Neurodevelopment and Vector-borne Diseases: Building Research Capacity in the Tropics

神经发育和媒介传播疾病：热带地区研究能力建设

• 批准号: 9344713
• 负责人: Angelle Desiree LaBeaud
• 金额: $ 14.7万
• 依托单位: WINDWARD ISLANDS RESEARCH & ED FDN
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-07 至 2018-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9344713
• 关键词: 2 year old; Address; Arboviruses; Area; Brazil; Caribbean region; Chikungunya virus; Child; Child Development; Community Health; Country; Culicidae; Data; Dengue; Developing Countries; Development; Diet; Dietary intake; Disease Outbreaks; Economics; Endemic Diseases; Environmental Risk Factor; Enzyme-Linked Immunosorbent Assay; Epidemic; Equipment; Evaluation; Exposure to; Fetal Alcohol Spectrum Disorder; Fetal Development; Gestational Diabetes; Goals; Government; Grant; Grenada; Health; Health Policy; Healthcare; Human Resources; Impaired cognition; Impairment; Income; Inequality; Infant; Infection; Institution; International; Intervention; Link; Longitudinal Studies; Malaria; Martinique; Measures; Medical; Microcephaly; Mission; Modeling; Monitor; Mothers; Neurocognitive; Neurodevelopmental Impairment; Newborn Infant; Outcome; Parasitic Diseases; Pregnancy; Premature Birth; Prevalence; Psychological Stress; Public Health; Recurrence; Research; Research Institute; Research Personnel; Research Support; Resources; Risk; Scientist; Site; Socioeconomic Factors; Standardization; Students; Suriname; Surveys; Sustainable Development; Symptoms; Testing; Time; Toxicant exposure; Training; United States National Institutes of Health; Universities; Vector-transmitted infectious disease; Vertical Disease Transmission; Violence; Virus; Virus Diseases; Zika Virus; chikungunya; cognitive function; cost; experience; global health; in utero; infancy; international center; low and middle-income countries; neglected tropical diseases; nervous system infection; neurodevelopment; next generation; pathogen; pregnant; prevent; programs; public health priorities; tool

Project Summary/Abstract Vector-borne diseases (VBD) pose a significant economic and public health threat throughout developing tropical regions worldwide, including the Caribbean. The introduction in December 2013 and rapid spread of the chikungunya virus (CHIKV) throughout all the Caribbean nations, and more recently the emergence of the zika virus in Suriname and Martinique highlights the need to develop regional capacity to investigate, predict, contain, and respond to VBD. For example, recent evidence from la Réunion suggests that CHIKV can negatively impact neurodevelopment among infants born to mothers who were infected with the virus during pregnancy. However, these results have not yet been replicated in other sites internationally – such as the Caribbean – nor have any longitudinal studies been carried out to follow children who have experienced neurocognitive delay related to CHIKV infection. To address the paucity of data while building VBD research capacity in tropical LMICs where these diseases are endemic and the burden of impaired neurodevelopment is felt most, researchers from St. George's University (SGU) in Grenada will partner with researchers from Stanford University, Oxford University, and the Université de La Réunion to: (1) Determine the prevalence of mother to child transmission of CHIKV in Grenadian pregnant mothers; (2) Measure the neurodevelopment of children at 2 years of age exposed at different trimesters in utero to CHIKV and compare them with unexposed children; (3) Assess the burden of confounding factors to better understand the specific impact of VBD on neurodevelopment and inform public health priorities; (4) Build local capacity for arboviral and neurodevelopmental testing at SGU. To achieve Aim 1, 379 moms and their infants who were born during the CHIKV outbreak in Grenada, 473 moms and their infants who were born after the outbreak and may have been exposed to the virus in utero, and 190 moms and their infants who were born at least nine months after the outbreak (and thus, very unlikely to be exposed to the virus in utero) will complete a survey detailing the onset and symptoms related to their CHIKV infection and will then be tested for exposure to CHIKV by ELISA. Non CHIKV-exposed infants and moms, CHIKV-exposed moms but not infants, CHIKV-exposed moms and infants, and time of exposure during pregnancy will be used to divide groups for neurocognitive comparison at 2-years of age. To achieve Aims 2 and 3, we will administer the intergrowth 21st Neurodevelopment Assessment – a holistic assessment of early child development developed at Oxford University – while controlling for confounding neurodevelopmental factors. To achieve Aim 4, we will establish a Regional Center for Child Neurodevelopment while addressing seven key areas of needed research support: (1) Financial (i.e., granting); (2) Expertise; (3) On-the-ground human resources; (4) Student trainees to build local capacity; (5) Equipment, IT, and facilities support; (6) On-the-ground university and research institute administrative support; and (7) Local and regional government, relevant NGO, and professional/academic institutional support.

项目概要/摘要 媒介传播疾病（VBD）对整个发展中国家的经济和公共卫生构成重大威胁 全世界的热带地区，包括加勒比地区。 2013年12月推出并迅速普及 基孔肯雅病毒（CHIKV）遍布所有加勒比国家，最近又出现了 苏里南和马提尼克岛的寨卡病毒凸显了发展区域能力以调查、预测、 包含并响应VBD。例如，留尼汪岛最近的证据表明，CHIKV 可以 对在怀孕期间感染病毒的母亲所生的婴儿的神经发育产生负面影响 怀孕。然而，这些结果尚未在国际其他网站上得到复制——例如 加勒比地区——也没有进行任何纵向研究来跟踪经历过这种情况的儿童 与 CHIKV 感染相关的神经认知延迟。建立 VBD 研究时解决数据缺乏的问题 这些疾病流行且神经发育受损的负担的热带中低收入国家的能力 最感触的是，格林纳达圣乔治大学（SGU）的研究人员将与来自以下国家的研究人员合作： 斯坦福大学、牛津大学和留尼汪大学： (1) 确定以下疾病的患病率： 格林纳达孕妇中 CHIKV 的母婴传播； (2) 测量神经发育 2 岁儿童在子宫内不同妊娠期暴露于 CHIKV 并将其与未暴露的儿童进行比较 孩子们; (3) 评估混杂因素的负担，以更好地了解VBD对 神经发育并告知公共卫生优先事项； (4) 建设当地防治虫媒病毒和病毒的能力 SGU 的神经发育测试。为了实现目标 1，379 名母亲及其在该期间出生的婴儿 格林纳达爆发CHIKV，473名母亲及其婴儿在疫情爆发后出生，可能已被感染 在子宫内暴露于该病毒的 190 名母亲及其在该病毒出生后至少 9 个月的婴儿 爆发（因此不太可能在子宫内接触病毒）将完成一项详细说明发病情况的调查 以及与 CHIKV 感染相关的症状，然后将通过 ELISA 检测是否接触 CHIKV。非 暴露于 CHIKV 的婴儿和妈妈、暴露于 CHIKV 的妈妈但未暴露于婴儿、暴露于 CHIKV 的妈妈和婴儿， 怀孕期间的暴露时间将用于分组，以便在 2 岁时进行神经认知比较 的年龄。为了实现目标 2 和 3，我们将实施第 21 次共生神经发育评估 – 牛津大学开发的早期儿童发展全面评估——同时控制 混淆神经发育因素。为了实现目标 4，我们将建立一个儿童区域中心 神经发展，同时解决所需研究支持的七个关键领域：（1）财务（即资助）； (2) 专业知识； (3) 实地人力资源； (4) 学生实习生建设当地能力； (5) 设备、 IT和设施支持； (6) 实地大学和科研院所的行政支持；和（7） 地方和地区政府、相关非政府组织以及专业/学术机构的支持。