Preliminary Effectiveness Analysis of Universal Rotavirus Immunization, Nicaragua

尼加拉瓜轮状病毒普遍免疫效果初步分析

• 批准号: 7760273
• 负责人: Sylvia Irene Becker-Dreps
• 金额: $ 12.73万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-21 至 2011-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7760273
• 关键词: Centers for Disease Control and Prevention (U.S.); Child; Childhood; Clinical Trials; Collaborations; Communicable Diseases; Communities; Data Base Management; Development Plans; Diarrhea; Doctor of Philosophy; Effectiveness; Environment; Epidemiologist; Epidemiology; Family Practice; Feces; Frequencies; Gastroenterologist; Genotype; Health; Immunization; Incidence; Infectious Disease Epidemiology; International; Knowledge; Laboratories; Laboratory Study; Measures; Medical; Mentors; Mentorship; Nicaragua; North Carolina; Positioning Attribute; Primary Health Care; Recording of previous events; Research; Research Methodology; Rotavirus; Rotavirus Infections; Rotavirus Vaccines; Sampling; Specialist; System; Universities; Vaccines; Virus; Visit; Work; base; career development; case control; design; member; population based; primary care setting; public health relevance; vaccine effectiveness

DESCRIPTION (provided by applicant): Candidate: Sylvia Becker, MD, MPH is an NRSA-Primary Care Research Fellow in the Department of Family Medicine at the University of North Carolina at Chapel Hill (UNC). Career Development Plan: the candidate Will conduct mentored research and strengthen vital knowledge in global health research. The candidate will be positioned to become leader in vaccine effectiveness in the developing world. Immediate Objective: to acquire expertise in infectious disease epidemiology and vaccine effectiveness; to assess the effectiveness ofthe rotavirus vaccine in a developing world setting. Long-term Objective: to provide evidence on vaccine effectiveness for developing world decision makers. Specific Aims: 1) Determine the effectiveness ofthe rotavirus vaccine in the primary care setting. 2) Characterize the circulating genotypes of the virus following UIRI implementation. 3) Determine the effect of UIRI on the childhood diarrhea incidence rate in a community. Research Methods: In Aim 1, we will a case control design to determine the vaccine's effectiveness in reducing primary care visits among children for rotavirus diarrhea at eight primary care centers in Leon, Nicaragua. In Aim 2, we will characterize the genotypes among all rotavirus-positive stool samples collected in Aim 1 and explore whether type replacement may be occurring. In Aim 3, we will measure the diarrhea incidence rate among children in the community using a population-based sample provided by an existing Surveillance System based at University of Nicaragua, Leon (UNAN) and compare to the incidence prior to universal rotavirus immunization. Environment: we will work with eight primary care centers in Leon that have a long history of collaboration with members of the research team. Laboratory studies for Aim 1 will be carried out in a laboratory at UNAN while those for Aim 2 will be carried out at the CDC. Aim 3 will make use of an existing Surveillance System that has an international reputation for the quality of its research. Database management is within this Surveillance System. Mentorship: primary mentorship at the UNC will be provided by epidemiologist and infectious disease specialist, David J. Weber, MD, MPH. Primary mentorship at UNAN will be provided by Felix Espinoza, MD, PhD (Aims 1 and 2) and Rodolfo Peria, MD, PhD (Aim 3). Additional mentorship is provided by leaders in rotavirus epidemiology and vaccine effectiveness, Drs. Umesh Parashar and Manish Patel, by medical geographer, Micheal Emch, PhD, by biostatistician, Michael Hudgens, PhD, by vaccine epidemiologist Jennifer Smith, PhD, MPH, and by gastroenterologist, Douglas Morgan, MD, MPH, who has led the UNC-UNAN research collaboration. PUBLIC HEALTH RELEVANCE: We have the unique opportunity in Leon, Nicaragua to determine the effect of UIRI on the primary care and community levels. At the end of the proposed study, we would provide needed information to others in the developing world who are currently considering adding rotavirus vaccines to their vaccine armamentarium.

描述（由申请人提供）：候选人：MD，MPH的Sylvia Becker是NRSA主要护理研究员，北卡罗来纳大学教堂山（UNC）的家庭医学系。职业发展计划：候选人将在全球卫生研究中进行指导的研究并加强重要知识。候选人将被定位为发展中国家疫苗有效性的领导者。直接目标：获得传染病流行病学和疫苗有效性方面的专业知识；评估轮状病毒疫苗在发展中国家环境中的有效性。长期目标：为发展世界决策者提供有关疫苗有效性的证据。具体目的：1）确定轮状病毒疫苗在初级保健环境中的有效性。 2）表征UIRI实施后病毒的循环基因型。 3）确定UIRI对社区儿童腹泻发病率的影响。研究方法：在AIM 1中，我们将进行案例控制设计，以确定疫苗在降低尼加拉瓜莱昂市八个初级保健中心的轮状病毒腹泻儿童初级保健探访方面的有效性。在AIM 2中，我们将表征AIM 1中收集的所有轮状病毒阳性粪便样品中的基因型，并探索是否可能发生类型的替代品。在AIM 3中，我们将使用基于人群的样本在尼加拉瓜大学，莱昂（UNAN）的现有监视系统（UNAN）的现有监视系统中提供的基于人群的样本来衡量腹泻的发生率，并将其与全身轮状病毒免疫之前的发病率进行比较。环境：我们将与莱昂的八个初级保健中心合作，他们与研究团队成员有悠久的合作历史。 AIM 1的实验室研究将在UNAN的实验室进行，而AIM 2的实验室研究将在CDC进行。 AIM 3将利用现有的监视系统，该系统在其研究质量方面享有国际声誉。数据库管理在此监视系统内。指导：UNC的初级指导将由流行病学家和传染病专家，MD，MPH。 UNAN的主要指导将由医学博士Felix Espinoza（AIMS 1和2）和医学博士Rodolfo Peria（AIM 3）提供。轮状病毒流行病学和疫苗有效性的领导者提供了额外的指导。 Umesh Parashar和Manish Patel，由医学地理学家，Micheal Emch，博士，生物统计学家，Michael Hudgens，PhD，疫苗流行病学家Jennifer Smith，PhD，MPH，MPH，MPH和Gastroentercorks，Douglas Morgan，Douglas Morgan，Doglas Morgan，MDH，MPH，MPH，MPH，MPH，MPH，他领导了UNC-Unan研究的合作。 公共卫生相关性：我们在尼加拉瓜的莱昂有独特的机会来确定UIRI对初级保健和社区层面的影响。在拟议的研究结束时，我们将向发展中国家的其他人提供所需的信息，他们目前正在考虑将轮状病毒疫苗添加到其疫苗武器群中。