Document is current

Article History

Received: 20 March 2026

Accepted: 3 June 2026

First Online: 23 August 2026

Ethics

Acknowledgements: We are deeply grateful to all participants of the AADM and RODAM studies for their invaluable contributions. We also thank the dedicated fieldworkers, research staff and local study teams in Ghana, Nigeria, Kenya and Europe, whose commitment made recruitment, data collection and follow-up possible. The findings and conclusions presented in this paper are those of the authors and do not necessarily reflect the views of the National Institutes of Health (NIH) or the U.S. Department of Health and Human Services.

Data availability: The data supporting the findings of this study are available upon request from the corresponding authors (FPC and KACM) and will remain accessible for a minimum of 10 years following publication. Due to privacy and ethical considerations, the data cannot be made publicly available. Requests for access should be directed to the corresponding authors and will be reviewed by the scientific committees of the RODAM and AADM studies. Data may be shared with qualified researchers for non-commercial research purposes, including replication, meta-analysis and secondary analyses consistent with the original study aims. Access will be granted subject to approval by the relevant institutional ethics committees, execution of a data sharing agreement and compliance with the ethical guidelines of the RODAM and AADM studies and their participating institutions. There is no restriction on the nationality or affiliation of requesting researchers provided these conditions are met.

Funding: The current analyses are supported by the Amsterdam Public Health (Global Health) seed grant (2024105/MdB/DvDL). This research was additionally supported in part by the Intramural Research Program of the NIH. The RODAM study was funded by the European Commission under Framework Programme 7 (grant no. 278901). The AADM study received support for participant recruitment from the NIH grant no. 3T37TW00041-03S2 from the Office of Research on Minority Health. KACM is additionally supported by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) Pathway to Independence Award (K99/R00) DK131018. The funders of the study had no role in study design, data collection, data analysis, data interpretation or the writing of the report.

Authors’ relationships and activities: The authors declare that there are no relationships or activities that might bias, or be perceived to bias, their work.

Contribution statement: FPC, KACM, CA and SE conceived and designed the study. APD, GC, AAA and CNR contributed to the acquisition of data in the AADM study, and CH-B, SND, EO-D, EB and SB contributed to the acquisition of data in the RODAM study. SE and KACM conducted the statistical analyses, and FPC cross-checked the analyses. SE, FPC and KACM drafted the manuscript. CH-B, SND, EO-D, EB, SB, APD, GC, AAA, CNR and CA critically revised the manuscript for important intellectual content. All authors reviewed and approved the final version for publication. FPC and KACM are guarantors of this work and accept full responsibility for the integrity of the work as a whole. The contributions of the NIH authors are considered works of the United States Government.