Large-scale population-based study aiming to understand the burden and determinants of LTCs in rural and urban Malawi. It targets adolescents and adults aged 15 years and older, with recruitment ongoing across both rural and urban sites. Builds on prior NCD survey of 28,000 in same populations. Recruitment update: • Target population: 40,000 adolescents and adults (aged 15+ years) • Recruitment progress: To date, 32,064 participants have been recruited (21,803 from rural site and 10,261 from urban site) • Repeat measures for LTCs between 2013-2016 and 2021-2025: overlap ~ 10,000 individuals in the rural site, ~ 2,000 in urban site Data collected includes: • Sociodemographic characteristics • Lifestyle and behavioral factors • Medical history • Mental health: Depression, anxiety, alcohol use Physical measurements: • Anthropometry • Handgrip strength • Body composition Clinical measurements: • Blood pressure • Blood glucose Biological samples: • Blood samples collected from 21,418 individuals • Tests conducted on all samples: Glucose, full blood count • Samples stored for future analyses • Funding secured for genomic and metabolomic analyses on 20,000 participants Sub-sample data: Additional detailed information collected on: • Hepatitis B • Kidney disease • Objective measures of physical activity (accelerometry) • Lung function (spirometry) Nested work included real-time capture and clinical characterization (including ECG, Echo and carotid doppler) of cardiovascular events.