Impact of zooprophylaxis on zoonotic cutaneous leishmaniasis transmission

动物预防对人畜共患皮肤利什曼病传播的影响

• 批准号: 9111261
• 负责人: Elyes Zhioua
• 金额: $ 13.76万
• 依托单位: INSTITUT PASTEUR DE TUNIS
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-06-15 至 2018-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9111261
• 关键词: Achievement; Adult; Affect; African; Age-Months; Animals; Antimony; Area; Biodiversity; Biological; Bite; Breeding; Calories; Canis familiaris; Central America; Chemicals; Chickens; Cholesterol; Collaborations; Communities; Country; Cutaneous Leishmaniasis; Developing Countries; Disease; Disease Reservoirs; Distress; Domestic Animals; Ecology; Economics; Ecosystem; Effectiveness; Endemic Diseases; Environment; Environmental Impact; Epidemiology; Exposure to; Family; Far East; Fatty acid glycerol esters; Female; Food; Fostering; Glucantime; Goals; Health; Health Benefit; Health Policy; Housing; Human; Human Bites; Incidence; Income; Individual; Infection; Injection of therapeutic agent; Insecticide Resistance; Insecticides; Institutes; Interruption; Intervention; Intervention Trial; Jird; Kansas; Kenya; Laboratories; Lead; Learning; Leishmania; Leishmania major; Leishmaniasis; Lesion; Livestock; Measures; Meat; Methods; Middle East; Modeling; Near East; New Zealand; Northern Africa; Nutritional; Oryctolagus cuniculus; Outcome; Parasites; Patients; Pharmaceutical Preparations; Phlebotomus; Physiology; Poisoning; Population; Poverty; Prevalence; Psammomys; Public Health; Publishing; Research; Research Personnel; Residual state; Resistance; Resources; Rodent; Role; Rural Community; Sand Flies; Sand Rats; Seasons; Secure; Site; Skin; Source; South America; Stress; Sunlight; Testing; Treatment Cost; Tunisia; United States National Institutes of Health; Universities; Urine; Vaccines; Vector-transmitted infectious disease; Vulnerable Populations; Wild Animals; Work; Zinc; authority; base; beef; chemotherapy; cost effective; disease transmission; evidence base; experience; farmer; feeding; improved; innovation; killings; low income country; low socioeconomic status; man; neglected tropical diseases; novel strategies; nutrition; programs; psychologic; rural area; scale up; social; success; transmission process; vector; vector control

 DESCRIPTION (provided by applicant): Zoonotic cutaneous leishmaniasis (ZCL) is a vector-borne disease caused by Leishmania major, transmitted by the bites of phlebotomine sand flies. The fat sand rat (Psammomys obesus) and the desert's gird (Meriones shawi ) are the main reservoir hosts of this parasite. Cutaneous leishmaniasis is considered by the WHO to be a neglected tropical disease, affecting about 1.5 million people per year worldwide. The disease is widespread in Central and South America, the Mediterranean basin, and the near and far east countries where it is strongly correlated with poverty. Although ZCL is not fatal, the lesions produced may cause substantial disfigurement and severe distress to infected individuals with lifelong psychological and social consequences. No vaccine is available and treatment of humans is largely based on chemical therapy (pentavalent antimony/glucantime). To date, resistance of L. major to glucantime, the only affordable drug in developing countries for more than 40 years, has become a major concern. New alternatives to control ZCL are urgently needed. In Tunisia, ZCL is a peridomestic disease endemic in rural areas with low socio-economic status with an annual incidence rate of 669.7/100,000 per year. Phlebotomus papatasi is the main vector of L. major in Tunisia and in North Africa. Only chemical therapy with glucantime is currently available, with neither vector nor dog control programs. Killing or diverting infected sand flies from humans can reduce the transmission of ZCL. Although indoor residual spraying (IRS) of insecticides is effective in reducing the incidence of ZCL, it requires expensive yearly applications and its applicability is thus limited by financial constraints in low income countries. Insecticide-treated curtains or bednets offer effective protection against P. papatasi; but transmission continues as before after cessation of these measures. Despite their efficacy in the interruption of ZCL transmission, programs based on the distribution of ITNs are poorly implemented in many endemic countries and are beyond the means of many families in ZCL-endemic villages. Although poisoning ZCL rodent reservoirs with zinc phosphide has reduced the incidence of ZCL, this approach is ecologically unsound. We aim to develop a sustainable method based on diverting sand fly vectors from humans to reduce the transmission of ZCL in endemic areas. Numerous studies show that host diversity could reduce the incidence of zoonotic vector- borne diseases by a dilution effect. A high species diversity in the community of vector hosts reduces the infection prevalence or abundance of the vectors by diluting the effects of the most competent disease reservoir and subsequently reducing the incidence of the disease. Zooprophylaxis is the use of wild or domestic animals, which are not reservoir hosts of a given diseases, to deflect vectors from humans creating a dilution effect. The presence of livestock around houses may diminish transmission of the disease and protect humans from the bites of infected sand flies. Our preliminary studies have shown that breeding rabbits in artificia burrows located in peri-domestic areas significantly reduces the indoor abundance of P. papatasi within houses. Rabbits strongly attract sand flies but are a dead-end host for L. major. We hypothesize that rabbits bred in man-made underground holes located in the peri-domestic areas act as a dilution hosts and exert a zooprophylactic effects on the transmission of ZCL in endemic areas. The objective of this proposal is to establish a new vector control strategy based on zooprophylaxis to reduce transmission of ZCL in endemic focus. This program will be validated in Tunisia for several reasons: (1) endemicity of disease; (2) limited current control options; (3) access to laboratory models and field sites for testing intervention strategies; and (4) ability to conduct field-based research in a representative region that is stable politically. Indeed, lessons learned from this project should impact public health policy authorities in the politically sensitive Middle East and North African (MENA) nations. This two-year project will develop a new approach to control ZCL transmission built upon the transfer of expertise from the US to Tunisia, fostering both capacity building and innovation.

