RFA-GH-20-005, Project of Febrile Illness Surveillance in the Andean and Amazon Countries (PISAAC)

RFA-GH-20-005，安第斯和亚马逊国家发热性疾病监测项目 (PISAAC)

• 批准号: 10669093
• 负责人: Eduardo Gotuzzo
• 金额: $ 99.76万
• 依托单位: UNIVERSIDAD PERUANA CAYETANO HEREDIA
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-01 至 2025-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10669093
• 关键词: RFA; GH; 20; 005; Project

Project Summary/Abstract Acute febrile illness (AFI) is an important cause of morbidity and productivity loss in Latin America. Despite efforts for surveillance and advancements in diagnostic capacity, the etiology of AFI is still unknown in over 50% of cases. Our Project of Febrile Illness Surveillance in the Andean and Amazon Countries (“PISAAC”) proposes to study AFI etiology and epidemiology, to strengthen the core public health systems that prevent and mount prompt containing responses in front of outbreaks. PISAAC, led by Dr. Eduardo Gotuzzo at Universidad Cayetano Heredia, is a multi institutional initiative developed in close collaboration with key actors and institutions at the Peruvian Ministry of Health (MoH), including the Peruvian National Health Institute (INS). This initiative will be carried out in partnership with the National Institute of Health Leopoldo Izquieta Perez (INSPI) and Escuela Superior Politécnica del Litoral (ESPOL), in Ecuador, aiming to develop a coordinated effort to establish a systematic surveillance system within the Coastal, Andean and Amazon regions of South America. Additional key partners include U.S. Naval Medical Research Unit Nº6, and the University of Texas Medical Branch in Galveston. Our specific aims are to determine the etiology and epidemiology of acute undifferentiated febrile illness in strategically selected regions of Peru and Ecuador, improve laboratory capacity for the diagnosis of illness, produce timely and accurate surveillance data, and develop a workforce that can continue with these measures. Additionally, we aim to determine the prevalence of antimicrobial resistance, and the etiology and antimicrobial resistance of acute diarrheal disease. The study will start in two regions in Peru during the first year. Subsequently, during the second year, two regions in Ecuador will be added, and 1 to 2 new regions per country will be added per year. The initial stage is a prospective study of sentinel surveillance that will enroll subjects that present to healthcare centers of primary and secondary care level with AFIs. Blood and serum samples will be taken at acute presentation for PCR based tests and serology. Additionally, urine and nasal samples will be collected and stored along with serum alliquotes in a biorepository for future studies. Convalescent sera will be collected for paired serology testing in those patients that resulted negative for initial testing with molecular methods. During the second year, components of antimicrobial resistance (AMR) surveillance and diarrheal disease surveillance will be implemented, as these two health problems are considered public health priorities for Peru. PISAAC is in a unique position to strengthen the national surveillance and emergency response systems as it builds upon the pre-existing infrastructure and public health delivery platforms, provides strategic complementary partnerships across lab diagnosis to disease control and addresses the core technical areas demanded by the Global Health Security Agenda.

项目总结/摘要 急性发热性疾病（AFI）是拉丁美洲发病率和生产力损失的重要原因。 尽管努力监测和诊断能力的进步，AFI的病因仍然是 在50%以上的病例中未知。我们在安第斯和亚马逊地区的发热性疾病监测项目 国家（“PISAAC”）建议研究AFI病因学和流行病学，以加强核心公众 卫生系统在疫情爆发前预防和迅速采取遏制措施。 PISAAC由卡耶塔诺埃雷迪亚大学的Eduardo Gotuzzo博士领导，是一个多机构 与秘鲁农业部的主要行为者和机构密切合作制定的倡议 卫生部，包括秘鲁国家卫生研究所。这一举措将在 与国家卫生研究所Leopoldo Izquieta Perez（INSPI）和Escuela合作 厄瓜多尔的上级文学的政治学院，旨在开展协调努力， 在南部沿海、安第斯和亚马逊地区建立系统的监测系统 美国参考其他主要合作伙伴包括美国海军第六医学研究所和宾夕法尼亚大学。 德州医疗分支在加尔维斯顿。 我们的具体目标是确定急性未分化发热的病因学和流行病学， 在秘鲁和厄瓜多尔的战略性选定地区， 疾病诊断，及时准确地提供监测数据，并培养一支能够 继续采取这些措施。此外，我们的目标是确定抗菌药物的流行率， 耐药性、急性腹泻病的病原学及耐药性。 第一年将在秘鲁的两个地区开始这项研究。随后，在第二年， 厄瓜多尔将增加两个地区，每个国家每年将增加1至2个新地区。的 初始阶段是一项前哨监测的前瞻性研究， 初级和二级保健中心与AFI。血液和血清样本将 在急性症状时进行PCR检测和血清学检查。另外，尿液和鼻腔样本 将收集并与血清等分试样一起沿着储存在生物储存库中用于未来研究。 对于结果为阴性的患者，将采集恢复期血清进行配对血清学检测 用分子方法进行初步测试在第二年， 抗生素耐药性（AMR）监测和疟疾监测将实施，因为这两个 健康问题被视为秘鲁的公共卫生优先事项。 PISAAC在加强国家监测和应急反应方面具有独特的地位 系统，因为它建立在现有的基础设施和公共卫生服务平台，提供 从实验室诊断到疾病控制的战略互补伙伴关系， 全球卫生安全议程所要求的技术领域。