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Air Pollution Effects on Transmission of Mycobacterium tuberculosis in Urban Slum Community in Uganda

Award Number: R01ES020382
ORGANIZATION: NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH SCIENCES
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 09/15/2012
PERIOD OF PERFORMANCE END DATE: 06/30/2028

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Air Pollution Effects on Transmission of Mycobacterium tuberculosis in Urban Slum Community in Uganda - Air pollution and tuberculosis (TB) represent two of the most devastating and life-threatening global public health problems. With hundreds of million persons living in urban slums worldwide, vulnerable, marginalized and hard- to-reach populations are most affected by indoor and outdoor air pollution and Mycobacterium tuberculosis (Mtb) transmission. This project explores if and how air pollution fine particulate matter (PM2.5) exposure increases the transmission of Mtb from TB index cases to their household contacts (HC) in a high TB incidence urban slum area (Namuwongo) in Kampala/Uganda. We have previously shown that air pollution PM2.5 exposures suppress essential, protective, Mtb-specific, human innate and adaptive host immune responses. A key unanswered question of great significance to global TB control efforts is whether air pollution exposure increases the risk for transmission of Mtb in vulnerable communities, both through increased infectiousness (of the TB index cases) and susceptibility to Mtb infection (of their contacts). We hypothesize that inhalational exposure to PM2.5 increases the infectiousness of TB index cases by increasing their source strength i.e. the Mtb content in their respiratory aerosols, and by triggering cough. We further hypothesize that PM2.5 exposure suppresses protective immune responses leading to increased susceptibility to Mtb infection in the HC of the TB index cases. Both would be expected to increase transmission of Mtb in the community. To address our hypotheses, we will evaluate (1) the source strength of TB index cases and new Mtb infection in their HC (Mtb transmission) (SA1), (2) personal air pollution (PM2.5) exposures (SA2) and (3) how personal air pollution (PM2.5) exposure is associated with PM load in airway macrophages, source strength, and Mtb transmission to HC (SA3). To assess the source strength of the TB index cases, we will quantify the Mtb load in their respiratory aerosols using a novel face mask sampling approach. We will also determine TB index case cough frequencies with the Leicester Cough Monitor, assess chest radiographs and time to culture positivity (MGIT culture). Transmission of Mtb from TB index cases to HC will be ascertained by tuberculin skin test and QFN-Plus blood test between weeks 0 and 8. All measures combined reflect infectiousness of TB index cases. Exposure to PM2.5 of TB index cases and a random sample of HC will be studied using multiple approaches: `gold standard' gravimetric (UPAS) and real- time air monitoring between weeks 0 and 8, assessment of PM load in airway macrophages obtained by sputum induction of TB index cases and in randomly selected as well as newly Mtb-infected HC, stationary household PM2.5 and outdoor PM2.5 monitoring, and household study with questionnaires. Associations between TB index case source strength, Mtb transmission and PM2.5 exposure will be sought using linear modeling, to identify both main effects and modifying factors. Deciphering environmental factors that contribute to transmission of Mtb in vulnerable urban populations will provide much needed data for mandated public health actions and improved TB control approaches worldwide.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2024 ( Subtotal = $519,900 )
2024	2024	RUTGERS THE STATE UNIVERSITY OF NEW JERSEY	65 BERGEN ST	NEWARK	NJ	07107	ESSEX	USA	Environmental Health	000	8	6/11/2024	NON-COMPETING CONTINUATION	$519,900
														Subtotal = $519,900

Issue Date FY: 2023 ( Subtotal = $0 )
2023	2022	RUTGERS, THE STATE UNIVERSITY OF NEW JERSEY	65 BERGEN ST	NEWARK	NJ	07107	ESSEX	USA	Environmental Health	000	7	6/27/2023	COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2022 ( Subtotal = $572,284 )
2022	2022	RUTGERS, THE STATE UNIVERSITY OF NEW JERSEY	65 BERGEN ST	NEWARK	NJ	07107	ESSEX	USA	Environmental Health	001	7	9/13/2022	COMPETING CONTINUATION	$572,621
2022	2022	RUTGERS, THE STATE UNIVERSITY OF NEW JERSEY	65 BERGEN ST	NEWARK	NJ	07107	ESSEX	USA	Environmental Health	003	7	9/19/2022	COMPETING CONTINUATION	$0
2022	2022	RUTGERS, THE STATE UNIVERSITY OF NEW JERSEY	65 BERGEN ST	NEWARK	NJ	07107	ESSEX	USA	Environmental Health	002	7	9/14/2022	COMPETING CONTINUATION	$0
2022	2016	RUTGERS, THE STATE UNIVERSITY OF NEW JERSEY	683 HOES LN W	PISCATAWAY	NJ	08854	MIDDLESEX	USA	Environmental Health	000	5	10/1/2021	SUPPLEMENT FOR EXPANSION	-$337
														Subtotal = $572,284

Issue Date FY: 2021 ( Subtotal = -$42,849 )
2021	2016	RUTGERS, THE STATE UNIVERSITY OF NEW JERSEY	683 HOES LN W	PISCATAWAY	NJ	08854	MIDDLESEX	USA	Environmental Health	000	6	6/12/2021	EXTENSION WITH OR WITHOUT FUNDS	-$42,849
														Subtotal = -$42,849

Issue Date FY: 2019 ( Subtotal = $0 )
2019	2016	RUTGERS, THE STATE UNIVERSITY OF NEW JERSEY	683 HOES LN W	PISCATAWAY	NJ	08854	MIDDLESEX	USA	Environmental Health	000	6	5/9/2019	EXTENSION WITH OR WITHOUT FUNDS	$0
														Subtotal = $0

