Low Cost Monitoring Strategy to Optimize Tuberculosis Treatment in Children

优化儿童结核病治疗的低成本监测策略

基本信息

项目摘要

DESCRIPTION (provided by applicant): Despite the fact that effective tuberculosis (TB) treatments have been available for over 60 years, TB remains a leading cause of death worldwide. Aggressive public health efforts designed to improve medication adherence do improve patient outcomes but do not guarantee a cure. This is because improving adherence does not address other critical factors that reduce circulating drug concentrations and impede drug efficacy such as: substandard generic/counterfeit drugs, concurrent infections, co-morbid diseases, normal growth and development, genetic variations, and extemporaneous drug compounding. Despite the best intentions of the health care providers that treat patients with TB, there simply is no way to ensure that adequate drug levels are achieved and sustained without a means to measure drug concentrations. However, traditional sample collection (phlebotomist performed venipuncture with temperature controlled sample processing, storage and transport) is not practical in remote, resource-constrained communities serving individuals who, by the very nature of their circumstances, are at the greatest risk of therapeutic failure. This investigation is driven by the general hypothesis that dried blood spot (DBS) technology can be used to facilitate pharmacokinetic analyses in children with tuberculosis and provide information on dose-exposure relationships necessary to guide dosing in various pediatric subpopulations. The activities of this investigation will 1) develop and validate methods for quantitative DBS analysis of first and second line antitubercular drugs, 2) examine the association between antitubercular drug concentrations derived from concurrent specimens collected by traditional venipuncture vs. DBS, and 3) evaluate the performance of nucleic acid isolated from DBS in genetic analyses for mutations that influence antitubercular exposure/response. As a therapeutic tool, DBS sampling offers a safe, effective and inexpensive way to dynamically monitor and individualize treatment for children living in remote, undeveloped communities. As a research tool, DBS technology will allow investigators to validate dose-exposure relationships in populations that would otherwise never be represented in pharmacokinetic studies. PUBLIC HEALTH RELEVANCE: The most appropriate doses of tuberculosis medicines for children in remote, resource-constrained communities remain unclear because these children are never represented in pediatric pharmacokinetic studies that are designed to characterize the dose-exposure relationship. A major contributing factor is the inability to obtain and process traditional blood samples (phlebotomist performed venipuncture with temperature controlled sample processing, storage and transport) in these remote regions. This investigation will develop tools, based on dried blood spot technology, that will overcome the limitations of traditional drug sampling and enable large-scale surveillance (for research and clinical purposes) in rural communities.
描述(由申请人提供):尽管有效的结核病 (TB) 治疗方法已存在 60 多年,但结核病仍然是全世界死亡的主要原因。旨在提高药物依从性的积极公共卫生努力确实可以改善患者的治疗结果,但不能保证治愈。这是因为提高依从性并不能解决降低循环药物浓度和阻碍药物疗效的其他关键因素,例如:不合格的仿制药/假药、并发感染、共病疾病、正常生长和发育、遗传变异和临时药物配制。尽管治疗结核病患者的医疗保健提供者的初衷是最好的,但如果没有测量药物浓度的方法,根本无法确保达到并维持足够的药物水平。然而,传统的样本采集(采血师通过温度控制的样本处理、储存和运输进行静脉穿刺)在偏远、资源有限的社区中并不实用,这些社区为那些因其环境的本质而面临治疗失败风险最大的个人提供服务。这项研究是基于这样一个普遍假设:干血斑 (DBS) 技术可用于促进结核病儿童的药代动力学分析,并提供指导各种儿科亚群给药所需的剂量-暴露关系信息。这项研究的活动将 1) 开发和验证一线和二线抗结核药物的定量 DBS 分析方法,2) 检查传统静脉穿刺与 DBS 收集的同时标本中获得的抗结核药物浓度之间的关联,以及 3) 评估从 DBS 分离的核酸在影响抗结核暴露/反应的突变的遗传分析中的性能。作为一种治疗工具,DBS 采样提供了一种安全、有效且廉价的方法,可以动态监测生活在偏远、不发达社区的儿童并对其进行个性化治疗。作为一种研究工具,DBS 技术将允许研究人员验证人群中的剂量暴露关系,否则这些人群将永远不会在药代动力学研究中得到体现。 公共卫生相关性:对于偏远、资源有限社区的儿童来说,结核病药物的最合适剂量仍不清楚,因为这些儿童从未参加过旨在描述剂量-暴露关系的儿科药代动力学研究。一个主要因素是无法在这些偏远地区获取和处理传统的血液样本(抽血师通过温控样本处理、储存和运输进行静脉穿刺)。这项调查将开发基于干血斑技术的工具,该工具将克服传统药物采样的局限性,并能够在农村社区进行大规模监测(用于研究和临床目的)。

