Ophthalmic Disease and Laboratory Surveillance in a Viral Hemorrhagic Fever Zone

病毒性出血热地区眼科疾病及实验室监测

基本信息

批准号：
10480923
负责人：
JESSICA Shantha
金额：
$ 24.85万
依托单位：
UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-09-01 至 2024-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10480923
关键词：
Adult Africa African Anti-Inflammatory Agents Aqueous Humor Asia Attention Autoimmune Autopsy Blindness Caring Cataract Cataract Extraction Cessation of life Child Health Child Mortality Childhood Cicatrix Clinical Clinical Management Clinical Research Clinical Skills Collaborations Communicable Diseases Competence Complication Control Groups Cystoid Macular Edema Cytomegalovirus Detection Development Diagnosis Diagnostic Diagnostic tests Disease Disease Outbreaks Disease Surveillance Ebola Hemorrhagic Fever Ebola virus Emerging Communicable Diseases Epidemic Epidemiologic Methods Epidemiology Etiology Event Eye Eye Development Eye diseases Foundational Skills Foundations Future Glaucoma Goals Government Guidelines Health Health Personnel Health Policy Hospitals Immune Incidence Individual Inflammation Inflammatory Infrastructure International Investigation K-Series Research Career Programs Knowledge Laboratories Lassa Fever Lassa virus Lead Liberia Liberian Liquid substance Marburgvirus Medical Records Mentored Patient-Oriented Research Career Development Award Mentors Mentorship Methodology Methods Morbidity - disease rate Neuraxis Organ Outcome Pathogen detection Pharmaceutical Preparations Phenotype Policies Prevalence Prevention Prospective cohort study Public Health Quality of life Readiness Recording of previous events Recurrence Reporting Research Research Project Grants Resource-limited setting Resources Retina Retrospective cohort Risk Risk Factors Sampling Scientist Security Seminal fluid Series Sierra Leone Site Survivors Symptoms Syndrome System Techniques Testing Time Time Factors Tissue Sample Tissues Toxoplasmosis Training United States United States National Institutes of Health Universities Uveitis Viral Viral Hemorrhagic Fevers Vision Visual Visual Acuity Visual impairment World Health Organization Zika Virus acute infection antimicrobial body system career career development clinical care cohort design detection method disease diagnosis education research emerging pathogen epidemiology study global health hearing impairment infectious disease model long-term sequelae meetings minimally invasive molecular diagnostics mortality multidisciplinary novel pathogen prevent research clinical testing screening skills success surveillance network surveillance study symposium tool transmission process

项目摘要

Project Summary Emerging infectious diseases can lead to devastating epidemics and pose a threat to global health security. The World Health Organization has identified pathogens that are likely to cause severe and imminent outbreaks, which include Ebolavirus (EBOV) and Lassa fever virus, all of which require urgent attention in research. The West African Ebola virus disease (EVD) outbreak of 2013-2016 is the most devasting EBOV outbreak in history with over 28,600 infected and 11,300 deaths. To date there continue to be isolated outbreaks with significant morbidity and mortality. There are approximately 17,000 EVD survivors who are at-risk for Post-Ebolavirus Disease Syndrome, a recently described entity, which includes systemic conditions, ocular disease, and viral persistence in immune privileged sites (aqueous humor, semen, and central nervous system). Viral persistence is of public health importance, given its initiation of EBOV transmission events and its association with end-organ damage. Uveitis, a potentially blinding inflammatory eye disease, is the most common ocular complication, occurring in approximately 13-34% of EVD survivors in West Africa. We have described vision loss due to ocular complications in retrospective cohorts in both Sierra Leone and Liberia. Specifically, within Liberian EVD survivors with uveitis developed vision impairment was noted in 60% and blindness (vision worse than 20/400) in approximately 40% of EVD survivors. Currently, we have insufficient knowledge about the disease course of EVD-associated uveitis, long-term visual acuity outcomes, and appropriate treatment for this sight-threatening disease. Besides our recent studies related to clinical uveitis in EVD survivors, our recent investigation of EBOV persistence raises questions about the potential for the eye to serve as a novel tissue site for infectious disease surveillance, particularly in a viral hemorrhagic fever zone endemic for other emerging pathogens of public health significance. The objectives of this study are to 1. Determine the prevalence of uveitis, incident vision loss over time, and risk factors for uveitis development in EVD survivors 2. Explore ophthalmic manifestation in Lassa fever virus survivors 3. Validate ocular fluid sampling as method for detection for surveillance of infectious diseases in collaboration with the Child Health and Mortality Prevention Surveillance study. The career development aims for this K-23 proposal are to 1. Obtain methodological skills in disease surveillance systems 2. Gain competency in molecular diagnostics of ocular fluid in the diagnosis of infectious pathogens 3. Continue to develop skills in clinical research in international settings 4. Further my training in statistical and epidemiology methods necessary for success in clinical studies. To accomplish these goals, I have designed a training plan that includes coursework, mentorship with international leaders, attendance and presentation at local and national research meetings/conferences, and directed, hands-on training. This K23 mentored career development award will be the foundation for the skills necessary to become a successful independent clinician scientist.

项目摘要新兴的传染病可能导致毁灭性的流行病，并对全球卫生安全构成威胁。世界卫生组织已经确定了可能引起严重爆发的病原体，其中包括埃博氏病毒（EBOV）和LASSA发烧病毒，所有这些都需要在研究中紧急关注。西非埃博拉病毒 2013 - 2016年疾病（EVD）爆发是历史上最破坏的EBOV爆发，感染了28,600多次 11,300人死亡。迄今为止，仍有明显的发病率和死亡率继续孤立的暴发。有大约有17,000名EVD幸存者患有症状后病毒疾病综合征，最近描述的实体，其中包括全身性疾病，眼部疾病和免疫特权部位的病毒持续性（水性幽默，精液和中枢神经系统）。鉴于其启动EBOV，病毒持久性具有公共卫生的重要性传输事件及其与最终器官损坏的关联。葡萄膜炎是一种潜在盲目的炎症性眼病，是最常见的眼部并发症，发生在西非大约13-34％的EVD幸存者。我们描述了由于眼并发症而导致的视力丧失塞拉利昂和利比里亚的回顾展。具体而言，在利比里亚EVD幸存者中在60％的情况下，发达的视力障碍在大约40％的EVD中注意到了60％，视力障碍（视力差于20/400）幸存者。目前，我们对与EVD相关的葡萄膜炎的疾病病程的了解不足，长期视力结果，并为这种威胁性疾病进行适当的治疗。除了我们最近的研究与 EVD幸存者中的临床葡萄膜炎，我们最近对EBOV持久性的调查提出了有关潜在的疑问眼睛充当传染病监测的新组织部位，特别是在病毒出血热区其他具有公共卫生意义的新兴病原体的特有。这项研究的目标是1。确定葡萄膜炎的患病率，随着时间的流逝事件视力丧失和风险因素 EVD幸存者中的葡萄膜炎的发展2。与儿童健康合作监测传染病的检测方法的眼液抽样和预防死亡率监视研究。这项K-23提案的职业发展目标是1。 2。在感染性病原体诊断中获得眼液分子诊断的能力。在国际环境中发展临床研究技能4。进一步我在统计和流行病学方法方面的培训在临床研究中取得成功所必需的。为了实现这些目标，我设计了一个培训计划，其中包括课程工作，与国际领导人的指导，出勤和演讲会议/会议和指导动手培训。这个K23指导的职业发展奖将是成为成功的独立临床医生所必需的技能基础。