Epidemiological and statistical research on health problems of low and middle-income countries: MRC Tropical Epidemiology Group (TEG)

低收入和中等收入国家健康问题的流行病学和统计研究：MRC热带流行病学组（TEG）

• 批准号: MR/R010161/1
• 负责人: Helen Weiss
• 金额: $ 526万
• 依托单位: London School of Hygiene & Tropical Medicine
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2018
• 资助国家: 英国
• 起止时间: 2018 至 无数据
• 项目状态: 未结题
• 来源: https://gtr.ukri.org/projects?ref=MR%2FR010161%2F1
• 关键词: Epidemiological; statistical; research; health; problems

The mission of the MRC Tropical Epidemiology Group (TEG) is to help improve health in low- and middle-income countries (LMICs), by conducting research that identifies and evaluates effective interventions. Infectious diseases, including malaria, HIV, tuberculosis (TB) and neglected tropical diseases (NTDs), remain a main focus of our research, as they are the leading causes of ill-health in Africa. In the next grant period, we will expand our research on emerging diseases, adolescent health and non-communicable diseases - particularly hypertension, diabetes and chronic obstructive pulmonary disease, which are major disease problems in LMICs. Our research focuses on conditions that are major causes of ill-health, and for which improved prevention or treatment leads directly to improved economic and social outcomes. The importance of these issues to the UK is highlighted in the 2015 Government strategy for overseas aid, on tackling global challenges in the national interest.The scale-up of malaria control tools, primarily long-lasting insecticidal nets, and effective combination therapies, has prevented an estimated 663 million clinical malaria cases in sub-Saharan Africa since 2000, and has made malaria elimination an achievable goal in some countries. However, these gains may be threatened by insecticide resistance, drug-resistance, and resource-constraints. Within the next grant period, our focus will be on evaluating new tools, combining new and existing control strategies, and investigating sustainable and more effective deployment of these strategies. For HIV, we focus on the goal that 90% of those living with HIV know their status, 90% of known HIV-positive individuals receive sustained ART, and 90% of individuals on ART have durable viral suppression. For example, we are leading a major trial in South Africa and Zambia to evaluate the impact of a combination prevention intervention on new cases of HIV in the community. The intervention includes household-based HIV testing and linkage-to-health services by community care providers, and immediate initiation of treatment delivered through routine healthcare services.TEG research on TB includes studies to evaluate improved TB treatment strategies, improved diagnosis, prevention and control of drug-resistant TB, improved TB case finding and prevention, and evaluation of structural interventions (social support and monetary incentives) to control TB. For example, we are working on a trial to evaluate an improved electronic medication device for TB patients to reduce treatment failure and subsequent recurrence/retreatment in the absence of directly observed treatment.We will continue our long-standing work on intervention strategies for the control and elimination of NTDs, and our more recent involvement in the control of outbreaks such as the Ebola and Zika virus outbreaks. We will also continue our work on the effectiveness of lay-health worker interventions to treat common mental disorders (depression and anxiety), focusing particularly on treatment of these conditions among adolescents, in whom over half of mental health disorders start. Through the MRC Programme Grant, we leverage additional funding for research projects and support salaries for around 30 statisticians and epidemiologists, based at LSHTM. The grant is critical to enable us to recruit and retain these scientists, who have disease and methodological expertise in the design and analysis of epidemiological studies in LMICs. We collaborate with the MRC Units in The Gambia and Uganda, and over 50 other research institutes in LMICs. We will continue our initiatives to increase capacity in medical statistics in sub-Saharan Africa, for example by expanding the MRC TEG Fellowship scheme, which to date has trained 17 medical statisticians through a Masters in Medical Statistics at LSHTM, followed by a placement year. All are now working as medical statisticians in Africa.

