Advancing One Health Data Capture at the Point of Zoonotic Spillover in the Congo Basin Forest Perimeter

项目摘要 由于人类对刚果盆地森林周边脆弱生态系统的侵蚀， 病原体扩散到边境社区，造成世界性影响。的区域 布温迪森林，位于乌干达西南角，与民主共和国接壤 刚果（DRC）是一个生物多样性热点，拥有世界上最多的灵长类和蝙蝠物种 非洲的森林它也位于非洲人口最稠密的地区之一。医疗保健 该地区的医疗机构对埃博拉病毒病或马尔堡出血热的爆发保持警惕 （MHF）。鉴于邻近地区最近证实爆发埃博拉病毒病，这是特别及时的。利用 一个健康的方法，该项目将建立一个必要的监测基础设施，调查埃博拉病毒 和其他人畜共患病溢出事件，通过开发一个综合的移动医疗系统， 提供者同时监测人类和野生动物的疾病爆发。这个目标 监测系统是为了提高检测人畜共患病在布温迪地区蔓延，并帮助回答几十年来， 关于支持埃博拉病毒出现的生态情景的长期问题，使预测能够 有助于防止未来的爆发。具体而言，在本项目的R21阶段，我们将：（1）开发一个村庄 卫生团队（VHT）数据收集系统，用于远程捕获AFI和野生动物发病率/死亡率信息 使用基于One Health智能手机的APP和基于社区的SMS系统， 使用手机塔三角测量和机器学习优化的被动地理定位系统， 在智能手机和非智能手机技术中实现，以提高定位的准确性 （3）在布温迪地区建立一个综合的“一个健康”AFI疫情警报系统， 为快速准确地检测疾病爆发而优化。在本项目的R33阶段，我们将：（1）完善， 扩大和评估分层移动健康监测平台，以改善纵向AFI病例识别; 利用Bwindi mHealth监测系统调查埃博拉病毒暴露的流行病学 与该地区的野生动物接触有关。该项目与现有的NIAID资助的AFI很好地结合在一起 监测方案，并与乌干达卫生部密切合作。该项目将提供一个 严格评估在长期人畜共患疾病中加入移动健康组件的益处的最佳方案 疾病监测，有利于所有发达平台的可持续性。

Project Summary Due to human encroachment on the fragile ecosystems of the Congo basin forest perimeter, spillover of zoonotic pathogens into border communities have proliferated and resulted in worldwide implications. The region of the Bwindi Impenetrable Forest, located in the southwestern corner of Uganda bordering the Democratic Republic of Congo (DRC) is a biodiversity hotspot harboring among the largest number of primate and bat species of any forest in Africa. It is also situated in one of the most densely human populated regions of Africa. Healthcare facilities in this region remain vigilant for an outbreak of Ebola virus disease (EVD) or Marburg hemorrhagic fever (MHF). This is especially timely given the recent confirmed outbreaks of EVD in neighboring districts. Utilizing a One Health approach, this project will build an essential surveillance infrastructure for investigating ebolavirus and other zoonotic disease spillover events by developing an integrated mHealth system that allows healthcare providers to monitor outbreaks of disease in both humans and wildlife simultaneously. The goal of this surveillance system is to improve detection of zoonotic spillover in the Bwindi region and help to answer decades long questions about the ecological scenarios supporting ebolavirus emergence, enabling forecasting that could help prevent future outbreaks. Specifically, during the R21 phase of this project we will: (1) develop a Village Health Team (VHT) data collection system to capture AFI and wildlife morbidity / mortality information in remote forest settings using a One Health smartphone based APP and community-based SMS system; (2) develop a passive geo-location system using cell-phone tower triangulation with machine learning optimization that can be implemented across smartphone and non-smartphone-based technologies to improve accuracy in localization of outbreaks; and (3) create an integrated One Health AFI outbreak alert system operational in the Bwindi region, optimized for rapid and accurate detection of outbreaks. During the R33 phase of this project we will: (1) refine, expand and evaluate the tiered mHealth surveillance platform for improved longitudinal AFI case identification; and (2) utilize the Bwindi mHealth surveillance system to investigate the epidemiology of ebolavirus exposure associated with wildlife contact in the region. This project is well integrated with existing NIAID funded AFI surveillance programs and collaborates closely with the Ugandan Ministry of Health. This project will provide an optimal scenario for rigorously evaluating the benefits of adding an mHealth component to long term zoonotic disease monitoring, benefiting the sustainability of all developed platforms.