EMERGING MDR TUBERCULOSIS ACROSS THE US/MEXICO BORDER

产品说明：我们的应用程序将创建动态数据库，以分析和生成关于德克萨斯州南部和墨西哥东北部的结核病（TB），特别是耐多药结核病（MDR-TB）传播的精确模式的初步数据。这将通过一个两国联合体来实现，该联合体将分享各自地区结核病病例的社会、人口和地理数据。该联盟的目标是：1）汇总目前由联盟成员单独持有的现有社会人口统计学、耐药性和分子指纹数据库; 2）合并、地理编码和分析汇总的数据库; 3）建立通用的方案和程序，用于检测耐药性、提取M.结核病DNA和分离株的分子特征4）评估社会网络分析作为改进MDR-TB传播追踪的方法。这些分析将3-5年内的个案与分子指纹、药物敏感性模式、社会人口特征和地理位置联系起来，使区域能够了解耐多药结核病和耐多药结核病跨界传播的分布和动态。这些数据将用于改进控制技术，并成为假设的基础，这些假设将在未来更复杂的研究应用中进行测试。这些应用将包括流行病学和转化研究，使用共同的协议，为两国项目的新出现的疾病，特别是耐多药结核病。该联合体的地理区域包括从墨西哥湾到拉雷多的下格兰德河河谷（LRGV）的5个县，以及墨西哥边境的塔毛利帕斯州和新莱昂州。该联合会将由得克萨斯大学公共卫生学院位于布朗斯维尔的区域校区的院长和教员领导，布朗斯维尔距离边境不到一英里，并将提供分子微生物学、流行病学、生物统计学、社会网络研究和时空分析方面的专门知识。休斯顿、圣安东尼奥和蒙特雷的主要结核病研究人员将在加强研究地区开展耐多药结核病专业公共卫生、流行病学和分子基础研究的能力方面发挥关键作用。边境联盟的参与者来自两国负责消除结核病的所有公共卫生部门。生物恐怖主义引入MDR的一个重要防御措施是了解这些微生物的传播与非耐药结核病（如果有的话）的不同，并详细了解当地MDR菌株，以便快速区分已知的MDR结核病流行菌株和新引入的菌株。该应用程序将有助于解决所有这些问题。

DESCRIPTION: (provided by applicant) Our application will create dynamic databases to analyze and generate preliminary data on the precise patterns of transmission of tuberculosis (TB), especially multidrug resistant tuberculosis (MDR-TB), across South Texas and North Eastern Mexico. This will be achieved through a binational consortium that will share social, demographic, and geographic data on tuberculosis cases from each of their respective areas. The aims of the consortium are 1) aggregate existing sociodemographic, drug resistance and molecular fingerprinting databases currently held separately by consortium members 2) merge, geocode and analyze the aggregated database 3) establish common protocols and procedures for testing of drug resistance, extraction of M. tuberculosis DNA, and molecular characterization of isolates 4) evaluate social network analysis as a method for improving the tracking of MDR-TB transmission. These analyses link individual cases over 3-5 years with molecular fingerprints, drug susceptibility patterns, sociodemographic characteristics and geographic location, allowing regional understanding of the distribution and dynamics of DR and MDR-TB transmission across the border. These data will be used to improve control techniques and become the basis of hypotheses that will be tested in future, more elaborate research applications. These applications will include epidemiologic and translational research studies using common protocols for binational projects in emerging diseases, specifically MDR-TB. The geographic area of the consortium encompasses 5 counties of the Lower Rio Grande Valley (LRGV) from the Gulf of Mexico to Laredo, and the Mexican border states of Tamaulipas and Nuevo Leon. The consortium will be led by the Dean and faculty of the University of Texas School of Public Health Regional Campus at Brownsville, less than a mile from the border and contributing expertise in molecular microbiology, epidemiology, biostatistics, social network studies and spatial-temporal analyses. Leading tuberculosis researchers in Houston, San Antonio and Monterrey will play key roles in strengthening the capacity to conduct specialized public health, epidemiologic, and molecular based research on MDR-TB in the study area. Border consortium participants are from all the public health investigatorities responsible for TB elimination in both countries. An important defense of MDR introduction by bioterrorism is understanding how transmission of these organisms may differ from non resistant TB (if at all) and detailed knowledge of local strains of MDR that will allow quick distinction between known circulating strains of MDR TB and newly introduced strains. This application will be instrumental in addressing all of these issues.