Sub-Saharan Africa (SSA) is facing a growing burden of non-communicable diseases due to epidemiological transitions following increasing urbanization and changing lifestyle. But available tools for prediction of these diseases including cardiovascular disease (CVD) are largely adapted from western regions data. So, there is an urgent need for building appropriate tools from large and long population-based cohorts in SSA.

The objective of the pilot project TAHES was to explore the feasibility of a large cohort study focused on CVD and risk factors in Benin.

TAHES pilot project is a prospective cohort ongoing since February 2015 among all people aged 25 years or above living at Tanvè, a village of Agbangnizoun in the center of Benin Republic. CVD risk factors data were collected using a standardized questionnaire adapted from the WHO Steps instrument through a baseline door-to-door survey, followed by annuals visits. A daily surveillance was implemented by visits of medical network for recording events of interest: peripheral artery diseases, myocardial infraction, stroke, congestive heart failure and deaths. This had been supported by a community surveillance through household weekly visit to offset the low health services coverage and limited use of formal health services by the population. Community agent notifies events and administrates a verbal autopsy in case of death. To perform a good follow-up and bypass specifics challenges as no house addresses and lack of civil registration, geographic data were collected for each household and each included subject have been identified through a composite 8-digit ID number, including specifics numbers for area (1 digit), house number (3 digit), household number (2 digit) and individual number (2 digit).

Up to date a total of 1793 participants were enrolled equaling to 4068.7 persons years of follow-up. Women represented 61.1% and the mean age was 42.7±16.5 years. At baseline, we recorded a prevalence of 2.3% (95% CI: 1.7–3.2) of daily smoking, 9.15% (95% CI: 7.9–10.6) of harmful use of alcohol, 9.3% (95% CI: 8.0–10.8) of obesity, 32.1% (95% CI: 29.9–34.3) of high blood pressure, and 3.5% (95% CI: 2.7–4.5) of diabetes.

During follow-up 64 events occurred in the cohort: 15 within the first year of follow-up, 18 for the second year and 31 for the third year. Recorded events were 55 cases of death, 6 cases of stroke and 3 cases of congestive heart failure. The mean age of death occurrence was 71.4±25.2. CVD represented 29.0% of the causes of death (8/55 for stroke, 5/55 for congestive health failure, 2/55 for sudden death and 1/55 for PAD). The others causes are infectious diseases (25.4%), others noncomunicables diseases (25.4%) and undetermined causes (20.0%). The overall incidence of CVD events was 25 cases equal to 6.1 cases for 1000 person-year. The rate of death for CVD event was 48.0%.

CVD had a high burden among this rural population and was associated to a high rate of death. TAHES methodology is being improved by adapting to local specifics challenges. Lessons from the pilot phase will help building strong and large cohort that should survives generations for being useful.