R01AI155739

Soil Epidemiology: A New Tool for Environmental Surveillance of Soil-Transmitted Helminth Infections in Endemic Settings - Project Summary

Soil-Transmitted Helminth (STH) infections (intestinal worms) affect 1.5 billion individuals globally. Recent evidence from trials and modeling studies suggests that community-wide mass drug administration (CMDA) of deworming medication with sufficient coverage and adherence can eliminate STH transmission. However, in settings with ongoing environmental transmission and low coverage of networked sanitation, persistent environmental reservoirs of STH eggs result in high reinfection rates and hinder progress towards elimination.

STH control programs use human stool-based methods to assess STH prevalence and intensity in endemic settings. However, individual stool sampling is expensive and logistically difficult, particularly when human infection prevalence is low. If collecting and analyzing soil from locations in communities with high human activity (e.g., home entrances, water collection points, schools) were established to be equally or more sensitive than human stool diagnostics, this approach may represent a less invasive and more cost-effective surveillance tool for CMDA program monitoring and evaluation.

This study will leverage a multi-country cluster-randomized controlled trial delivering three years of biannual CMDA in Benin and India (DEWORM3). The trial will collect and analyze, by quantitative polymerase chain reaction (QPCR), human stool samples 24 months (N=80,000 in total) after the final round of CMDA, which will yield highly accurate human STH infection prevalence estimates in the study areas.

Through extensive laboratory studies and field testing in India and Benin, our team has developed a sensitive and specific molecular method for detecting STH environmental DNA (eDNA) in large volumes of soil. We will nest soil sampling within the trial at the same time point as human stool collection and one year later with the specific aims to:

1) Quantify the effect of a biannual CMDA intervention on the soil STH reservoir;
2) Determine whether soil STH eDNA levels can predict community-level human STH infection prevalence; and
3) Develop the optimal soil sampling strategy and compare costs to human stool-based surveillance.

Pairing soil STH eDNA assessments with human infection prevalence data already being collected by the DEWORM3 trial is a unique and time-sensitive opportunity to validate and test the utility of environmental STH surveillance. Our findings will also contribute to understanding the conditions under which CMDA program integration with improved sanitation interventions is needed for achieving sustained reductions in STH infection prevalence.

Regents Of The University Of California

TO ASSIST PUBLIC AND PRIVATE NONPROFIT INSTITUTIONS AND INDIVIDUALS TO ESTABLISH, EXPAND AND IMPROVE BIOMEDICAL RESEARCH AND RESEARCH TRAINING IN INFECTIOUS DISEASES AND RELATED AREAS, TO CONDUCT DEVELOPMENTAL RESEARCH, TO PRODUCE AND TEST RESEARCH MATERIALS. TO ASSIST PUBLIC, PRIVATE AND COMMERCIAL INSTITUTIONS TO CONDUCT DEVELOPMENTAL RESEARCH, TO PRODUCE AND TEST RESEARCH MATERIALS, TO PROVIDE RESEARCH SERVICES AS REQUIRED BY THE AGENCY FOR PROGRAMS IN INFECTIOUS DISEASES, AND CONTROLLING DISEASE CAUSED BY INFECTIOUS OR PARASITIC AGENTS, ALLERGIC AND IMMUNOLOGIC DISEASES AND RELATED AREAS. PROJECTS RANGE FROM STUDIES OF MICROBIAL PHYSIOLOGY AND ANTIGENIC STRUCTURE TO COLLABORATIVE TRIALS OF EXPERIMENTAL DRUGS AND VACCINES, MECHANISMS OF RESISTANCE TO ANTIBIOTICS AS WELL AS RESEARCH DEALING WITH EPIDEMIOLOGICAL OBSERVATIONS IN HOSPITALIZED PATIENTS OR COMMUNITY POPULATIONS AND PROGRESS IN ALLERGIC AND IMMUNOLOGIC DISEASES. BECAUSE OF THIS DUAL FOCUS, THE PROGRAM ENCOMPASSES BOTH BASIC RESEARCH AND CLINICAL RESEARCH. SMALL BUSINESS INNOVATION RESEARCH (SBIR) PROGRAM EXPANDS AND IMPROVES PRIVATE SECTOR PARTICIPATION IN BIOMEDICAL RESEARCH. THE SBIR PROGRAM INTENDS TO INCREASE AND FACILITATE PRIVATE SECTOR COMMERCIALIZATION OF INNOVATIONS DERIVED FROM FEDERAL RESEARCH AND DEVELOPMENT, TO INCREASE SMALL BUSINESS PARTICIPATION IN FEDERAL RESEARCH AND DEVELOPMENT, AND TO FOSTER AND ENCOURAGE PARTICIPATION OF SOCIALLY AND ECONOMICALLY DISADVANTAGED SMALL BUSINESS CONCERNS AND WOMEN-OWNED SMALL BUSINESS CONCERNS IN TECHNOLOGICAL INNOVATION. THE SMALL BUSINESS TECHNOLOGY TRANSFER (STTR) PROGRAM STIMULATES AND FOSTERS SCIENTIFIC AND TECHNOLOGICAL INNOVATION THROUGH COOPERATIVE RESEARCH AND DEVELOPMENT CARRIED OUT BETWEEN SMALL BUSINESS CONCERNS AND RESEARCH INSTITUTIONS, TO FOSTER TECHNOLOGY TRANSFER BETWEEN SMALL BUSINESS CONCERNS AND RESEARCH INSTITUTIONS, TO INCREASE PRIVATE SECTOR COMMERCIALIZATION OF INNOVATIONS DERIVED FROM FEDERAL RESEARCH AND DEVELOPMENT, AND TO FOSTER AND ENCOURAGE PARTICIPATION OF SOCIALLY AND ECONOMICALLY DISADVANTAGED SMALL BUSINESS CONCERNS AND WOMEN-OWNED SMALL BUSINESS CONCERNS IN TECHNOLOGICAL INNOVATION. RESEARCH CAREER DEVELOPMENT AWARDS SUPPORT THE DEVELOPMENT OF SCIENTISTS DURING THE FORMATIVE STAGES OF THEIR CAREERS. INDIVIDUAL NATIONAL RESEARCH SERVICE AWARDS (NRSAS) ARE MADE DIRECTLY TO APPROVE APPLICANTS FOR RESEARCH TRAINING IN SPECIFIED BIOMEDICAL SHORTAGE AREAS. IN ADDITION, INSTITUTIONAL NATIONAL RESEARCH SERVICE AWARDS ARE MADE TO ENABLE INSTITUTIONS TO SELECT AND MAKE AWARDS TO INDIVIDUALS TO RECEIVE TRAINING UNDER THE AEGIS OF THEIR INSTITUTIONAL PROGRAM.

93.855 - Allergy and Infectious Diseases Research

National Institute of Allergy and Infectious Diseases (NIAID) [HHS - NIH]

Berkeley, California 947101754 United States

Single Zip Code

NIH Research Project Grant (Parent R01 Clinical Trial Not Allowed) (PA-20-185)

Amendment Since initial award the total obligations have increased 423% from $627,723 to $3,282,077.