Optimizing Surveillance and Treatment for Control of Cutaneous Leishmaniasis

概述总结 我们的TMRC计划“优化监测和治疗，以控制皮肤 利什曼病“是一个协调一致的跨学科和跨部门的努力， 在哥伦比亚和拉丁美洲区域，控制皮肤利什曼病的制约因素。控制 人畜共患皮肤利什曼病的重点是病例识别和治疗。然而，分散的 风险人口的分布、报告不足、缺乏关于 治疗失败率和耐药性证据的增加， 现有的抗利什曼药物破坏和破坏控制努力。TMRC“优化”的目标 为控制皮肤利什曼病而进行的监察及治疗”， 对治疗的反应水平：影响治疗结果的宿主先天反应和相应的 生物标志物;药物敏感性和治疗结果中的寄生虫依赖因素; 受影响社区、病例和治疗后续行动。 1.解决在确定干预措施的目标和评价方面的关键知识差距， 皮肤黑热病 2.确定寄生虫对抗利什曼原虫药物敏感性与临床和 对标准治疗的寄生虫学反应，以及定义这种关系的寄生虫因素。 3.确定在抗利什曼病药物治疗期间有助于治愈或失败的先天宿主功能， 相关的生物标志物 该中心计划将由国家和国际调查人员组成的多学科团队开发 包括相关领域的公认专家、职业中期和新研究人员：流行病学、病媒 生态学、分子生物学和基因组学、免疫学和细胞生物学。主要研究者和 核心领导人已经成功地合作。每一个都带来了高水平的专业能力， 相应的项目，并共同提供了一个广阔的视野，以TMRC。每个研究项目将 通过解决信息和知识差距以及在适当、适当和适当的情况下， 适当的治疗，以实现治愈，减少复发的风险，并提供信息和工具， 减少皮肤利什曼病的流行和后果。CIDEIM是世卫组织合作中心 治疗利什曼病建议的TMRC计划的范围和重点是优化 监测和治疗将与我们作为世界卫生组织协调委员会的作用协同作用， 培训计划，以引导和扩大该地区的能力建设，并将研究结果转化为 国家主管当局

OVERVIEW SUMMARY Our TMRC program “Optimizing surveillance and treatment for control of cutaneous leishmaniasis”constitutes a concerted transdisciplinary and intersectorialeffort to address fundamental constraints on the control of cutaneous leishmaniasis in Colombia and the Latin American Region. Control of zoonotic cutaneous leishmaniasis is centered on case identification and treatment. However, the dispersed distribution of the populations at risk, underreporting, unavailability of information on the effectiveness of treatments administered, and increasing rates of treatment failure and evidence of drug resistance to the few available antileishmanial drugs undermine and subvert control efforts. The Goal of the TMRC “Optimizing Surveillance and Treatment for Control of Cutaneous Leishmaniasis” will be developed at three inter-related levels of response to treatment: Host innate responses affecting outcome of treatment and corresponding biomarkers; Parasite-dependent factors in drug susceptibility and therapeutic outcome; Active detection of affected Communities, cases and treatment follow-up. 1. To address critical knowledge gaps in the targeting and evaluation of interventions for control of cutaneous leishmaniasis. 2. To determine the relation of parasite susceptibility to anti-leishmanial drugs with the clinical and parasitological response to standard-of-care treatment, and parasite factors defining this relationship. 3. Identify innate host functions that contribute to cure or failure during antileishmanial drug therapy and their related biomarkers. This Center Program will be developed by a multidisciplinary team of national and international investigators that includes recognized experts, mid-career and new investigators in the relevant fields: Epidemiology, Vector Ecology, Molecular Biology and Genomics, Immunology and Cell Biology. The Principal Investigators and Core Leaders have already worked together successfully. Each brings high level specialized capacities to the corresponding projects and together, provide a broad scope of vision to the TMRC. Each Research Project will contribute to more effective control by addressing information and knowledge gaps and barriers to opportune, appropriate treatment to achieve cure, decrease the risk of relapse and by providing information and tools to reduce the prevalence and consequences of cutaneous leishmaniasis. CIDEIM is a WHO Collaborating Center for Leishmaniasis since 1992. The scope and focus of proposed TMRC program on the optimization of surveillance and treatment will be synergistic with our role as a WHOCC allowing the TMRC research and training program to channel and amplify capacity building within the Region and to translate findings to the competent national authorities