EPIDEMIOLOGIC AND ECOLOGIC DETERMINANTS OF MONKEYPOX IN A DISEASE-ENDEMIC SETTING

描述（由申请方提供）：猴痘是一种人畜共患病，在刚果民主共和国的几个地区流行。在人类中，猴痘病毒感染可导致天花样疾病，在高达15%的患者中具有致命结果[1-4]。本项目的最终目标是确定适当、有效的干预措施，以减少人类感染猴痘病毒的风险，并在发生人类猴痘时尽量减少发病率和死亡率。为了了解与人类猴痘病毒感染相关的特定风险，以确定潜在的干预措施，我们将研究病毒在人类中传播的主要机制，以及人类从动物获得感染的主要方式。我们将进一步努力开发工具（例如，新的床旁诊断测试）和方法（例如，应用标准化的监测病例定义，[5-7]），可以促进早期识别人类猴痘并减少病毒的人际传播。 我们建议在刚果民主共和国赤道省Tshuapa区进行实地研究。该区人口约150万，每年向卫生部报告600-900例猴痘病例。这项计划包括6个活动范畴：（1）医护人员培训及社区外展。(2)加强猴痘监测。(3)研究方案的设计与实施。(4)识别风险因素。(5)研究潜在的动物宿主。(6)即时诊断检测的评价：我们设想，在Tshuapa区开展的具体活动的结果将使全国各地、可能是整个刚果盆地的猴痘病毒感染风险人群受益。

DESCRIPTION (provided by applicant): Monkeypox is a zoonosis, endemic to several regions within the Democratic Republic of the Congo. In humans, monkeypox virus infection can lead to a smallpox-like illness with fatal outcomes in up to 15% of patients [1-4]. The ultimate objectives of this project are to identify appropriate, effective interventions that will diminish risks for human acquisition of monkeypox virus infection, and minimize morbidity and mortality consequences of human monkeypox when it occurs. To achieve an understanding of specific risks associated with human monkeypox virus infection, in order to identify potential interventions, we will investigate both the principal mechanisms of virus transmission among humans, and the principal manner in which humans acquire infection from animals. We will further work toward the development of tools (e.g., novel point-of-care diagnostic tests), and approaches (e.g. application of a standardized surveillance case definition, [5-7]), that can promote early identification of human monkeypox and diminish inter-human spread of the virus. We propose that the field component of the research be conducted in the Tshuapa District of Equateur Province, Democratic Republic of the Congo. The population of the district is ~1.5 million persons and 600-900 cases of monkeypox are reported to the Ministry of Health annually. The six activity areas encompassed by this project are: (1) Health care worker training and community outreach. (2) Enhanced monkeypox surveillance. (3) Design and implementation of research protocols. (4) Identification of risk factors. (5) Investigation of potential animal reservoirs. (6) Evaluation of point-of-care diagnostic assays.We envision that findings from specific activities in Tshuapa district will benefit persons at risk for monkeypox virus infection throughout the country and possibly throughout the Congo Basin.