Characterizing infectiousness of subclinical TB and identifying novel early diagnostic strategies for preventing transmission

表征亚临床结核病的传染性并确定预防传播的新型早期诊断策略

• 批准号: 9889831
• 负责人: Jason Randolph Andrews
• 金额: $ 15.77万
• 依托单位: STANFORD UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-03-11 至 2024-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9889831
• 关键词: Address; Aerosols; Algorithms; Biological Assay; Blood; Brazil; Caring; Cause of Death; Characteristics; Clinical; Collaborations; Communicable Diseases; Communities; Coughing; Country; Data; Development; Diagnosis; Diagnostic; Disease; Early Diagnosis; Early treatment; Effectiveness of Interventions; Environment; Epidemic; Exhalation; Gene Expression; Gene Expression Profile; Gene Expression Profiling; General Population; Goals; HIV Seronegativity; Health; Imprisonment; Incidence; Individual; Infection; Intervention; Joints; Knowledge; Masks; Mass Screening; Measures; Medical; Methods; Microbiology; Modality; Modeling; Mycobacterium tuberculosis; Population; Prevalence; Prisoner; Prisons; Reference Standards; Research; Research Infrastructure; Roentgen Rays; Role; Sampling; Sputum; Sustainable Development; Symptoms; System; Testing; Time; Tuberculosis; Whole Blood; base; case finding; cost effective; cost effectiveness; design; diagnostic screening; effective therapy; epidemiologic data; genetic signature; genomic data; mathematical model; molecular diagnostics; novel; novel diagnostics; novel strategies; point of care; prevent; screening; symptom treatment; tool; transmission process

Project Summary Tuberculosis remains the leading cause of death by an infectious disease worldwide, despite the widespread availability of effective therapy. Two major scientific knowledge gaps constrain our ability to effectively respond this epidemic: 1) understanding characteristics of individuals who are transmitting infection within the population; and 2) identifying efficient means of diagnosing these individuals early in their course of disease to prevent ongoing transmission. Our preliminary research and that of others has demonstrated that, for any given time in a population, a substantial proportion of individuals with microbiologically confirmed tuberculosis have few or no classical symptoms. This state has been described as “subclinical tuberculosis”. What fraction of cases are subclinical, how infectious these individuals are, and the total contribution of subclinical tuberculosis towards transmission in the population is poorly understood. This proposal leverages our unique research infrastructure in prisons in Central-Western Brazil to evaluate novel tools, including a disposable mask to capture exhaled bioaerosols, for early detection of tuberculosis in asymptomatic individuals. We will test the following hypotheses: 1) individuals with tuberculosis who lack symptoms are on average at least 50% as infectious as those with symptoms, and contribute equally to overall transmission; 2) mask aerosol sampling will be more effective than sputum testing for tuberculosis diagnosis in individuals with few or no symptoms; 3) biannual mass screening with diagnostics targeted at subclinical tuberculosis would be cost- effective in prisons. Overall, this project will address fundamental questions about tuberculosis transmission, while testing practical approaches to control tuberculosis in high burden settings.

项目总结