Community Transmission of Tuberculosis Urban Africa

非洲城市结核病的社区传播

• 批准号: 10226961
• 负责人: Christopher C. Whalen
• 金额: $ 63.98万
• 依托单位: UNIVERSITY OF GEORGIA
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-04-01 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10226961
• 关键词: Address; Africa; African; Archives; Area; BCG Vaccine; Bacillus Calmette-Guerin Therapy; Bayesian Modeling; Cellular Phone; Communities; Community Networks; Complex; Data; Detection; Development; Diagnosis; Disease; Effectiveness; Epidemic; Epidemiology; Event; Genetic Variation; Genomics; Geography; Goals; Household; Incidence; Individual; Infection; Intervention; Interview; Investigation; Lead; Locales; Location; Maps; Measures; Metadata; Methods; Modeling; Molecular Epidemiology; Movement; Mycobacterium tuberculosis; Patients; Pattern; Phylogenetic Analysis; Population; Prevalence; Pulmonary Tuberculosis; Recording of previous events; Records; Research; Resolution; Role; Social Mobility; Social Network; Symptoms; Time; Trees; Tuberculosis; Uganda; Variant; World Health Organization; advanced disease; burden of illness; case finding; community setting; design; disorder control; falls; genome sequencing; indexing; meetings; mycobacterial; next generation; novel; novel strategies; prevent; programs; public health intervention; support network; theories; transmission process; tuberculosis treatment; urban setting; whole genome

According to the World Health Organization, the global burden of tuberculosis peaked in 2000 and has since declined by 1.5% per year. This modest progress falls short of the Millennial Development Goals for tuberculosis elimination. Moreover, this average decline hides important variation in the incidence and prevalence of tuberculosis around the world today. This variation highlights that determinants of disease incidence may differ across regions, so interventions must be tailored to local the epidemiology of disease. The standard approach to tuberculosis control today relies on detection and treatment of prevalent tuberculosis cases. This approach may have limited effectiveness in areas of high tuberculosis burden where M. tuberculosis transmission is correspondingly high. Indeed, by the time a case is diagnosed and treated, the next generation of cases has already been newly infected. To make progress in curbing the epidemic of tuberculosis, new cases must be prevented, either by reducing transmission or by preventing disease. Household contact investigation has been a mainstay of active case finding of tuberculosis for decades. Although the household is a setting of intense transmission of tuberculosis, household transmission accounts for less than 25% of tuberculosis that occurs in a given community. While the household is a convenient, localized social network for transmission that is easily identified and evaluated, we must better understand the complex community networks that support M. tuberculosis transmission and lead to disease ‘hotspots’. The goal of this proposal is to develop methods for measuring community networks that support tuberculosis transmission. In this proposal, we plan to reconstruct the social and mobility networks of infectious tuberculosis cases before diagnosis by using cellular telephone metadata and integrate this information with whole genome sequences of the M. tuberculosis strains from index cases to infer transmission networks. The Specific Aims are: 1) To assess the movement of pulmonary tuberculosis cases before diagnosis as an indicator of M. tuberculosis transmission in an urban African community; 2) To infer transmission trees of M. tuberculosis in an urban African community using whole genome sequencing of isolates from tuberculosis index cases and relate transmission inferences to social networks and mobility patterns. To address these aims, we will expand the design of our current project by collecting archived cellular telephone metadata from index cases for one year prior to the diagnosis of tuberculosis. We will then construct socio-mobility networks that map movement within the community prior to diagnosis of tuberculosis. We will use whole genome sequencing of isolates collected from case networks to reconstruct transmission trees using a Bayesian framework which combines social and mobility networks with phylogenetic information. This novel approach to mapping transmission may give tuberculosis control programs a useful way to tailor public health interventions that are responsive to the local epidemiology of tuberculosis.

