Tuberculosis evolution and climate change: How much work is ahead?

Exploring the impact of socioeconomic and natural factors on pulmonary tuberculosis incidence in China (2013-2019) using explainable machine learning: A nationwide study

Pulmonary tuberculosis (PTB) stands as a significant and prevalent infectious disease in China. Integrating 13 natural and socioeconomic factors, we conduct nine machine learning (ML) models alongside the Tree-Structured Parzen Estimator to predict the monthly PTB incidence rate from 2013 to 2019 in mainland China. With explainable ML techniques, our research highlights that population size, per capita GDP, and PM10 concentration emerge as the primary determinants influencing the PTB incidence rate. We delineate both the independent and interactive impacts of these factors on the PTB incidence rate. Furthermore, crucial thresholds associated with factors influencing the PTB incidence rate are identified. Taking factors that have a positive effect on reducing the incidence rate of PTB as an example, the thresholds at which the effects of factors PM2.5, PM10, O3, and RH on the incidence rate change from increase to decrease are 105.5 µg/m3, 75.5 µg/m3, 90.8 µg/m3, and 72.3 % respectively. Our work will contribute valuable insights for public health interventions.

The impact of climate change on the risk factors for tuberculosis: A systematic review

BACKGROUND

Tuberculosis (TB) continues to pose a major public health risk in many countries. The current incidence of disease exceeds guidelines proposed by the World Health Organisation and United Nations. Whilst the relationship between climate change and TB has surfaced in recent literature, it remains neglected in global agendas. There is a need to acknowledge TB as a climate-sensitive disease to facilitate its eradication.

OBJECTIVE

To review epidemiological and prediction model studies that explore how climate change may affect the risk factors for TB, as outlined in the Global Tuberculosis Report 2021: HIV infection, diabetes mellitus, undernutrition, overcrowding, poverty, and indoor air pollution.

METHODS

We conducted a systematic literature search of PubMed, Embase, and Scopus databases to identify studies examining the association between climate variables and the risk factors for TB. Each study that satisfied the inclusion criteria was assessed for quality and ethics. Studies then underwent vote-counting and were categorised based on whether an association was found.

RESULTS

53 studies met inclusion criteria and were included in our review. Vote-counting revealed that two out of two studies found a positive association between the examined climate change proxy and HIV, nine out of twelve studies for diabetes, eight out of seventeen studies for undernutrition, four out of five studies for overcrowding, twelve out of fifteen studies for poverty and one out of three studies for indoor air pollution.

DISCUSSION

We found evidence supporting a positive association between climate change and each of the discussed risk factors for TB, excluding indoor air pollution. Our findings suggest that climate change is likely to affect the susceptibility of individuals to TB by increasing the prevalence of its underlying risk factors, particularly in developing countries. This is an evolving field of research that requires further attention in the scientific community.

A scoping review on climate change and tuberculosis

Climate change is a global public health challenge. The changes in climatic factors affect the pattern and burden of tuberculosis, which is a worldwide public health problem affecting low and middle-income countries. However, the evidence related to the impact of climate change on tuberculosis is few and far between. This study is a scoping review following a five-stage version of Arksey and O'Malley's method. We searched the literature using the keywords and their combination in Google scholar, and PubMed. Climate change affects tuberculosis through diverse pathways: changes in climatic factors like temperature, humidity, and precipitation influence host response through alterations in vitamin D distribution, ultraviolet radiation, malnutrition, and other risk factors. The rise in extreme climatic events induces population displacement resulting in a greater number of vulnerable and risk populations of tuberculosis. It creates a conducive environment of tuberculosis transmission and development of active tuberculosis and disrupts tuberculosis diagnosis and treatment services. Therefore, it stands to reasons that climate change affects tuberculosis, particularly in highly vulnerable countries and areas. However, further studies and novel methodologies are required to address such a complex relationship and better understand the occurrence of tuberculosis attributable to climate change.

Climate change and epilepsy: Insights from clinical and basic science studies

Climate change is with us. As professionals who place value on evidence-based practice, climate change is something we cannot ignore. The current pandemic of the novel coronavirus, SARS-CoV-2, has demonstrated how global crises can arise suddenly and have a significant impact on public health. Global warming, a chronic process punctuated by acute episodes of extreme weather events, is an insidious global health crisis needing at least as much attention. Many neurological diseases are complex chronic conditions influenced at many levels by changes in the environment. This review aimed to collate and evaluate reports from clinical and basic science about the relationship between climate change and epilepsy. The keywords climate change, seasonal variation, temperature, humidity, thermoregulation, biorhythm, gene, circadian rhythm, heat, and weather were used to search the published evidence. A number of climatic variables are associated with increased seizure frequency in people with epilepsy. Climate change-induced increase in seizure precipitants such as fevers, stress, and sleep deprivation (e.g. as a result of more frequent extreme weather events) or vector-borne infections may trigger or exacerbate seizures, lead to deterioration of seizure control, and affect neurological, cerebrovascular, or cardiovascular comorbidities and risk of sudden unexpected death in epilepsy. Risks are likely to be modified by many factors, ranging from individual genetic variation and temperature-dependent channel function, to housing quality and global supply chains. According to the results of the limited number of experimental studies with animal models of seizures or epilepsy, different seizure types appear to have distinct susceptibility to seasonal influences. Increased body temperature, whether in the context of fever or not, has a critical role in seizure threshold and seizure-related brain damage. Links between climate change and epilepsy are likely to be multifactorial, complex, and often indirect, which makes predictions difficult. We need more data on possible climate-driven altered risks for seizures, epilepsy, and epileptogenesis, to identify underlying mechanisms at systems, cellular, and molecular levels for better understanding of the impact of climate change on epilepsy. Further focussed data would help us to develop evidence for mitigation methods to do more to protect people with epilepsy from the effects of climate change.