Issue Date FY: 2018 ( Subtotal = $0 )
2018	2016	RUTGERS, THE STATE UNIVERSITY OF NEW JERSEY	683 HOES LN W	PISCATAWAY	NJ	08854	MIDDLESEX	USA	Environmental Health	000	6	4/27/2018	EXTENSION WITH OR WITHOUT FUNDS	$0
														Subtotal = $0

Issue Date FY: 2017 ( Subtotal = $0 )
2017	2016	RUTGERS, THE STATE UNIVERSITY OF NEW JERSEY	683 HOES LN W	PISCATAWAY	NJ	08854	MIDDLESEX	USA	Environmental Health	001	6	2/4/2017	EXTENSION WITH OR WITHOUT FUNDS	$203,664
2017	2015	RUTGERS, THE STATE UNIVERSITY OF NEW JERSEY	683 HOES LN W	PISCATAWAY	NJ	08854	MIDDLESEX	USA	Environmental Health	000	5	2/4/2017	NON-COMPETING CONTINUATION	-$203,664
														Subtotal = $0

Issue Date FY: 2016 ( Subtotal = $642,184 )
2016	2016	Rutgers, The State Univ Biomedical & Health Sciences	65 Davidson Road	Piscataway	NJ	08854	MIDDLESEX	USA	Environmental Health	000	5	12/4/2015	SUPPLEMENT FOR EXPANSION	$28,517
2016	2016	Rutgers, The State Univ Biomedical & Health Sciences	65 Davidson Road	Piscataway	NJ	08854	MIDDLESEX	USA	Environmental Health	001	6	5/23/2016	EXTENSION WITH OR WITHOUT FUNDS	$613,667
														Subtotal = $642,184

Issue Date FY: 2015 ( Subtotal = $597,988 )
2015	2015	Rutgers, The State Univ Biomedical & Health Sciences	65 Davidson Road	Piscataway	NJ	08854	MIDDLESEX	USA	Environmental Health	000	5	5/6/2015	NON-COMPETING CONTINUATION	$597,988
														Subtotal = $597,988

Issue Date FY: 2014 ( Subtotal = $777,045 )
2014	2014	Rutgers, The State Univ Biomedical & Health Sciences	65 Davidson Road	Piscataway	NJ	08854	MIDDLESEX	USA	Environmental Health	004	4	9/14/2014	SUPPLEMENT FOR EXPANSION	$172,541
2014	2014	Rutgers, The State Univ Biomedical & Health Sciences	65 Davidson Road	Piscataway	NJ	08854	MIDDLESEX	USA	Environmental Health	002	4	9/8/2014	SUPPLEMENT FOR EXPANSION	$172,541
2014	2014	Rutgers, The State Univ Biomedical & Health Sciences	65 Davidson Road	Piscataway	NJ	08854	MIDDLESEX	USA	Environmental Health	001	4	5/30/2014	NON-COMPETING CONTINUATION	$602,212
2014	2014	Rutgers, The State Univ Biomedical & Health Sciences	65 Davidson Road	Piscataway	NJ	08854	MIDDLESEX	USA	Environmental Health	003	4	9/12/2014	SUPPLEMENT FOR EXPANSION	-$172,541
2014	2013	Rutgers, The State Univ Biomedical & Health Sciences	65 Davidson Road	Piscataway	NJ	08854	MIDDLESEX	USA	Environmental Health	000	3	3/21/2014	CHANGE OF GRANTEE / TRAINING INSTITUTION / AWARDING INSTITUTION	$2,292
														Subtotal = $777,045

Issue Date FY: 2013 ( Subtotal = $598,060 )
2013	2013	UMDNJ, ROBERT WOOD JOHNSON MED SCH	335 GEO ST LIBERTY PLAZA 4 FL	NEW BRUNSWICK	NJ	08903	MIDDLESEX	USA	Environmental Health	000	2	6/20/2013	NON-COMPETING CONTINUATION	$595,768
2013	2013	Rutgers, The State Univ Biomedical & HEALTH Sciences	65 Davidson Road	Piscataway	NJ	08554		USA	Environmental Health	002	3	9/20/2013	CHANGE OF GRANTEE / TRAINING INSTITUTION / AWARDING INSTITUTION	$549,189
2013	2013	UMDNJ, ROBERT WOOD JOHNSON MED SCH	335 GEO ST LIBERTY PLAZA 4 FL	NEW BRUNSWICK	NJ	08903	MIDDLESEX	USA	Environmental Health	001	2	9/19/2013	NON-COMPETING CONTINUATION	-$549,189
2013	2013	Rutgers, The State Univ Biomedical & HEALTH Sciences	65 Davidson Road	Piscataway	NJ	08554		USA	Environmental Health	003	3	3/21/2014	CHANGE OF GRANTEE / TRAINING INSTITUTION / AWARDING INSTITUTION	$2,292
														Subtotal = $598,060

Issue Date FY: 2012 ( Subtotal = $601,923 )
2012	2012	UMDNJ, ROBERT WOOD JOHNSON MED SCH	335 GEO ST LIBERTY PLAZA 4 FL	NEW BRUNSWICK	NJ	08903	MIDDLESEX	USA	Environmental Health	000	1	8/30/2012	NEW	$601,923
														Subtotal = $601,923

Grand Total All Awards = $4,266,534

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Air Pollution Effects on Transmission of Mycobacterium tuberculosis in Urban Slum Community in Uganda

Award Number: R01ES020382

ORGANIZATION: NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH SCIENCES

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 09/15/2012

PERIOD OF PERFORMANCE END DATE: 06/30/2028

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