Improving the control of multidrug-resistant tuberculosis through targeted screening and use of novel anti-tuberculosis drugs

通过针对性筛选和使用新型抗结核药物提高耐多药结核病的控制

• 批准号: 9109823
• 负责人: Reza YAESOUBI
• 金额: $ 13.1万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-04-15 至 2020-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9109823
• 关键词: Acquired Immunodeficiency Syndrome; Address; Adopted; Antibiotic Resistance; Antibiotics; Biological; Collaborations; Communicable Diseases; Communities; Complex; Computer Simulation; Conflict (Psychology); Consensus; Cost Effectiveness Analysis; Country; Data; Detection; Development; Diagnosis; Diagnostic tests; Doctor of Philosophy; Drug resistance; Early Diagnosis; Effectiveness; Employee Strikes; Employment; Epidemic; Epidemiology; Equilibrium; Goals; Guidelines; Health Policy; Household; Incidence; Interdisciplinary Study; Intervention; Investigation; K-Series Research Career Programs; Life; Measures; Mentors; Mentorship; Methods; Modeling; Moldova; Multidrug-Resistant Tuberculosis; New Agents; Notification; Patient-Focused Outcomes; Patients; Performance; Peru; Pharmaceutical Preparations; Phenotype; Policies; Population; Prevalence; Probability; Public Health; Public Health Schools; Quality-Adjusted Life Years; Regimen; Research; Resistance; Resource Allocation; Resources; Science; Scientist; Solid; Structure; System; Techniques; Time; Training; Treatment Protocols; Tuberculosis; Update; Work; bacterial resistance; base; care delivery; case finding; cost; cost effective; disease natural history; disease transmission; falls; global health; improved; infectious disease model; intervention effect; microbial disease; mid-career faculty; mortality; novel; novel diagnostics; novel therapeutics; population health; professor; programs; public health relevance; response; scale up; screening; simulation; skills; therapy design; tool; transmission process; tuberculosis drugs; tuberculosis treatment; years of life lost

 DESCRIPTION (provided by applicant): This proposal presents a four-year research career development award for Dr. Reza Yaesoubi, an Assistant Professor in the Department of Health Policy and Management at the Yale School of Public Health (YSPH). His proposal aims to address important policy questions to control the ongoing spread of multidrug-resistant tuberculosis (MDR-TB) strains, which are resistant to essential antibiotics included in the first-line TB treatment regimen. While global efforts to scale up the diagnosis and treatment of MDR-TB and confront the growing problem of drug resistance have been slow moving, the recent introduction of new tools to control the threat of MDR-TB offer promise to accelerate the response. These new tools include rapid diagnostic tests for drug resistance and the novel anti-TB drugs. This proposal describes a rigorous, model-based investigation to identify strategies that can maximize the beneficial impact of these novel tools for TB and MDR-TB control. To study the overall impact of different control policies on MDR-TB spread, the candidate will develop detailed mathematical and simulation models of TB epidemics and calibrate them using data from two high MDR-TB prevalence countries, Peru and The Republic of Moldova (Aim 1). The candidate will then use these models to i) identify cost-effective, adaptive policies which use updated epidemiological information to guide targeted screening for TB and MDR-TB (Aim 2); and ii) identify drug-introduction policies that maximize the societal benefits of novel anti-T drugs and regimens while minimizing the probability of the emergence of antibiotic resistance (Aim 3). The proposed work will be conducted under the co-mentorship of Dr. Ted Cohen, MD, MPH, DrPH, Associate Professor of Epidemiology of Microbial Diseases at YSPH, and Dr. A. David Paltiel, PhD, MBA, Professor of Public Health, and Health Policy and Management at YSPH, and will be done in collaboration with the Center for Interdisciplinary Research on AIDS, the Center for Infectious Disease Modeling at YSPH, and the Center for Communicable Disease Dynamics at the Harvard School of Public Health (HSPH).The candidate will also be advised by Dr. Marc Lipsitch, DPhill, Professor of Epidemiology at HSPH and Dr. Joshua Salomon, PhD, Professor of Global Health at HSPH. Dr. Yaesoubi's training goals are (1) to develop a solid understanding of the dynamics of infectious diseases and the biological mechanisms governing the emergence of resistant bacteria, in particular MDR-TB, (2) to become an expert in methods for modeling complex multi-agent systems and optimizing the overall performance of these systems through the efficient allocation of available resources, and (3) to improve his mentoring, management, and collaboration skills that are essential for his successful transition to independence. The candidate's long-term goal is to become an independent scientist developing and applying decision science techniques to improve policies for the management and eradication of infectious diseases.

 描述（由应用程序提供）：该提案为耶鲁公共卫生学院（YSPH）的卫生政策与管理部助理教授Reza Yaesoubi博士颁​​发了为期四年的研究职业发展奖。他的建议旨在解决重要的政策问题，以控制多种抗性结核病（MDR-TB）菌株的持续扩散，这些菌株对第一线结核病治疗方案中包含的基本抗生素具有抗药性。尽管全球扩大MDR-TB的诊断和治疗以及面对耐药性越来越大的问题的努力一直缓慢移动，但最近引入了控制MDR-TB威胁的新工具提供了有望加速反应的承诺。这些新工具包括耐药性和新型抗TB药物的快速诊断测试。该提案描述了一项严格的，基于模型的投资，以确定可以最大程度地利用这些新型工具对结核病和MDR-TB控制的有益影响的策略。为了研究不同控制策略对MDR-TB扩散的总体影响，候选人将开发TB流行病的详细数学和仿真模型，并使用来自两个高MDR-TB流行国家和摩尔多瓦共和国的数据来校准它们（AIM 1）。然后，候选人将使用这些模型i）确定使用更新的流行病学信息来指导TB和MDR-TB的目标筛查（AIM 2）；和ii）确定最大化新型抗T药物和方案的社会益处的药物引入政策，同时最大程度地减少出现抗生素耐药性的可能性（AIM 3）。 The proposed work will be conducted under the co-mentorship of Dr. Ted Cohen, MD, MPH, DrPH, Associate Professor of Epidemiology of Microbial Diseases at YSPH, and Dr. A. David Paltiel, PhD, MBA, Professor of Public Health, and Health Policy and Management at YSPH, and will be done in collaboration with the Center for Interdisciplinary Research on AIDS, the Center for Infectious Disease Modeling at YSPH和哈佛公共卫生学院（HSPH）的传染性疾病动态中心。候选人也将由HSPH的Dphill，Dphill，Dphill博士和HSPH全球健康教授Joshua Salomon博士，HSPH博士提供建议。 Yaesoubi博士的培训目标是（1），以深入了解感染性疾病的动态以及管理抗性细菌出现的生物学机制，尤其是MDR-TB的出现，（2）成为建模复杂的多项式系统的方法的专家，并通过有效地分配了这些系统，以有效地分配了这些系统，以提高这些系统的整体性能，以改善他的精神和（3），并（3）能够改善他和（3），并（3）能够改善他和（3），并（3）能够改善他的精神和（3），并（3）能够改善他的精神和（3）。过渡到独立。候选人的长期目标是成为一名独立的科学家发展，并运用决策科学技术，以改善管理和消除传染病的政策。