Forecasting Trachoma Control

项目摘要/摘要 沙眼项目取得了巨大的成功，但它们没有达到全球范围内的目标 到2020年消灭沙眼。近三分之一的流行区仍未达到控制门槛。 为什么？ 一个原因可能是，2020年的目标是在获得足够证据之前很久就设定的。在 在最初的资助期间，我们使用项目调查来预测全球活动性沙眼的分布。我们 我还使用了NEI临床试验数据来更好地定义临床活动和实际衣原体之间的关系 感染。新的临床、感染和血清学数据现在将使更准确的估计成为可能。在执行 我们将利用这些丰富的信息来源来预测哪些地区将 在当前的努力下实现控制。 第二个因素是，沙眼干预指南基本上是“一刀切”的。这里, 我们建议评估必要的加强干预措施，以实现对热点地区的控制，目前的努力 不足以控制沙眼。 最后，世卫组织的计划承认，疫情可能会卷土重来。在最初的授权期内，我们 表明沙眼患病率的调查有时从支持控制转变为质疑 控制力。在当前的提案中，我们建议对复苏进行建模，以便可以对复苏进行监视 改进了。 总之，我们建议：(A)制定切合实际的中期和淘汰的实时开放获取预测 帮助保持我们特定协作利益相关者计划的正轨的目标；(B)更好地瞄准热点的模式 加强干预措施以加速成功的地点；(C)合理监测死灰复燃的模式 一旦宣布成功，就保持控制。

PROJECT SUMMARY/ABSTRACT Trachoma programs have been enormously successful, but they fell short of their goal of Global Elimination of Trachoma by 2020. Nearly one third of endemic districts still had not met the threshold for control. Why? One reason may be that the 2020 goals were set long before sufficient evidence was available. In the original grant period, we used program surveys to forecast the distribution of active trachoma worldwide. We also used NEI clinical trial data to better define the relationship between clinical activity and actual chlamydial infection. New clinical, infection, and serology data will now enable more precise estimates. In carrying out the aims of this current proposal, we will use these enriched information sources to forecast which districts will achieve control under current efforts. A second factor is that the trachoma intervention guidelines have essentially been “one size fits all”. Here, we propose to assess the enhanced interventions necessary to achieve control in hotspots where current efforts are not sufficient for trachoma control. Finally, the WHO plan acknowledged that resurgence may happen. In the original grant period, we demonstrated that surveys of trachoma prevalence sometimes switched from supporting control to questioning control. In this current proposal we propose to model resurgence so that surveillance of resurgence can be improved. In summary, we propose: (a) real-time open-access forecasts that set realistic interim and elimination goals to help keep our specific collaborating stakeholder's programs on track; (b) models for better targeting hot spots with enhanced interventions to accelerate success; (c) models for rational surveillance for resurgence to maintain control once success has been declared.