Optimizing Surveillance and Treatment for Control of Cutaneous Leishmaniasis

概述摘要 我们的TMRC计划“优化监测和治疗，以控制皮肤 利什曼病“构成了一种跨学科和跨部门的协调努力，以解决根本问题 哥伦比亚和拉丁美洲地区皮肤利什曼病控制方面的制约因素。控制 人畜共患皮肤利什曼病以病例识别和治疗为中心。然而，分散的 高危人群的分布、报告不足、无法获得关于预防艾滋病有效性的信息 给予的治疗，以及治疗失败率和少数人耐药证据的增加 现有的抗利什曼病药物破坏和颠覆了控制努力。TMRC“优化”的目标 “皮肤利什曼病监测和治疗”将在三个相互关联的地方开展 治疗反应水平：宿主先天反应影响治疗结果 生物标志物；药物敏感性和治疗结果中的寄生虫依赖因子；主动检测 受影响的社区、病例和治疗后续行动。 1.解决控制疟疾干预措施的目标和评价方面的关键知识差距 皮肤利什曼病。 2.确定寄生虫对抗利什曼药物的敏感性与临床和临床的关系 寄生虫学对标准护理治疗的反应，以及定义这种关系的寄生虫因素。 3.确定在抗利什曼药物治疗期间有助于治愈或失败的固有宿主功能 它们相关的生物标志物。 该中心计划将由一个由国家和国际调查人员组成的多学科团队制定 这包括相关领域的公认专家、职业生涯中期和新的调查人员：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。首席调查员和 核心领导人已经成功地合作了。每一项都为 相应的项目和共同努力，为TMRC提供了广阔的视野。每个研究项目都将 通过解决信息和知识差距和障碍，帮助更有效地控制时机， 适当的治疗，以实现治愈，降低复发风险，并通过提供信息和工具 减少皮肤利什曼病的患病率和后果。CIDEIM是世卫组织的一个合作中心 自1992年以来一直用于治疗利什曼病。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中心的角色协同工作，允许TMRC研究和 培训方案，以引导和扩大区域内的能力建设，并将结果转化为 国家主管部门

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