The climate change emergency: impacts on health governance

Purpose

To enable readers to gain an overview of the content of any issue of IJHG and in this way select papers most relevant to their interests or requirements.

Design/methodology/approach

The IJHG review section extracts information from all submissions in a single issue, developing and expanding on key themes in common.

Findings

NA

Originality/value

The original value of the IJHG Review section is that no other Emerald journal includes a Review section of this kind.

Early warning climate indices for malaria and meningitis in tropical ecological zones

This study aims at assessing the impacts of climate indices on the spatiotemporal distribution of malaria and meningitis in Nigeria. The primary focus of the research is to develop an Early Warning System (EWS) for assessing climate variability implications on malaria and meningitis spread in the study area. Both climate and health data were used in the study to determine the relationship between climate variability and the occurrence of malaria and meningitis. The assessment was based on variations in different ecological zones in Nigeria. Two specific sample locations were randomly selected in each ecological zone for the analysis. The climatic data used in this study are dekadal precipitation, minimum and maximum temperature between 2000 and 2018, monthly aerosol optical depth between 2000 and 2018. The results show that temperature is relatively high throughout the year because the country is located in a tropical region. The significant findings of this study are that rainfall has much influence on the occurrence of malaria, while temperature and aerosol have more impact on meningitis. We found the degree of relationship between precipitation and malaria, there is a correlation coefficient R2 ≥ 70.0 in Rainforest, Freshwater, and Mangrove ecological zones. The relationship between temperature and meningitis is accompanied by R2 ≥ 72.0 in both Sahel and Sudan, while aerosol and meningitis harbour R2 = 77.33 in the Sahel. The assessment of this initial data seems to support the finding that the occurrences of meningitis are higher in the northern region, especially the Sahel and Sudan. In contrast, malaria occurrence is higher in the southern part of the study area. In all, the multiple linear regression results revealed that rainfall was directly associated with malaria with β = 0.64, p = 0.001 but aerosol was directly associated with meningitis with β = 0.59, p < 0.001. The study concludes that variability in climatic elements such as low precipitation, high temperature, and aerosol may be the major drivers of meningitis occurrence.

Social determinants, ethical issues and future challenge of tuberculosis in a pluralistic society: the example of Israel

Tuberculosis is a very serious respiratory infectious disease, caused by the bacillus Mycobacterium tuberculosis, which generates a relevant societal and clinical burden. It has always represented a permanent concern and a public health challenge over the course of human history, because of its severe epidemiological, and economic-financial implications. The present review aims at over-viewing the impact of tuberculosis on the Israeli healthcare system, its temporal trend and evolution, stratified according to ethnicities and minorities, the need of establishing new facilities and implementing screening techniques, public health strategies and diagnostic tests, following massive immigration waves from countries characterized by a high incidence rate of tuberculosis during the fifties-sixties until the nineties, and the policies implemented by the Israeli government in the control, management and treatment of tuberculosis, as well as the role played by Israeli prominent scientists in discovering new druggable targets and finding bioactive compounds and bio-molecules in the fight against tuberculosis. Israel represents a unique, living laboratory in which features of developed and developing countries mix together. This country as a case-study of immigrant, pluralistic society underlines the importance of adopting a culturally-sensitive community intervention approach. The understanding of the subtle interplay between race/ethnic host and pathogen factors, including the role of gene variations and polymorphisms can pave the way for a personalized treatment and management of tuberculosis patients, contributing to the development of new tools for targeted tuberculosis therapeutics, immunodiagnostics and vaccination products.

Brain diseases in changing climate

Climate change is one of the biggest and most urgent challenges for the 21st century. Rising average temperatures and ocean levels, altered precipitation patterns and increased occurrence of extreme weather events affect not only the global landscape and ecosystem, but also human health. Multiple environmental factors influence the onset and severity of human diseases and changing climate may have a great impact on these factors. Climate shifts disrupt the quantity and quality of water, increase environmental pollution, change the distribution of pathogens and severely impacts food production - all of which are important regarding public health. This paper focuses on brain health and provides an overview of climate change impacts on risk factors specific to brain diseases and disorders. We also discuss emerging hazards in brain health due to mitigation and adaptation strategies in response to climate changes.