Optimal control strategies for rodent-borne zoonoses in Brazilian slum settlements

巴西贫民窟居住区啮齿动物传播的人畜共患病的最佳控制策略

• 批准号: MR/P024084/1
• 负责人: Michael Begon
• 金额: $ 75.57万
• 依托单位: University of Liverpool
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2017
• 资助国家: 英国
• 起止时间: 2017 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=MR%2FP024084%2F1
• 关键词: Optimal; control; strategies; rodent; borne

One billion of the world's population lives in slum settlements, comprising 78% of the urban populations from the world's poorest countries. Residents suffer an increased burden of a wide range of diseases. Many of these health problems involve zoonotic disease - infections circulating in wildlife or domesticated 'reservoir' hosts that can be transmitted to humans, where they can cause serious illness or mortality. Most of the infectious diseases that have emerged in humans recently are zoonotic (e.g. HIV-AIDS, Ebola). Most circulate naturally in wildlife, often rodent reservoirs. Hence, learning to control the spread of infection from rodent reservoirs to humans in urban slums, particularly in poor countries, is a challenge that must be addressed. Leptospirosis is perhaps the most widespread zoonotic disease. Hosts are infected with bacteria, leptospires, which infect the kidneys of reservoir hosts and are shed with the urine. This is the ultimate source of infection for humans, though the main mode of transmission is contact with contaminated water or soil. Leptospirosis is a systemic disease in humans. Manifestations range from relatively mild to severe life-threatening forms for which case fatality may be >50%. Its burden falls mainly on the world's poorest people, traditionally rural-based subsistence farmers, but recently shifting from a rural to an urban setting. Our study will focus on leptospirosis, which is important in its own right, but the project is directly relevant to other zoonoses in slum settings, and to the health of these communities more generally. The work will be carried out in the urban slums (favelas) of the city of Salvador, Brazil. More than 12,000 cases of leptospirosis are reported in Brazil during urban epidemics each year of which around 12% are fatal. Realistically, the threat from leptospirosis and similar diseases in impoverished urban slums will not be countered by technological or sophisticated measures. Rather, a global health priority, and an overarching aim of our program, is to develop the means of enabling agencies working locally to minimise the threat that these reservoirs of infection pose, using methodologies that can be applied effectively, cheaply, and without the need for a sophisticated infrastructure. To this end, we will determine the consequences of various management practices (controlling either rats or the environment) so that optimal interventions can be identified that reduce total rat population size, and hence the quantity of shed leptospires and the risk to humans, in the most cost-effective way. We are in an arguably unique position to do this. We have a very broad multi-disciplinary team from medics to social scientists, combining expertise from the UK, Brazil and the USA, and we have strong links to local public health agencies. Hence, through our project, we will determine the efficacy (evidenced by a range of metrics) of a range of control strategies, guided by, and in collaboration with, local agencies. The overall structure of our study will be a comparison of the range of sanitation-control measures currently being employed in different favelas across the municipality of Salvador. Following consultations locally, we have identified three categories that have been operational for at least the last twelve months, and that provide us with sufficient sites to support statistically valid comparisons. At each site, the following data will be collected: (i) rat abundance; (ii) the proportion of the rat populations carrying leptospires and other key pathogens (iii) concentrations of pathogenic leptospires in the environment; (iv) the proportion of the human population that have been infected with leptospires and these other key pathogens; (v) severe cases of leptospirosis reported in humans over the last 20 years; and (vi) attitudes of local residents to methods of sanitation control, especially in relation to effects on disease risk.

