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Cholera in Goma, DRC

刚果民主共和国戈马的霍乱

基本信息

批准号：
10584601
负责人：
John Glenn Morris
金额：
$ 74.36万
依托单位：
UNIVERSITY OF FLORIDA
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-04-18 至 2025-03-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10584601
关键词：
Address Advisory Committees Africa Africa South of the Sahara Area Bacteriophages Bangladesh Case Study Cessation of life Chad Cholera Cities Clinical Communities Congo Country Data Data Collection Democratic Republic of the Congo Development Disease Emergency Situation Environment Epidemic Epidemiology Evolution Frequencies Geographic Locations Goals Great Lakes Region Home Hot Spot Household Human Infection Infrastructure Intervention Modernization Morbidity - disease rate Nutrient Pathway interactions Patients Pattern Persons Play Population Population Growth Poverty Public Health Rain Recommendation Recurrence Refugees Reporting Risk Factors Role Route Rwanda Site Socioeconomic Status Source Techniques Temperature Urbanization Vibrio cholerae O1 Water Yemen behavior change burden of illness climate change demographics disorder prevention high risk interest member mortality pathogen transmission process

项目摘要

Project Summary/Abstract Cholera is an ancient disease that has shown a remarkable ability to persist and spread in the modern world. In WHO data for 2016, 132,121 cholera cases and 2420 deaths were reported from 38 countries. However, taking into account likely underreporting, the global disease burden has been estimated to be in the range of 1.3 to 4.0 million cholera cases and 21,000-143,000 deaths per year. Cholera is frequently a disease of poverty, striking in areas with humanitarian emergencies and crumbling public health infrastructure: most recently, this has been highlighted by the massive epidemic in Yemen, with over a million cases reported to date. Given the intransigence of such problems, and ongoing issues with climate change, urbanization, and population growth, cholera is likely to remain a recurring global threat to public health. While the Indian subcontinent is the ancestral home of cholera, and epidemics may occur in crisis situations such as currently seen in Yemen, over the past two decades sub-Saharan Africa has emerged as the primary locus of the global cholera disease burden. Within Africa, two major regional inland “hotspots” of cholera activity have been identified: one in the Lake Chad region, and the other in the Great Lakes region, centered on Goma in the DRC. The WHO Global Task Force for Cholera Control has recently developed a “global roadmap” leading toward cholera eradication, based on three strategic axes: the second of these axes is “Prevention of disease reoccurrence by targeting multi-sectorial interventions in cholera hotspots.” Within this roadmap, they have also placed a strong focus on the need for country-level data, with targeting of interventions directed by an understanding of local circumstances and transmission patterns. Goma, with a population of over 1 million (including substantial refugee populations), is on the northern shore of Lake Kivu, bordering Rwanda; the city has had recurrent, annual cholera epidemics for at least the past decade, with phylodynamic analysis demonstrating the persistence of a “Great Lakes” clade of V. cholerae O1 in the region. We are proposing a targeted, multi-sectorial analysis of cholera transmission in Goma, utilizing robust epidemiologic and phylodynamic techniques, with two major goals: 1) to further expand our understanding of how this ancient pathogen evolves and adapts to new geographic areas and new populations; and 2) to provide data for development of a practical, scientifically-informed plan for cholera control in this regional cholera hotspot, building on recommendations of the WHO Global Task Force. Specific Aims to accomplish these objectives: • Specific Aim 1: Studies of cholera transmission and infection within households of suspected cholera cases in Goma; • Specific Aim 2: Identification and assessment of aquatic environmental sources/reservoirs for cholera; and • Specific Aim 3. Phylodynamic analysis of clinical and environmental V. cholerae O1 strains.

项目概要/摘要霍乱是一种古老的疾病，但在现代却显示出惊人的持续和传播能力世界。世界卫生组织 2016 年数据显示，38 个国家报告了 132,121 例霍乱病例和 2420 例死亡。然而，考虑到可能存在的漏报情况，全球疾病负担估计为每年有 1.3 至 400 万霍乱病例和 21,000-143,000 人死亡。霍乱是一种常见的疾病贫困、发生人道主义紧急情况和公共卫生基础设施摇摇欲坠的地区：大多数最近，也门爆发的大规模疫情凸显了这一点，据报告病例已超过百万例。日期。鉴于这些问题的顽固性，以及气候变化、城市化和气候变化等持续存在的问题，随着人口增长，霍乱可能仍然是对公共卫生的反复出现的全球威胁。而印度次大陆是霍乱发源地，危机中可能爆发疫情过去二十年来，撒哈拉以南非洲地区出现了像目前也门这样的情况全球霍乱疾病负担的主要来源。在非洲，两个主要的区域性内陆“热点” 已查明霍乱活动：一个在乍得湖地区，另一个在大湖地区，以刚果民主共和国戈马为中心。世界卫生组织全球霍乱控制工作组最近制定了根除霍乱的“全球路线图”基于三个战略轴：第二个轴是“通过针对霍乱热点地区的多部门干预措施来预防疾病复发。”之内在此路线图中，他们还重点关注对国家级数据的需求，目标是通过了解当地情况和传播模式来指导干预措施。戈马人口超过 100 万（包括大量难民），位于北部基伍湖岸边，与卢旺达接壤；该市至少在过去几年中经常发生霍乱流行病过去十年，系统动力学分析证明了 V 的“五大湖”分支的持续存在。该地区霍乱O1。我们提议对霍乱传播进行有针对性的多部门分析戈马利用强大的流行病学和系统动力学技术，有两个主要目标：1）进一步扩大我们对这种古老病原体如何进化并适应新地理区域和新环境的理解人口； 2) 为制定实用、科学的霍乱计划提供数据根据世卫组织全球工作组的建议，控制这一区域霍乱热点地区。实现这些目标的具体目标： • 具体目标 1：霍乱疑似病例家庭内霍乱传播和感染的研究在戈马； • 具体目标2：确定和评估霍乱水生环境源/库；和 • 具体目标3。临床和环境霍乱弧菌O1 菌株的系统动力学分析。