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

项目总结 土壤传播蠕虫(STH)-钩虫(十二指肠钩口线虫和美洲钩虫)， 蛔虫和鞭虫是最普遍被忽视的热带疾病 全球人口(NTD)，对最贫穷和最脆弱的社区产生了不成比例的影响。在……里面 农村，人口，密集的动物-人与牲畜和同伴动物结合在一起的贫穷 个人卫生和环境卫生可导致人畜共患传染病的传播，并导致人畜共患病的源头。 感染的可能性。据估计，全球30%的家庭拥有家畜，其中南方和 东南亚和非洲贡献的比例最大。这些地区还承担着最高的 全球范围内的……大多数性传播感染的流行病学调查和数学模型都没有考虑或衡量 通过直接接触动物或动物粪便或从人畜共患病来源获得感染的风险 间接地从环境中释放。由于存在人畜共患疾病而无法中断传播 环境感染宿主可能会延长大规模药物管理(MDA)活动，并导致 出现驱虫药抗药性。 这个多学科协作应用程序的主要目标是使用One Health 研究人类、动物和人类之间相互关联的负担和传播模式的框架 通过整合仔细收集的流行病学、环境和 定性研究数据，采用最先进的分子技术，更好地为监测和消除提供信息 地方病社区的战略。我们将利用正在进行的社区随机对照试验 广泛的传染病和即将在两个生态流行病学和文化上截然不同的一个健康项目 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物种在个体、家庭和社区水平的传播动态；(2)确定 社区范围丙二醛对人兽共患性病传播的影响及疫情筛查 苯并咪唑抗性标记；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病物种的STH诊断。现场和实验室数据 将提供关键参数来构建特定物种的STH传播模型，并探讨 人类、动物和环境宿主对性传播疾病的控制措施，传播范围 场景。该TMRC的One Health框架将为未来的规划提供急需的数据 集成的STH控制程序，将社区范围的MDA与升级的WASH相结合，由 POC分子诊断学。该中心将为早期职业调查人员提供一个平台，进行多项研究 学科一关于性传播疾病以及其他人畜共患或蠕虫类非传染性疾病的健康研究。

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.