项目成果

期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)

数据更新时间:{{ journalArticles.updateTime }}

{{ item.title }}
{{ item.translation_title }}
  • DOI:
    {{ item.doi }}
  • 发表时间:
    {{ item.publish_year }}
  • 期刊:
  • 影响因子:
    {{ item.factor }}
  • 作者:
    {{ item.authors }}
  • 通讯作者:
    {{ item.author }}

数据更新时间:{{ journalArticles.updateTime }}

{{ item.title }}
  • 作者:
    {{ item.author }}

数据更新时间:{{ monograph.updateTime }}

{{ item.title }}
  • 作者:
    {{ item.author }}

数据更新时间:{{ sciAawards.updateTime }}

{{ item.title }}
  • 作者:
    {{ item.author }}

数据更新时间:{{ conferencePapers.updateTime }}

{{ item.title }}
  • 作者:
    {{ item.author }}

数据更新时间:{{ patent.updateTime }}

SUSAN M ABDEL-RAHMAN其他文献

SUSAN M ABDEL-RAHMAN的其他文献

{{ item.title }}
{{ item.translation_title }}
  • DOI:
    {{ item.doi }}
  • 发表时间:
    {{ item.publish_year }}
  • 期刊:
  • 影响因子:
    {{ item.factor }}
  • 作者:
    {{ item.authors }}
  • 通讯作者:
    {{ item.author }}

{{ truncateString('SUSAN M ABDEL-RAHMAN', 18)}}的其他基金

Children's Mercy Hospital Collaborative Fellowship Program in Pediatric Pharmacology
儿童慈善医院儿科药理学合作奖学金计划
  • 批准号:
    9270585
  • 财政年份:
    2011
  • 资助金额:
    $ 16.75万
  • 项目类别:
Ensuring Medication Safety in Pediatric Emergencies
确保儿科紧急情况下的用药安全
  • 批准号:
    8300431
  • 财政年份:
    2011
  • 资助金额:
    $ 16.75万
  • 项目类别:
Low Cost Monitoring Strategy to Optimize Tuberculosis Treatment in Children
优化儿童结核病治疗的低成本监测策略
  • 批准号:
    8293006
  • 财政年份:
    2011
  • 资助金额:
    $ 16.75万
  • 项目类别:
Children's Mercy Hospital Collaborative Fellowship Program in Pediatric Pharmacology
儿童慈善医院儿科药理学合作奖学金计划
  • 批准号:
    9114327
  • 财政年份:
    2011
  • 资助金额:
    $ 16.75万
  • 项目类别:
Childrens Mercy Hospital Fellowship Program in Pediatric Pharmacology
儿童慈善医院儿科药理学奖学金计划
  • 批准号:
    8852151
  • 财政年份:
    2011
  • 资助金额:
    $ 16.75万
  • 项目类别:
Evaluating Trichophyton tonsurans Carriage and Infection
评估断发毛癣菌的携带和感染
  • 批准号:
    7140196
  • 财政年份:
    2005
  • 资助金额:
    $ 16.75万
  • 项目类别:
Evaluating Trichophyton tonsurans Carriage and Infection
评估断发毛癣菌的携带和感染
  • 批准号:
    6955511
  • 财政年份:
    2005
  • 资助金额:
    $ 16.75万
  • 项目类别:
FUNGAL PROTEIN/GLYCOPROTEIN EXPRESSION IN TINEA CAPITIS
头癣中真菌蛋白/糖蛋白的表达
  • 批准号:
    6512243
  • 财政年份:
    2001
  • 资助金额:
    $ 16.75万
  • 项目类别:
FUNGAL PROTEIN/GLYCOPROTEIN EXPRESSION IN TINEA CAPITIS
头癣中真菌蛋白/糖蛋白的表达
  • 批准号:
    6259345
  • 财政年份:
    2001
  • 资助金额:
    $ 16.75万
  • 项目类别:
FUNGAL PROTEIN/GLYCOPROTEIN EXPRESSION IN TINEA CAPITIS
头癣中真菌蛋白/糖蛋白的表达
  • 批准号:
    6632804
  • 财政年份:
    2001
  • 资助金额:
    $ 16.75万
  • 项目类别:

