Epidemiology of Hep E Virus Infections in Bangladesh

孟加拉国戊型肝炎病毒感染的流行病学

• 批准号: 6460356
• 负责人: Kenrad E Nelson
• 金额: $ 21万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-09-01 至 2004-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6460356
• 关键词: Bangladesh; clinical research; disease /disorder proneness /risk; environmental contamination; epidemiology; human data; human morbidity; human mortality; human population study; human subject; immunoglobulin G; immunoglobulin M; infant mortality; infectious hepatitis; longitudinal human study; pregnancy infection; questionnaires; statistics /biometry; water supply

DESCRIPTION (provided by applicant): Hepatitis E virus (HEV) infections cause serious morbidity and mortality, especially in pregnant women. Few population-based studies have characterized HEV epidemiology. Proposed is a two-year, multi-component, population-based study to describe the epidemiology and quantify the burden of HEV infections and disease in rural Bangladesh (Matlab District). These studies will be nested within a population of 105,000 under intensive longitudinal health surveillance since 1966. This unique research setting, maintained by the International Center for Diarrheal Disease Research, represents the most accurate and oldest population health surveillance in the developing world. Evidence suggests Bangladesh is HEV endemic, yet no known studies have examined HEV there. The age-specific population prevalence of 1gM and lgG antibodies to HEV will be determined using a random sample of 1030 individuals from the Matlab cohort. A large proportion of the population is under age 15, allowing a description of HEV antibody prevalence among children using improved, reliable assays. Data will be collected at baseline, 12, and 18 months. Incidence of HEV infection and disease will be calculated from HEV seroconversion rates and by extracting reports of hepatitis disease from surveillance system records. A ratio of asymptomatic HEV infections to clinical HEV will be estimated. A nested case-control study is also proposed during the 18-month period to identify potential risk factors associated with sporadic HEV disease. Contaminated water is known to precipitate HEV outbreaks, but risk factors for sporadic HEV are unknown. A visual algorithm will identify potential HEV cases near the time of infection. Only anti-HEV 1gM positive cases will be enrolled. Two HEV-naive controls will be age-matched to a case. A questionnaire will assess potential behavioral, animal and environmental risk factors associated with incident HEy. Multiple logistic regression will be used to model risk factors. Using GIS, cases will be analyzed for spatial or temporal clustering. Virus isolates from acute cases will be sequenced for a phylogenetic analysis of Bangladesh HEy. These studies in a well-defined South-East Asian population will provide a comprehensive epidemiologic profile of endemic and epidemic HEV in a high risk population, and could form the basis for future preventive interventions, such as vaccine trials.

描述(申请人提供)：戊型肝炎病毒(HEV)感染原因 严重的发病率和死亡率，特别是孕妇。一些 以人群为基础的研究具有HEV流行病学的特点。建议的是一个 描述流行病学的两年、多组分、基于人群的研究 并量化孟加拉国农村地区HEV感染和疾病的负担 (MatLab区)。这些研究将嵌套在10.5万人口中 自1966年以来一直处于密集的纵向健康监测之下。这个独一无二的 研究环境，由国际腹泻病中心维护 研究，代表了最准确和最古老的人口健康 发展中世界的监视。有证据表明孟加拉国是HEV 地方性的，但没有已知的研究检查那里的HEV。特定于年龄的 戊型肝炎病毒1gm和lgg抗体的人群流行率将通过以下方法确定 随机抽取了1030名受试者作为样本，这些样本来自MatLab队列。很大的比例 的人口年龄在15岁以下，允许描述HEV抗体 使用改进的、可靠的分析方法在儿童中的流行率。数据将是 分别在基线、12个月和18个月时收集。戊型肝炎病毒感染的发病率和 疾病将根据HEV血清转换率和通过提取 监测系统记录中的肝炎报告。A比率： 将对临床HEV的无症状HEV感染进行估计。嵌套的 还建议在18个月期间进行病例对照研究，以确定 与散发性HEV疾病相关的潜在危险因素。受污染的水 已知会导致HEV爆发，但零星HEV的风险因素是 未知。一个视觉算法将识别潜在的HEV病例 感染。只有抗-HEV-1gm阳性的病例才会被录取。两个HEV-幼稚 控制将与案例的年龄相匹配。一份调查问卷将评估潜力 与事件有关的行为、动物和环境风险因素。 将使用多元Logistic回归对风险因素进行建模。利用地理信息系统， 将对病例进行空间或时间聚集性分析。从中国分离出的病毒 将对急性病例进行测序，以进行孟加拉国的系统发育分析。 这些在定义明确的东南亚人口中的研究将提供一个 地方性和流行性戊型肝炎高危人群的综合流行病学特征 人口，并可能成为未来预防性干预的基础，如 作为疫苗试验。