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Ophthalmic Disease and Laboratory Surveillance in a Viral Hemorrhagic Fever Zone

病毒性出血热地区眼科疾病及实验室监测

基本信息

批准号：
10480923
负责人：
JESSICA Shantha
金额：
$ 24.85万
依托单位：
UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-09-01 至 2024-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10480923
关键词：
Adult Africa African Anti-Inflammatory Agents Aqueous Humor Asia Attention Autoimmune Autopsy Blindness Caring Cataract Cataract Extraction Cessation of life Child Health Child Mortality Childhood Cicatrix Clinical Clinical Management Clinical Research Clinical Skills Collaborations Communicable Diseases Competence Complication Control Groups Cystoid Macular Edema Cytomegalovirus Detection Development Diagnosis Diagnostic Diagnostic tests Disease Disease Outbreaks Disease Surveillance Ebola Hemorrhagic Fever Ebola virus Emerging Communicable Diseases Epidemic Epidemiologic Methods Epidemiology Etiology Event Eye Eye Development Eye diseases Foundational Skills Foundations Future Glaucoma Goals Government Guidelines Health Health Personnel Health Policy Hospitals Immune Incidence Individual Inflammation Inflammatory Infrastructure International Investigation K-Series Research Career Programs Knowledge Laboratories Lassa Fever Lassa virus Lead Liberia Liberian Liquid substance Marburgvirus Medical Records Mentored Patient-Oriented Research Career Development Award Mentors Mentorship Methodology Methods Morbidity - disease rate Neuraxis Organ Outcome Pathogen detection Pharmaceutical Preparations Phenotype Policies Prevalence Prevention Prospective cohort study Public Health Quality of life Readiness Recording of previous events Recurrence Reporting Research Research Project Grants Resource-limited setting Resources Retina Retrospective cohort Risk Risk Factors Sampling Scientist Security Seminal fluid Series Sierra Leone Site Survivors Symptoms Syndrome System Techniques Testing Time Time Factors Tissue Sample Tissues Toxoplasmosis Training United States United States National Institutes of Health Universities Uveitis Viral Viral Hemorrhagic Fevers Vision Visual Visual Acuity Visual impairment World Health Organization Zika Virus acute infection antimicrobial body system career career development clinical care cohort design detection method disease diagnosis education research emerging pathogen epidemiology study global health hearing impairment infectious disease model long-term sequelae meetings minimally invasive molecular diagnostics mortality multidisciplinary novel pathogen prevent research clinical testing screening skills success surveillance network surveillance study symposium tool transmission process

项目摘要

Project Summary Emerging infectious diseases can lead to devastating epidemics and pose a threat to global health security. The World Health Organization has identified pathogens that are likely to cause severe and imminent outbreaks, which include Ebolavirus (EBOV) and Lassa fever virus, all of which require urgent attention in research. The West African Ebola virus disease (EVD) outbreak of 2013-2016 is the most devasting EBOV outbreak in history with over 28,600 infected and 11,300 deaths. To date there continue to be isolated outbreaks with significant morbidity and mortality. There are approximately 17,000 EVD survivors who are at-risk for Post-Ebolavirus Disease Syndrome, a recently described entity, which includes systemic conditions, ocular disease, and viral persistence in immune privileged sites (aqueous humor, semen, and central nervous system). Viral persistence is of public health importance, given its initiation of EBOV transmission events and its association with end-organ damage. Uveitis, a potentially blinding inflammatory eye disease, is the most common ocular complication, occurring in approximately 13-34% of EVD survivors in West Africa. We have described vision loss due to ocular complications in retrospective cohorts in both Sierra Leone and Liberia. Specifically, within Liberian EVD survivors with uveitis developed vision impairment was noted in 60% and blindness (vision worse than 20/400) in approximately 40% of EVD survivors. Currently, we have insufficient knowledge about the disease course of EVD-associated uveitis, long-term visual acuity outcomes, and appropriate treatment for this sight-threatening disease. Besides our recent studies related to clinical uveitis in EVD survivors, our recent investigation of EBOV persistence raises questions about the potential for the eye to serve as a novel tissue site for infectious disease surveillance, particularly in a viral hemorrhagic fever zone endemic for other emerging pathogens of public health significance. The objectives of this study are to 1. Determine the prevalence of uveitis, incident vision loss over time, and risk factors for uveitis development in EVD survivors 2. Explore ophthalmic manifestation in Lassa fever virus survivors 3. Validate ocular fluid sampling as method for detection for surveillance of infectious diseases in collaboration with the Child Health and Mortality Prevention Surveillance study. The career development aims for this K-23 proposal are to 1. Obtain methodological skills in disease surveillance systems 2. Gain competency in molecular diagnostics of ocular fluid in the diagnosis of infectious pathogens 3. Continue to develop skills in clinical research in international settings 4. Further my training in statistical and epidemiology methods necessary for success in clinical studies. To accomplish these goals, I have designed a training plan that includes coursework, mentorship with international leaders, attendance and presentation at local and national research meetings/conferences, and directed, hands-on training. This K23 mentored career development award will be the foundation for the skills necessary to become a successful independent clinician scientist.

项目总结