Spatial and molecular epidemiology of hepatitis B transmission in the Democratic Republic of the Congo

刚果民主共和国乙型肝炎传播的空间和分子流行病学

• 批准号: 10463070
• 负责人: Camille Morgan
• 金额: $ 3.88万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-04-01 至 2026-11-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10463070
• 关键词: Africa; Africa South of the Sahara; African; Asia; Automobile Driving; Behavior Therapy; Birth; Capital; Caring; Case-Control Studies; Cessation of life; Childhood; Cities; Clinical; Communicable Diseases; Communities; Complement; Country; Cross-Sectional Studies; Data; Democratic Republic of the Congo; Demographic and Health Surveys; Disease; Dose; Enrollment; Epidemiologic Methods; Epidemiology; Fellowship; Future; Genetic; Genetic Diseases; Genetic Variation; Genomic approach; Geographic Locations; Geography; Goals; HIV; Hepatitis B Prevalence; Hepatitis B Transmission; Hepatitis B Vaccination; Hepatitis B Virus; Hepatology; Horizontal Disease Transmission; Household; Individual; Infant; Infection; Infectious Disease Epidemiology; Infrastructure; Interdisciplinary Study; Intervention; Knowledge; Mentors; Methods; Molecular; Molecular Epidemiology; Morbidity - disease rate; Mothers; North Carolina; Odds Ratio; Organizational Objectives; Participant; Pattern; Perinatal transmission; Phylogenetic Analysis; Physicians; Population; Population Genetics; Prevalence; Prevention Measures; Prevention program; Prevention strategy; Prophylactic treatment; Research; Research Infrastructure; Research Proposals; Resources; Risk Factors; Role; STEM research; Sampling; Scientist; Statistical Models; Training; Translating; Translational Research; Universities; Vaccination; Vaccines; Variant; Vertical Disease Transmission; Virus Diseases; Work; World Health Organization; antenatal; antenatal care; base; career; chronic infection; clinical practice; clinically relevant; community transmission; data management; design; genetic analysis; genetic epidemiology; high risk; high risk population; improved; innovation; member; mortality; offspring; pathogen; programs; scale up; screening; sex; skills; spatial epidemiology; theories; transmission process; virology

Project Abstract Hepatitis B virus (HBV) remains endemic in sub-Saharan Africa (SSA), despite an effective vaccine. While perinatal transmission from mother-to-child has been the prevailing theory for continued HBV endemicity based on studies in Asia, limited evidence from SSA suggests transmission at the household- and community-levels is a more important driver of transmission in SSA contexts. Given that scale-up of HBV vaccination will be slow and insufficient to reach the World Health Organization goal of HBV elimination by 2030, additional prevention measures are needed for HBV control, which first require a better understanding of HBV transmission in SSA. The Democratic Republic of the Congo (DRC) has a national HBV prevalence of ~3.3%, which translates to approximately 3.5 million chronic infections in a setting where advanced hepatology care is essentially inaccessible. This proposal builds upon a strong research infrastructure (~20 years) between scientists at the University of North Carolina at Chapel Hill (UNC) and in DRC’s capital city, Kinshasa, to study HBV transmission using data and samples from an ongoing household-based case-control study and from the DRC’s latest national Demographic and Health Survey. The overall goal of this proposal is to improve understanding of HBV transmission in a low-resourced, sub-Saharan Africa setting. The specific aims of this proposal are: 1) Characterize the epidemiology of HBV transmission in households in urban Kinshasa, DRC, and identify associated individual, household, and community risk factors; and 2) Investigate evidence of community-level horizontal transmission using phylogenetic analysis. Through this research proposal and a carefully constructed training plan, the trainee will achieve the following fellowship goals: 1) develop a unique and interdisciplinary research skillset that integrates epidemiology, geography, genetics, and infectious diseases; 2) engage in meaningful clinical training that will enhance the trainee’s future clinical practice and the translation of research findings to clinically relevant interventions; and 3) develop professional skills that will facilitate a successful academic career as a physician-scientist.

项目摘要 尽管有有效的疫苗，乙型肝炎病毒（HBV）在撒哈拉以南非洲（SSA）仍然流行。尽管 围产期母婴传播一直是乙肝病毒持续流行的主流理论 根据亚洲的研究，SSA 的有限证据表明家庭和社区层面的传播 是 SSA 环境中更重要的传播驱动因素。鉴于乙肝疫苗接种规模的扩大将会缓慢 不足以实现世界卫生组织到 2030 年消除乙肝病毒的目标，需要额外预防 需要采取措施控制乙肝病毒，这首先需要更好地了解乙肝病毒在 SSA 中的传播情况。 刚果民主共和国 (DRC) 的全国 HBV 患病率约为 3.3%，这意味着 大约有 350 万慢性感染者发生在需要先进肝病护理的环境中 无法访问。该提案建立在科学家之间强大的研究基础设施（约 20 年）的基础上 北卡罗来纳大学教堂山分校 (UNC) 和刚果民主共和国首都金沙萨研究乙肝病毒 使用来自正在进行的基于家庭的病例对照研究和来自 刚果民主共和国最新的全国人口和健康调查。该提案的总体目标是改进 了解乙型肝炎病毒在资源匮乏的撒哈拉以南非洲地区的传播情况。 该提案的具体目标是： 1) 描述 HBV 传播的流行病学特征 刚果民主共和国金沙萨城市的家庭，并确定相关的个人、家庭和社区 风险因素； 2) 使用以下方法调查社区水平水平传播的证据 系统发育分析。 通过本研究计划和精心构建的培训计划，学员将实现以下目标 奖学金目标：1）发展独特的跨学科研究技能，整合流行病学， 地理、遗传学和传染病； 2）参加有意义的临床培训，以增强 受训者未来的临床实践以及将研究结果转化为临床相关干预措施；和 3）发展专业技能，以促进作为一名医师科学家的成功学术生涯。