Changing the Landscape of Soil Transmitted Helminth Infections in India Using a One Health Approach

使用单一健康方法改变印度土壤传播的蠕虫感染状况

• 批准号: 10434981
• 负责人: Sitara Swarna Rao Ajjampur
• 金额: $ 34.71万
• 依托单位: CHRISTIAN MEDICAL COLLEGE
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-03-20 至 2027-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10434981
• 关键词: Adult; Affect; Africa; Age; Animals; Anthelmintics; Ascaris lumbricoides; Ascaris suum; Canis familiaris; Characteristics; Child; Cluster randomized trial; Collection; Communities; Complex; DNA; DNA Library; Data; Diagnostic; Drug resistance; Effectiveness; Environment; Environmental Pollution; Epidemiology; Exposure to; Failure; Family suidae; Feces; Future; Geographic Locations; Geography; Goals; Health; Helminths; Hookworms; Household; Human; Hybrids; Hygiene; India; Individual; Infection; Interruption; Intervention; Laboratories; Livestock; Malaria; Measures; Medical Research; Microscopy; Modeling; Molecular; Monitor; Morbidity - disease rate; Morphology; Necator americanus; Nursery Schools; Old World Hookworm; Pattern; Performance; Persons; Pharmaceutical Preparations; Population; Prevalence; Public Health; Qualitative Research; Randomized, Controlled Trials; Recommendation; Research; Research Personnel; Resistance; Resources; Role; Rural; Sampling; Sanitation; School-Age Population; Sequence Analysis; Sewage; Site; Soil; Source; Southeastern Asia; Surveys; Techniques; Training; Trichocephalus trichiura; Vector-transmitted infectious disease; Water; Woman; Zoonoses; benzimidazole resistance; career; companion animal; cost effective; detection method; diagnostic tool; helminth infection; human DNA; human disease; improved; infection burden; infection risk; mathematical model; molecular diagnostics; multidisciplinary; neglected tropical diseases; nucleic acid detection; portability; prevent; programs; reproductive; rural residence; screening; stool sample; success; transmission process; vulnerable community

PROJECT SUMMARY Soil transmitted helminths (STH) - hookworms (Ancylostoma duodenale and Necator americanus), Ascaris lumbricoides and Trichuris trichiura - are among the most widespread neglected tropical diseases (NTD) of humans worldwide, disproportionately affecting the poorest and most vulnerable communities. In rural, populations, intensive animal-human mixing with livestock and companion animals combined with poor hygiene and sanitation can lead to transmission of zoonotic infections as well as result in zoonotic sources of infection. It is estimated that 30% of households globally have domestic livestock animals, with south and southeast Asia and Africa contributing the largest proportion. These regions also have the highest burden of STH globally. Most epidemiological surveys and mathematical models of STH do not account for or measure the risk of infections acquired from zoonotic sources, either by direct contact with animals or animal feces or indirectly from the environment. The inability to interrupt transmission due to presence of zoonotic and environmental reservoirs of infection may prolong mass drug administration (MDA) campaigns and result in emergence of anthelmintic resistance. The overarching goal of this multi-disciplinary collaborative application is to use a One Health framework to examine the interconnected burden and transmission patterns between human, animal and environmental reservoirs of STH by integrating carefully collected epidemiological, environmental and qualitative research data with state-of-art molecular techniques to better inform monitoring and elimination strategies in endemic communities. We will leverage an ongoing randomized controlled trial on community wide MDA and an upcoming One Health project in two eco-epidemiologically and culturally distinct geographic regions of India (Tamil Nadu and Meghalaya) to: (1) comprehensively investigate the transmission dynamics of different STH species at individual, household and community levels; (2) ascertain the impact of community wide MDA on zoonotic STH transmission and screen for emergence of benzimidazole resistance markers; and (3) develop and validate field-ready, portable point-of-collection (POC) diagnostics for STH based on prevalent human and zoonotic species. The field and laboratory data will provide the key parameters to build species-specific STH transmission models and explore the impact of human, animal and environmental reservoirs on STH control measures, across a range of transmission scenarios. The One Health framework of this TMRC will provide much needed data for future planning of integrated STH control programs that combine community wide MDA with upgraded WASH, supported by POC molecular diagnostics. The center will provide a platform for early career investigators to conduct multi- disciplinary One Health research on STH as well as other zoonotic or helminth NTDs.

项目概要 土壤传播的蠕虫 (STH) - 钩虫（十二指肠钩虫和美洲钩虫）、 蛔虫和鞭虫 - 是最普遍被忽视的热带疾病 (NTD) 影响了全世界人类，对最贫穷和最脆弱的社区造成了不成比例的影响。在 农村、人口、牲畜和伴侣动物与人畜的密集混合以及贫困 个人卫生和环境卫生可能导致人畜共患感染的传播以及人畜共患源 的感染。据估计，全球 30% 的家庭饲养家畜，其中南方和 东南亚和非洲所占比例最大。这些地区的负担也最重 全球范围内的某事。大多数流行病学调查和数学模型没有考虑或测量 通过直接接触动物或动物粪便或从人畜共患病来源获得感染的风险 间接来自环境。由于人畜共患疾病的存在而无法中断传输 感染的环境储存库可能会延长大规模药物管理（MDA）运动并导致 出现驱虫药耐药性。 这一多学科协作应用程序的总体目标是使用 One Health 框架来检查人类、动物和动物之间相互关联的负担和传播模式 通过整合仔细收集的流行病学、环境和 采用最先进的分子技术的定性研究数据，以便更好地为监测和消除提供信息 流行社区的策略。我们将利用一项正在进行的社区随机对照试验 广泛的 MDA 和即将在两个生态流行病学和文化上截然不同的 One Health 项目 印度地理区域（泰米尔纳德邦和梅加拉亚邦）：(1) 全面调查 不同STH物种在个人、家庭和社区层面的传播动态； (2) 确定 社区范围内的 MDA 对人畜共患 STH 传播和筛查出现的影响 苯并咪唑耐药标记； (3) 开发和验证现场就绪的便携式收集点 (POC) 基于流行的人类和人畜共患物种的 STH 诊断。现场和实验室数据 将提供关键参数来建立物种特异性 STH 传播模型并探索 人类、动物和环境宿主对某物控制措施的影响，涵盖一系列传播 场景。该 TMRC 的“同一个健康”框架将为未来的规划提供急需的数据。 集成的 STH 控制程序，将社区范围的 MDA 与升级的 WASH 相结合，并得到以下支持 POC 分子诊断。该中心将为早期职业调查人员提供一个平台，进行多方面的研究 关于 STH 以及其他人畜共患病或蠕虫 NTD 的学科 One Health 研究。