世界上有10亿人口生活在贫民窟，占世界上最贫穷国家城市人口的78%。居民遭受各种疾病的负担增加。这些健康问题中有许多涉及人畜共患疾病--在野生动物或驯养的“宿主”宿主中传播的感染，可以传播给人类，在那里它们可能导致严重的疾病或死亡。最近在人类中出现的大多数传染病都是人畜共患的（例如艾滋病毒/艾滋病、埃博拉病毒）。大多数在野生动物中自然循环，通常是啮齿动物水库。因此，学会控制感染从啮齿动物宿主传播到城市贫民窟中的人类，特别是在贫穷国家，是一个必须解决的挑战。 钩端螺旋体病可能是最广泛的人畜共患病。寄生虫感染细菌，钩端螺旋体，感染宿主的肾脏，并与尿液一起脱落。这是人类感染的最终来源，尽管主要的传播方式是接触受污染的水或土壤。钩端螺旋体病是一种全身性疾病。表现形式从相对轻微到严重的危及生命的形式不等，其病死率可能> 50%。它的负担主要福尔斯在世界上最贫穷的人身上，他们传统上是以农村为基地的自给农民，但最近从农村转移到城市。我们的研究将集中在钩端螺旋体病，这是重要的，在其本身的权利，但该项目是直接相关的其他人畜共患病在贫民窟设置，并对这些社区的健康更普遍。这项工作将在巴西萨尔瓦多市的城市贫民窟进行。在巴西，每年城市流行期间报告的钩端螺旋体病病例超过12，000例，其中约12%是致命的。实际上，在贫困的城市贫民窟中，钩端螺旋体病和类似疾病的威胁将无法通过技术或复杂的措施来应对。相反，全球卫生的优先事项，以及我们计划的首要目标，是开发使当地工作的机构能够最大限度地减少这些感染源构成的威胁的方法，使用可以有效应用的方法，成本低廉，并且不需要复杂的基础设施。为此，我们将确定各种管理措施（控制老鼠或环境）的后果，以便确定最佳干预措施，以最具成本效益的方式减少老鼠总数，从而减少钩端螺旋体的数量和对人类的风险。我们可以说处于一个独特的位置来做到这一点。我们有一个非常广泛的多学科团队，从医务人员到社会科学家，结合了英国，巴西和美国的专业知识，我们与当地公共卫生机构有着密切的联系。因此，通过我们的项目，我们将确定一系列控制策略的有效性（通过一系列指标证明），由当地机构指导并与之合作。 我们的研究的总体结构将是一个范围内的卫生控制措施，目前正在使用的不同贫民窟在整个萨尔瓦多市的比较。在当地进行磋商后，我们确定了三个类别，这些类别至少在过去12个月内一直在运作，为我们提供了足够的地点来支持统计上有效的比较。在每个地点，将收集以下数据：㈠老鼠的数量; ㈡携带钩端螺旋体和其他关键病原体的老鼠种群的比例; ㈢环境中致病性钩端螺旋体的浓度; ㈣感染钩端螺旋体和其他关键病原体的人口比例; ㈤过去20年中报告的人类严重钩端螺旋体病病例;以及（vi）当地居民对卫生控制方法的态度，特别是对疾病风险的影响。

项目成果

Coinfection modifies carriage of enzootic and zoonotic parasites in Norway rats from an urban slum

• DOI: 10.1002/ecs2.2887
• 发表时间: 2019-10-01
• 期刊: ECOSPHERE
• 影响因子: 2.7
• 作者: Carvalho-Pereira, Ticiana S. A.;Souza, Fabio Neves;Begon, Mike
• 通讯作者: Begon, Mike

Using Rhodamine B to assess the movement of small mammals in an urban slum

• DOI: 10.1111/2041-210x.13693
• 发表时间: 2021-08-11
• 期刊: METHODS IN ECOLOGY AND EVOLUTION
• 影响因子: 6.6
• 作者: Awoniyi, Adedayo Michael;Souza, Fabio Neves;Khalil, Hussein
• 通讯作者: Khalil, Hussein

Structural factors associated with SARS-CoV-2 infection risk in an urban slum setting in Salvador, Brazil: A cross-sectional survey.

• DOI: 10.1371/journal.pmed.1004093
• 发表时间: 2022-09
• 期刊: PLoS medicine
• 影响因子: 15.8

Poverty, sanitation, and Leptospira transmission pathways in residents from four Brazilian slums.

• DOI: 10.1371/journal.pntd.0009256
• 发表时间: 2021-03
• 期刊: PLoS neglected tropical diseases
• 影响因子: 3.8
• 作者: Khalil H;Santana R;de Oliveira D;Palma F;Lustosa R;Eyre MT;Carvalho-Pereira T;Reis MG;Ko AI;Diggle PJ;Alzate Lopez Y;Begon M;Costa F
• 通讯作者: Costa F

Optimal Control of Rat-Borne Leptospirosis in an Urban Environment

• DOI: 10.3389/fevo.2019.00209
• 发表时间: 2019-06-19
• 期刊: FRONTIERS IN ECOLOGY AND EVOLUTION
• 影响因子: 3
• 作者: Minter, Amanda;Costa, Federico;Begon, Mike
• 通讯作者: Begon, Mike