Surveillance for Respiratory Syncytial Virus (RSV) and Other Viral Respiratory Infections Among American Indians/Alaska Natives

美洲印第安人/阿拉斯加原住民中呼吸道合胞病毒 (RSV) 和其他病毒性呼吸道感染的监测

• 批准号: 10228535
• 负责人: Laura Hammitt
• 金额: $ 210万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-08-01 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10228535
• 关键词: Surveillance; Respiratory; Syncytial; Virus; RSV

Project Summary Respiratory Syncytial virus (RSV) is the leading viral cause of acute lower respiratory tract infection (ALRI), including bronchiolitis and pneumonia, globally. RSV disease in infancy is associated with substantial morbidity and mortality, and infants who experience severe RSV are at increased risk of recurrent wheeze and asthma later in life. American Indians and Alaska Natives (AI/AN), who experience many health disparities, are at substantially increased risk of RSV compared to the general US population. Numerous products for the prevention of RSV in infants and children are currently in late stage development, including maternal vaccines and monoclonal antibodies. Such interventions are urgently needed in AI/AN communities. Current CDC surveillance systems do not measure RSV illness in AI/AN populations. Furthermore, the burden of RSV in pregnant women and the effect it may have on pregnancy and delivery outcomes are poorly understood. Quantifying the current burden and characterizing the epidemiology of RSV disease in AI/AN children and pregnant women is a critical step to inform optimal use of RSV-prevention products to reduce disease and promote health equity. The proposed research will build upon long-standing collaborations between tribal partners, the Johns Hopkins Center for American Indian Health (JHCAIH) and the Alaska Native Tribal Health Consortium (ANTHC) to create the RSV Surveillance in Native Americans (RSV-SuNA) system. RSV-SuNA will quantify and describe RSV disease in AI/AN children under five years and pregnant women in three communities in the southwestern US and two communities in Alaska over five RSV seasons. The platform will consist of active, population- based, in-patient and outpatient surveillance for ALRI across multiple settings and seasons in order to provide a robust understanding of RSV disease in Native populations. Nasal swabs will be collected from consenting participants and tested for the presence of RSV and other pathogens associated with ALRI using validated laboratory methods. This, and the use of standardized case definitions and data collection in instruments, will facilitate comparison across sites and with other active surveillance networks (e.g. CDC’s existing New Vaccine Surveillance Network). This study will determine the age-specific incidence of RSV-associated hospitalizations and outpatient visits in these AI/AN communities and characterize RSV- and non-RSV associated ALRI, including risk factors, clinical course, and sequalae. The collaborative, multi-site approach will fill key gaps in our understanding of the epidemiology of RSV and produce meaningful data to inform policy and monitor RSV disease in AI/AN populations. The RSV-SuNA system could be replicated in other AI/AN populations and could be used after the introduction of RSV prevention products to quantify their impact on the burden of both RSV and non-RSV ALRI.

项目摘要 呼吸综合病毒（RSV）是导致急性下呼吸道感染（ALRI）， 婴儿期的RSV疾病与大量发病有关 和死亡率，经历严重RSV的婴儿经常发生Wheeleze和哮喘的风险增加 后来生活。经历了许多健康差异的美国印第安人和阿拉斯加原住民（AI/AN）处于 与美国普通人群相比，RSV的风险大大增加。许多产品 预防婴儿和儿童目前处于晚期发展，包括Mater Caginas 和单克隆抗体。 AI/A社区迫切需要进行此类干预措施。 当前的CDC监视系统未测量AI/AN人群中的RSV疾病。此外，伯宁 孕妇的RSV及其对怀孕和分娩结果的影响很差 理解。量化电流燃烧并表征AI/AN中RSV疾病的流行病学 儿童和孕妇是为RSV预防产品提供最佳使用以减少最佳使用的关键步骤 疾病并促进健康公平。 拟议的研究将基于部落伙伴之间的长期合作，约翰·霍普金斯（John Hopkins） 美洲印第安人卫生中心（JHCAIH）和阿拉斯加土著部落卫生联盟（ANTHC） 在美洲原住民（RSV-SUNA）系统中创建RSV监视。 RSV-SUNA将量化和描述 AI/AI/A/A的RSV疾病五年以下的儿童和西南部三个社区的孕妇 在五个RSV季节中，我们和阿拉斯加的两个社区。该平台将包括积极的人口 - 基于多个设置和季节的Alri基于ALRI的住院和门诊监视，以提供 对本地人群中RSV疾病的强烈了解。鼻拭子将从同意中收集 参与者使用经过验证的RSV和其他与Alri相关的病原体的存在测试 实验室方法。这，以及在工具中使用标准化的案例定义和数据收集的使用，将 促进跨站点以及其他主动监视网络的比较（例如，CDC现有的新型 疫苗监视网络）。这项研究将确定与RSV相关的年龄特异性发生率 这些AI/A/A社区的住院和门诊就诊，并表征RSV-和非RSV 相关的ALRI，包括危险因素，临床过程和序列。 协作，多站点方法将填补我们对RSV流行病学和 产生有意义的数据，以告知政策并监测AI/A A A/A的RSV疾病。 RSV-SUNA 系统可以在其他AI/A A A/A人群中复制，并且可以在引入RSV后使用 预防产品可以量化其对RSV和非RSV ALRI燃烧的影响。