Trypanosoma cruzi testing of Triatoma vectors in a likely endemic area of Southeast Texas

在德克萨斯州东南部可能流行的地区对克氏锥虫载体进行测试

• 批准号: 9087422
• 负责人: KRISTY MURRAY
• 金额: $ 7.95万
• 依托单位: BAYLOR COLLEGE OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-02-01 至 2018-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9087422
• 关键词: Acute Disease; Animals; Area; Back; Blood; Canis familiaris; Carbon Dioxide; Cardiomyopathies; Cessation of life; Chagas Cardiomyopathy; Chagas Disease; Cities; Collaborations; Collection; County; DNA; Diagnosis; Diagnostic; Dilated Cardiomyopathy; Disease; Early Diagnosis; Epidemiologic Studies; Epidemiologist; Epidemiology; Fibrosis; Fostering; Funding; Future; Goals; Health; Health Campaign; Heart Diseases; Home environment; Human; Human Resources; Infection; Insect Vectors; Insecta; Intervention; Life; Mammals; Medical; Methods; Mitochondria; Molecular; Outcome; Parasites; Parasitic Diseases; Patients; Pilot Projects; Population; Prevalence; Prevention; Preventive Intervention; Public Health; RNA, ribosomal, 12S; Recording of previous events; Research Personnel; Risk; Shelter facility; Source; Staging; Surveys; Symptoms; System; Target Populations; Testing; Texas; Triatoma; Trypanosoma cruzi; United States; Work; authority; burden of illness; disease transmission; disorder risk; high risk; improved; innovation; metropolitan; neglected tropical diseases; outcome forecast; preference; prevent; public health relevance; rRNA Genes; residence; screening; sucking; transmission process; vector; vector control

 DESCRIPTION (provided by applicant): Chagas' disease (Trypanosoma cruzi infection) transmission occurs between a mammalian host and a triatomine insect vector. Acute disease in humans is normally nonspecific and mild; however, approximately 20-30% of those infected with the parasite will go on to develop cardiomyopathy, characterized by conduction system abnormalities, progressive dilated cardiomyopathy, and ultimately death. Early diagnosis is critical for initiating treatment to prevent irreversible fibrosis and improve health outcomes. In he southern United States, we are finding mounting evidence of autochthonous disease transmission between infected vectors and humans. Texas has the highest number of locally acquired human cases. In fact, the first geographic clustering of locally acquired human cases in the United States was identified in the city of Houston, Texas. Additionally, this city has a substantial veterinary disease burden, particularly among shelter dogs. Historical studies dating back to 1987 support a continuous landscape of disease transmission in this potentially endemic area. Unfortunately, epidemiologic studies of the vector are severely lacking, and the true burden of disease has not been fully elucidated in this area. This current proposal aims to collect and test local vectors for infection, clarify local vector species, and perform blood meal analysis to determine host preferences. Identification of Trypanosoma cruzi infected vectors is essential to (1) prevent disease transmission, (2) better understand the epidemiology of the disease, and (3) identify high risk populations to target for screening and intervention. This innovative pilot project will be the first to assess Trypanosoma cruzi infection prevalence among triatomine vectors in Houston, the nation's 4th largest city, to better ascertain disease burden and risk to residents. The overall goal of this study is to identify areas of positive Trypanosoma cruzi vectors and assess the risk of disease transmission to humans. We hypothesize that half of collected vectors will be infected and that blood meal analysis will indicate domestic mammals and humans as the most prevalent meal source. This project will foster new collaborations between resident epidemiologists with expertise on human Chagas disease and expert entomologists with a long history of handling vectors of medical importance in the region. The long-term goals of this study are to establish vector surveillance capacity in a potentially endemic area and to develop effective public health campaigns targeted for residents living in high-risk areas for transmission. This high impact study will critically impact our understanding of Chagas disease transmission factors in Texas, with an opportunity to identify high risk populations for targeted prevention and intervention efforts.

 描述(由申请人提供)：恰加斯病(克氏锥虫感染)在哺乳动物宿主和三叶虫昆虫媒介之间传播。人类的急性疾病通常是非特异性的和轻微的；然而，大约20%-30%的寄生虫感染者会继续发展为心肌病，其特征是传导系统异常，进行性扩张型心肌病，最终死亡。早期诊断对于启动治疗以预防不可逆转的纤维化和改善健康结局至关重要。在美国南部，我们发现越来越多的证据表明，受感染的病媒和人类之间存在本土疾病传播。德克萨斯州是当地感染人间病例最多的州。事实上，美国第一个当地获得的人间病例的地理聚集性是在德克萨斯州的休斯顿市发现的。此外，这座城市有很大的兽医疾病负担，特别是收容所的狗。追溯到1987年的历史研究支持在这个潜在的地方病流行地区疾病传播的持续图景。不幸的是，对该媒介的流行病学研究严重缺乏，在这一领域，疾病的真正负担还没有完全阐明。这项目前的提议旨在收集和测试当地媒介的感染情况，澄清当地媒介物种，并进行血餐分析以确定宿主的偏好。克氏锥虫感染媒介的识别对于(1)预防疾病传播，(2)更好地了解疾病的流行病学，以及(3)识别高危人群以进行筛查和干预是至关重要的。这一创新的试点项目将是第一个评估美国第四大城市休斯敦三聚氰胺媒介中克氏锥虫感染率的项目，以更好地确定居民的疾病负担和风险。这项研究的总体目标是确定锥虫克氏阳性媒介的区域，并评估疾病向人类传播的风险。我们假设一半收集的媒介将被感染，血粉分析将表明家养哺乳动物和人类是最普遍的食物来源。该项目将促进具有人类恰加斯病专门知识的常驻流行病学家和具有处理该区域重要医学病媒的长期历史的专家昆虫学家之间的新合作。这项研究的长期目标是在可能流行的地区建立病媒监测能力，并针对生活在传播高危地区的居民开展有效的公共卫生运动。这项高影响力的研究将严重影响我们对德克萨斯州恰加斯病传播因素的理解，有机会确定高危人群，进行有针对性的预防和干预努力。