PUERTO RICO ENHANCED SURVEILLANCE AND CONTROL OF ARBOVIRUSES (PRESCA) PROGRAM

波多黎各加强虫媒病毒监测和控制 (PRESCA) 计划

• 批准号: 10470455
• 负责人: Vanessa Rivera-Amill
• 金额: $ 249.5万
• 依托单位: PONCE SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-01 至 2025-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10470455
• 关键词: PUERTO; RICO; ENHANCED; SURVEILLANCE; CONTROL

PROJECT SUMMARY The impact of infections transmitted by mosquitoes is global. Arboviral diseases such as dengue, chikungunya, and Zika are a significant health concern due to the expanding geographical range of many mosquito species. Emphasis on disease surveillance systems is central to evaluate the effectiveness of primary and secondary dengue prevention methods and strategies, including the introduction of dengue vaccines and new vector control methods. In the current application, the study team will address specific and fundamental gaps in the diagnosis and clinical management of dengue and other acute febrile illnesses (AFI); ultimately, evaluating the efficacy of vector control strategies in reducing the incidence of arbovirus infection through a combination of both clinic- and community-based surveillance systems. The study team’s long-term goal is to mitigate arboviral and other AFI disease burdens by improving diagnosis, clinical management, and prevention strategies. The study’s central hypothesis is that arbovirus infections and AFI disease surveillance, through the continuation of SEDSS and COPA, will promote evidence-driven public health policy decisions and reduce the burden of disease. The rationale for the current study is that understanding the etiology, epidemiology, and severity of arboviral diseases will allow the United States to be better prepared and respond to critical vector- borne disease outbreaks. The study team will test the central hypothesis by pursuing two specific aims: 1) Explore the natural history of dengue and arboviral infections and other acute febrile illnesses in their differential diagnosis to understand their epidemiology, spectrum of disease, and outcomes to provide recommendations for diagnosis and clinical management, and; 2) Define the correlates of risk and protection of arbovirus transmission in the setting of vector-reduction strategies. Under Specific Aim 1, the team will strengthen hospital surveillance of acute febrile illness (AFI) and maintain an AFI platform for conducting clinical research. For Specific Aim 2, the team will maintain a community-based cohort to assess the incidence and prevalence of arboviral infection, as well as, evaluate the incidence, prevalence, and etiology of other AFIs in selected communities. Central to both aims is the establishment of a data management system and the continuation of strengthening collaborations with the local government, community leaders, and other stakeholders to ensure continuity of the established program. The proposed research is significant because it is expected to deliver robust and broad knowledge regarding the epidemiologic patterns of common arboviral diseases in the context of other AFI of the present and those that may emerge in the geographical setting. Such results provide evidence- based responses to critical questions regarding dengue (and other arboviruses) diagnosis, immune response, and clinical management. Also, the community-based system will be central to evaluate the efficacy of vector control strategies in reducing the incidence of arboviral diseases in humans and assessing its potential use among other populations.

项目摘要 蚊子传播的感染影响是全球性的。虫媒病毒疾病如登革热， 基孔肯雅病毒和寨卡病毒是一个重大的健康问题，由于许多人的地理范围不断扩大， 蚊子种类强调疾病监测系统是评估初级卫生保健有效性的核心。 和二级登革热预防方法和战略，包括采用登革热疫苗， 新的病媒控制方法。在目前的应用中，研究小组将解决具体和基本的问题， 登革热和其他急性发热性疾病（AFI）的诊断和临床管理方面的差距;最终， 评估媒介控制策略在降低虫媒病毒感染发生率方面的效力， 结合诊所和社区监测系统。研究小组的长期目标是 通过改善诊断、临床管理和预防，减轻虫媒病毒和其他AFI疾病的负担 战略布局这项研究的中心假设是，虫媒病毒感染和AFI疾病监测，通过 SEDSS和COPA的继续，将促进以证据为导向的公共卫生政策决策，并减少 疾病负担。目前研究的基本原理是，了解病原学、流行病学和 虫媒病毒疾病的严重性将使美国能够更好地准备和应对关键的媒介， 传播疾病的爆发。研究小组将通过追求两个具体目标来测试中心假设：1） 探索登革热和虫媒病毒感染和其他急性发热性疾病的自然史， 诊断，以了解他们的流行病学，疾病谱和结果，以提供建议 用于诊断和临床管理; 2）定义虫媒病毒的风险和保护的相关性 在减少媒介策略的设定中传播。根据具体目标1，该小组将加强医院 监测急性发热性疾病（AFI），并维持AFI平台进行临床研究。为 具体目标2，该小组将维持一个以社区为基础的队列，以评估 虫媒病毒感染，以及，评估其他AFI的发病率，患病率和病因，在选定的 社区.这两个目标的核心是建立一个数据管理系统， 加强与地方政府、社区领袖和其他利益攸关方的合作，以确保 延续既定的计划。拟议的研究是重要的，因为它预计将提供 关于常见虫媒病毒疾病的流行病学模式的强大和广泛的知识， 其他AFI的目前和那些可能出现的地理环境。这些结果提供了证据- 基于对有关登革热（和其他虫媒病毒）诊断，免疫应答， 临床管理。此外，以社区为基础的系统将是评估病媒 降低人类虫媒病毒病发病率的控制策略及其潜在用途的评估 在其他人群中。