Utility of Contact Investigation of Drug Susceptible and Resistant TB in Tanzani

描述(由申请人提供)：这是一份K01奖项的申请书，授予伊丽莎白·费尔博士，她是加州大学旧金山分校肺部和重症监护医学部的流行病学家。费尔博士在流行病学和成本效益分析方面确立了自己的研究员地位，以评估新的结核病(TB)病例检测方法在资源有限、结核病和艾滋病毒高发以及耐药结核病威胁增加的环境中的可行性、成本和影响。这一K01奖项将为费尔博士提供必要的支持，以实现以下目标：(1)成为应用先进分析方法评估结核病干预措施成本效益的专家；(2)学会应用传染病传播的数学模型来评估结核病干预措施的影响；(3)成为在低资源环境下设计、招募和管理前瞻性队列研究的专家；(4)将实验室研究技术应用于结核病基因分型和耐药性测试；以及(5)发展和独立的临床研究事业。为了实现这些目标，费尔博士组建了一个指导团队，成员包括一名主要导师、国际公认的全球结核病控制权威菲利普·霍普韦尔博士，以及两名共同导师：国际公认的成本效益研究专家詹姆斯·G·卡恩博士，以及出版颇丰的数学建模专家和流行病学家特拉维斯·波尔科博士。 新结核病患者发现率低是全球控制该疾病的主要限制因素，特别是在艾滋病毒高发地区。费尔博士的研究将确定在低收入、高结核病负担的环境中进行家庭接触调查是否会导致结核病的早期诊断(目标1)。她还将评估计划条件下接触调查的成本、成本效益和影响(目标2)；并表征通过家庭接触调查发现的新病例中结核分枝杆菌菌株的传播性和致病性(目标3)。这项研究将成为未来R01拨款申请的基础，以解决结核病传播和致病性的科学基础，特别是耐药结核分枝杆菌菌株的科学基础。

DESCRIPTION (provided by applicant): This is an application for a K01 award for Dr. Elizabeth Fair, an epidemiologist in the Division of Pulmonary and Critical Care Medicine at the University of California, San Francisco. Dr. Fair is establishing herself as an investigator in epidemiologic and cost effectiveness analyses to evaluate the feasibility, cost, and impact of new tuberculosis (TB) case detection methods in resource limited-settings with high incidences of TB and HIV and increasing threats of drug-resistant TB. This K01 award will provide Dr. Fair with the support necessary to accomplish the following goals: (1) to become expert in applying advanced analytic methods for evaluating the cost effectiveness of programmatic TB interventions; (2) to learn to apply mathematical modeling of infectious disease transmission for evaluating the impact of TB interventions; (3) to become expert in the design, enrollment, and management of a prospective cohort study in a low-resource setting; (4) to apply laboratory research techniques for TB genotyping and drug resistance testing; and (5) to develop and independent clinical research career. To achieve these goals, Dr. Fair has assembled a mentoring team comprised of a primary mentor, Dr. Philip Hopewell, an internationally recognized authority on global TB control, and 2 co-mentors: Dr. James G. Kahn, an internationally recognized expert on cost effectiveness studies, and Dr. Travis Porco, a well-published mathematical modeler and epidemiologist. Low case finding of new TB patients is a major limitation to global control of the disease, especially in high HIV-prevalence areas. Dr. Fair's research will determine whether household contact investigation in a low-income, high TB burden setting results in earlier diagnosis of TB (Aim 1). She will also assess the costs, cost-effectiveness, and impact of contact investigation under program conditions (Aim 2); and characterize the transmissibility and pathogenicity of M.tb strains from new cases found through household contact investigation (Aim 3). The research will form the basis for a future R01 grant application to address the scientific basis of TB transmission and pathogenicity, specifically of drug-resistant M.tb strains.