Evaluation of Clinical Interventions, Surveillance, and Ecological Factors that Influence the Burden of Human Monkeypox in the Democratic Republic of the Congo (DRC)

7.项目概要/摘要 大多数人猴痘（MPX）感染每年发生在刚果民主共和国。 刚果（刚果民主共和国），特别是高度依赖瘦肉作为蛋白质来源的农村人口 当地资源来维持村庄。在本项目建议书中，我们建议开展一系列活动， 了解MPX的流行病学和生态学，预防人类MPX感染的临床干预措施， 临床随访，以更好地了解人类MPX病毒感染的参数，改善 实验室诊断监测和床旁检测，以及社区和卫生保健工作者教育。 该项目的目标是确定有效的流行病学和临床干预措施， 通过a）减少感染风险和B）确定利用 治疗的医学对策。 在Tshuapa省维持现有的基于实验室的MPX监测增强措施 将继续进行，因为疾病的检测和确认对当前和拟议的研究有直接影响。 我们将继续对MPX病例和高危人群进行生态学和流行病学调查， 社区，以更好地了解特定的行为或环境，使个人处于更高的风险， 以制定更有针对性的循证预防战略。准确的地理数据将 在Tshuapa收集的数据，以更好地为生态、流行病学和卫生系统的公共卫生分析提供信息。 我们将继续实施和评估针对社区和医疗保健工作者的教育信息， 预防MPX感染并更好地为研究提供信息。 该项目将继续实施现有的研究协议，以评估 第三代天花疫苗，以防止MPX感染的高危人群频繁接触。数据 以评估暴露后接种疫苗保护密切接触者的潜力 MPX患者该项目还将审查MPX疾病表现和支持性证据的有限证据。 制定和实施一项方案来随访MPX患者，以评估疾病 介绍临床护理，目标是改善患者预后。 我们将评估通过实施以下措施提高刚果民主共和国MPX诊断及时性的方法： 利用该国区域实验室的现有能力进行MPX和正痘病毒检测。生物安全和 生物安全实践将在MPX病例发生地区的选定实验室进行评估， 将在国家实验室对检测结果进行验证。我们还将验证点的使用- 在患者治疗发生的环境中进行护理诊断测试，评估用户的可操作性和 用于诊断MPX病例的侧流诊断测定。

7. Project Summary/Abstract The majority of human monkeypox (MPX) infections occur each year in the Democratic Republic of Congo (DRC), notably among rural populations that are highly dependent on bushmeat as a source of protein local resources to sustain villages. In the present project proposal, we propose a range of activities to better understand the epidemiology and ecology of MPX, clinical interventions to prevent human MPX infections, clinical follow-up to better understand the parameters of human MPX virus infections, improvement of laboratory diagnostic surveillance and point-of-care testing, and community and healthcare worker education. The goal of this project is to determine effective epidemiological and clinical interventions that minimize human morbidity and mortality by a) diminishing the risk of infection and b) identifying opportunities to utilize medical countermeasures for treatment. Maintenance of the existing enhancements to laboratory-based MPX surveillance in Tshuapa Province will continue, as detection and confirmation of disease has direct impacts on the current and proposed studies. We will continue to implement ecological and epidemiological investigations of MPX cases and at-risk communities to better understand specific behaviors or environments that place individuals at higher risk in order to develop more targeted, evidence-based prevention strategies. Accurate geographic data will be collected in Tshuapa to better inform ecological, epidemiological, and health systems public health analyses. We will continue to implement and evaluate educational messaging for communities and healthcare workers to prevent MPX infections and better inform research studies. The project will continue to implement an existing research protocol to assess the effectiveness of a third-generation smallpox vaccine to prevent MPX infection in a high-risk group with frequent exposures. Data from this study will be reviewed to assess the potential for post-exposure vaccination to protect close contacts of MPX patients. The project will also review the limited evidence on MPX disease presentation and supportive care regimens to develop and implement a protocol to follow MPX patients in order to evaluate disease presentation with respect to clinical care, with the goal of improving patient outcomes. We will assess approaches to improve the timeliness of MPX diagnosis in DRC by implementation of MPX and Orthopoxvirus testing using existing capacity at regional laboratories in the country. Biosafety and biosecurity practices will be evaluated at select laboratories located in regions with MPX cases and independent validation of test results will be performed at the national laboratory. We will also validate the use of a point-of- care diagnostic test in a setting where patient treatment occurs, evaluating the user operability and acceptance of a lateral flow diagnostic assay to diagnose MPX cases.