Dengue epidemiology in Thailand and implications for vaccine development

泰国的登革热流行病学及其对疫苗开发的影响

• 批准号: 7407602
• 负责人: Kathryn B Anderson
• 金额: $ 3.77万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-09-30 至 2010-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7407602
• 关键词: Dengue; epidemiology; Thailand; implications; vaccine

DESCRIPTION (provided by applicant): Dengue is an important global health problem that is increasing in geographic range and epidemic severity each year. This research project will address critical gaps in our understanding of the epidemiology and pathogenesis of dengue illnesses. Specific aims. The major aims of this research will be: (1) to evaluate the association of prior flavivirus immunity with DHF, as well as the association of infecting dengue serotype and the outcome of primary and secondary infections; (2) to better define the spectrum of clinical presentations in dengue illness and to develop and test more sensitive and specific case definitions; to use hospital-based data to evaluate predictors of progression to DHF and dengue shock syndrome (DSS) to guide early intervention; (3) to evaluate how and why the demographics and distribution of dengue viruses have changed over time in Thailand. Research Desiqn. The research will involve both existing datasets and primary data collection in Bangkok, Thailand, and AFRIMS' dengue field site in Kamphaeng Phet Province (KPP), Thailand. 30 years of passive surveillance data on DHF hospitalizations have been collected in Bangkok, with 12 years of more detailed clinical data from children hospitalized with dengue at Queen Sirikit National Children's Hospital in Bangkok. A prospective study in KPP has collected data on symptomatic dengue illnesses and asymptomatic seroconversion in cohorts of school-aged children since 1998, with a cluster component for viremic cases added for the period 2003-2008. Methods. The effects of prior flavivirus immunity will be evaluated using the KPP cohort data which include information on the presence/absence of antibodies to Japanese Encephalitis at enrollment, the clinical severity of incident dengue illnesses, and whether the infection represented a primary, secondary, or post-secondary infection. Case definitions will be tested and modified by incorporating existing data into predictive models, with evaluation of sensitivity, specificity and Receiver Operating Characteristic curves. Predictors for progression to DHF will be assessed based upon laboratory markers and clinical characteristics on admission to the hospital. "Best fit" models for case definitions and predictors of progression to DHF will then be tested prospectively. Changes in the demographics and transmission patterns of dengue infections will be assessed, including whether and how the mean age of DHF has increased. Siqnificance. Dengue is an important global health problem. This research will address key questions in the epidemiology, virology, and immunology of dengue viruses and dengue illness.

描述（由申请人提供）：登革热是一个重要的全球健康问题，每年地理范围和流行严重程度正在增加。该研究项目将解决我们对登革热疾病流行病学和发病机理的理解时的关键差距。具体目标。这项研究的主要目的是：（1）评估先前的黄病毒免疫与DHF的关联，以及感染登革热血清型的关联以及原发性和继发感染的结果； （2）更好地定义登革热疾病中临床表现的范围，并开发和测试更灵敏，更具体的病例定义；使用基于医院的数据来评估发展为DHF和DHF和登革热综合征（DSS）的预测因素来指导早期干预； （3）评估登革热病毒的人口统计学和分布在泰国的变化。研究Desiqn。该研究将涉及泰国曼谷，泰国曼谷和阿夫里姆斯的登革热场地的现有数据集和主要数据收集。在曼谷收集了30年的有关DHF住院的被动监视数据，并在曼谷的Sirikit National National儿童医院住院的儿童提供了12年的更详细的临床数据。自1998年以来，一项针对KPP的前瞻性研究收集了有关登革热疾病和无症状的血清转化的数据，并在2003 - 2008年期间添加了用于病毒性病例的群集成分。方法。将使用KPP队列数据评估先前的黄病毒免疫力的影响，该数据包括有关入学时日本脑炎抗体的信息，登记登革热疾病的临床严重程度以及感染是否代表了主要，次要，次要或后感染。案例定义将通过将现有数据纳入预测模型，并评估灵敏度，特异性和接收器操作特征曲线，对案例定义进行测试和修改。将根据实验室标记和入院的临床特征来评估发展到DHF的预测因素。然后将对案例定义的“最佳拟合”模型前瞻性测试。将评估登革热感染的人口统计学和传播模式的变化，包括DHF的平均年龄以及如何增加。 siqnificance。登革热是一个重要的全球健康问题。这项研究将解决登革热病毒和登革热疾病的流行病学，病毒学和免疫学中的关键问题。