Spatial and molecular epidemiology of hepatitis B transmission in the Democratic Republic of the Congo

刚果民主共和国乙型肝炎传播的空间和分子流行病学

• 批准号: 10624807
• 负责人: Camille Morgan
• 金额: $ 3.17万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-04-01 至 2026-11-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10624807
• 关键词: Africa; Africa South of the Sahara; African; Asia; Automobile Driving; Behavior Therapy; Birth; Capital; Caring; Case/Control Studies; Cessation of life; Childhood; Cities; Communicable Diseases; Communities; Complement; Country; Data; Democratic Republic of the Congo; Demographic and Health Surveys; Disease; Dose; Enrollment; Epidemiologic Methods; Epidemiology; Fellowship; Future; Genetic; Genetic Diseases; Genetic Variation; Genomic approach; Geographic Locations; Geography; Goals; HIV; Hepatitis B Prevalence; Hepatitis B Transmission; Hepatitis B Vaccination; Hepatitis B Vaccines; Hepatitis B Virus; Hepatology; Horizontal Disease Transmission; Household; Individual; Infant; Infection; Infectious Disease Epidemiology; Infrastructure; Interdisciplinary Study; Intervention; Knowledge; Mentors; Methods; Molecular; Molecular Epidemiology; Morbidity - disease rate; Mothers; North Carolina; Odds Ratio; Organizational Objectives; Participant; Pattern; Perinatal transmission; Phylogenetic Analysis; Physicians; Population; Population Genetics; Prevalence; Prevention Measures; Prevention program; Prevention strategy; Prophylactic treatment; Research; Research Infrastructure; Research Proposals; Resources; Risk Factors; Role; STEM research; Sampling; Scientist; Statistical Models; Training; Transact; Translating; Translational Research; Universities; Vaccination; Vaccines; Variant; Vertical Disease Transmission; Vertical Transmission; Virus Diseases; Work; World Health Organization; antenatal; antenatal care; career; chronic infection; clinical practice; clinical training; clinically relevant; community transmission; data management; design; genetic analysis; genetic epidemiology; high risk; high risk population; improved; innovation; member; mortality; offspring; pathogen; programs; scale up; screening; sex; skills; spatial epidemiology; theories; transmission process; virology

Project Abstract Hepatitis B virus (HBV) remains endemic in sub-Saharan Africa (SSA), despite an effective vaccine. While perinatal transmission from mother-to-child has been the prevailing theory for continued HBV endemicity based on studies in Asia, limited evidence from SSA suggests transmission at the household- and community-levels is a more important driver of transmission in SSA contexts. Given that scale-up of HBV vaccination will be slow and insufficient to reach the World Health Organization goal of HBV elimination by 2030, additional prevention measures are needed for HBV control, which first require a better understanding of HBV transmission in SSA. The Democratic Republic of the Congo (DRC) has a national HBV prevalence of ~3.3%, which translates to approximately 3.5 million chronic infections in a setting where advanced hepatology care is essentially inaccessible. This proposal builds upon a strong research infrastructure (~20 years) between scientists at the University of North Carolina at Chapel Hill (UNC) and in DRC’s capital city, Kinshasa, to study HBV transmission using data and samples from an ongoing household-based case-control study and from the DRC’s latest national Demographic and Health Survey. The overall goal of this proposal is to improve understanding of HBV transmission in a low-resourced, sub-Saharan Africa setting. The specific aims of this proposal are: 1) Characterize the epidemiology of HBV transmission in households in urban Kinshasa, DRC, and identify associated individual, household, and community risk factors; and 2) Investigate evidence of community-level horizontal transmission using phylogenetic analysis. Through this research proposal and a carefully constructed training plan, the trainee will achieve the following fellowship goals: 1) develop a unique and interdisciplinary research skillset that integrates epidemiology, geography, genetics, and infectious diseases; 2) engage in meaningful clinical training that will enhance the trainee’s future clinical practice and the translation of research findings to clinically relevant interventions; and 3) develop professional skills that will facilitate a successful academic career as a physician-scientist.

项目摘要 尽管有有效的疫苗，但在撒哈拉以南非洲（SSA）仍保持乙型肝炎病毒（HBV）。尽管 从母亲到儿童的围产期传播一直是基于HBV内在性的普遍理论 关于亚洲的研究，SSA的有限证据表明，家庭和社区级别的传播 是SSA上下文中传输的更重要的驱动力。鉴于HBV疫苗接种的扩大会很慢 而且不足以达到世界卫生组织消除HBV的目标，到2030年，额外的预防 HBV控制需要措施，这首先需要更好地了解SSA中的HBV传输。 刚果民主共和国（DRC）的全国性HBV患病率约为3.3％，这转化为 在先进的肝病护理中，大约有350万个慢性感染 无法访问。该提议建立在科学家之间强大的研究基础设施（约20年）的基础上 北卡罗来纳大学教堂山（UNC）和刚果民主共和国首都金沙萨（Kinshasa）学习HBV 使用正在进行的家庭病例对照研究中的数据和样品进行传输以及 刚果民主共和国最新的国家人口和健康调查。该提议的总体目标是改善 在低资源，撒哈拉以南非洲的环境中了解HBV传播。 该提案的具体目的是：1）表征HBV传播的流行病学 刚果民主共和国城市金沙萨的家庭，并确定相关的个人，家庭和社区 风险因素； 2）调查使用社区级水平传播的证据 系统发育分析。 通过这项研究建议和仔细构建的培训计划，实习生将实现以下内容 奖学金目标：1）开发一种独特而跨学科的研究技能，将流行病学整合， 地理，遗传学和传染病； 2）进行有意义的临床培训，以增强 受训者的未来临床实践以及将研究结果转化为临床相关的干预措施；和 3）发展专业技能，将有助于作为身体科学家成功的学术职业。