Investigating the contribution of geographic accessibility and vaccine delivery channels to untimely measles vaccination and zero-dose prevalence in The Gambia: implications for disease outbreaks

调查地理可达性和疫苗输送渠道对冈比亚不及时麻疹疫苗接种和零剂量流行的影响：对疾病爆发的影响

• 批准号: 10731770
• 负责人: Oghenebrume Wariri
• 金额: $ 11.33万
• 依托单位: MEDICAL RESEARCH COUNCIL UNIT THE GAMBIA AT THE LONDON SCHOOL OF HYGIENE & TROPICAL MEDICINE
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-07-15 至 2028-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10731770
• 关键词: Achievement; Africa; African; Age; Area; Award; Child; Clinic; Communicable Diseases; Communities; Competence; Country; Data; Data Set; Diphtheria; Disease Outbreaks; Disparity; Doctor of Philosophy; Dose; Educational workshop; Ensure; Equity; Exhibits; Fellowship; Fogarty International Center; Funding; Gambia; Geography; Goals; Grant; Health; Herd Immunity; Heterogeneity; High Prevalence; Household; Immunity; Immunization; Income; Inequality; Inequity; International; Link; Location; Longitudinal cohort; Low income; Manuscripts; Maps; Masks; Measles; Measures; Mentors; Methodology; Mission; Modeling; Pattern; Pertussis; Population; Predisposition; Prevalence; Research; Resolution; Resources; Risk; Rural Population; Sampling; Schedule; Serology; Services; Shapes; Structure; System; Techniques; Tetanus; Training; Travel; Vaccinated; Vaccination; Vaccines; Writing; biobank; design; disease transmission; epidemiologic data; epidemiology study; health data; high risk; infectious disease model; insight; multidisciplinary; novel; outbreak concern; outbreak prediction; outreach; programs; remote communities; service providers; skills; spatial epidemiology; spatiotemporal; transmission process; unvaccinated; uptake; vaccination strategy; vaccine acceptance; vaccine delivery; vaccinology

In 2021 alone, 25 million children globally did not receive the first dose of the diphtheria-tetanus-pertussis- containing vaccine (DTP1). The vast majority of these - live in low-income and middle- income countries. In addition, many children received their first dose of the measles-containing vaccine (MCV1) much later than scheduled, thus, are at significant risk of becoming infected before they are eventually vaccinated and may contribute to suboptimal herd immunity. In The Gambia, there is a recent upsurge of measles, with a 6-fold increase in cases as of mid-2022 compared to 2020 figures despite achieving a minimum MCV1coverage of 90% over the last decade. Recent data suggest that a large proportion of vaccinations are delayed or not delivered in an age-appropriate manner, according to the national vaccination windows. In addition, untimely MCV1 and zero-dose are thought to co-exist and clustered in certain remote communities and may contribute to suboptimal herd immunity. The PI, Dr Oghenebrume Wariri will apply novel spatiotemporal modelling approaches to map the subpopulation with untimely measles vaccination and zero- dose at fine-spatial scale and examine potential links with suboptimal herd immunity and risk of measles outbreaks. He will also examine how geographic accessibility shapes the uptake and delivery of routine vaccination in The Gambia. The project will leverage longitudinal cohort data from Health and Demographic Surveillance Systems in The Gambia, and bio-banked serological samples covering rural populations in the Kiang West District of The Gambia. There are four specific aims for this K43 award: 1) to determine the spatiotemporal pattern of untimely MCV1 and zero-dose children at high-spatial resolution in The Gambia; 2) to determine if there is a spatiotemporal relationship between cluster location of untimely MCV1 and measles population immunity in The Gambia; 3) To investigate the contribution of geographic accessibility (between households and vaccination posts; and between fixed and outreach vaccination posts) to zero-dose prevalence and delayed MCV1; 4) to model geographic access to routine vaccination services to understand the utility of the current vaccine delivery channels and potentially identify optimal locations of vaccination clinics and posts. This K43 Award will equip Dr Wariri with novel skills and competencies in geospatial and infectious disease modelling, manuscript and grant writing. Dr Wariri will be working with a multi-disciplinary mentoring committee comprising internationally-recognised African, UK, and US-based experts in vaccinology, population immunity and infectious diseases modelling, and geospatial modelling. The proposed research, in combination with a structured mentoring and training plan that includes didactic courses and workshops, is designed to facilitate Dr. -term goal of developing an independently funded infectious diseases and spatial epidemiology research program focussed on vaccination in Africa, consistent with the mission of the Fogarty International Centre.

仅在2021年，全球有2500万儿童就没有接受第二剂二甲状腺果蝇的剂量。 含有疫苗（DTP1）。其中的绝大多数 - 生活在低收入和中间 收入国家。此外，许多儿童接受了含麻疹疫苗的第一个剂量 （MCV1）因此，比计划晚得多，在最终被感染之前，他们有很大的风险 接种疫苗，可能有助于次优牛群免疫。在冈比亚，最近有一次 麻疹，截至2022年中期的病例增加了6倍，尽管达到了2020年的数字 在过去十年中，最低MCV1覆盖率为90％。最近的数据表明，很大一部分 根据国家疫苗接种 视窗。此外，认为MCV1和零剂量被认为是共存并聚集在某些遥控器中 社区，可能会导致次优牛群的免疫力。 PI，Oghenebrume Wariri博士将应用小说 时空建模方法以不合时宜的麻疹疫苗接种和零 - 剂量以细尺度剂量，检查潜在的联系，并具有次优牛群免疫力和麻疹风险 爆发。他还将检查地理可及性如何塑造常规的吸收和交付 冈比亚疫苗接种。该项目将利用健康和人群的纵向队列数据 冈比亚的监视系统以及涵盖农村人群的生物银行血清学样本 冈比亚的基安西区。该K43奖有四个具体目标：1）确定 冈比亚高空间分辨率的不合时宜的MCV1和零剂量儿童的时空模式； 2）到 确定不合时宜的MCV1和麻疹的簇位置之间是否存在时空关系 冈比亚的人口免疫； 3）调查地理可及性的贡献 家庭和疫苗接种职位；在固定和外推疫苗接种后）到零剂量的患病率 并延迟MCV1； 4）建模地理访问常规疫苗接种服务以了解 当前的疫苗输送通道，并有可能确定疫苗接种诊所和职位的最佳位置。 该K43奖将使Wariri博士在地理空间和传染病方面具有新颖的技能和能力 建模，手稿和赠款写作。 Wariri博士将与多学科指导委员会合作 包括国际公认的非洲，英国和美国疫苗学专家，人口免疫力 以及传染病建模和地理空间建​​模。拟议的研究结合了 包括教学课程和讲习班在内的结构化指导和培训计划旨在促进 博士 - 发展独立资助的传染病和空间流行病学的目标 研究计划着重于非洲疫苗接种，与Fogarty International的使命一致 中心。