Responding to the challenge of MERS-CoV: Development and testing of interventions to reduce risk among Bedouin populations in Southern Jordan

Building on a successful GCRF Foundation Award, we aim to: i) Address knowledge gaps required to inform future vaccination strategies for MERS-CoV, ii) Develop and implement contextualized behavioural public health interventions to mitigate risk of MERS-CoV infection and iii) Build capacity for research, surveillance and control activities targeted at MERS-CoV. Two parallel longitudinal studies of camel owning households and their camel herds, together with an ethnographic survey, will be conducted in southern Jordan (Ma'an and Aqaba governorates). These studies will address knowledge gaps identified through the Foundation Award as important to inform future vaccination strategies such as who should be targeted for vaccination and the sociocultural issues, including vaccine acceptability, that are likely to be faced. Appropriate hygiene education interventions will be introduced as part of a randomized pilot feasibility trial in which half of the households will be randomly selected at month 18th of the project, with the other half remaining as 'control arm' during the following 6 months. Primary outcomes of the trial will be obtained from interviews on acceptability, perceived difficulty in implementing together with reported and observed behaviour related to avoiding camel oral and nasal secretions. Secondary outcomes will be based on serology in humans and camels in those having had the intervention in first half of year two compared to those who have not yet had the intervention. We will exploit opportunities for capacity building through grass-roots and higher-level workshops and engagement activities with the support of Jordan's Royal Scientific Society and US NIH. The importance , timeliness and opportunity of this project resides on the global public health threat posed by MERS-CoV, with Jordan as one of its epicenters, and the work carried out with the Foundation Award, which has generated knowledge and conditions that allow piloting of interventions.