根据世界卫生组织的数据，结核病的全球燃烧在2000年达到顶峰，此后一直 每年下降1.5％。这个适中的进步尚未达到千禧一代发展目标 消除结核病。此外，这种平均下降隐藏了事件的重要变化， 当今世界各地的结核病患病率。这种变化凸显了决定疾病的 在各个地区的发病率可能有所不同，因此必须针对局部疾病流行病学量身定制干预措施。 当今的结核病控制的标准方法依赖于检测和治疗普遍的结核病 案例。这种方法在伯嫩高结核病区域的有效性可能有限。 结核病的传播相应高。确实，当诊断和处理病例时， 下一代病例已经被新感染。为了遏制流行病的进展 结核病，必须通过减少传播或预防疾病来预防新病例。 几十年来，家庭接触调查一直是结核病的主动病例发现的主要主导。 尽管家庭是结核病的强烈传播，但家庭传播帐户 在给定社区中不到25％的结核病。虽然家庭很方便，但 易于识别和评估的本地化社交网络，我们必须更好地了解 支持结核分枝杆菌传播并导致疾病“热点”的复杂社区网络。 该提案的目的是开发用于衡量支持结核病的社区网络的方法 传播。在此提案中，我们计划重建感染性结核病的社会和流动性网络 通过使用蜂窝电话元数据诊断前的病例，并将这些信息与整个基因组整合在一起 索引病例的结核分枝杆菌菌株的序列来推断传输网络。具体目标 为：1）在诊断为M的指标之前，要评估肺结核病例的运动。 城市非洲社区的结核病传播； 2）推断结核分枝杆菌的传播树 非洲非洲社区使用结核病指数及相关案例中分离株的整个基因组测序 向社交网络和流动性模式的传播推断。 为了解决这些目标，我们将通过收集存档的蜂窝来扩展当前项目的设计 在结核病诊断之前，索引病例的电话元数据。然后我们将构建 在结核病诊断之前，在社区内绘制运动的社会运动网络。我们将 使用从案例网络收集的分离株的整个基因组测序来重建传输树 使用将社会和流动性网络与系统发育信息相结合的贝叶斯框架。这 映射传输的新方法可能会为结核病控制程序提供一种有用的方式来量身定制公众 对肺结核局部流行病学有反应的健康干预措施。

项目成果

Modeling the potential impact of host population survival on the evolution of M. tuberculosis latency.

模拟宿主种群生存对结核分枝杆菌潜伏期进化的潜在影响。

• DOI: 10.1371/journal.pone.0105721
• 发表时间: 2014
• 期刊: PloS one
• 影响因子: 3.7
• 作者: Zheng,Nibiao;Whalen,ChristopherC;Handel,Andreas
• 通讯作者: Handel,Andreas

Ethical, Legal, and Sociocultural Issues in the Use of Mobile Technologies and Call Detail Records Data for Public Health in the East African Region: Scoping Review.

• DOI: 10.2196/35062
• 发表时间: 2022-06-02
• 期刊: Interactive journal of medical research
• 影响因子: 2

Low Prevalence of Tuberculin Skin Test Boosting among Community Residents in Uganda.

乌干达社区居民中结核菌素皮试阳性率较低。

• DOI: 10.4269/ajtmh.17-0591
• 发表时间: 2018
• 期刊: The American journal of tropical medicine and hygiene
• 作者: Sekandi,JulietN;Zalwango,Sarah;Nkwata,AllanK;Martinez,Leonardo;Kakaire,Robert;Mutanga,JaneN;Whalen,ChristopherC;Kiwanuka,Noah
• 通讯作者: Kiwanuka,Noah

In reply to 'Active case finding for tuberculosis: what is the most informative measure for policy makers?'.

回复“积极发现结核病病例：对政策制定者来说最有信息性的措施是什么？”。

• DOI: 10.5588/ijtld.13.0924-2
• 发表时间: 2014
• 期刊: The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease
• 作者: Sekandi,JN;List,J;Luzze,H;Yin,X;Dobbin,K;Corso,PS;Oloya,J;Okwera,A;Whalen,CC
• 通讯作者: Whalen,CC

Defining adequate contact for transmission of Mycobacterium tuberculosis in an African urban environment.

确定非洲城市环境中结核分枝杆菌传播的充分接触。

• DOI: 10.1186/s12889-020-08998-7
• 发表时间: 2020
• 期刊: BMC public health
• 影响因子: 4.5
• 作者: Castellanos,MaríaEugenia;Zalwango,Sarah;Kakaire,Robert;Ebell,MarkH;Dobbin,KevinK;Sekandi,Juliet;Kiwanuka,Noah;Whalen,ChristopherC
• 通讯作者: Whalen,ChristopherC