Novel threat detection methodology to detect HIV outbreaks in Washington

用于检测华盛顿艾滋病毒爆发的新型威胁检测方法

• 批准号: 10683347
• 负责人: SARAH E HOLTE
• 金额: $ 18.91万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-12 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10683347
• 关键词: 2019-nCoV; AIDS prevention; Area; Caring; Case Study; Centers for Disease Control and Prevention (U.S.); Classification; Collaborations; Communicable Diseases; Complement; Computer software; County; Data; Data Reporting; Detection; Diagnosis; Disease; Disease Outbreaks; Drug resistance; Epidemic; Evaluation; Funding; Future; Genetic; Genetic Complementation Test; Geography; Goals; Gonorrhea; HIV; HIV Infections; HIV diagnosis; Health; Hot Spot; Incidence; Infection; Infrastructure; Injecting drug user; Investigation; Knowledge; Link; Location; Methodology; Methods; Modeling; Molecular; Monitor; Newly Diagnosed; Performance; Persons; Population; Predisposition; Process; Provider; Public Health; Public Health Practice; Recommendation; Reporting; Research; Research Personnel; Residual state; Resources; Sampling Biases; Scanning; Sequence Analysis; Series; Space-Time Clustering; Stochastic Processes; Syphilis; Testing; Time; Training; Washington; Work; data streams; disease transmission; flexibility; improved; innovation; multidisciplinary; new growth; novel; prevent; prevention service; preventive intervention; simulation; spatiotemporal; statistics; surveillance data; transmission process; treatment services; uptake

Abstract/summary Despite recent significant advances in biomedical HIV prevention, HIV diagnosis rates in Washington State have been stable over the past several years, with a rate of 5.3 per 100,000 in 2014 and 5.4 per 100,000 in 2018. Identifying and responding to outbreaks is a cornerstone of public health practice; rapid public health action in such cases may decrease the transmission of HIV and other infectious diseases. While the Centers for Disease Control and Prevention (CDC) require that local health departments conduct analyses to identify HIV molecular clusters and/or time-space clusters of new HIV diagnoses, no recent HIV outbreaks have been identified by methods other than local health department staff or providers noticing increases in cases in specific areas or populations. Working in collaboration with the Washington State Department of Health (DOH), we propose the following aims to evaluate a new methodology to identify HIV outbreaks: (1) To adapt rapid threat detection methodology that was developed by our team to identify outbreaks in gonorrhea to instead identify spatial- temporal clusters of HIV cases, or changes in previously identified clusters in Washington State, based on retrospective data from multiple counties, and (2) To compare the performance of this methodology to the performance of current cluster identification methods being used by the Washington DOH, including CDC recommended strategies for molecular and time-space cluster identification. We will determine whether this method could have identified outbreaks sooner than the routine, CDC-recommended approaches, including an HIV outbreak that occurred among injection drug users in King County, WA in 2018. We propose an innovative approach; the methods are adapted and expanded from statistical change detection and spatiotemporal approaches to identify the time and location of the clusters rapidly. If our approach is found to provide added value to ongoing work at Washington DOH, we will help implement the approach so that it can be used in conjunction with HIV surveillance in Washington State. While our approach does not rely on HIV genetic sequence information, if successful, it can also be used to assist in identifying more appropriate local criteria to identify HIV molecular clusters. This approach is flexible and can be applied in numerous scenarios, including for other infections such as syphilis or SARS-CoV-2.

摘要/概要 尽管最近在生物医学艾滋病预防方面取得了重大进展，但华盛顿州的艾滋病诊断率 在过去几年中一直保持稳定，2014年为每10万人5.3人，2015年为每10万人5.4人。 2018.确定和应对疫情是公共卫生实践的基石;快速公共卫生 在这种情况下采取行动可能会减少艾滋病毒和其他传染病的传播。虽然中心 疾病控制和预防中心（CDC）要求当地卫生部门进行分析， 艾滋病毒分子簇和/或新的艾滋病毒诊断的时空簇，最近没有艾滋病毒爆发， 通过当地卫生部门工作人员或提供者以外的方法发现， 具体地区或人口。 与华盛顿州卫生部（DOH）合作，我们提出以下建议 目的是评估一种新的方法来确定艾滋病毒爆发：（1）适应快速威胁检测 我们的团队开发了一种方法来识别淋病的爆发， 艾滋病毒病例的时间集群，或华盛顿州先前确定的集群的变化，基于 来自多个国家的回顾性数据，以及（2）将该方法的性能与 华盛顿卫生部（包括疾病控制和预防中心）使用的当前聚类识别方法的性能 推荐的分子和时空聚类识别策略。我们将决定这是否 这种方法可以比CDC推荐的常规方法更快地发现疫情， 2018年在华盛顿州金县注射吸毒者中发生的艾滋病毒爆发。 我们提出了一种创新的方法，该方法是适应和扩大从统计变化检测 和时空方法，以快速识别集群的时间和位置。如果我们的方法是 发现为华盛顿卫生部正在进行的工作提供附加值，我们将帮助实施该方法， 它可以与华盛顿州的艾滋病监测一起使用。虽然我们的方法并不依赖于 关于艾滋病病毒基因序列的信息，如果成功的话，还可以用来协助识别更合适的 以确定艾滋病毒分子簇的地方标准。这种方法是灵活的，可以应用于许多 包括梅毒或SARS-CoV-2等其他感染。