Environmental change and diarrheal disease

环境变化与腹泻病

• 批准号: 6844842
• 负责人: Joseph N. S. Eisenberg
• 金额: $ 61.19万
• 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/6844842
• 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）：当粪便 - 口腔病原体遇到人类的贫困和脱落时，腹泻疾病是可预测的结果。腹泻疾病是否敏感的社会经济水平，资源可用性和人类社会接触的敏感指标？这样的过程极难以受控的方式研究。为此目的，在厄瓜多尔沿海厄瓜多尔建造一条新道路提供了一个宝贵的自然实验。这条路将将一些以前的偏远村庄与当地，地区和国家的商品，服务和人员网络联系起来，并在其中建立新的联系。我们假设：（1）村庄之间的连接水平和类型与肠道病原体的感染相关； （2）村庄内部个人的社会联系，新资源以及卫生和卫生行为的不断变化与肠道病原体的感染相关。这些假设将村庄用作分析单位。在估计各种暴露风险对疾病发生率的贡献时，探索这些途径之间相互依赖的含义也很重要。这是我们研究的第三个目的：使用疾病传播模型分析这些接触模式中变化的联合影响。使用准实验设计，将遵循20个村庄4年，以便完全代表农村城市的连续体。该连续体将由几个因素将一个给定村庄与北港（Borbon）联系起来的几个因素，该城镇位于两条河流的汇合处，这些河流支持该地区内的村庄。数据将分为三个级别。首先，生活在正在研究的村庄中的健康促进者将实施一个积极的监视计划。他们将管理一种新的调查工具来测量所有腹泻疾病的发病率，并监测给定村庄中疾病的近端和远端决定因素。其次，我们的野外团队将对每个社区进行一次双年一次的访问，该团队最近在这些村庄完成了一项横截面可行性研究。每次访问将持续两个星期。在这些访问中，将从所有有症状的个体和随机选择对照中收集粪便样品。此外，在这些访问期间，调查工具将用于收集有关水利用行为卫生，卫生，食物消费方式以及旅行和移民的信息。第三，半年度访问每个村庄将由当地的厄瓜多尔人类学家进行。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。访问还将允许乡村发展和道路。