Diarrheal diseases are predictable outcomes when fecal-oral pathogens meet human poverty and-dislocation. Are diarrheal diseases sensitive indicators of change in socioeconomic level, resource availability, and human social contacts? Processes like these are extremely difficult to study in a controlled fashion. The construction of a new road in coastal Ecuador provides a valuable natural experiment for this purpose. This road will link some previously remote villages to local, regional, and national networks of goods, services, and people, creating new connections among them. We hypothesize that: (1) the level and type of connections between villages are correlated with infection of enteric pathogens; and (2) the changing social connections, new resources, and sanitary and hygienic behaviors of individuals within villages are correlated with infection of enteric pathogens. These hypotheses use the village as their unit of analysis. When estimating the contribution of various exposure risks to disease incidence, it is also important to explore the implications of interdependence between these pathways. This is the third aim of our study: analyzing the joint effects of changes in these contact patterns using disease transmission models. Using a quasi-experimental design, twenty villages will be followed for 4 years, selected so that a rural-urban continuum is fully represented. This continuum will be measured by several factors that relate a given village to Borbon, the town located at the confluence of two rivers that support the villages within the region. Data will be collected at three levels. First, health promoters who live in the villages under study will implement an active surveillance program. They will administer a new survey tool to measure the incidence of all the diarrheal illnesses and monitor both proximal and distal determinants of disease, in a given village. Second, a biannual visit to each community will be conducted by our field team, which has recently completed a cross sectional feasibility study in these villages. Each visit will last two weeks. In these visits, stool samples will be collected from all symptomatic individuals and a random selection of controls. In addition, during these visits, survey tools will be used to collect information on water-use behavior sanitation, hygiene, food consumption patterns, and travel and migration. Third, semi-annual visits to each village will be undertaken by the local Ecuadorian anthropologist. These visits will include open-ended interviews as well as additional questions about social network formation and change. The visits will also allow village development and road.

Agency
National Institute of Health (NIH)
Institute
National Institute of Allergy and Infectious Diseases (NIAID)
Type
Research Project (R01)
Project #
5R01AI050038-06
Application #
7163489
Study Section
Special Emphasis Panel (ZRG1-EDC-3 (01))
Program Officer
Schmitt, Clare K
Project Start
2003-01-15
Project End
2008-06-30
Budget Start
2007-01-01
Budget End
2008-06-30
Support Year
6
Fiscal Year
2007
Total Cost
$679,784
Indirect Cost
Name
University of Michigan Ann Arbor
Department
Public Health & Prev Medicine
Type
Schools of Public Health
DUNS #
073133571
City
Ann Arbor
State
MI
Country
United States
Zip Code
48109
Moser, Kara A; Zhang, Lixin; Spicknall, Ian et al. (2018) The Role of Mobile Genetic Elements in the Spread of Antimicrobial-Resistant Escherichia coli From Chickens to Humans in Small-Scale Production Poultry Operations in Rural Ecuador. Am J Epidemiol 187:558-567
Kraay, Alicia N M; Brouwer, Andrew F; Lin, Nan et al. (2018) Modeling environmentally mediated rotavirus transmission: The role of temperature and hydrologic factors. Proc Natl Acad Sci U S A 115:E2782-E2790
Lopez, Velma K; Dombecki, Carolyn; Trostle, James et al. (2018) Trends of child undernutrition in rural Ecuadorian communities with differential access to roads, 2004-2013. Matern Child Nutr 14:e12588
Kraay, Alicia N M; Trostle, James; Brouwer, Andrew F et al. (2018) Determinants of Short-term Movement in a Developing Region and Implications for Disease Transmission. Epidemiology 29:117-125
Bhavnani, Darlene; Bayas, Rosa de los Ángeles; Lopez, Velma K et al. (2016) Distribution of Enteroinvasive and Enterotoxigenic Escherichia coli Across Space and Time in Northwestern Ecuador. Am J Trop Med Hyg 94:276-84
Fuller, James A; Villamor, Eduardo; Cevallos, William et al. (2016) I get height with a little help from my friends: herd protection from sanitation on child growth in rural Ecuador. Int J Epidemiol 45:460-9
Braykov, Nikolay P; Eisenberg, Joseph N S; Grossman, Marissa et al. (2016) Antibiotic Resistance in Animal and Environmental Samples Associated with Small-Scale Poultry Farming in Northwestern Ecuador. mSphere 1:
Fuller, James A; Eisenberg, Joseph N S (2016) Herd Protection from Drinking Water, Sanitation, and Hygiene Interventions. Am J Trop Med Hyg 95:1201-1210
Zhang, Lixin; Levy, Karen; Trueba, Gabriel et al. (2015) Effects of selection pressure and genetic association on the relationship between antibiotic resistance and virulence in Escherichia coli. Antimicrob Agents Chemother 59:6733-40
Chiriboga, Jorge; Barragan, Verónica; Arroyo, Gabriela et al. (2015) High Prevalence of Intermediate Leptospira spp. DNA in Febrile Humans from Urban and Rural Ecuador. Emerg Infect Dis 21:2141-7

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