 描述（由申请人提供）：人畜共患皮肤利什曼病（ZCL）是一种由大型利什曼原虫引起的媒介传播疾病，通过白蛉叮咬传播。肥沙鼠（Psammomys obesus）和沙漠鼠（Meriones shawi）是这种寄生虫的主要储存宿主。皮肤利什曼病被世界卫生组织认为是一种被忽视的热带疾病，每年影响全世界约 150 万人。该疾病在中美洲和南美洲、地中海盆地以及近东和远东国家广泛传播，这些国家的疾病与贫困密切相关。尽管 ZCL 并不致命，但所产生的损伤可能会对感染者造成严重的毁容和严重的痛苦，从而造成终生的心理和社会后果。目前尚无疫苗可用，人类的治疗主要基于化学疗法（五价锑/葡聚糖时间）。迄今为止，L. Major 对葡聚糖酶（40 多年来发展中国家唯一负担得起的药物）的耐药性已成为一个主要问题。迫切需要控制 ZCL 的新替代方案。在突尼斯，ZCL是一种流行于社会经济地位较低的农村地区的家庭周围疾病，年发病率为669.7/10万。 Phlebotomus papatasi 是突尼斯和北非主要白蛉的主要媒介。目前只有葡聚糖时间化学疗法可用，既没有媒介也没有狗控制计划。杀死或转移受感染的白蛉远离人类可以减少 ZCL 的传播。尽管杀虫剂的室内滞留喷洒（IRS）可有效减少 ZCL 的发生率，但每年需要昂贵的施用量，因此其适用性因低收入地区的财政限制而受到限制。 收入国家。经过杀虫剂处理的窗帘或蚊帐可有效预防 P. papatasi；但这些措施停止后，传播仍像以前一样继续。尽管在阻断 ZCL 传播方面有效，但基于驱虫蚊帐分发的计划在许多流行国家实施得很差，并且超出了 ZCL 流行村庄的许多家庭的承受能力。虽然用磷化锌毒害 ZCL 啮齿动物水库可以降低 ZCL 的发病率，但这种方法在生态上是不健全的。我们的目标是开发一种基于从人类转移白蛉媒介的可持续方法，以减少 ZCL 在流行地区的传播。大量研究表明，宿主多样性可以通过稀释效应降低人畜共患媒介传播疾病的发病率。媒介宿主群落中的高度物种多样性通过稀释最有能力的疾病储存库的影响并随后降低疾病的发病率来降低媒介的感染流行率或丰度。动物预防是利用野生或家养动物（它们不是特定疾病的储存宿主）来转移人类的媒介，从而产生稀释效应。房屋周围饲养牲畜可能会减少疾病的传播并保护人类免受受感染白蛉的叮咬。我们的初步研究表明，在家庭周边地区的人工洞穴中饲养兔子会显着减少房屋内 P. papatasi 的室内丰度。兔子强烈吸引白蛉，但却是大白蛉的死胡同。我们假设在家庭周边地区的人造地下洞中饲养的兔子充当​​稀释宿主，并对 ZCL 在流行地区的传播产生动物预防作用。该提案的目的是建立一种基于动物预防的新病媒控制策略，以减少 ZCL 在流行病灶中的传播。该计划将在突尼斯得到验证，原因如下：(1) 疾病流行； (2) 有限的电流控制选项； (3) 获得实验室模型和现场地点以测试干预策略； （4）有能力在政治稳定的代表性地区开展实地研究。事实上，从该项目中吸取的经验教训应该会影响政治敏感的中东和北非（MENA）国家的公共卫生政策当局。这个为期两年的项目将在美国向突尼斯转让专业知识的基础上开发一种控制 ZCL 输电的新方法，从而促进能力建设和创新。