相似海外基金

I-Corps: Medication Adherence System
I-Corps:药物依从性系统
  • 批准号:
    2325465
  • 财政年份:
    2023
  • 资助金额:
    $ 16.75万
  • 项目类别:
    Standard Grant
Improving Repositioning Adherence in Home Care: Supporting Pressure Injury Care and Prevention
提高家庭护理中的重新定位依从性:支持压力损伤护理和预防
  • 批准号:
    490105
  • 财政年份:
    2023
  • 资助金额:
    $ 16.75万
  • 项目类别:
    Operating Grants
An innovative, AI-driven prehabilitation platform that increases adherence, enhances post-treatment outcomes by at least 50%, and provides cost savings of 95%.
%20创新、%20AI驱动%20康复%20平台%20%20增加%20依从性、%20增强%20治疗后%20结果%20by%20at%20至少%2050%、%20和%20提供%20成本%20节省%20of%2095%
  • 批准号:
    10057526
  • 财政年份:
    2023
  • 资助金额:
    $ 16.75万
  • 项目类别:
    Grant for R&D
CO-LEADER: Intervention to Improve Patient-Provider Communication and Medication Adherence among Patients with Systemic Lupus Erythematosus
共同领导者:改善系统性红斑狼疮患者的医患沟通和药物依从性的干预措施
  • 批准号:
    10772887
  • 财政年份:
    2023
  • 资助金额:
    $ 16.75万
  • 项目类别:
Nuestro Sueno: Cultural Adaptation of a Couples Intervention to Improve PAP Adherence and Sleep Health Among Latino Couples with Implications for Alzheimer’s Disease Risk
Nuestro Sueno:夫妻干预措施的文化适应,以改善拉丁裔夫妇的 PAP 依从性和睡眠健康,对阿尔茨海默病风险产生影响
  • 批准号:
    10766947
  • 财政年份:
    2023
  • 资助金额:
    $ 16.75万
  • 项目类别:
Pharmacy-led Transitions of Care Intervention to Address System-Level Barriers and Improve Medication Adherence in Socioeconomically Disadvantaged Populations
药房主导的护理干预转型,以解决系统层面的障碍并提高社会经济弱势群体的药物依从性
  • 批准号:
    10594350
  • 财政年份:
    2023
  • 资助金额:
    $ 16.75万
  • 项目类别:
Unintrusive Pediatric Logging Orthotic Adherence Device: UPLOAD
非侵入式儿科记录矫形器粘附装置:上传
  • 批准号:
    10821172
  • 财政年份:
    2023
  • 资助金额:
    $ 16.75万
  • 项目类别:
Antiretroviral therapy adherence and exploratory proteomics in virally suppressed people with HIV and stroke
病毒抑制的艾滋病毒和中风患者的抗逆转录病毒治疗依从性和探索性蛋白质组学
  • 批准号:
    10748465
  • 财政年份:
    2023
  • 资助金额:
    $ 16.75万
  • 项目类别:
Improving medication adherence and disease control for patients with multimorbidity: the role of price transparency tools
提高多病患者的药物依从性和疾病控制:价格透明度工具的作用
  • 批准号:
    10591441
  • 财政年份:
    2023
  • 资助金额:
    $ 16.75万
  • 项目类别:
Development and implementation of peer-facilitated decision-making and referral support to increase uptake and adherence to HIV pre-exposure prophylaxis in African Caribbean and Black communities in Ontario
制定和实施同行协助决策和转介支持,以提高非洲加勒比地区和安大略省黑人社区对艾滋病毒暴露前预防的接受和依从性
  • 批准号:
    491109
  • 财政年份:
    2023
  • 资助金额:
    $ 16.75万
  • 项目类别:
    Fellowship Programs
{{ showInfoDetail.title }}

作者:{{ showInfoDetail.author }}

知道了