Dissecting the impact of forced displacement on Type Two Diabetes

摘要 目前，黎巴嫩是世界上人均难民集中度最高的国家， 在黎巴嫩，每四个人中就有一个是从叙利亚流离失所的。虽然一些研究集中在 关于难民中传染病发生率的数据极为有限， 关于强迫流离失所对慢性非传染性疾病的影响， 2型糖尿病（T2 D）我们假设，强迫流离失所导致不利的 生活方式的改变与2型糖尿病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合作研究平台， 属于难民和东道国人口的个人的预期纵向队列， 提供机会进行多学科研究调查， 强迫流离失所对T2 D的短期和长期健康影响。因此，拟议的 该项目不仅与迫切和不断增长的低收入和中等收入国家（LMIC）有关， 这将是一个优先事项，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）提供一个详细的计划， 这一队列将包括大约8,000名年龄范围广泛的男女，他们将 从选定的初级卫生保健中心（PHCs）子集（n=70）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）进行试点研究 评估被迫流离失所和不良生活方式改变对2型糖尿病的影响 在难民和东道国人口患者的一个子集的发展。拟议的项目将 提供一个理想的环境，以应用基于生命阶段的整体方法的分析工具 以及将流行病学和人口健康科学相结合的多学科战略 促进我们对T2 D和其他非传染性疾病的决定因素的理解。 拟议的项目将准备研究基础设施（数据、联网、能力 建设）所需的更全面的研究计划，提高知识 为可持续地加强中低收入国家研究能力的长期目标奠定基础， 以应对非传染性疾病。因此，它将导致更好的诊断，预防和治疗 战略布局

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.