TUBERCULOSIS IN A MULTIETHNIC INNER CITY POPULATION

内城多民族人群的结核病

• 批准号: 2228337
• 负责人: MICHAEL MARMOR
• 金额: $ 18.79万
• 依托单位: NEW YORK UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 1994
• 资助国家: 美国
• 起止时间: 1994-08-01 至 1998-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2228337
• 关键词: HIV infections; Mycobacterium tuberculosis; child (0-11); communicable disease control; epidemiology; genetic strain; health behavior; high risk behavior /lifestyle; human subject; human therapy evaluation; intravenous drug abuse; nutrition; pathologic process; questionnaires; racial /ethnic difference; respiratory disorder chemotherapy; respiratory disorder diagnosis; restriction fragment length polymorphism; sex partner; therapy compliance; tuberculosis; urban area

Our broad, long-term objective is to develop knowledge needed for the control and treatment of tuberculosis. Specific research aims are as follows: 1) To determine the incidence of Mycobacterium tuberculosis (M. tb.) infection in HIV-infected and uninfected injecting drug users (IDUs), sexual partners of IDUs, and children in contact with TB-infected adults; 2) To identify risk factors for development of M. tb. infection; 3) To describe the natural history of M. tb. disease in children and adults; 4) To investigate the epidemiology of specific strains of M. tb. identified through restriction-fragment-length polymorphisms (RFLP) patterns of clinical isolates; 5) To evaluate the effect of M. tb. coinfection on the rate of progression of HIV disease; and 6) To investigate factors influencing compliance with tuberculosis prophylaxis and therapy. New York City is faced with a dramatic resurgence of tuberculosis, including an increase in drug-resistant strains. The proposed research will provide urgently needed information regarding incidence, risk factors, natural history, molecular epidemiology, treatment, and prevention of tuberculosis in an especially vulnerable multi-ethnic inner-city population with a high HIV seropositivity rate. The project will study the above-list critical issues regarding TB prospectively and retrospectively in three groups of patients: (1) intravenous drug users and their sexual contacts in an already-recruited cohort; (2) children who receive their primary care at Bellevue Hospital Medical Center; and (3) Bellevue Hospital Center inpatients with TB and outpatients undergoing prophylactic treatment. In addition to environmental risk factors (e.g., hopelessness, cohabitation with tuberculosis patients and injected drug use), we will investigate host factors, including: (a) HIV infection; (b) immune status among HIV- seropositive persons, as indicated by quantitative p24 antibodies; CD4, CD8, and gammadelta T cell counts; and (c) race, age, and nutritional status Incidence and risk-factors in the cohort will be assessed by interview, blood draw, PPD screening, medical record review, and anergy panel. Natural history and impact on HIV disease in adult and pediatric populations will be assessed by interviews, clinical screening and laboratory measures. Drug sensitivity testing and RFLP typing of specimens from the two populations will be conducted, respectively, at the Bellevue Mycobacteriology Lab and the Public Health Research Institute. Factors affecting treatment compliance will be assessed by self-administered questionnaire.

我们广泛的长期目标是建立所需的知识 结核病的控制和治疗。 具体的研究目的是 如下：1）确定结核分枝杆菌的发生率（M. TB。）感染HIV感染和未感染的吸毒者 （IDU），IDU的性伴侣和与TB感染的孩子 成年人; 2）确定M. TB发展的危险因素。感染; 3）描述M. TB的自然史。儿童疾病， 成年人; 4）研究特异性菌株的流行病学。 通过限制性差异长度多态性（RFLP）确定 临床分离株的模式； 5）评估M. TB的效果。 对艾滋病毒疾病进展率的共同感染；和6）到 研究影响预防结核病的因素 和治疗。 纽约市面临着结核病的戏剧性复苏 包括耐药菌株的增加。 拟议的研究 将提供有关发病率，风险的急需信息 因素，自然病史，分子流行病学，治疗和 在一个特别脆弱的多种族中预防结核病 艾滋病毒血清阳性率高的城市内部人口。 该项目将研究有关结核病的上述关键问题 前瞻性和回顾性三组患者：（1） 静脉注册的静脉吸毒者及其性接触 队列； （2）在贝尔维尤医院接受初级保健的孩子 医疗中心； （3）贝尔维尤医院中心的住院患者和结核病 接受预防治疗的门诊患者。 此外 环境风险因素（例如，绝望，与 结核病患者并注入药物），我们将调查宿主 因素，包括：（a）HIV感染； （b）艾滋病毒之间的免疫状态 如定量p24抗体所示，血清阳性人； CD4， CD8和Gammadelta T细胞计数； （c）种族，年龄和营养 该队列中的状态发病率和风险因素将由 访谈，抽血，PPD筛查，病历审查和无反应 控制板。 自然病史和对成人和小儿艾滋病毒疾病的影响 人口将通过访谈，临床筛查和 实验室措施。 药物敏感性测试和RFLP键入 将分别进行两个人群的标本 Bellevue分枝杆菌实验室和公共卫生研究 研究所。 影响治疗依从性的因素将由 自我管理问卷。