Changing the Landscape of Soil Transmitted Helminth Infections in India Using a One Health Approach

项目摘要 土壤传播蠕虫（STH）-钩虫（钩虫和美洲钩虫）， 蛔虫和鞭虫是最普遍的被忽视的热带疾病之一， (NTD)这一现象严重影响到全世界最贫穷和最脆弱的社区。在 农村，人口，密集的动物-人与牲畜和伴侣动物混合， 个人卫生和环境卫生可导致人畜共患病传染病传播，并产生人畜共患病的传染源 感染据估计，全球有30%的家庭拥有家畜， 东南亚和非洲所占比例最大。这些地区也有最高的负担， 在全球范围内。大多数流行病学调查和STH的数学模型都没有考虑或测量 从人畜共患病来源获得感染的风险，无论是通过直接接触动物或动物粪便， 间接来自环境。由于存在人畜共患病和 感染的环境储存库可能会延长大规模药物管理（MDA）活动， 出现驱虫药耐药性。 这个多学科协作应用程序的首要目标是使用一个健康 研究人、动物和动物之间相互关联的负担和传播模式的框架， 通过整合精心收集的流行病学，环境和 定性研究数据与最先进的分子技术，以更好地为监测和消除提供信息 地方性社区的战略。我们将利用一项正在进行的随机对照试验， 广泛的MDA和即将到来的一个健康项目，在两个生态流行病学和文化上不同的 印度地理区域（泰米尔纳德邦和梅加拉亚）：（1）全面调查 不同STH物种在个人、家庭和社区水平上的传播动态;（2）确定 社区范围内MDA对人畜共患STH传播的影响以及 苯并咪唑耐药性标记;以及（3）开发和验证可现场使用的便携式采集点 (POC)基于流行的人类和人畜共患物种的STH诊断。现场和实验室数据 将提供关键参数，以建立特定物种的STH传播模型，并探讨 人类、动物和环境宿主对性病控制措施的影响， 场景该TMRC的“一个健康”框架将为未来规划提供急需的数据， 综合STH控制计划，该计划将联合收割机社区范围的MDA与升级的WASH相结合， POC分子诊断。该中心将为早期职业调查人员提供一个平台， 学科一健康研究性病以及其他人畜共患病或蠕虫NTD。

PROJECT SUMMARY Soil transmitted helminths (STH) - hookworms (Ancylostoma duodenale and Necator americanus), Ascaris lumbricoides and Trichuris trichiura - are among the most widespread neglected tropical diseases (NTD) of humans worldwide, disproportionately affecting the poorest and most vulnerable communities. In rural, populations, intensive animal-human mixing with livestock and companion animals combined with poor hygiene and sanitation can lead to transmission of zoonotic infections as well as result in zoonotic sources of infection. It is estimated that 30% of households globally have domestic livestock animals, with south and southeast Asia and Africa contributing the largest proportion. These regions also have the highest burden of STH globally. Most epidemiological surveys and mathematical models of STH do not account for or measure the risk of infections acquired from zoonotic sources, either by direct contact with animals or animal feces or indirectly from the environment. The inability to interrupt transmission due to presence of zoonotic and environmental reservoirs of infection may prolong mass drug administration (MDA) campaigns and result in emergence of anthelmintic resistance. The overarching goal of this multi-disciplinary collaborative application is to use a One Health framework to examine the interconnected burden and transmission patterns between human, animal and environmental reservoirs of STH by integrating carefully collected epidemiological, environmental and qualitative research data with state-of-art molecular techniques to better inform monitoring and elimination strategies in endemic communities. We will leverage an ongoing randomized controlled trial on community wide MDA and an upcoming One Health project in two eco-epidemiologically and culturally distinct geographic regions of India (Tamil Nadu and Meghalaya) to: (1) comprehensively investigate the transmission dynamics of different STH species at individual, household and community levels; (2) ascertain the impact of community wide MDA on zoonotic STH transmission and screen for emergence of benzimidazole resistance markers; and (3) develop and validate field-ready, portable point-of-collection (POC) diagnostics for STH based on prevalent human and zoonotic species. The field and laboratory data will provide the key parameters to build species-specific STH transmission models and explore the impact of human, animal and environmental reservoirs on STH control measures, across a range of transmission scenarios. The One Health framework of this TMRC will provide much needed data for future planning of integrated STH control programs that combine community wide MDA with upgraded WASH, supported by POC molecular diagnostics. The center will provide a platform for early career investigators to conduct multi- disciplinary One Health research on STH as well as other zoonotic or helminth NTDs.