Strategies for tuberculosis control in prisons

监狱结核病控制策略

• 批准号: 10607550
• 负责人: Jason Randolph Andrews
• 金额: $ 63.77万
• 依托单位: STANFORD UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-03-01 至 2028-02-29
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10607550
• 关键词: Acceleration; Address; Algorithms; Americas; Benchmarking; Biological Markers; Blood; Brazil; COVID-19; COVID-19 pandemic; Cause of Death; Cessation of life; Cohort Studies; Communicable Diseases; Communities; Conscious; Country; Data; Detection; Digital Radiography; Digital X-Ray; Disease; Electricity; Enrollment; Epidemic; Future; Gene Expression Profiling; Genomics; Goals; Haplotypes; Health; Health protection; Image; Immune response; Imprisonment; Incidence; Individual; Infection; Longitudinal cohort; Longitudinal trends; Low Dose Radiation; Mass Screening; Measures; Methods; Molecular; Monitor; Mycobacterium tuberculosis; Notification; Participant; Persons; Population; Population Sizes; Prevalence; Prevention; Prevention Measures; Preventive therapy; Prisons; Recommendation; Resource-limited setting; Risk; Roentgen Rays; Sampling; Specificity; Sputum; System; Testing; Thoracic Radiography; Time; Tuberculosis; Tuberculosis diagnosis; Validation; Work; case finding; cohort; cost; cost effective; cost effectiveness; deep learning; deep learning algorithm; density; diagnostic accuracy; effective therapy; genome sequencing; genomic data; high risk; high risk population; improved; low and middle-income countries; mathematical model; mortality; new technology; novel; novel strategies; portability; prevent; progression risk; screening; sobriety; success; tool; transmission process; trend; virtual; whole genome

Project Summary Tuberculosis remains one of the leading causes of death worldwide, despite the widespread availability of effective treatment and prevention measures. Prisons harbor among the highest rates of tuberculosis worldwide, and, in many regions, tuberculosis burden in correctional settings is growing. The WHO now recommends active case finding for tuberculosis in prisons and other high burden settings, but there is a dearth of evidence for how to accurate and efficiently identify cases early to reduce transmission. To address these gaps, we propose to a prospect cohort study among incarcerated individuals in high tuberculosis burden prisons in Central Western Brazil to: 1) evaluate the use of portable, digital x-rays with automated interpretation for intensive case finding; 2) determine whether genomic data can be used to track transmission rates at the population level; and 3) use mathematical models to identify effective, scalable strategies for tuberculosis case finding and prevention in prisons. We will test the hypotheses that: 1) x-ray with automated interpretation can achieve WHO target product profile thresholds for accuracy as a screening test among incarcerated individuals, even among those with asymptomatic or early disease; 2) emerging phylodynamic methods can be used to monitor trends in transmission; and 3) serial screening combined with preventive therapy would be a cost-effective and impactful approach for tuberculosis control in high-burden prisons globally. Overall, this project will address critical gaps in tuberculosis diagnosis and prevention among a large, underserved, high-risk population, to protect their health and the health of their communities.

项目概要 尽管结核病仍然是全世界死亡的主要原因之一 广泛提供有效的治疗和预防措施。监狱港 是全球结核病发病率最高的国家之一，而且在许多地区，结核病 惩教机构的负担正在增加。世界卫生组织现在建议活跃病例 在监狱和其他高负担环境中发现结核病，但缺乏 有关如何及早准确有效地识别病例以减少传播的证据。 为了解决这些差距，我们建议对被监禁的人进行一项前瞻性队列研究 巴西中西部结核病高负担监狱中的个人：1) 评估 使用带有自动判读功能的便携式数字 X 射线进行密集病例查找； 2) 确定基因组数据是否可用于跟踪传输速率 人口水平； 3）使用数学模型来识别有效的、可扩展的 监狱结核病病例发现和预防策略。我们将测试 假设：1）具有自动判读功能的 X 射线可以实现 WHO 目标​​产品 作为被监禁个人的筛查测试的准确性阈值，甚至 无症状或早期疾病患者； 2）新兴的系统动力学方法 可用于监测传播趋势； 3）系列筛选结合 预防性治疗将是一种具有成本效益且有效的结核病治疗方法 全球高负担监狱的控制。总体而言，该项目将解决以下方面的关键差距： 在大量服务不足的高危人群中进行结核病诊断和预防， 保护他们的健康和社区的健康。