Forecasting Trachoma Control

 描述（由申请人提供）：世界卫生组织沙眼控制计划的目标是到2020年消除致盲性沙眼，但要取得成功，卫生工作者、政策制定者和其他贡献组织就不能浪费时间和精力。一些地区尚未接受单一的大规模阿奇霉素治疗，而另一些地区尽管取得了明显的成功，但仍在接受治疗。传染病预测虽然还处于起步阶段，但已开始在流感和其他疾病方面取得成功。沙眼消除计划将受益于疾病预测，因为它将有助于确定需要更多努力的地方。我们建议使用数学模型，统计预测和专家意见来预测沙眼流行，并在数据可用时前瞻性地测试这些预测。更具体地说，沙眼消除计划依赖于临床体征，而不是实验室数据。我们建议：（a）检验模型对临床试验数据预测的拟合是否在短期内显著优于专家意见或统计外推，（B）检验模型对程序数据预测的拟合是否显著优于专家意见或统计外推。 最后，（c）使用最成功的模型和来自国际沙眼倡议的地区一级流行率数据，以帮助指导全球地区一级盲性沙眼消除规划决策。这些决定包括组织是否应该更长时间或更频繁地治疗，以及即使我们减少努力，一些地区是否会成功。这些努力不仅有助于指导世卫组织沙眼控制计划到2020年控制沙眼的工作，并在实现控制后加强监测工作。它们还将为流行病预测方法提供重要的检验。项目小组将作出重大努力，致力于不断传播和绘制项目开发的预测和模型，以帮助在整个项目期间更好地向国际热带工业协会和其他利益攸关方提供信息，包括根据具体区域的实际可用资源，应其要求提供定制预测。

 DESCRIPTION (provided by applicant): The WHO Trachoma control program aims to eliminate blinding trachoma by 2020, but to succeed, health workers, policy makers, and other contributing organizations cannot afford to waste time and effort. Some districts have yet to receive a single mass azithromycin treatment, while others are still being treated despite apparent success. Infectious disease forecasting, while in its infancy, has begun to achieve success in influenza and other diseases. The trachoma elimination program will benefit from disease forecasting, because it will help identify places where more effort is needed. We propose to use mathematical models, statistical forecasts, and expert opinion to predict trachoma epidemics, and prospectively test these forecasts against data as it becomes available. More specifically, trachoma elimination programs rely on clinical signs, and not laboratory data. We propose to (a) test whether models fit to clinical trial data forecast significantly better than expert opinion or statistical extrapolation in the short term, (b) test whether models fit to program data forecast significantly better than expert opinion or statistical extrapolation in the longer term, and finally (c) use the most successful models with district-leve prevalence data from the International Trachoma Initiative to help guide global district-level blinding trachoma elimination planning decisions. Such decisions include whether organizations should treat for longer or more frequently, as well as whether some districts will succeed even if we reduce effort. These efforts will not only help to guide the WHO trachoma control program's efforts to control trachoma by 2020 and enhance surveillance efforts after control has been achieved. They will also provide crucial tests of epidemic forecasting methods. Significant project team efforts will be dedicated towards ongoing dissemination and mapping of project-developed forecasts and models to help better inform ITI and other stakeholders throughout the project, including customized forecasts if requested by specific regions, based on their actual available resources.