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（由申请人提供）：乙型肝病毒（HEV）感染引起 严重的发病率和死亡率，尤其是在孕妇中。很少 基于人群的研究表征了HEV流行病学。提议的是 两年的多组分，基于人群的研究，以描述流行病学 并量化孟加拉国农村HEV感染和疾病的负担 （MATLAB区）。这些研究将嵌套在105,000的人群中 自1966年以来，在密集的纵向健康监视下。 由国际腹泻疾病中心维持的研究环境 研究是最准确，最古老的人口健康 发展中国家的监视。有证据表明孟加拉国是HEV 地方病，但尚无已知研究检查那里的HEV。特定年龄的 将使用1GM和HEV抗体的人口患病率确定 来自MATLAB队列的1030个个体的随机样本。很大一部分 人口的15岁以下，允许对HEV抗体的描述 使用改进，可靠的测定法的儿童患病率。数据将是 在基线，12个月和18个月时收集。 HEV感染的发生率和 疾病将根据HEV血清转化率计算，并提取 监视系统记录中肝炎疾病的报告。一个比率 将估计对临床HEV的无症状HEV感染。一个嵌套 还提出了在18个月的时间内进行病例对照研究 与零星静脉疾病有关的潜在危险因素。被污染的水 众所周知会导致HEV爆发，但是零星HEV的危险因素是 未知。视觉算法将在附近确定潜在的HEV病例 感染。只有抗H-HEV 1GM阳性病例将被招募。两个Hev-Neive 控件将与案例相匹配。问卷将评估潜力 与事件有关的行为，动物和环境风险因素嘿。 多个逻辑回归将用于建模风险因素。使用GIS， 将对空间或时间聚类进行分析。病毒分离出来 急性病例将进行孟加拉国的系统发育分析。 这些在明确明确的东南亚人口中的研究将提供 高风险的流行和流行性HEV的全面流行病学特征 人口，并可能成为未来预防干预措施的基础， 作为疫苗试验。