and dying from chronic illnesses like cancer, diabetes, and cardiovascular diseases.

Needless to say, the incidence of such diseases has been rising, going by media reports and official statistics, resulting in their reference as the global disease burden.

Non-communicable diseases, including cancer, have been among the leading causes of death in many developing countries. Their morbid yet gradual global accumulation means they can no longer be considered privy to socioeconomically developed countries.

More concerning is also the fact that these diseases have no common causal inference. Variables like diet, genetic inheritance, lifestyle, and even the environment in which one lives all contribute significantly to the incidence of these diseases.

The study of disease, not surprisingly, has historically focused largely on the patient, who is the individual already affected by the disease. In the search for causes, this approach is suitable for diseases whose onset closely follows the inciting exposure, which is the case with many infectious diseases like malaria.

However, for chronic diseases like cancer, whose origins lie in exposures and behaviors spanning years or even decades before the onset of disease, a study of the patient is unlikely to reveal the underlying causes fully.

At this juncture, birth cohort studies come in handy as they discern the causes of chronic health problems and thus help develop preventative strategies. In birth cohorts, participants are identified at or around birth and recruited to join the cohort.

Mothers, children, and perhaps other family members are actively followed up to collect biological material and specific clinical and genetic information.

Rwanda is a country making strides in various healthcare domains. This would be an ideal moment to reflect on birth cohort studies. Such exercise would enable the public to understand contemporary diseases’ underlying causes.

The study would also consider certain factors like the tragic history of genocide and its impact on the current cognitive ability and mental health of citizens, with forecasts and predictions into the future.

The contributions of these studies to public health cannot be overstated. Analyses of places where such studies have been implemented support the execution of related relevant policies based on emerging population needs. For example, cohort studies in the United Kingdom assessed the key risk factors for cardiovascular disease as early as 1948.

This supported early public health prevention through awareness of risk factors like smoking and alcohol consumption.

With the implementation of birth cohort studies, citizens would know the risk factors that endanger their health. Educators would be informed on the number of psychologists and medical doctors to train based on exact statistics of demographic health situations.

The study has the potential to inform and transform evidence-based policies and practices to improve the prosperity of the nation.

Cohort studies would enable citizens to understand how all aspects of the environment work together to impact lifelong health and well-being. As Rwanda remains a technology hub in the region, collecting information would be cost-effective, secure, and less burdensome to study participants.

Technology would also aid in the quick and safe processing of information, allowing society to reap the benefits of the study research more immediately.

The writer is a Rwandan Epidemiologist currently working on Northern Birth cohort in Finland.

The views expressed in this article are of the writer.