Tuberculosis in teens: a geospatial approach to predict community transmission

青少年结核病：预测社区传播的地理空间方法

• 批准号: 10624673
• 负责人: Meredith Blair Brooks
• 金额: $ 12.44万
• 依托单位: BOSTON UNIVERSITY MEDICAL CAMPUS
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-13 至 2026-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10624673
• 关键词: 14 year old; 19 year old; Adolescence; Adolescent; Adult; Award; Bayesian Modeling; Characteristics; Child; Childhood; Cognitive; Communities; Computer Models; Data; Data Science; Development Plans; Disease; Epidemic; Epidemiology; Event; Genotype; Geography; Goals; Heterogeneity; Household; Incidence; Individual; Infection; Influentials; Intervention; Knowledge; Location; Machine Learning; Maps; Mentors; Mentorship; Methods; Minisatellite Repeats; Modeling; Pattern; Persons; Peru; Population; Preventive treatment; Pulmonary Tuberculosis; Reporting; Research; Research Project Grants; Research Training; Scholarship; Science; Scientist; Social Network; Spatial Distribution; Techniques; Teenagers; Testing; Time; Training; Tuberculosis; Work; base; career development; community transmission; epidemiologic data; experience; genome sequencing; high risk population; insight; member; neglect; novel; psychologic; public health relevance; random forest; screening; simulation; social; social contact; spatiotemporal; symposium; transmission process; trend; tuberculosis treatment; whole genome

Modified Project Summary/Abstract Section Adolescents—individuals 10-19 years old—are a unique population undergoing dynamic cognitive, social, psychological, and physical changes. Yet there is a dearth of research on adolescent tuberculosis (TB) epidemiology. Standard TB research reporting conventions make it difficult to examine this group: 10-14 year olds are grouped with children, while 15-19 year olds with adults. Notably, research findings in children and adults may have limited applicability to adolescents, leaving large knowledge gaps about TB during adolescence. With their ability to spread TB and expanding social networks, adolescents may be an important group to target in order to break cycles of TB transmission. By using geospatial and genotypic analyses of transmission networks around adolescents with TB, we can better characterize local TB transmission in high burden settings. These methods will elucidate important person, place, and time interactions of TB transmission in adolescents. I propose to complete three aims, focused in epidemiology and data science, using existing data from Lima, Peru. In Aim 1, I will characterize the spatial heterogeneity of TB transmission events in adolescents. I will identify spatial clusters of genotypically matched TB cases, using MIRU-VNTR- and whole genome sequencing-based data, to identify locations where recent transmission has occurred. I will visualize these spatial clusters using non-parametric distance-based mapping. In Aim 2, I will predict the spatial distribution of TB transmission events in adolescents. I will assess the association between spatial distributions of individual-, household-, and population-level characteristics with the spatial variability of TB transmission events in adolescents using hierarchical Bayesian spatial models. Then, I will build an integrated model combining random forests and ordinary kriging to generate spatial predictions of TB transmission events in adolescents. In Aim 3, I will estimate and compare the impact of screening and treatment interventions tailored for adolescents on reducing community TB transmission. I will conduct a simulation study, calibrated to the local epidemic curve and spatiotemporal clustering pattern of adolescent TB transmission events. I will quantify how a set of interventions tailored to adolescents can reduce TB transmission in a community. Interventions include active screening efforts, increasing TB preventive treatment, and treatment support to increase treatment completion rates. My K01 portfolio of mentored research and training will enable me to develop expertise in adolescent tuberculosis epidemiology, spatial analysis, and TB transmission dynamics. This award will enable me to take the next critical step toward becoming an independent and influential scientist, including a research grant (R01) proposal to test novel, targeted interventions in high-risk populations, like adolescents. I have defined a detailed career development plan and assembled an experienced team of mentors: Prof. Megan Murray and Prof. Mercedes Becerra, globally renowned experts in TB transmission dynamics and pediatric TB epidemiology, respectively.

修改的项目摘要/摘要部分 青少年（10-19岁的个人）是一个独特的人群，经历了动态的认知，社会，心理和身体变化。然而，关于青少年结核病（TB）流行病学的研究死亡。标准结核病研究报告惯例使得很难检查这一组：10-14岁的孩子与儿童分组，而15-19岁的年轻人与成人。值得注意的是，儿童和成人的研究结果可能对青少年的适用性有限，在青少年期间留下了有关结核病的巨大知识差距。凭借其传播结核病和扩大社交网络的能力，青少年可能是目标的重要群体，以打破结核病传播的周期。通过使用TB青少年周围的传输网络的地理空间和基因型分析，我们可以更好地表征高负担设置中的本地结核病传播。这些方法将阐明重要的人，我建议使用秘鲁利马市的现有数据来完成三个专注于流行病学和数据科学的目标。在AIM 1中，我将表征青少年结核传输事件的空间异质性。我将使用MIRU-VNTR和全基因组测序数据来确定与基因型匹配的结核病病例的空间簇，以识别发生最近传播的位置。将使用非参数基于距离的映射来可视化这些空间簇。在AIM 2中，我将预测青少年中结核病传输事件的空间分布。我将评估使用分层贝叶斯空间模型在青少年中，个体，家庭和人口水平特征的空间分布与TB传播事件的空间变异性之间的关联。然后，我将建立一个结合随机森林的集成模型，在AIM 3中，我将估算并比较为青少年量身定制的筛查和治疗干预措施对减少社区结核病传播的影响。我将进行一项模拟研究，校准青少年结核病传播事件的局部流行曲线和空间临时聚类模式。我将量化针对青少年的一组干预措施如何减少社区中的结核病传播。干预措施包括积极的筛查工作，增加TB预防治疗以及增加治疗率的治疗支持。我的K01研究和培训组合将使我能够在青少年结核病流行病学，空间分析和结核病传播动力学方面发展专业知识。该奖项将使我能够迈出一个关键步骤，成为一名独立和有影响力的科学家，包括研究赠款（R01）提案，以测试像青少年一样在高风险人群中进行小说，有针对性的干预措施。我已经定义了一项详细的职业发展计划，并组建了一支经验丰富的导师团队：梅根·默里（Megan Murray）和梅赛德斯·贝贝拉（Mercedes Becerra）教授，分别在全球著名的结核病传输动力学专家和儿科结核病流行病学。