Dynamics of Influenza Transmission in Nicaraguan Households

尼加拉瓜家庭流感传播动态

• 批准号: 9234280
• 负责人: AUBREE L GORDON
• 金额: $ 70.66万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-01-01 至 2021-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9234280
• 关键词: Address; Aerosols; Affect; Age; Air; Antibodies; Asthma; Biological Assay; Cessation of life; Characteristics; Child; Childhood; Chronic Disease; Climate; Cohort Studies; Collaborations; Communities; Crowding; Data; Dengue; Developing Countries; Disease; Drops; Effectiveness; Enrollment; Environmental Risk Factor; Environmental air flow; Epidemiology; Exposure to; Family; Hand; Health; Hemagglutination; Home environment; Hour; Household; Housing; Humidity; Immunity; Incidence; Individual; Infection; Influenza; Integration Host Factors; Intervention; Investigation; Knowledge; Lead; Measurement; Measures; Medical; Methodology; Michigan; Modeling; Monitor; Nicaragua; Nicaraguan; Obesity; Participant; Pattern; Persons; Precipitation; Proxy; Public Health; Quantitative Reverse Transcriptase PCR; RNA; Recording of previous events; Research; Research Design; Research Personnel; Resolution; Resources; Respiratory Tract Infections; Risk; Risk Factors; Route; Sampling; Serum; Severities; Severity of illness; Sleep; Social Interaction; Socialization; Surface; Surveys; Symptoms; Technology; Temperature; Time; Universities; Viral; Virus; Virus Diseases; Virus Shedding; Work; aerosolized; age group; air sampling; diabetes risk; diaries; disorder control; flu transmission; improved; influenzavirus; innovation; mathematical model; novel; pandemic influenza; pathogen; prevent; programs; prospective; seasonal influenza; social; therapy development; transmission process; viral transmission

PROJECT SUMMARY/ABSTRACT Influenza virus is an airborne pathogen of major medical and public health significance worldwide that causes millions of severe respiratory infections and an estimated 500,000 deaths each year. Despite decades of research, basic questions remain about the routes of influenza transmission and the effect of viral, environmental, and host factors on transmission. This is especially true in tropical developing countries, where the relative contributions of the routes of transmission and the effect of climatic, environmental and social factors differ from temperate settings. To undertake a detailed investigation of influenza transmission in Nicaragua, we propose to conduct a prospective household cohort study. The research questions addressed build naturally on the findings of our two current studies, the Pediatric Influenza Cohort Study and the Influenza Household Transmission Study in Managua, Nicaragua. The proposed study benefits from over 12 years of collaboration between the study investigators at the University of Michigan and the Nicaraguan Ministry of Health and from the scientific capacity building in Managua that has resulted from numerous studies on dengue and influenza. Specifically, we will conduct a 5-year household cohort study designed to examine aerosol, droplet, and contact transmission of influenza in urban Nicaraguan households. Our central hypothesis is that aerosol transmission is a major route of transmission of influenza in Nicaraguan households and that it occurs primarily at night when people crowd together to both socialize and sleep. We employ an innovative combination of rigorous epidemiological methodology, state-of-the-art technologies, and mathematical modeling that will enable investigation of influenza transmission in a novel context with an unprecedented level of detail. In Aim 1, we will investigate the potential for aerosol, droplet, direct contact, and indirect contact transmission using air and surface sampling. In Aim 2, we will examine the effect of environmental factors including temperature, humidity, precipitation, and ventilation proxies collected at the household level on the transmission of influenza. In Aim 3, we will determine the effect of host factors that condition exposure, including viral shedding and household crowding, sleeping conditions, and social interactions, measured using surveys, contact diaries, and sociometric badges, on the risk of influenza transmission. In Aim 4, we will characterize the effect of host factors, such as pre-existing immunity, age and the presence of chronic diseases, that influence whether an exposed person becomes infected and whether that infection progresses to disease or severe disease. This proposal addresses major gaps in knowledge on influenza transmission in tropical developing country settings. It is thus timely and well-poised to have substantial public health and scientific impact.

项目概要/摘要 流感病毒是一种通过空气传播的病原体，在全球范围内具有重大医学和公共卫生意义，可导致 每年有数百万人遭受严重呼吸道感染，估计有 50 万人死亡。尽管几十年来 研究中，关于流感传播途径和病毒影响的基本问题仍然存在， 环境和宿主因素对传播的影响。在热带发展中国家尤其如此，这些国家 传播途径的相对贡献以及气候、环境和社会因素的影响 与温带设置不同。对流感传播情况进行详细调查 尼加拉瓜，我们建议进行一项前瞻性家庭队列研究。研究问题 所解决的问题自然建立在我们当前两项研究的结果之上，即儿科流感队列研究和 尼加拉瓜马那瓜的流感家庭传播研究。拟议的研究受益于超过 12 密歇根大学和尼加拉瓜部的研究人员多年的合作 卫生部门和马那瓜的科学能力建设，这是大量研究的结果 登革热和流感。具体来说，我们将进行一项为期 5 年的家庭队列研究，旨在检验 尼加拉瓜城市家庭中流感的气溶胶、飞沫和接触传播。我们的中央 假设气溶胶传播是尼加拉瓜流感的主要传播途径 家庭，它主要发生在晚上，当时人们聚集在一起社交和睡觉。 我们采用严格的流行病学方法、最先进的技术、 和数学模型，将能够在新的背景下调查流感传播 前所未有的细节水平。在目标 1 中，我们将研究气溶胶、液滴、直接接触和 使用空气和表面采样进行间接接触传播。在目标 2 中，我们将检查以下效果： 环境因素，包括在现场收集的温度、湿度、降水量和通风指标 家庭层面对流感传播的影响。在目标 3 中，我们将确定宿主因素的影响 条件暴露，包括病毒传播和家庭拥挤、睡眠条件和社交 通过调查、接触日记和社会计量徽章衡量流感风险的互动 传播。在目标 4 中，我们将描述宿主因素的影响，例如预先存在的免疫力、年龄和 慢性疾病的存在，影响接触者是否被感染以及是否 感染进展为疾病或严重疾病。该提案解决了以下方面的主要知识空白： 热带发展中国家的流感传播。因此，现在是及时且准备充分的 重大的公共卫生和科学影响。