One-Health Approach to Study Human Fasciola hepatica Transmission and Inform Strategic Control

研究人类肝片形吸虫传播并为战略控制提供信息的单一健康方法

基本信息

批准号：
10612456
负责人：
MIGUEL MAURICIO CABADA
金额：
$ 48.01万
依托单位：
UNIVERSITY OF TEXAS MED BR GALVESTON
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-04-22 至 2027-03-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10612456
关键词：
Address Affect Africa Aftercare Agriculture Anemia Animals Antigens Area Asia Automobile Driving Biological Factors Cells Child Chronic Collaborations Communicable Diseases Communities Complex Country DNA Data Developing Countries Development Diagnosis Diagnostic Diagnostic Procedure Diagnostic tests Disease Drug resistance Economics Effectiveness Environment Environmental Risk Factor Epidemiologic Factors Epidemiology Fasciola Fasciola hepatica Fascioliasis Fostering Geographic Information Systems Goals Growth Habitats Health Helminths Hematopoietic Hepatica Human Human Resources Image Immune Immunologic Memory Immunology In Vitro Incidence Infection Inflammatory Response Innate Immune Response Intervention Life Cycle Stages Liver diseases Livestock Macrophage Malnutrition Methods Middle East Modeling Molecular Mus Parasite Control Parasites Parasitology Peru Peruvian Pharmaceutical Preparations Polymerase Poverty Predisposition Prevalence Production Prospective cohort Public Health Recommendation Reporting Research Research Personnel Resolution Resource-limited setting Resources Risk Ruminants Rural Community Sampling Studies School-Age Population Site Snails South America Southeastern Asia Specimen Statistical Data Interpretation Statistical Models T cell response Testing Time Training Treatment Effectiveness Treatment Efficacy Treatment Failure Trematode Infections Tropical Medicine Weather Zoonoses adaptive immune response burden of illness chemotherapy chronic infection cohort drug efficacy efficacy evaluation enzootic experience food insecurity high resolution imaging infection burden infection risk insight land use multidisciplinary neglected tropical diseases novel predicting response preventive intervention recombinase response stem surveillance strategy tool transmission process treatment response vaccine response

项目摘要

PROJECT SUMMARY/ABSTRACT Fascioliasis in an important zoonic infection with a worldwide distribution. It is a significant public health problem in poor rural communities in countries of South America, Middle East, Asia, and Africa. School age children bear a disproportionate burden of the diseases suffering from anemia and stunted growth. Fasciola causes substantial economic losses in livestock production in developed and developing countries. It has a complex epidemiology stemming from its capacity to infect multiple definitive hosts and more than 30 species of snails and adapt to multiple environments. Despite Fasciola’s inclusion in the WHO neglected tropical diseases list very little progress in parasite control has been achieved. Mass treatment has been the preferred control intervention in human and livestock. However, a single drug, triclabendazole, is recommended for treatment and control in humans and preferred for livestock. Concerns for decreasing efficacy of triclabendazole have been raised in endemic countries. Tools to predict fascioliasis risk and guide preventive interventions have focused on livestock. Most models have ignored human infection risk and factor associated with vulnerability such as treatment failure, poverty, and susceptibility. Out TMRC application proposes using a comprehensive One Health approach to study human transmission of Fasciola in two sites of the Peruvian highlands. Our approach will consider the spatial and temporal association of fascioliasis in snail intermediate hosts, livestock, human, and the environment. Importantly we will include studies to tackle factors that modify the risk of infection among human such as weather and land use, hinder diagnosis and surveillance such as the lack of simple diagnostic tests to use in all hosts, and the potential effects of chronic infection on treatment response and infection susceptibility. We will use agent-based modeling to identify crucial steps in transmission and potential areas of intervention that could be address simultaneous with a large impact on transmission and small impact on the environment and drug effectiveness. At the end of our TMRC we expect to gain substantial insights into human Fasciola transmission and to identify potential integrated control interventions, simple sensitive tools to diagnose and surveil infection, and immune mechanisms behind drug effectiveness and infection susceptibility.

项目概要/摘要片形吸虫病是一种重要的人畜共患病，在世界范围内分布，是一个重大的公共卫生问题。在南美洲、中东、亚洲和非洲国家的贫困农村社区，学龄儿童生育。贫血和片形吸虫生长迟缓所造成的疾病负担过重。发达国家和发展中国家畜牧业生产的经济损失具有复杂的流行病学特征。源于其能够感染多种最终宿主和 30 多种蜗牛并适应尽管片形吸虫被列入世卫组织被忽视的热带病名单中，但在多种环境中，这种情况很少见。寄生虫控制已取得进展，大规模治疗已成为首选控制干预措施。然而，建议使用单一药物三氯苯达唑来治疗和控制。人类和牲畜首选三氯苯达唑的功效降低的担忧已在以下国家提出。预测片形吸虫病风险和指导预防性干预措施的工具主要针对牲畜。大多数模型忽略了人类感染风险和与脆弱性相关的因素，例如治疗失败、 TMRC 申请建议采用全面的“同一个健康”方法来解决贫困和易感性问题。在秘鲁高地的两个地点研究片形吸虫的人类传播我们的方法将考虑片形吸虫病在蜗牛中间宿主、牲畜、人类和动物中的空间和时间关联重要的是，我们将开展研究来解决影响人类感染风险的因素。天气和土地利用等因素阻碍诊断和监测，例如缺乏简单的诊断测试在所有宿主中的使用，以及慢性感染对治疗反应和感染易感性的潜在影响。我们将使用基于主体的建模来确定传播的关键步骤和潜在的干预领域可以同时解决，对传输影响大，对环境影响小在我们的 TMRC 结束时，我们希望获得对人类片形吸虫的深入了解。传播并识别潜在的综合控制干预措施，简单敏感的工具来诊断和监测感染以及药物有效性和感染易感性背后的免疫机制。