Arbovirus Prediction and Mitigation in the Indo-Pacific

项目摘要/摘要 登革热是一种潜在威胁生命的疾病，在过去50年里增加了30倍。在印度尼西亚，三分之一的人 儿童在5岁之前就感染了登革热。印度-太平洋的岛屿非常容易受到气候的影响 变化和水的不安全是虫媒病毒传播的两个关键驱动因素。预测和缓解虫媒病毒 印度-太平洋地区的传播对于解决美国未来虫媒病毒日益增长的风险至关重要 几十年来，美国可能有一半的人拥有适合埃及伊蚊和伊蚊的栖息地。白纹伊蚊 传播登革热、基孔肯雅热、寨卡病毒和黄热病病毒。 振兴非正规住区及其环境(RISE)是一项整群随机对照试验 升级印度尼西亚和斐济城市贫民窟当地水利基础设施的好处。崛起干预 是未来贫民窟改造的原型，以解决整个印度的气候变化和水不安全问题-- 太平洋。尽管世界卫生组织建议将永久性环境改造作为 虫媒病毒控制策略，这是以前从未经过严格测试的。崛起提供了一个重要的 评估该模型是否会减少或无意中增加虫媒病毒传播的机会。 除了评估缓解虫媒病毒传播的新范例外，Rise还是一个理想的平台 评估有关虫媒病毒传播的环境驱动因素的知识差距。我的假设是 可改变的环境条件促使虫媒病毒在这些社区传播。为了检验这一假设， 我将利用Rise平台研究该地区的虫媒病毒风险因素，并评估 对城市贫民窟虫媒病毒传播的永久性环境改造。我还将创建一个 在气候变化和气候变化范围内模拟虫媒病毒在该地区传播的数学模型 干预场景。 我已经制定了一份定制的职业发展计划，与我提出的研究相一致。它包含了 在拉博德和卢比博士的指导下进行正式和非正式培训。这份培训计划制定了 基于我在全球卫生、热带医学和流行病学方面的现有专业知识；它将增强我的专业知识 实验室诊断学、地理空间分析和数学建模。计划中的教学和技术 包括在这里的培训将为我实现成为一名学者的目标提供必要的基础 在气候变化时代，医生专注于缓解传染病的传播。

Project Summary / Abstract Dengue, a potentially life-threatening disease, has increased 30-fold in the last 50 years. In Indonesia, 1 in 3 children have had a dengue infection by 5 years old. Islands in the Indo-Pacific are highly vulnerable to climate change and water insecurity, two key drivers of arbovirus spread. Predicting and mitigating arbovirus transmission in the Indo-Pacific is critical to addressing the increasing risk of arboviruses in the U.S. In the next several decades, half the U.S. may have habitat suitable for Aedes aegypti and Ae. albopictus, mosquitos which spread dengue, chikungunya, Zika, and yellow fever viruses. Revitalizing Informal Settlements and their Environments (RISE) is a cluster randomized control trial evaluating the benefits of upgrading local water infrastructure in urban slums in Indonesia and Fiji. The RISE intervention is a prototype for future slum upgrading to address climate change and water insecurity throughout the Indo- Pacific. Although the World Health Organization recommends permanent environmental modification as an arbovirus control strategy, this has never before been rigorously tested. RISE provides an important opportunity to evaluate whether this model decreases or inadvertently increases arbovirus transmission. In addition to evaluating a new paradigm for mitigating arbovirus transmission, RISE is an ideal platform to assess gaps in knowledge about environmental drivers of arbovirus transmission. My hypothesis is that modifiable environmental conditions drive arbovirus transmission in these communities. To test this hypothesis, I will leverage the RISE platform to study arbovirus risk factors in this region and evaluate the impact of permanent environmental modification on arbovirus transmission in urban slums. I will also create a mathematical model to simulate arbovirus transmission in this region under a range of climate change and intervention scenarios. I have developed a customized career development plan that aligns with my proposed research. It incorporates both formal and informal training under the mentorship of Drs. LaBeaud and Luby. This training plan draws upon my existing expertise in global health, tropical medicine, and epidemiology; it will enhance my expertise in laboratory diagnostics, geospatial analysis, and mathematical modeling. The planned didactics and technical training included here will provide the foundation necessary to achieve my goal of becoming an academic physician focused on mitigating the spread of infectious diseases in the era of climate change.