Predictors of Influenza-Associated Absenteeism and Impact of Vaccination in a Cohort of Guatemalan Agricultural Workers

项目概要/摘要 这是丹尼尔奥尔森，医学博士的K23以病人为导向的指导职业发展奖的申请。 这项拟议中的研究将评估流感在一个队列中的临床和社会经济影响， 危地马拉的农业工作者，评估流感的临床、生物学和社会经济预测因素， 相关缺勤，并衡量基于工作场所的流感疫苗在减少 疾病和缺勤。 候选人Olson博士是一名委员会认证的儿科医生和传染病（ID）专家， 科罗拉多大学（CU）医学院儿科教授， 在科罗拉多公共卫生学院流行病学系担任二级职务。 训练通过动手指导研究，教学课程和会议/研讨会，奥尔森博士的 K23职业发展目标包括：1）开发和正式化临床试验设计技能， 实施，2）建立疫苗学专业知识，3）获得管理和开发 高质量的全球健康研究网站。 导师/环境。奥尔森博士组建了一个多元化的导师团队，每个人都有自己的具体技能。 提出研究和职业发展目标。Edwin Asturias博士，儿科ID副教授 和流行病学在CU和朱尔斯阿米尔主席社区儿科，将是他的主要导师。的 其余的导师委员会包括李纽曼博士，凯瑟琳爱德华兹博士，朱梅博士，和博士。 Frederick Hayden，提供了一批具有广泛经验和专业知识的高级导师。 Research.低收入和中等收入国家继续承受着不成比例的 流行性感冒。工作场所流感疫苗接种计划可能提供一种具有成本效益的策略， 因流感而缺勤和丧失生产力。农业工人代表着一种经济战略 拉丁美洲的劳动力人数以及流感等疾病相关缺勤的驱动因素尚不清楚。 CU在危地马拉的研究基地有一个由2，706名来自附近一个农业工人组成的队列。 香蕉种植园和训练有素的研究团队。为了更好地了解流感对 农业工人和工作缺勤的司机，我们的目标是1）评估临床和社会经济 流感对危地马拉农业工人队列的影响，并确定工作的预测因素 因流感而缺勤，以及2）测量流感疫苗接种对疾病发病率的有效性， 缺勤率和工作表现。我们假设流感会对 农业工人的负担，具体的临床，生物学和社会经济预测因素可能是 与更大的缺勤率有关，并且基于工作场所的流感疫苗计划将显着 减少临床疾病和流感相关缺勤。

PROJECT SUMMARY/ABSTRACT This is an application for a K23 Patient-Oriented Mentored Career Development award by Daniel Olson, MD. The proposed research will assess the clinical and socioeconomic impacts of influenza in a cohort of agricultural workers in Guatemala, evaluate clinical, biological, and socioeconomic predictors of influenza- associated absenteeism, and measure the effectiveness of workplace-based influenza vaccine in reducing disease and absenteeism. Candidate. Dr. Olson is a board-certified pediatrician and infectious disease (ID) specialist who is an Assistant Professor in the Department of Pediatrics at the University of Colorado (CU) School of Medicine, with a secondary appointment in the Department of Epidemiology in the Colorado School of Public Health. Training. Through hands-on mentored research, didactic coursework, and conferences/seminars, Dr. Olson’s K23 Career Development aims include: 1) Develop and formalize skills in clinical trial design and implementation, 2) Establish expertise in vaccinology, and 3) Obtain competencies to manage and develop a high quality global health research site. Mentors/Environment. Dr. Olson has assembled a diverse team of mentors, each with specific skills in his proposed research and career development aims. Dr. Edwin Asturias, an Associate Professor of Pediatric ID and Epidemiology at CU and the Jules Amer Chair of Community Pediatrics, will be his primary mentor. The remaining mentorship committee includes Dr. Lee Newman, Dr. Kathryn Edwards, Dr. May Chu, and Dr. Frederick Hayden, providing a diverse group of senior level mentors with broad experience and expertise. Research. Low- and middle-income countries (LMICs) continue to suffer a disproportionate burden of influenza disease. Workplace influenza vaccination programs may offer a cost-effective strategy to limit absenteeism and lost productivity due to influenza. Agricultural workers represent an economically strategic workforce in Latin America, and the drivers of illness-associated absenteeism, such as influenza, are unknown. The CU research site in Guatemala has an established cohort of 2,706 agricultural workers from a nearby banana plantation and a well-trained research team. To better understand the impact of influenza on agricultural workers and the drivers of work absenteeism, we aim to 1) Evaluate the clinical and socioeconomic impacts of influenza on a cohort of Guatemalan agricultural workers and determine predictors of work absenteeism due to influenza, and 2) Measure the effectiveness of influenza vaccination on disease incidence, absenteeism, and job performance in the same cohort. We hypothesize that influenza places a significant burden on agricultural workers, that specific clinical, biological, and socioeconomic predictors may be associated with greater absenteeism, and that a workplace-based influenza vaccine program will significantly reduce clinical disease and influenza-associated absenteeism.