Control of Plague in Uganda

描述(由申请人提供)：该项目的目标是：1)减少乌干达因鼠疫引起的人类发病率和死亡率，2)减少疾病传播到包括美国在内的其他人群的风险，3)填补我们对鼠疫生态学和人类风险因素的知识和理解方面的空白，4)实地评估针对腺疫爆发的紧急干预措施，包括适用于美国的措施，以及5)收集乌干达各种动物来源的鼠疫细菌分离物，供疾控中心存档和未来研究。该项目特别针对总统关于国土安全的国家战略，提供了实地测试紧急控制措施的独特机会，并为疾控中心提供了一份鼠疫分离档案，以供今后研究。该项目具体涉及疾控中心关于2010年全球疾病检测和健康人的任务优先事项。通过在鼠疫病例发生时对居民和村庄进行环境和生态调查，将完成病媒和宿主物种的识别、动物来源菌株分离的收集以及人类鼠疫风险因素的识别。乌干达平均每年约有300例鼠疫病例(1999-2003年)，这可能大大低估了总的疾病负担。此外，还将通过以村庄为基础的病例对照研究来探索风险因素，在该研究中，环境和生态参数将在有鼠疫病例史的村庄和没有鼠疫病例史的村庄之间进行比较(尽可能匹配生态和人口相似性)。还将利用全球定位系统(GPS)和与世界其他区域鼠疫风险相关的气候参数，尝试建立时间和地理风险模型。将在疫区内选定的地点建立长期气候数据收集站。将根据已确定的风险因素和生态调查结果，制定控制鼠疫的具体方法。这些方法可能使用已知的或新的技术，并将通过在村庄一级的应用进行评估--测量疾病发病率和死亡率以及减少生态风险(例如跳蚤或啮齿动物密度)。当然，降低疾病发病率和死亡率是公共卫生的支柱。该项目通过完善的科学调查和直接应用实现了这一点。

DESCRIPTION (provided by applicant): The objectives of this project are to: 1) reduce human morbidity and mortality due to plague in Uganda, 2) reduce the risk of disease spread to other populations including the United States, 3) fill gaps in our knowledge and understanding of plague ecology and human risk factors, 4) field evaluate emergency intervention measures for bubonic plague outbreaks including measures applicable within the United States, and, 5) collect plague bacterial isolates from a variety of animal sources in Uganda for CDC archiving and future research. This project specifically addresses the President's National Strategy on Homeland Security by providing a unique opportunity to field test emergency control measures and by providing CDC an archive of plague isolates for future studies. This project specifically addresses CDC mission priorities on Global Disease Detection and Healthy People 2010. Identification of vector and reservoir species, collection of strain isolates from animal sources, and the identification of human plague risk factors will be accomplished by conducting environmental and ecological investigations at the residences and villages of plague cases as they occur. Uganda has averaged approximately 300 plague cases per year (1999-2003), which is likely a significant underestimate of total disease burden. Risk factors will additionally be explored through a village-based case-control study in which environmental and ecological parameters will be compared between villages with a history of plague cases vs. villages without a history of plague cases (matched for ecological and demographic similarity as much as possible). Temporal and geographical risk models will also be attempted utilizing global positioning system (GPS) and climatic parameters found to correlate with plague risk in other regions of the world. Long-term climate data collection stations will be erected at selected locations within the endemic region. Specific methods to control plague will be developed based upon identified risk factors and ecological findings. These methods may use known or novel techniques and will be evaluated by their application at the village level - measuring disease morbidity and mortality reduction as well as ecological risk reduction such as flea or rodent density). Reduction of disease morbidity and mortality is, of course, the backbone of public health. This project achieves that through sound scientific investigation followed by direct application.