Expressions of Intent for International Polar Year 2007-2008 Activities

Expression of Interest Details

PROPOSAL INFORMATION

The burden of infectious diseases in Greenland – means of evaluation and reduction  (Infectious diseases in Greenland)

Outline
Although infectious diseases, once a major cause of death in Arctic regions, have decreased in incidence, infectious diseases still remain major causes of excess morbidity and mortality in these areas. Some infections, such as tuberculosis and sexually transmitted diseases, have decreased markedly in incidence over the last 40 years due to focused efforts, but still represent substantial and excess burdens of disease. Other infections, such as hepatitis B and acute and chronic otitis media have for years been known to be highly prevalent, but have not been given much public health attention, and incidence rates do not seem to decrease. Rates of other infections, such as respiratory tract infections and invasive bacterial diseases, are very high, but due to lack of surveillance it is unknown whether rates have changed. Finally, rates of a number of chronic diseases known to be associated with infections such as carcinoma of the uterine cervix (associated with human papillomavirus) and carcinomas of the nasopharynx and salivary glands (associated with Epstein Barr virus) are high. In this proposal we wish to address the burden of infectious diseases in Greenland by establishing research programmes to evaluate long-term consequences of certain infectious diseases, to evaluate the use of routine surveillance data and to initiate intervention trials in order to prevent infectious diseases. Using register information, blood and tissue banks, established and new laboratory methods, and through hospital-based and field studies in various settings in Greenland, the specific study aims are to • Establish the importance of severe human papilloma virus infection and subsequent risk of carcinoma of the uterine cervix in a population at high risk of this disease • Determine long-term consequences of hepatitis B virus infection and effect of genotype distribution • Identify determinants for Epstein-Barr virus antibody patterns associated with nasopharyngeal and salivary gland carcinoma in a population at high risk of these diseases • Determine the prevalence of latent tuberculosis in Greenlanders • Evaluate the scientific use of the nation-wide outpatient register for infectious disease hospitalisations and routine reporting of microbiological data from regional laboratories • Perform vaccine trials with conjugate pneumococcal vaccine and determine the effects against invasive and non-invasive pneumococcal disease

What significant advance(s) in relation to the IPY themes and targets can be anticipated from this project?
This programme will document the present and predict the future burdens of infectious diseases in a time of rapidly changing living conditions in the Arctic. It will document the research feasibility of routine surveillance data and will device means of reducing the burden of infectious diseases. It will collect a broad-ranging set of samples, data and information that will be available in an open and timely manner to provide a reference for comparison with the future and the past. It will strengthen and enhance international collaboration and co-operation in Arctic human health research and monitoring and attract a new generation of polar researchers.

What international collaboration is involved in this project?
Large parts of this programme are carried out in international collaboration, primarily with researchers from the Arctic Investigations Programme and the International Circumpolar Surveillance Network, CDC, Alaska (primary investigators Alan Parkinson, Michael Bruce and Brian McMahon), and from Canada (Dr. Gerald Minuk and Bryce Larke) and Russia (Vladimir Chulanov).

FIELD ACTIVITY DETAILS

Geographical location(s) for the proposed field activities:
The field and hospital-based activities under this programme will be carried out in most of Greenland. The international activities will be carried out in similarly inhabited areas of Arctic Canada, Alaska, and Northern Russia. Blood sample analyses will be carried out in Denmark, Greenland, and in Alaska.

Approximate timeframe(s) for proposed field activities:
Arctic: 03/07 – 02/10            
Antarctic: n/a

Significant facilities will be required for this project:
The field studies under this research programme will take place in towns and settlements with relatively easy access by scheduled air plane or helicopters or by boat. Existing hospital and laboratory facilities will be used. Therefore no major logistic support/facilities are needed specifically for this programme.

Will the project leave a legacy of infrastructure?
Two of the main aims of the study are to evaluate the use of routine surveillance data and to initiate intervention trials in order to prevent infectious diseases. We expect these activities to leave legacies of infrastructure through refinement and new utilizations of such routine surveillance systems and possible new prevention strategies in the form of for instance new vaccination programmes.

How is it envisaged that the required logistic support will be secured?
Commercial operator
Own support
Other sources of support

As stated above logistics will be limited and secured through existing channels (commercial airlines and laboratory facilities).

Has the project been "endorsed" at a national or international level?
Yes - This project has been included as a part of the Arctic Human Health Initiative (AHHI) core proposal (No. 167), led by Dr. Alan Parkinson, Arctic Investigations Programme, Centers for Disease Control and Prevention, Anchorage, Alaska

PROJECT MANAGEMENT AND STRUCTURE

Is the project a short-term expansion (over the IPY 2007-2008 timeframe) of an existing plan, programme or initiative or is it a new autonomous proposal?
Yes

Parts of this programme consist of existing and planned activities (Hepatitis B- and Epstein-Barr virus epidemiology, prevalence of latent tuberculosis, bacterial surveillance through the International Circumpolar Surveillance Network), while other parts are new activities (Human papillomavirus epidemiology, use of other surveillance data, vaccine trials).

How will the project be organised and managed?
Overall, the programme will be organised and coordinated by the Department of Epidemiology Research at Statens Serum Institut, Copenhagen, Denmark. Most individual parts of the programme will be managed by the Department of Epidemiology Research in collaboration with Danish, Greenlandic and international collaborators. The tuberculosis part of the programme will be managed by the International Reference Laboratory of Mycobacteriology at Statens Serum Institut, also in collaboration with others (the Department of Epidemiology Research and other Danish, Greenlandic and international collaborators).

What are the initial plans of the project for addressing the education, outreach and communication issues outlined in the Framework document?
Parts of this programme include education of PhD candidates, and PhD studies within the hepatitis, Epstein-Barr virus and tuberculosis parts are planned. Results will be published in international scientific journals and in popular reports to the local populations of the involved areas of the Arctic.

What are the initial plans of the project to address data management issues (as outlined in the Framework document?
Data will be analysed and kept at the involved scientific institutions. Results of analyses will be published as described above. Raw data may after acquisition of necessary permissions from scientific ethical committee and data management boards, be available to other researchers.

How is it proposed to fund the project?
The project will be thought funded through national and international fundings.

Is there additional information you wish to provide?
None

PROPOSER DETAILS

Senior researcher, MD, PhD Anders Koch
Department of Epidemiology Research, Statens Serum Institut
Artillerivej 5
DK-2300 Copenhagen S
Denmark

Tel: +45 3268 3964
Mobile: +45 29868802
Fax: +45 3268 3165
Email:

Other project members and their affiliation