Cholera in Goma, DRC

刚果民主共和国戈马的霍乱

• 批准号: 9918251
• 负责人: John Glenn Morris
• 金额: $ 75.01万
• 依托单位: UNIVERSITY OF FLORIDA
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-04-18 至 2024-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9918251
• 关键词: Address; Advisory Committees; Africa; Africa South of the Sahara; Area; Bacteriophages; Bangladesh; Case Study; Cessation of life; Chad; Cholera; Cities; Clinical; Communities; Congo; Country; Data; Data Collection; Democratic Republic of the Congo; Development; Disease; Emergency Situation; Environment; Epidemic; Epidemiology; Evolution; Frequencies; Geographic Locations; Goals; Great Lakes Region; Home environment; Hot Spot; Household; Human; Infection; Infrastructure; Intervention; Modernization; Morbidity - disease rate; Nutrient; Pathway interactions; Patients; Pattern; Persons; Play; Population; Population Growth; Poverty; Public Health; Recommendation; Recurrence; Refugees; Reporting; Risk Factors; Rivers; Role; Route; Rwanda; Site; Socioeconomic Status; Source; Techniques; Temperature; Urbanization; Vibrio cholerae O1; Water; Yemen; base; behavior change; burden of illness; climate change; demographics; disorder prevention; high risk; interest; member; mortality; pathogen; transmission process

Project Summary/Abstract Cholera is an ancient disease that has shown a remarkable ability to persist and spread in the modern world. In WHO data for 2016, 132,121 cholera cases and 2420 deaths were reported from 38 countries. However, taking into account likely underreporting, the global disease burden has been estimated to be in the range of 1.3 to 4.0 million cholera cases and 21,000-143,000 deaths per year. Cholera is frequently a disease of poverty, striking in areas with humanitarian emergencies and crumbling public health infrastructure: most recently, this has been highlighted by the massive epidemic in Yemen, with over a million cases reported to date. Given the intransigence of such problems, and ongoing issues with climate change, urbanization, and population growth, cholera is likely to remain a recurring global threat to public health. While the Indian subcontinent is the ancestral home of cholera, and epidemics may occur in crisis situations such as currently seen in Yemen, over the past two decades sub-Saharan Africa has emerged as the primary locus of the global cholera disease burden. Within Africa, two major regional inland “hotspots” of cholera activity have been identified: one in the Lake Chad region, and the other in the Great Lakes region, centered on Goma in the DRC. The WHO Global Task Force for Cholera Control has recently developed a “global roadmap” leading toward cholera eradication, based on three strategic axes: the second of these axes is “Prevention of disease reoccurrence by targeting multi-sectorial interventions in cholera hotspots.” Within this roadmap, they have also placed a strong focus on the need for country-level data, with targeting of interventions directed by an understanding of local circumstances and transmission patterns. Goma, with a population of over 1 million (including substantial refugee populations), is on the northern shore of Lake Kivu, bordering Rwanda; the city has had recurrent, annual cholera epidemics for at least the past decade, with phylodynamic analysis demonstrating the persistence of a “Great Lakes” clade of V. cholerae O1 in the region. We are proposing a targeted, multi-sectorial analysis of cholera transmission in Goma, utilizing robust epidemiologic and phylodynamic techniques, with two major goals: 1) to further expand our understanding of how this ancient pathogen evolves and adapts to new geographic areas and new populations; and 2) to provide data for development of a practical, scientifically-informed plan for cholera control in this regional cholera hotspot, building on recommendations of the WHO Global Task Force. Specific Aims to accomplish these objectives: • Specific Aim 1: Studies of cholera transmission and infection within households of suspected cholera cases in Goma; • Specific Aim 2: Identification and assessment of aquatic environmental sources/reservoirs for cholera; and • Specific Aim 3. Phylodynamic analysis of clinical and environmental V. cholerae O1 strains.

项目摘要/摘要 霍乱是一种古老的疾病 世界。在2016年的WHO数据中，有38个国家报告了132,121例霍乱病例和2420例死亡。 但是，考虑到可能不足的报道，伯恩伯恩估计是 每年1.3至400万例霍乱病例和21,000-143,000例死亡的范围。霍乱经常是一种疾病 贫困，在人道主义紧急情况和崩溃的公共卫生基础设施中震惊：大多数 最近，也门的大量流行病已经强调了这一点，据报道有超过一百万个案件 日期。鉴于此类问题的不适以及气候变化，城市化和持续的问题 人口增长，霍乱可能仍然是对公共卫生的反复发生的全球威胁。 虽然印度次大陆是霍乱的祖先，而情节可能发生在危机中 在过去的二十年中，诸如目前在也门目前看到的情况已经出现为 伯宁全球霍乱疾病的主要基因座。在非洲，两个主要的区域内陆“热点” 已经确定了霍乱活动：一个在乍得湖地区，另一个在大湖地区， 以刚果民主共和国的戈马为中心。 WHO全球霍乱控制工作队最近开发了 基于三个战略轴的“全球路线图”通向霍乱根除：这些轴的第二个 是“通过靶向霍乱热点中的多部门干预措施来预防疾病再次发生。”之内 在此路线图中，他们还强烈关注对国家 /地区数据的需求，针对 通过了解当地情况和传输模式的干预措施。 戈马人口超过100万（包括大量难民人口），位于北部 基沃湖的海岸，与卢旺达接壤；这个城市的年度霍乱经常性剧集至少在 过去的十年，通过系统动力学分析，证明了V的“大湖”进化枝的持久性。 该地区的霍乱O1。我们提出了针对性的霍乱传播的有针对性的多部门分析 戈马，利用强大的流行病学和系统动力学技术，有两个主要目标：1）进一步扩展 我们对这种古老的病原体如何发展和适应新地理区域和新的理解 人口； 2）提供用于制定霍乱的实用，科学知识计划的数据 控制这个区域霍乱热点，基于WHO全球工作队的建议。 实现这些目标的具体目的： •具体目的1：研究可疑霍乱病例家庭中的霍乱传播和感染 在戈马； •具体目标2：霍乱的水生环境来源/储层的识别和评估；和 •特定目标3。临床和环境V.霍乱O1菌株的系统动力学分析。