Neurodevelopment and Vector-borne Diseases: Building Research Capacity in the Tropics

神经发育和媒介传播疾病：热带地区研究能力建设

基本信息

批准号：
9344713
负责人：
Angelle Desiree LaBeaud
金额：
$ 14.7万
依托单位：
WINDWARD ISLANDS RESEARCH & ED FDN
依托单位国家：
美国
项目类别：
财政年份：
2016
资助国家：
美国
起止时间：
2016-09-07 至 2018-12-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9344713
关键词：
2 year old Address Arboviruses Area Brazil Caribbean region Chikungunya virus Child Child Development Community Health Country Culicidae Data Dengue Developing Countries Development Diet Dietary intake Disease Outbreaks Economics Endemic Diseases Environmental Risk Factor Enzyme-Linked Immunosorbent Assay Epidemic Equipment Evaluation Exposure to Fetal Alcohol Spectrum Disorder Fetal Development Gestational Diabetes Goals Government Grant Grenada Health Health Policy Healthcare Human Resources Impaired cognition Impairment Income Inequality Infant Infection Institution International Intervention Link Longitudinal Studies Malaria Martinique Measures Medical Microcephaly Mission Modeling Monitor Mothers Neurocognitive Neurodevelopmental Impairment Newborn Infant Outcome Parasitic Diseases Pregnancy Premature Birth Prevalence Psychological Stress Public Health Recurrence Research Research Institute Research Personnel Research Support Resources Risk Scientist Site Socioeconomic Factors Standardization Students Suriname Surveys Sustainable Development Symptoms Testing Time Toxicant exposure Training United States National Institutes of Health Universities Vector-transmitted infectious disease Vertical Disease Transmission Violence Virus Virus Diseases Zika Virus chikungunya cognitive function cost experience global health in utero infancy international center low and middle-income countries neglected tropical diseases nervous system infection neurodevelopment next generation pathogen pregnant prevent programs public health priorities tool

项目摘要

Project Summary/Abstract Vector-borne diseases (VBD) pose a significant economic and public health threat throughout developing tropical regions worldwide, including the Caribbean. The introduction in December 2013 and rapid spread of the chikungunya virus (CHIKV) throughout all the Caribbean nations, and more recently the emergence of the zika virus in Suriname and Martinique highlights the need to develop regional capacity to investigate, predict, contain, and respond to VBD. For example, recent evidence from la Réunion suggests that CHIKV can negatively impact neurodevelopment among infants born to mothers who were infected with the virus during pregnancy. However, these results have not yet been replicated in other sites internationally – such as the Caribbean – nor have any longitudinal studies been carried out to follow children who have experienced neurocognitive delay related to CHIKV infection. To address the paucity of data while building VBD research capacity in tropical LMICs where these diseases are endemic and the burden of impaired neurodevelopment is felt most, researchers from St. George's University (SGU) in Grenada will partner with researchers from Stanford University, Oxford University, and the Université de La Réunion to: (1) Determine the prevalence of mother to child transmission of CHIKV in Grenadian pregnant mothers; (2) Measure the neurodevelopment of children at 2 years of age exposed at different trimesters in utero to CHIKV and compare them with unexposed children; (3) Assess the burden of confounding factors to better understand the specific impact of VBD on neurodevelopment and inform public health priorities; (4) Build local capacity for arboviral and neurodevelopmental testing at SGU. To achieve Aim 1, 379 moms and their infants who were born during the CHIKV outbreak in Grenada, 473 moms and their infants who were born after the outbreak and may have been exposed to the virus in utero, and 190 moms and their infants who were born at least nine months after the outbreak (and thus, very unlikely to be exposed to the virus in utero) will complete a survey detailing the onset and symptoms related to their CHIKV infection and will then be tested for exposure to CHIKV by ELISA. Non CHIKV-exposed infants and moms, CHIKV-exposed moms but not infants, CHIKV-exposed moms and infants, and time of exposure during pregnancy will be used to divide groups for neurocognitive comparison at 2-years of age. To achieve Aims 2 and 3, we will administer the intergrowth 21st Neurodevelopment Assessment – a holistic assessment of early child development developed at Oxford University – while controlling for confounding neurodevelopmental factors. To achieve Aim 4, we will establish a Regional Center for Child Neurodevelopment while addressing seven key areas of needed research support: (1) Financial (i.e., granting); (2) Expertise; (3) On-the-ground human resources; (4) Student trainees to build local capacity; (5) Equipment, IT, and facilities support; (6) On-the-ground university and research institute administrative support; and (7) Local and regional government, relevant NGO, and professional/academic institutional support.

项目摘要/摘要媒介传播疾病（VBD）在整个发展中构成了重大的经济和公共卫生威胁全球热带地区，包括加勒比海地区。 2013年12月的介绍以及快速传播整个加勒比海国家的基孔肯雅病毒（Chikv），最近的出现苏里南和马提尼克岛的寨卡病毒强调了需要开发区域能力来调查，预测，预测，包含并响应VBD。例如，LaRéunion的最新证据表明Chikv可以对在感染该病毒的母亲出生的婴儿中对神经发育产生负面影响怀孕。但是，这些结果尚未在国际其他地点进行复制 - 例如加勒比海 - 也没有进行任何纵向研究，以跟随经历过的孩子与CHIKV感染有关的神经认知延迟。在构建VBD研究时解决数据的匮乏这些疾病具有内在疾病且神经发育受损的燃烧的热带LMIC的能力是感觉最多，格林纳达圣乔治大学（SGU）的研究人员将与斯坦福大学，牛津大学和拉雷尼翁大学：（1）确定患病率母亲在格林纳迪亚孕妇的母亲传播Chikv的母亲；（2）测量神经发育 2岁的儿童暴露在子宫内不同的三重镜头上，并将其与意想不到的孩子们; （3）评估混杂因素的燃烧，以更好地了解VBD的特定影响神经发育并告知公共卫生的重点；（4）为arboviral和 SGU的神经发育测试。达到目标1、379位妈妈及其婴儿在爆发后出生的473位妈妈及其婴儿的Chikv爆发，可能是暴露于子宫里的病毒，190位妈妈及其婴儿至少出生于九个月后爆发（因此，不太可能在子宫内暴露于病毒）将完成详细介绍发作的调查以及与其CHIKV感染有关的符号，然后将测试Elisa对Chikv的暴露。非暴露于Chikv的婴儿和妈妈，chikv暴露的妈妈，但没有婴儿，chikv暴露的妈妈和妈妈，怀孕期间的暴露时间将用于分裂两年的神经认知比较年龄。为了实现目标2和3，我们将管理增长21的神经发育评估 - 对牛津大学发展的早期儿童发展的整体评估 - 在控制的同时混淆神经发育因素。为了实现目标4，我们将建立一个儿童区域中心神经发育在解决所需研究支持的七个关键领域时：（1）财务（即授予）；（2）专业知识；（3）地面人力资源；（4）学生学员建立地方能力；（5）设备，它和设施支持；（6）现场大学和研究所的行政支持；（7）地方和区域政府，相关非政府组织以及专业/学术机构支持。