MRC热带流行病学小组（TEG）的使命是通过开展研究，确定和评估有效的干预措施，帮助改善低收入和中等收入国家（LMIC）的健康状况。传染病，包括疟疾，艾滋病毒，结核病（TB）和被忽视的热带病（NTD），仍然是我们研究的主要重点，因为它们是非洲健康不良的主要原因。在下一个赠款期，我们将扩大对新兴疾病、青少年健康和非传染性疾病的研究，特别是高血压、糖尿病和慢性阻塞性肺病，这些是中低收入国家的主要疾病问题。我们的研究重点是健康状况不佳的主要原因，以及改善预防或治疗直接导致改善经济和社会成果的条件。这些问题对英国的重要性在2015年政府海外援助战略中得到了强调，该战略旨在从国家利益出发应对全球挑战。自2000年以来，疟疾控制工具（主要是长效驱虫蚊帐）和有效的联合疗法的推广，在撒哈拉以南非洲预防了约6.63亿例临床疟疾病例，并使消除疟疾成为一些国家可实现的目标。然而，这些成果可能受到杀虫剂耐药性、耐药性和资源限制的威胁。在下一个资助期内，我们的重点将是评估新的工具，结合新的和现有的控制策略，并调查这些策略的可持续和更有效的部署。对于艾滋病毒，我们的目标是90%的艾滋病毒感染者知道自己的状况，90%的已知艾滋病毒阳性个体接受持续的抗逆转录病毒治疗，90%的抗逆转录病毒治疗个体具有持久的病毒抑制。例如，我们正在南非和赞比亚领导一项重大试验，以评估综合预防干预措施对社区艾滋病毒新病例的影响。干预措施包括以家庭为基础的艾滋病毒检测和社区保健提供者提供的与健康有关的服务，以及通过常规保健服务立即开始治疗。TEG对结核病的研究包括评估改进的结核病治疗策略，改进的诊断，预防和控制耐药结核病，改进结核病病例发现和预防，和评估控制结核病的结构性干预措施（社会支持和货币奖励）。例如，我们正在进行一项试验，评估一种改进的结核病电子药物设备，以减少在没有直接观察治疗的情况下治疗失败和随后复发/再治疗的情况。我们将继续长期致力于控制和消除NTD的干预策略，以及我们最近参与控制埃博拉和寨卡病毒爆发等疫情的工作。我们还将继续努力提高非专业卫生工作者干预措施在治疗常见精神疾病（抑郁和焦虑）方面的效力，特别侧重于治疗青少年中的这些疾病，因为超过一半的精神健康疾病是从青少年开始的。通过MRC计划赠款，我们为研究项目提供额外资金，并为LSHTM的约30名统计学家和流行病学家提供工资支持。这笔赠款对于我们招募和留住这些科学家至关重要，他们在设计和分析中低收入国家的流行病学研究方面具有疾病和方法学方面的专业知识。我们与冈比亚和乌干达的MRC单位以及LMIC的50多个其他研究机构合作。我们将继续采取举措，提高撒哈拉以南非洲的医疗统计能力，例如，扩大医学研究中心技术专家小组研究金计划，该计划迄今已通过LSHTM的医疗统计硕士课程培训了17名医疗统计人员，随后进行了一年的实习。他们现在都在非洲担任医疗统计学家。

项目成果

Prevalence and antimicrobial resistance profiles of respiratory microbial flora in African children with HIV-associated chronic lung disease.

• DOI: 10.1186/s12879-021-05904-3
• 发表时间: 2021-02-25
• 期刊: BMC infectious diseases
• 影响因子: 3.7
• 作者: Abotsi RE;Nicol MP;McHugh G;Simms V;Rehman AM;Barthus C;Mbhele S;Moyo BW;Ngwira LG;Mujuru H;Makamure B;Mayini J;Odland JØ;Ferrand RA;Dube FS
• 通讯作者: Dube FS

Additional file 1 of Prevalence and antimicrobial resistance profiles of respiratory microbial flora in African children with HIV-associated chronic lung disease

附加文件 1：患有艾滋病毒相关慢性肺病的非洲儿童呼吸道微生物菌群的患病率和抗菌药物耐药性概况

• DOI: 10.6084/m9.figshare.14121587
• 发表时间: 2021
• 作者: Abotsi R

Sputum bacterial load and bacterial composition correlate with lung function and are altered by long-term azithromycin treatment in children with HIV-associated chronic lung disease.

• DOI: 10.1186/s40168-023-01460-x
• 发表时间: 2023-02-20
• 期刊: Microbiome
• 影响因子: 15.5

Intense and Mild First Epidemic Wave of Coronavirus Disease, The Gambia.

• DOI: 10.3201/eid2708.204954
• 发表时间: 2021-08
• 期刊: Emerging infectious diseases
• 影响因子: 11.8
• 作者: Abatan B;Agboghoroma O;Akemoke F;Antonio M;Awokola B;Bittaye M;Bojang A;Bojang K;Brotherton H;Cerami C;Clarke E;D'Alessandro U;de Silva T;Drammeh M;Forrest K;Hofmann N;Jagne S;Jah H;Jarju S;Jaye A;Jobe M;Kampmann B;Manjang B;Martinez-Alvarez M;Mohammed N;Nadjm B;Ndiath MO;Nkereuwem E;Nwakanma D;Oko F;Okoh E;Okomo U;Olatunji Y;Oriero E;Prentice AM;Roberts C;Roca A;Sabally B;Sambou S;Samateh A;Secka O;Sesay AK;Singhateh Y;Susso B;Usuf E;Vilane A;Wariri O
• 通讯作者: Wariri O

Additional file 3 of Prevalence and antimicrobial resistance profiles of respiratory microbial flora in African children with HIV-associated chronic lung disease

附加文件 3：患有艾滋病毒相关慢性肺病的非洲儿童呼吸道微生物菌群的患病率和抗菌药物耐药性概况

• DOI: 10.6084/m9.figshare.14121593
• 发表时间: 2021
• 作者: Abotsi R