Dissecting the impact of forced displacement on Type Two Diabetes

摘要 目前，黎巴嫩是世界上难民人均集中度最高的国家， 黎巴嫩每四个人中就有一个是从叙利亚流离失所的。虽然有几项研究集中在 关于难民中发生传染病的数据极其有限。 关于强迫流离失所对慢性非传染性疾病(NCD)的影响 为2型糖尿病(T2D)。我们假设强迫流离失所会导致不利的 生活方式的改变与T2D和其他非传染性疾病的发展有关。我们的目标是 计划建立一个可持续的协作研究平台，通过建立一个独特的 难民和收容人口的预期纵向队列， 提供机会进行多学科研究，以调查 强迫移位对T2D的短期和长期健康影响。因此，建议的 该项目不仅与紧急和日益增长的中低收入国家(LMIC)有关 这是一个优先事项，但将提高LMIC进行此类研究的能力。 我们计划通过以下方式实现我们的目标：1)提供建立潜在客户的详细计划 这一队列将包括大约8000名年龄范围很广的男性和女性，他们将 从选定的初级卫生保健中心子集(n=70)中招募 为49,023名患者提供服务，其中包括7,733名叙利亚难民；2)进行一项试点研究 评估强迫流离失所和不良生活方式改变对T2D的影响 难民和收容人口患者子集的发展。拟议的项目将 为应用以生命阶段、整体方法为基础的分析工具提供理想环境 以及整合流行病学和人口健康科学的多学科战略 以促进我们对T2D和其他非传染性疾病决定因素的理解。 拟议项目将准备研究基础设施(数据、网络、能力 建筑)所需的更全面的研究方案，以增强知识 为可持续加强小岛屿发展中国家研究能力的长期目标奠定基础并加以补充 以解决非传染性疾病。因此，它将导致更好的诊断、预防和治疗 战略。

Abstract Currently, Lebanon has the highest per capita concentration of refugees in the world, where one in four persons in Lebanon is displaced from Syria. While several studies have focused on the occurrence of communicable diseases among refugees, data are extremely limited about the effects of forced displacement on chronic, noncommunicable diseases (NCDs) such as type 2 diabetes (T2D). We hypothesize that forced displacement leading to adverse changes in lifestyle is associated with T2D and other NCDs development. Our objective is to plan for the establishment of a sustainable collaborative research platform by building a unique prospective longitudinal cohort of individuals belonging to refugee and host population, providing opportunities to conduct a multitude of multidisciplinary studies investigating the short and long-term health effects of forced displacement on T2D. Accordingly the proposed project is not only relevant to an urgent and growing Low and Middle Income Countries (LMIC) priority, but will improve the capacity in the LMIC to conduct such research studies. We plan to achieve our objective by: 1) providing a detailed plan for establishing a prospective cohort that will include approximately 8,000 men and women with a wide age range, who will be recruited from a selected subset (n=70) of Primary Health Care Centers (PHCs) serving 49,023 patients including 7,733 Syrian refugees and 2) conducting a pilot study assessing the impact of forced displacement and adverse lifestyle changes on T2D development in a subset of refugee and host population patients. The proposed project would provide an ideal setting to apply analytic tools grounded with a life-stage, holistic approach and a multidisciplinary strategy that integrates epidemiology and population health sciences to advance our understanding of the determinants of T2D and other NCDs. The proposed project will prepare the research infrastructure (data, networking, capacity building) required for more comprehensive research programs that enhance the knowledge base and add to the long-term goals of sustainably strengthening research capacity in LMICs to address NCDs. Accordingly, it will result in better diagnostics, prevention, and treatment strategies.