Soil epidemiology: a new tool for environmental surveillance of soil-transmitted helminth infections in endemic settings.

土壤流行病学：流行地区土源性蠕虫感染环境监测的新工具。

• 批准号: 10450113
• 负责人: Sitara Swarna Rao Ajjampur
• 金额: $ 67万
• 依托单位: UNIVERSITY OF CALIFORNIA BERKELEY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-07-13 至 2026-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10450113
• 关键词: Adherence; Affect; Area; Biological Assay; COVID-19 pandemic; Collection; Communities; Country; DNA; Data; Detection; Effectiveness; Epidemiology; Evaluation; Feces; Foundations; Geography; Helminths; Home; Household; Human; Human Activities; India; Individual; Infection; Infrastructure; Intervention; Intestinal parasite; Intestines; Laboratory Study; Lead; Location; Logistics; Measurement; Methods; Modeling; Molecular; Molecular Analysis; Monitor; Morbidity - disease rate; Only Child; Parents; Persons; Pharmaceutical Preparations; Population; Population Density; Populations at Risk; Prevalence; Program Effectiveness; Randomized Controlled Trials; Recrudescences; Resources; Sampling; Sanitation; School-Age Population; Schools; Site; Soil; Source; Study models; Surveillance Methods; Temperature; Testing; Time; Water; Water Supply; base; burden of illness; cost; cost effective; diagnostic strategy; egg; enteric pathogen; field study; helminth infection; improved; infection rate; infection risk; novel; predictive modeling; prevent; programs; soil sampling; standard of care; stool sample; success; tool; transmission process

PROJECT SUMMARY Soil-transmitted helminth (STH) infections (intestinal worms) affect 1.5 billion individuals globally. Recent evidence from trials and modeling studies suggests that community-wide mass drug administration (cMDA) of deworming medication with sufficient coverage and adherence can eliminate STH transmission. However, in settings with ongoing environmental transmission and low coverage of networked sanitation, persistent environmental reservoirs of STH eggs result in high reinfection rates, and hinder progress towards elimination. STH control programs use human stool-based methods to assess STH prevalence and intensity in endemic settings. However, individual stool sampling is expensive and logistically difficult, particularly when human infection prevalence is low. If collecting and analyzing soil from locations in communities with high human activity (e.g. home entrances, water collection points, schools) were established to be equally or more sensitive than human stool diagnostics, this approach may represent a less invasive and more cost-effective surveillance tool for MDA program monitoring and evaluation. This study will leverage a multi-country cluster-randomized controlled trial delivering three-years of biannual cMDA in Benin and India (DeWorm3). The trial will collect and analyze by qPCR, human stool samples 24 months (n=80,000 in total) after the final round of cMDA, which will yield highly accurate human STH infection prevalence estimates in the study areas. Through extensive laboratory studies and field testing in India and Benin, our team has developed a sensitive and specific molecular method for detecting STH environmental DNA (eDNA) in large volumes of soil. We will nest soil sampling within the trial at the same time point as human stool collection and one year later with the specific aims to: 1) Quantify the effect of a biannual cMDA intervention on the soil STH reservoir; 2) Determine whether soil STH eDNA levels can predict community-level human STH infection prevalence; and 3) Develop the optimal soil sampling strategy and compare costs to human stool-based surveillance. Pairing soil STH eDNA assessments with human infection prevalence data already being collected by the DeWorm3 trial is a unique and time sensitive opportunity to validate and test the utility of environmental STH surveillance. Our findings will also contribute to understanding the conditions under which MDA program integration with improved sanitation interventions is needed for achieving sustained reductions in STH infection prevalence.

项目摘要 土壤传播的蠕虫（STH）感染（肠蠕虫）影响15亿个人 全球。试验和建模研究的最新证据表明，社区范围的质量 药物管理（CMDA）的驱虫药物，具有足够的覆盖范围和依从性 可以消除STH传输。但是，在具有持续环境传输的设置中 以及网络卫生的覆盖率低，STH鸡蛋的持续环境水库 导致较高的再感染率，并阻碍了消除的进展。 STH控制程序使用基于人凳的方法来评估STH患病率和 地方性环境中的强度。但是，单个粪便采样昂贵且在逻辑上很昂贵 困难，尤其是当人类感染率较低时。如果从 人类活动较高的社区中的位置（例如，房屋入口，水收集点， 学校被确定为比人粪便诊断更敏感的 方法可能代表MDA的侵入性较小，更具成本效益的监视工具 程序监控和评估。 这项研究将利用一项多国聚类的对照试验交付 贝宁和印度的三年CMDA三年（虫）。试验将收集和分析 通过qPCR，在CMDA最后一轮之后，人粪便样品24个月（n = 80,000）， 这将在研究区域产生高度准确的人类STH感染率估计。 通过印度和贝宁的广泛的实验室研究和现场测试，我们的团队拥有 开发了一种敏感且特定的分子方法，用于检测STH环境DNA （Edna）在大量土壤中。我们将在同一时间点内筑巢的土壤采样 作为人类粪便的收集，一年后的特定目的是：1）量化 一年一度的CMDA干预土壤STH水库； 2）确定土壤sth edna是否 水平可以预测社区水平的人类STH感染流行； 3）发展最佳 土壤采样策略，并将成本与基于人凳的监视进行比较。 已经将土壤STH EDNA评估与人类感染率数据配对 被虫子3试验收集是一个独特而敏感的机会，可以验证和 测试环境STH监视的效用。我们的发现也将有助于 了解MDA计划集成以及改进的卫生条件 需要采取干预措施来实现STH感染患病率的持续降低。