Innovative Interdisciplinary Approaches to Sustainable Airborne Infection Control

Summary

Principal Investigator: Edward A Nardell
Abstract: DESCRIPTION (provided by applicant): After HIV, tuberculosis is the single largest infectious killer of adults in the world today. Among the most important aspects of TB control in most low and middle-income countries is the airborne spread of drug resistant (DR) tuberculosis, substantially in institutions such as hospitals, clinics, jails, prisons, and refugee camps. Institutional airborne infection control is a public health problem that intersects with several oter disciplines: architecture, engineering, and medicine. However, there have been no real innovations in airborne infection control in many decades, perhaps since the adaptation of industrial respirators for health care worker use in the 1990s. This proposal seeks to build international research capacity to address the issue of airborne spread of infections in buildings. Of greatest concern is the DR TB epidemic, but most of the interventions that result from this research will be equally relevant to other infections with airborne potential, such as pandemic influenza. This proposal continues the air disinfection engineering research training conducted under a 1-year Stimulus Fogarty Innovations Framework grant in Boston and in South Africa. It expands that work to include research training for architects as well as engineers in Boston and South Africa, using as a Partners In Health (PIH) clinical sites around the world, as well as research sites accessible through our South African partners, the Council for Scientific and Industrial Research (CSIR) and the University of Pretoria (UP). Course work will be available through UP. Under expert multidisciplinary mentorship, our trainees will develop and test novel indicators of successful building designs and, with another partner, the Medical Research Council (MRC) of South Africa, quantitatively test novel air disinfection technology developed in Boston and Pretoria. Our trainees will perform testing at the Airborne Infections Research (AIR) Facility (Witbank, SA), an established collaborative project between the MRC, the US CDC, UP, and Brigham &Women's (BWH) Hospital. If these innovations show promise, we will work with our local partners and two transitional research partners (the National Institute of Design of Indi and Frog Design, Inc) to optimize and commercialize products for local manufacture so that implementation is sustainable. Our own research at the AIR facility has demonstrated the rapid and powerful effect of effective treatment on TB transmission, even for drug resistant strains. Therefore, another complementary approach to the airborne spread of DR TB will be to test the impact on TB transmission of active case finding through cough surveillance followed by rapid molecular testing and drug susceptibility testing that will allow patients to be rapidly placed on effective treatment. Our physician trainees will test this approach at a large general hospital in Lima, Peru that has carefully monitored TB cases among its workers over the years. Our partners in this clinical research and training project will be the National Institute of Health of Peru (INS) and Socios En Salud (SES), the Peru arm of PIH, with course work in epidemiology available through San Marcos University.
Funding Period: 2012-08-18 - 2017-08-31
more information: NIH RePORT

Top Publications

  1. ncbi Upper-room ultraviolet germicidal irradiation (UVGI) for air disinfection: a symposium in print
    Edward Nardell
    Harvard Medical School, Harvard School of Public Health, Boston, MA, USA
    Photochem Photobiol 89:764-9. 2013

Detail Information

Publications1

  1. ncbi Upper-room ultraviolet germicidal irradiation (UVGI) for air disinfection: a symposium in print
    Edward Nardell
    Harvard Medical School, Harvard School of Public Health, Boston, MA, USA
    Photochem Photobiol 89:764-9. 2013
    ....

Research Grants30

  1. NUCLEAR STRUCTURE AND GENE EXPRESSION
    Janet L Stein; Fiscal Year: 2013
    ..abstract_text> ..
  2. Center for Novel Therapeutics for HIV-Associated Cognitive Disorders
    Justin C McArthur; Fiscal Year: 2013
    ..5. To identify and validate surrogate biomarkers based on proteomics and lipomics. ..
  3. Case GI SPORE
    Sanford D Markowitz; Fiscal Year: 2013
    ..The strength of these investigators and the resources at their disposal will ensure this program leads to important advances. ..
  4. Utility of Contact Investigation of Drug Susceptible and Resistant TB in Tanzani
    Elizabeth Fair; Fiscal Year: 2013
    ..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. ..
  5. Peruvian/Brazilian Amazon Center of Excellence in Malaria
    Joseph M Vinetz; Fiscal Year: 2013
    ..We hypothesize that asymptomatic infections may represent a major reservoir of parasites in this region, which is not addressed by traditional malaria control strategies. ..
  6. Northeast Biodefense Center
    W Ian Lipkin; Fiscal Year: 2013
    ..As a Center based in a School of Public Health and a State Department of Health, the NBC has a firm commitment to and practical understanding of Emergency Preparedness. ..
  7. Optimizing the impact of Xpert MTB/RIF on treatment outcomes of drug resistant TB
    ANNELIES T A VAN RIE; Fiscal Year: 2013
    ..The evidence generated will contribute to the successful implementation of this novel assay into routine practice in resource limited, high TB/HIV burden countries. ..
  8. Novel diagnostics and therapeutics for caliciviruses
    MARY KOLB ESTES; Fiscal Year: 2013
    ..abstract_text> ..
  9. Integrated, Home-based Treatment for MDR TB and HIV in Rural South Africa
    James C M Brust; Fiscal Year: 2013
    ....
  10. Community-Based Intensive Case Finding for HIV, TB, and MDR/XDR TB in Rural South
    Sheela Shenoi; Fiscal Year: 2013
    ..This project will provide data on the effect of intensive case finding on clinical outcomes and inform public health policy and practice in high prevalence TB and HIV settings globally. ..
  11. Novel molecular and cellular approaches for alcoholism medication development
    Robert A Harris; Fiscal Year: 2013
    ..The PPG has both internal and external advisory board members, providing expert guidance from scientists with a wide range of expertise in drug development and therapeutics. ..
  12. Network Models for Evaluating HIV-associated MDR TB transmission and control
    Jason Andrews; Fiscal Year: 2013
    ..The proposed training and research experience will provide the foundation for a career as an independent investigator. ..
  13. UCLA CENTER FOR AIDS RESEARCH (CFAR)
    Jerome A Zack; Fiscal Year: 2013
    ..Inclusion of this resource will be highly beneficial to clinical, behavioral and basic science studies. ..
  14. Research to control and eliminate malaria in SE Asia and SW Pacific
    JAMES WALTER KAZURA; Fiscal Year: 2013
    ..Synergy among the ICEMR projects and cores and incorporation ICEMR findings into national programs will help answer unresolved key issues related to malaria control and elimination locally and in the SE Asia region. ..
  15. Effect of HIV Infection on Pulmonary MDR-TB Transmission and Virulence
    Ashwin S Dharmadhikari; Fiscal Year: 2013
    ..tuberculosis virulence and the effeqt of HIV on the spread of MDR-TB. ..