Environmental change and diarrheal disease

环境变化与腹泻病

• 批准号: 6573454
• 负责人: Joseph N. S. Eisenberg
• 金额: $ 59.3万
• 依托单位: UNIVERSITY OF CALIFORNIA BERKELEY
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-01-15 至 2007-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6573454
• 关键词: Ecuador; behavioral /social science research tag; clinical research; communicable disease control; communicable disease transmission; community; diarrhea; enteric bacteria; feces; food contamination; gastroenteritis; gastrointestinal infection; geographic difference; health behavior; health care service availability; human subject; interpersonal relations; interview; longitudinal human study; nutrition; nutrition related tag; social change; social integration; socioeconomics; water pollution

DESCRIPTION (provided by applicant): Diarrheal diseases are predictable outcomes when fecal-oral pathogens meet human poverty and-dislocation. Are diarrheal diseases sensitive indicators of change in socioeconomic level, resource availability, and human social contacts? Processes like these are extremely difficult to study in a controlled fashion. The construction of a new road in coastal Ecuador provides a valuable natural experiment for this purpose. This road will link some previously remote villages to local, regional, and national networks of goods, services, and people, creating new connections among them. We hypothesize that: (1) the level and type of connections between villages are correlated with infection of enteric pathogens; and (2) the changing social connections, new resources, and sanitary and hygienic behaviors of individuals within villages are correlated with infection of enteric pathogens. These hypotheses use the village as their unit of analysis. When estimating the contribution of various exposure risks to disease incidence, it is also important to explore the implications of interdependence between these pathways. This is the third aim of our study: analyzing the joint effects of changes in these contact patterns using disease transmission models. Using a quasi-experimental design, twenty villages will be followed for 4 years, selected so that a rural-urban continuum is fully represented. This continuum will be measured by several factors that relate a given village to Borbon, the town located at the confluence of two rivers that support the villages within the region. Data will be collected at three levels. First, health promoters who live in the villages under study will implement an active surveillance program. They will administer a new survey tool to measure the incidence of all the diarrheal illnesses and monitor both proximal and distal determinants of disease, in a given village. Second, a biannual visit to each community will be conducted by our field team, which has recently completed a cross sectional feasibility study in these villages. Each visit will last two weeks. In these visits, stool samples will be collected from all symptomatic individuals and a random selection of controls. In addition, during these visits, survey tools will be used to collect information on water-use behavior sanitation, hygiene, food consumption patterns, and travel and migration. Third, semi-annual visits to each village will be undertaken by the local Ecuadorian anthropologist. These visits will include open-ended interviews as well as additional questions about social network formation and change. The visits will also allow village development and road.

描述（由申请人提供）：当粪口病原体遇到人类贫困和流离失所时，腹泻病是可预测的结果。腹泻病是否是社会经济水平、资源可用性和人类社会接触变化的敏感指标？像这样的过程很难以受控的方式进行研究。厄瓜多尔沿海新公路的建设为此目的提供了一次有价值的自然实验。这条道路将把一些以前偏远的村庄与当地、区域和国家的商品、服务和人员网络连接起来，在它们之间建立新的联系。我们假设：（1）村庄之间的联系水平和类型与肠道病原体的感染相关； (2)村内社会关系的变化、新的资源以及个人的卫生和卫生行为与肠道病原体的感染相关。这些假设使用村庄作为分析单位。在估计各种暴露风险对疾病发病率的影响时，探索这些途径之间相互依赖性的影响也很重要。这是我们研究的第三个目标：使用疾病传播模型分析这些接触模式变化的联合影响。采用准实验设计，将对 20 个村庄进行为期 4 年的跟踪调查，以充分体现城乡连续体。这种连续体将通过几个与特定村庄与博尔邦相关的因素来衡量，博尔邦镇位于两条河流的交汇处，支撑着该地区的村庄。数据将在三个层面上收集。首先，居住在所研究村庄的健康促进者将实施积极的监测计划。他们将使用一种新的调查工具来测量特定村庄中所有腹泻疾病的发病率，并监测疾病的近端和远端决定因素。其次，我们的实地团队将每两年对每个社区进行一次访问，该团队最近完成了对这些村庄的横断面可行性研究。每次访问将持续两周。在这些访问中，将从所有有症状的个体和随机选择的对照中收集粪便样本。此外，在这些访问期间，调查工具将用于收集有关用水行为、环境卫生、个人卫生、食物消费模式以及旅行和移民的信息。第三，当地厄瓜多尔人类学家将每半年对每个村庄进行一次访问。这些访问将包括开放式访谈以及有关社交网络形成和变化的其他问题。此次访问还将促进村庄发展和道路建设。