Feasibility of Using Different Approaches for Recruiting Younger Twins to Establish a Population Based Twin Register in Sri Lanka

The Sri Lankan Twin Registry: 2012 update

The Sri Lankan Twin Registry (SLTR), established in 1997, is a unique resource for twin and genetic research in a low- and middle-income country (LMIC). It comprises of a volunteer cohort of 14,120 twins (7,060 pairs) and 119 sets of triplets, and a population-based cohort of 19,040 (9,520 pairs) twins and 89 sets of triplets. Several studies have been conducted using this registry, including the Colombo Twin and Singleton Study (CoTaSS 1; 4,387 twins, 2,311 singletons), which have explored the prevalence and heritability of a range of psychiatric disorders as well as gene-environmental interplay. Currently, a follow-up study (CoTaSS 2) of the same cohort is underway, looking at the prevalence and interrelationship of key cardiovascular and metabolic risk markers (e.g., metabolic syndrome). A significant feature of CoTaSS 2 is the establishment of a biobank. Current SLTR work is extending beyond mental health and the interface between mental and physical health to new horizons, extending collaborations with the wider global twin research community. Ethics and governance have been given special emphasis in the initiative. Capacity building and public engagement are two crucial components. Establishment of a state-of-the-art genetic laboratory was a major accomplishment. SLTR is a classic showcase of successful North-South partnership in building a progressive research infrastructure in a LMIC.

Update From Sri Lankan Twin Registry: Establishment of a Population-Based Twin Register and Ongoing Project on Common Mental Disorders, Alcohol Abuse and Suicidal Ideations

The Sri Lankan Twin Registry began as a volunteer register in 1997. Previously, we have shown door-to-door surveys as the best option to build a population-based twin register of older, adult twins. Our aim was to build a population-based twin register in the Colombo district and use it for twin studies on common mental disorders. We aimed to identify a random sample of 4000 twins ascertained through the twin census. The Colombo district is divided into 13 divisional secretariat divisions (DSDs) and each division is further divided into Grama Niladari divisions administratively. Grama niladaris (GNs) are civil servants and visit each household in order to update the electoral register. GNs were used to do a census of twins while they updated the electoral register. The correlation between population density and twin rate among DSDs was .81, and between twin rate and the percentage of returned forms (from each DSD) was .74. We received 9648 forms notifying about twins and multiples. After removing the duplicates and information about twins who live in other districts, there were 17,406 multiples remaining. After incorporating twins and multiples from various other feasibility studies we now have 19,040 multiples with 8.46 twins per 1000 people in the Colombo district.

Capacity building through multi-disciplinary research: a report from Sri Lanka

Sri Lanka is an island situated close to the southern tip of the Indian subcontinent with a land area of about 65 000 km2. The population in 2001 was 18.5 million. It has an interesting genetic diversity, its five main populations revealing both European and Asian origins. Although Sri Lanka is a developing country, it has strengths that other developing countries do not have, mainly in health and education. However, Sri Lanka lacks a research culture and has inadequacies in its research capabilities; hence, capacity building is essential. Based on our research findings, we plan to achieve this by working with professionals, statutory services, policy-makers and the public. Our model is international collaboration based on our own research agenda. Such partnerships can produce high-quality research, with greater influence on national policy and practice (Costello & Zumla, 2000).