GH20-005, Conducting Integrated Infectious Disease and Public Health Research in Peru

项目概要： 所提出的应用旨在克服地方性和非地方性结核病病原学诊断中的诊断障碍， 急性发热性疾病（AFI）的流行病原因，将有效的最先进诊断技术转移到高风险地区， 地方性这项研究的长期目标是了解AFI在不同背景下的病因， 南美洲，并促进全球战略，改善病因特异性疾病估计， 公共卫生实践和政策。核心假设是，技术转让和执行 改进的诊断方法将提高区域诊断能力、流行病应对能力和 研究成果，以实践最大限度地提高研究成果的公共卫生影响。的理由 研究表明，这种方法的可行性将能够进行全面和适当的评估， 区域和国家利益攸关方的采纳。研究的目标将通过执行来实现 三个具体目标：1）使用TaqMan阵列建立稳定的全年急性发热性疾病监测 卡，同时检测超过30种病原体的AFI在三个流行病学背景下在洛雷托， 秘鲁;城市，河流与广泛的森林暴露，和农业河流背景沿着这三个国家 边界（秘鲁，巴西和哥伦比亚），以捕捉病原体的多样性，导致AFI在秘鲁超过一个 2）将这一诊断平台纳入区域疫情应对，以确定 急性发热性疾病流行病的病因学和验证改进的储存和运输程序;以及3） 开发和评估新型血清学诊断芯片，以实现单一平台血清学评估和下游 对高流行率和重要性的病原体进行护理点检测和重点诊断。全局控制 只有在尚未有效覆盖和纳入的领域， 在监测收缩和拟议的项目试图实施一项战略，使所有人口 改进的诊断方法。目前诊断策略的复杂性是一个关键的障碍， 及时查明大多数急性发热性疾病的病因，这对 区域和全球公共卫生影响，因为未确诊的AFI允许广泛传播 新出现的疾病作为有效的疾病控制措施是基于准确的病原学评估。该计划 是创新的，因为高度选择当地的研究人员，教育工作者，学员， 政策制定者。研究战略的实施将具有重要意义，因为预计它将有助于 在一个有记录的地区，AFI的地方性和流行性病因的病因学评估的准确性 病媒传播和人畜共患病原体的多样性，并成为当地诊断和报告的模式 南美的能力。

PROJECT SUMMARY: The proposed application aims to overcome diagnostic barriers in the etiologic diagnosis of endemic and epidemic causes of acute febrile illness (AFI) by moving efficient state of the art diagnostics to an area of high endemicity. The long-term goal of this research is to understand the etiology of AFI across diverse contexts in South America and contribute to global strategies that improve etiology-specific disease estimates to inform public health practice and policy. The central hypothesis is that the technology transfer and implementation of improved diagnostics will enhance regional diagnostic capacity, epidemic responsiveness, and translation of research findings to practice maximizing the public health impact of research findings. The rationale for the research is that the documented feasibility of this approach will enable a full and appropriate evaluation for uptake by regional and national stakeholders. The goals of the research will be achieved through the execution of three specific aims: 1) Establish stable year round acute febrile illness surveillance using the TaqMan array card, which simultaneously detects over 30 pathogens of AFI across three epidemiologic contexts in Loreto, Peru; urban, riverine with extensive sylvatic exposure, and agricultural riverine context along the three country border (Peru, Brazil, and Colombia) in order to capture the diversity of pathogens causing AFI in Peru over a four year period; 2) Integrate this diagnostic platform into the regional outbreak response to determine the etiology of epidemics of acute febrile illness and validating improved storage and transport procedures; and 3) Develop and evaluate novel serodiagnostic chip to enable single platform serologic assessment and downstream point of care tests and focused diagnostics for pathogens of high prevalence and importance. The global control of emerging infectious diseases will be improved only as the areas that are not reached and included effectively in surveillance shrink and the proposed project attempts to implement a strategy to make all populations reachable to the improved diagnostics. The complexity of current diagnostic strategies is a critical barrier to the timely regional ascertainment of the etiology of most cases of acute febrile illnesses and this has important regional and global public health implications as undiagnosed AFI allows for the widespread dissemination of emerging diseases as effective disease control measures are based on accurate etiologic assessment. The plan is innovative because of the meaningful integration of highly select local researchers, educators, trainees, and policymakers. The implementation of the research strategy will be significant because it is expected to contribute to the accuracy of etiologic assessment of endemic and epidemic etiologies of AFI in an area of documented diversity of vector-borne and zoonotic agents and serve as a model for enabling local diagnostic and reporting capacity in South America.