The long-term consequences of pulmonary tuberculosis and respiratory viruses on lung health in young South African children

肺结核和呼吸道病毒对南非儿童肺部健康的长期影响

基本信息

批准号：
10453960
负责人：
Marieke Margreet VAN DER ZALM
金额：
$ 8.1万
依托单位：
STELLENBOSCH UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-08-01 至 2025-07-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10453960
关键词：
2 year old Address Adenoviruses Adult Affect African Aftercare Age Airway Resistance Aspirate substance Awareness Biometry Child Child Health Childhood Chronic Disease Clinical Clinical Research Cohort Studies Communicable Diseases Control Groups Data Data Analyses Data Set Diffusion Disease Enrollment Event Funding Future Goals Grant Guidelines HIV Health Height Hospitalization Infection International Interruption Intervention Investigation Life Literature Long-Term Effects Longitudinal cohort Lung Lung diseases Measures Mentors Methods Microbiology Modeling Morbidity - disease rate Mycobacterium tuberculosis Oscillometry Outcome Outcome Measure Physical Examination Plethysmography Policies Pulmonary Tuberculosis Pulmonary function tests Quality of life Questionnaires Radiology Specialty Recording of previous events Research Research Personnel Research Project Grants Resistance Respiratory syncytial virus Risk Risk Factors Sampling Scientist Severities Smoking South Africa South African Spirometry Techniques Testing Thoracic Radiography Tidal Volume Time Training Translating Tuberculosis United States National Institutes of Health Vaccination Viral Viral Respiratory Tract Infection Vulnerable Populations Weight base burden of illness career career development clinical examination clinically relevant co-infection cohort critical period design experience follow-up functional outcomes health assessment high risk improved innovation interest low and middle-income countries lung development pathogen postnatal prevent prospective pulmonary function respiratory respiratory health respiratory infection virus respiratory morbidity respiratory pathogen respiratory virus skills translational impact ventilation

项目摘要

PROJECT SUMMARY Candidate: Dr. van der Zalm is highly motivated to find innovative feasible solutions to improve the long-term lung health outcomes in vulnerable children in settings with high burden of tuberculosis (TB) and other respiratory infectious diseases. Her overall career development goal is to become an independent clinician scientist with expertise in the design, implementation and analysis of translational clinical research, in order to effectively address high-priority lung health issues in children living in low- and middle- income countries (LMICs). Her overall goal is supported by three specific training aims: 1) designing and implementing research focused on a unique and as yet unaddressed aspect of clinical TB research in children. This includes an in- depth understanding of longitudinal data analysis and advanced biostatistics required to analyse this rich and unique cohort with long-term outcomes, 2) to develop into a contents expert and thought leader in pediatric TB and lung health assessment, and 3) to develop the skills to translate key research findings into relevant clinical guidelines to impact on policies and practice. This combination of analytical, clinical and translational skills is required to maximize the impact of translational clinical research in children, especially those in LMICs, where infectious disease contribute to significant morbidity including long-term lung health outcomes. Dr. van der Zalm has strong institutional support and has assembled a strong US and international mentoring team highly experienced in all critical aspects of pediatric TB and lung health research. Research project: Despite increasing awareness of post-TB respiratory morbidity in adults, there is no data in children. An estimated 5-10 million children had survived TB between 2000 and 2017 and are at potential risk of post-TB lung sequelae. The pre- and early postnatal years are the most critical period of lung development. Therefore, PTB events early in life due to this chronic disease, could have devastating long-term consequences on lung health of young children. I propose to investigate the impact of TB on lung health using an established cohort study, “Umoya,” which provides a unique opportunity to characterize the long-term effect of PTB and other common respiratory pathogens on lung health in children investigated for PTB, with well-characterized control groups. Specific aim 1 will investigate the long-term respiratory morbidity and evaluate risk factors for poor respiratory outcomes in children investigated for PTB. Specific aim 2 will describe lung function trajectories in South African children investigated for PTB. My proposed research aims to define and characterize the spectrum of respiratory morbidity in children who have survived PTB. An improved understanding of the impact of PTB and other modifying factors, e.g. viral co-infections, on lung development in children will inform future strategies to prevent respiratory illness later in life. Through this research I will obtain relevant research skills, establishing myself as an independent researcher and will use this unique dataset to apply for future R01 grant funding.

项目概要候选人：van der Zalm 博士非常积极地寻找创新可行的解决方案来改善长期结核病 (TB) 和其他疾病高负担环境中弱势儿童的肺部健康结果她的总体职业发展目标是成为一名独立的临床医生。具有转化临床研究设计、实施和分析专业知识的科学家，以便有效解决低收入和中等收入国家儿童的高度优先的肺部健康问题（中低收入国家）她的总体目标由三个具体培训目标支持：1）设计和实施研究。重点关注儿童临床结核病研究的一个独特且尚未解决的方面，其中包括一项研究。深入了解分析这种丰富而丰富的数据所需的纵向数据分析和高级生物统计学具有长期成果的独特群体，2) 发展成为儿科结核病的内容专家和思想领袖和肺部健康评估，3) 培养将关键研究成果转化为相关临床的技能这种分析、临床和转化技能的结合是对政策和实践产生影响的指南。需要最大限度地发挥儿童转化临床研究的影响，特别是中低收入国家的儿童，其中传染病导致显着的发病率，包括长期的肺部健康结果。 Zalm拥有强大的机构支持，并组建了强大的美国和国际导师团队在儿科结核病和肺部健康研究的所有关键方面都有丰富的经验。研究项目：尽管人们对成人结核病后呼吸道疾病的认识不断提高，但尚无数据 2000 年至 2017 年间，估计有 5-1000 万儿童罹患结核病并面临潜在风险。结核病后肺部后遗症的发生产前和产后早期是肺部发育的最关键时期。因此，生命早期由于这种慢性疾病而发生的 PTB 事件可能会产生毁灭性的长期影响。对幼儿肺部健康的影响。我建议使用一项已建立的队列研究“Umoya”来调查结核病对肺部健康的影响，该研究提供了一个独特的机会来描述 PTB 和其他常见呼吸道疾病的长期影响病原体对儿童肺部健康的影响进行 PTB 调查，并设有明确的对照组。 1 将调查长期呼吸系统发病率并评估呼吸系统不良结果的危险因素接受 PTB 调查的儿童的具体目标 2 将描述南非儿童的肺功能轨迹。我提出的研究旨在定义和描述呼吸谱系。 PTB 幸存儿童的发病率更好地了解 PTB 和其他疾病的影响。影响儿童肺部发育的改变因素，例如病毒合并感染，将为未来的策略提供信息通过这项研究，我将获得相关的研究技能，建立起预防呼吸道疾病的能力。我本人作为一名独立研究人员，将使用这个独特的数据集来申请未来的 R01 资助。