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Epidemiology of gut and liver multimorbidities in the context of chronic intestinal schistosomiasis

慢性肠血吸虫病背景下肠道和肝脏多种疾病的流行病学

基本信息

批准号：
EP/X021793/1
负责人：
Goylette Chami
金额：
$ 249.73万
依托单位：
University of Oxford
依托单位国家：
英国
项目类别：
Research Grant
财政年份：
2023
资助国家：
英国
起止时间：
2023 至无数据
项目状态：
未结题

来源：
https://gtr.ukri.org/projects?ref=EP%2FX021793%2F1
关键词：
Epidemiology gut liver multimorbidities context

项目摘要

Intestinal schistosomiasis is characterised by progressive injury to the gut and liver and caused by an infection of long duration with parasitic blood flukes (Schistosoma mansoni). Most infected individuals live in sub-Saharan Africa. Associated conditions include gut inflammation, hepatosplenomegaly, periportal fibrosis, portal hypertension, upper gastrointestinal bleeding, ascites, anaemia, and undernutrition. Mass drug administration (MDA) of praziquantel is used to treat the blood flukes instead of the conditions, relying on reaching individuals before morbidity develops.As a group of chronic conditions with complex aetiologies, we propose studying intestinal schistosomiasis as a set of multimorbidities as opposed to the conventional view as a single disease. Multimorbidity is the coexistence of 2+ chronic conditions within an individual irrespective of cause. It is rising worldwide and complicating diagnosis and case management. In Uganda, we recently discovered a high burden of gut and liver conditions despite repeated MDA. To establish the epidemiology of multimorbidities, we propose the following hypothesis. In the context of MDA, the accumulation and clustering of chronic S. mansoni-associated conditions within an individual, even in the short term (few years), is largely explained by interactions of those coexisting conditions and shared social-ecological risk factors between conditions within individuals. In Eastern and Western Uganda, we will establish a longitudinal, community-based cohort of 3,280 individuals for four years with six study periods. With major fieldwork, clinical and social epidemiology, and cutting-edge machine learning, our objectives are to 1) identify common clusters and interactions of gut and liver conditions; 2) develop computational tools to predict social-ecological patterning and condition trajectories; and 3) assess multimorbidities using patient-reported symptoms and priorities, and local health worker knowledge.

肠道血吸虫病的特征是肠道和肝脏的进行性损伤，由寄生血吸虫（血吸虫）长期感染引起。大多数感染者生活在撒哈拉以南非洲。相关疾病包括肠道炎症、肝脾肿大、门静脉周围纤维化、门静脉高压、上消化道出血、腹水、贫血和营养不良。吡喹酮的大规模药物管理（MDA）是用来治疗血吸虫，而不是条件，依靠达到个人发病率developed.As一组慢性条件与复杂的病因，我们建议研究肠道血吸虫病作为一组多发病，而不是传统的观点作为一种单一的疾病。多发病是指一个人同时存在2种以上慢性疾病，无论其原因如何。它在全球范围内不断上升，使诊断和病例管理变得复杂。在乌干达，我们最近发现，尽管MDA反复出现，但肠道和肝脏疾病的负担仍然很高。为了建立多病的流行病学，我们提出以下假设。在MDA的作用下，慢性S.即使在短期内（几年），个体内与曼氏症相关的疾病在很大程度上是由这些共存的疾病和个体内疾病之间共享的社会生态风险因素的相互作用来解释的。在乌干达东部和西部，我们将建立一个纵向的，以社区为基础的队列3，280人四年六个研究阶段。通过主要的实地调查，临床和社会流行病学以及尖端的机器学习，我们的目标是：1）确定肠道和肝脏疾病的常见集群和相互作用; 2）开发计算工具来预测社会生态模式和条件轨迹; 3）使用患者报告的症状和优先事项以及当地卫生工作者的知识来评估多病。