Optimizing ring screening strategy for control of Taenia solium infection

优化控制猪带绦虫感染的环筛策略

• 批准号: 8782645
• 负责人: Cesar Miguel Gavidia
• 金额: $ 52.51万
• 依托单位: OREGON HEALTH & SCIENCE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-12-15 至 2018-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8782645
• 关键词: Adult; Africa South of the Sahara; Animal Husbandry; Area; Asia; Award; Biological Assay; Brain; Central Nervous System Infections; Central Nervous System Parasitic Infections; Cestoda; Communities; Community Trial; Country; Cysticercosis; Data; Detection; Development; Diagnostic; Disadvantaged; Discipline; Doctor of Philosophy; Economic Development; Economics; Effectiveness; Enrollment; Environment; Epilepsy; Evaluation; Exploratory/Developmental Grant for Diagnostic Cancer Imaging; Family suidae; Feces; Food Safety; Fostering; Goals; Health; Health Professional; Household; Human; Income; Infection; Intestines; Investigation; Laboratory Research; Latin America; Lesion; Long-Term Effects; Mentorship; Methods; Neurosciences Research; Parasites; Performance; Peru; Public Health; Public Health Schools; Research; Research Infrastructure; Research Training; Resources; Risk; Rural; Serological; Side; Source; Staging; Taenia solium; Teniasis; Time; Tongue; Training; Training Programs; Translations; Ultrasonography; United States National Institutes of Health; Universities; Work; arm; cohort; cost effective; cost effectiveness; diagnostic assay; egg; experience; health economics; improved; meter; nervous system disorder; population based; programs; rural area; scale up; screening; tool; transmission process

DESCRIPTION (provided by applicant): Taenia solium is the most common parasitic infection of the central nervous system and a leading cause of acquired epilepsy in low and middle income countries. Endemic transmission occurs primarily in rural areas where pigs are allowed to roam and consume human feces, thus risking contamination with T. solium eggs and subsequent infection with larval cysts (cysticercosis). Identification and treatment of adult tapeworm carriers (taeniasis) who shed eggs into the environment is therefore critical to control strategy. In our previous NIH R21 award we demonstrated that targeted screening for taeniasis in household clusters surrounding infected pigs (ring-screening) identifies tapeworm carriers for treatment and significantly reduces community transmission of the parasite. This strategy involves identifying heavily-infected pigs through tongue examination followed by thorough investigation for the source tapeworm among residents in neighboring households. Our long-term goals are 1) to develop effective, affordable and sustainable strategies for T. solium control in endemic areas, and 2) to increase population-based research capacity for neurologic disorders in rural Peru. The first aim of this R01 proposal is to refine ring-screening strategy so that it can be implemented in control programs. We propose a community trial with five parallel study arms to evaluate the long-term efficacy, cost- effectiveness and acceptability of ring-screening for control of T. solium compared against mass treatment. Additional methods for evaluation include use of portable ultrasound and rapid-diagnostic serologic assays to identify heavily-infected pigs in the field, and presumptive treatment within rings (ring-treatment) as a potential alternative to ring-screening. We will enroll communities totaling approximately 10,000 residents and 6,000 pigs in studies which range from 2 to 4 years in duration. Our second aim is to increase the local capacity for planning, developing and operating neuroepidemiologic studies in rural northern Peru. We will train two PhD candidates in advanced quantitative methods at Johns Hopkins University Bloomberg School of Public Health, as well as 4 Masters level candidates in research-related disciplines at Universidad Cayetano Peruana Heredia in Lima over the 5-year award period. The results of our combined research and training programs will provide tools, methods and capacitation necessary to enable scale-up of the most promising control strategies we identify.

描述（由申请人提供）：Taenia solium是中枢神经系统最常见的寄生虫感染，也是低收入国家和中等收入国家获得癫痫的主要原因。地方性传播主要发生在允许猪漫游和消耗人粪便的农村地区，从而冒着污染卵卵污染的风险，随后感染了幼虫囊肿（囊肿）。因此，将卵浸入环境的成年tape虫载体（Taeniasis）的鉴定和处理对于控制策略至关重要。在我们以前的NIH R21奖中，我们证明了围绕感染猪（环形筛查）的家用簇中的尾虫病的针对性筛查确定了tape虫载体以进行治疗，并大大减少了寄生虫的社区传播。该策略涉及通过舌头检查确定受感染的猪，然后对邻近家庭中居民的来源tape虫进行彻底的研究。我们的长期目标是1）为T. solium控制制定有效，负担得起和可持续的策略 在地方性地区，以及2）增加秘鲁农村神经系统疾病的基于人群的研究能力。该R01提案的第一个目的是完善筛选策略，因此 可以在控制程序中实现。我们提出了一项具有五个平行研究组的社区试验，以评估环形筛查对控制T. solium的长期疗效，成本效益和可接受性与大规模治疗相比。用于评估的其他方法包括使用便携式超声和快速诊断的血清学测定方法来鉴定野外感染的猪，以及环内的推定治疗（环处理）作为环形筛查的潜在替代方法。我们将招募约10,000名居民和6,000头猪的社区，持续时间为2至4年。我们的第二个目的是提高秘鲁北部农村地区计划，开发和运营神经ePidemiologic研究的当地能力。我们将在约翰·霍普金斯大学彭博公共卫生学院培训两名候选人的高级定量方法，以及在5年奖励期间在利马大学的Cayetano Peruana Heredia大学的4个硕士级候选人。我们合并的研究和培训计划的结果将提供所需的工具，方法和能力，以实现我们确定的最有前途的控制策略的扩展。