co-Trimoxazole in Zambian Infants (TZI)

赞比亚婴儿中的复方新诺明 (TZI)

• 批准号: 6944065
• 负责人: Christopher J GILL
• 金额: $ 12.74万
• 依托单位: BOSTON UNIVERSITY MEDICAL CAMPUS
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-09-01 至 2009-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6944065
• 关键词: African; Plasmodium falciparum; Pneumocystis pneumonia; clinical research; communicable disease control; communicable disease transmission; comorbidity; drug adverse effect; health care policy; health care service evaluation; health services research tag; human immunodeficiency virus; human subject; human therapy evaluation; infant human (0-1 year); longitudinal human study; malaria; multidrug resistance; outcomes research; patient oriented research; pediatrics; protozoal infection; pyrimethamine; sulfamethoxazole; trimethoprim

DESCRIPTION (provided by applicant): Current World Health Organization guidelines recommend that infants exposed to HIV at birth should receive cotrimoxazole (TMZ-SMZ) as empiric prophylaxis against Pneumocystis pneumonia for one year without confirmation of H1V infection. However, 70-90% of exposed infants will not become HIV positive but would still take prophylaxis presumptively for one year. CoTrimoxazole in Zambian Infants (TZI) is a three year prospective study measuring population level effects of the WHO's proposal on common pediatric infectious diseases. TZI is funded by USAID and has been actively recruiting patients since July 1, 2003. TZI-MALARIA is a nested case control study within TZI focusing on TMP-SMZ's impact on infant malaria rates, drug resistance, and its effect on the acquistion of malaria immunity during infancy. TZI-MALARIA asks three questions: 1) Will TMP-SMZ exposure reduce rates of asymptomatic parasitemia and clinical malaria during the period of prophylaxis? 2) Will former recipients ofprophylaxis experience higher than expected rates of asymptomatic parasitemia and clinical malaria in the monthsfollowing the cessation of TMP-SMZ prophylaxis? 3) Will TMP-SMZ exposure increase rates of resistance to sulfadoxine-pyrimethamine, a leading antimalarial that is cross-tolerant with TMP-SMZ? These questions will be answered by comparing cumulative rates of malaria during and after the period of prophyalxis, and conducting genetic analsis for SP-resistance markers as a comparison between two groups of infants: Cases - infants exposed to HIV at birth and receiving prophylaxis (but later proven HIV negative at 12 months); and Controls - temporally and geographically matched HIV-unexposed, HIV negative infants, not receiving TMP-SMZ prophylaxis. TZI-MALARIA constitutes the core activity of a five year K23 career development plan. This program integrates class work, mentored research, practical field experience, additional project development, teaching, and other activities derived from the academic environment of Boston University's School of Public Health and my parent organization, the Center for International Health and Development.

描述（由申请人提供）：当前的世界卫生组织指南建议，出生时暴露于艾滋病毒的婴儿应接受共瑞唑唑（TMZ-SMZ）作为针对肺炎肺炎肺炎的经验预防，而不必确认H1V感染。但是，有70％至90％的裸露婴儿不会成为艾滋病毒阳性，但仍会推定预防一年。赞比亚婴儿（TZI）中的共瑞唑唑是一项为期三年的前瞻性研究，衡量了世卫组织提案对普通小儿传染病的人口水平的影响。 TZI由USAID资助，自2003年7月1日以来一直积极招募患者。TZI-Malaria是一项嵌套的病例对照研究，侧重于TMP-SMZ对婴儿疟疾耐药性，耐药性及其对婴儿疟疾免疫的影响。 Tzi-Malaria提出三个问题：1）TMP-SMZ暴露会在预防时期降低无症状寄生虫血症和临床疟疾的发生率吗？ 2）在遵循TMP-SMZ预防的几个月中，前prophy骨的接受者会经历高于预期的无症状寄生虫血症和临床疟疾的预期率吗？ 3）TMP-SMZ暴露会增加对磺胺毒素 - 乙胺胺的抗性，这是一种与TMP-SMZ交叉耐耐药的主要抗疟药？这些问题将通过比较先知期间和之后的疟疾累积发生率，以及对SP抗性标记的遗传性厌食症作为两组婴儿之间的比较：病例 - 病例 - 婴儿在出生时暴露于HIV并接受预防的婴儿（但后来证明了12个月的HIV阴性艾滋病毒）；和对照 - 时间和地理上匹配的HIV无暴露的HIV阴性婴儿，未接受TMP-SMZ预防。 Tzi-Malaria构成了五年K23职业发展计划的核心活动。该计划将班级工作，指导研究，实践经验，额外的项目发展，教学以及来自波士顿大学公共卫生学院和我的母公司国际健康与发展中心的学术环境而产生的其他活动。