1
|
Bharatiya M, Austin C, Arora M, Feeney RNM, Leonard ND, Low-Choy S, Paul B, Soficaru AD, Zhao JX, Smith TM. Tracking Childhood Lead Exposure in Early Industrial Romanians. CHEMOSPHERE 2024; 364:142947. [PMID: 39067821 DOI: 10.1016/j.chemosphere.2024.142947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2024] [Revised: 07/08/2024] [Accepted: 07/24/2024] [Indexed: 07/30/2024]
Abstract
Childhood lead exposure has been linked to severe adverse health outcomes throughout life. Measurements of lead in teeth have established that individuals living in contaminated environments show higher levels compared to individuals living further away, although less is known about when individuals are most susceptible to these exposures. We examined lead (Pb208) concentrations (ppm) in teeth over the first 2.5 years of life in 16 children born in the late 19th to early 20th century throughout Romania. This period of intense industrialization was characterized by increases in mining, coal burning, and oil refining-activities that contaminate air, water, and food with Pb. We hypothesized the distance from an operational mine or oil refinery, or being born in a city, would be positively associated with cumulative dentine Pb exposure (CDPE). We also predicted that Pb exposures would peak in the first six months of life when gastrointestinal (GI) absorption of Pb is likely highest. Laser ablation-inductively coupled plasma-mass spectrometry (LA-ICP-MS) of sectioned tooth dentine followed by Bayesian statistical analyses revealed that living 30 km or more from a mine or oil refinery did not explain CDPE. However, being born in a city explained 42% of CDPE. All individuals showed maximum Pb exposures after six months of age, likely due to contaminated solid food and/or non-milk liquids. This research demonstrates how tooth formation can be coupled with comprehensive elemental mapping to analyse the context and timing of early-life neurotoxicant exposures, which may be extended to well-preserved teeth from clinical and historic populations.
Collapse
Affiliation(s)
- Maya Bharatiya
- Griffith Centre for Social and Cultural Research, Griffith University, Queensland, Australia; Australian Research Centre for Human Evolution, Griffith University, Queensland, Australia.
| | - Christine Austin
- Department of Environmental Medicine and Climate Science, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Manish Arora
- Department of Environmental Medicine and Climate Science, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Robin N M Feeney
- UCD School of Medicine, University College Dublin, Dublin, Ireland
| | - Nicole D Leonard
- Radiogenic Isotope Facility, School of the Environment, The University of Queensland, Queensland, Australia
| | - Samantha Low-Choy
- Griffith Institute of Educational Research, Griffith University, Queensland, Australia; Centre of Planetary Health and Food Security, Griffith University, Nathan, Queensland, Australia
| | - Bence Paul
- School of Geography, Earth and Atmospheric Sciences, University of Melbourne, Victoria, Australia; Elemental Scientific Lasers, LLC., Montana, USA
| | - Andrei D Soficaru
- "Francisc I. Rainer" Institute of Anthropology, Romanian Academy, Bucharest, Romania
| | - Jian-Xin Zhao
- Radiogenic Isotope Facility, School of the Environment, The University of Queensland, Queensland, Australia
| | - Tanya M Smith
- Griffith Centre for Social and Cultural Research, Griffith University, Queensland, Australia; Australian Research Centre for Human Evolution, Griffith University, Queensland, Australia
| |
Collapse
|
2
|
Pellegrini L, Arsel M, Muñoa G, Rius-Taberner G, Mena C, Orta-Martínez M. The atlas of unburnable oil for supply-side climate policies. Nat Commun 2024; 15:2318. [PMID: 38485960 PMCID: PMC10940309 DOI: 10.1038/s41467-024-46340-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 02/22/2024] [Indexed: 03/18/2024] Open
Abstract
To limit the increase in global mean temperature to 1.5 °C, CO2 emissions must be drastically reduced. Accordingly, approximately 97%, 81%, and 71% of existing coal and conventional gas and oil resources, respectively, need to remain unburned. This article develops an integrated spatial assessment model based on estimates and locations of conventional oil resources and socio-environmental criteria to construct a global atlas of unburnable oil. The results show that biodiversity hotspots, richness centres of endemic species, natural protected areas, urban areas, and the territories of Indigenous Peoples in voluntary isolation coincide with 609 gigabarrels (Gbbl) of conventional oil resources. Since 1524 Gbbl of conventional oil resources are required to be left untapped in order to keep global warming under 1.5 °C, all of the above-mentioned socio-environmentally sensitive areas can be kept entirely off-limits to oil extraction. The model provides spatial guidelines to select unburnable fossil fuels resources while enhancing collateral socio-environmental benefits.
Collapse
Affiliation(s)
- Lorenzo Pellegrini
- International Institute of Social Studies (ISS), Erasmus University Rotterdam, The Hague, the Netherlands
| | - Murat Arsel
- International Institute of Social Studies (ISS), Erasmus University Rotterdam, The Hague, the Netherlands
| | - Gorka Muñoa
- Departament de Biologia Evolutiva, Ecologia i Ciències Ambientals, Facultat de Biologia, Universitat de Barcelona, Barcelona, Catalonia, Spain
- Institute de Recerca de la Biodiversitat (IRBio), Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Guillem Rius-Taberner
- Departament de Biologia Evolutiva, Ecologia i Ciències Ambientals, Facultat de Biologia, Universitat de Barcelona, Barcelona, Catalonia, Spain
- Institute de Recerca de la Biodiversitat (IRBio), Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Carlos Mena
- Institute of Geography, Universidad San Francisco de Quito, Quito, Ecuador
| | - Martí Orta-Martínez
- Departament de Biologia Evolutiva, Ecologia i Ciències Ambientals, Facultat de Biologia, Universitat de Barcelona, Barcelona, Catalonia, Spain.
- Institute de Recerca de la Biodiversitat (IRBio), Universitat de Barcelona, Barcelona, Catalonia, Spain.
| |
Collapse
|
3
|
O'Callaghan-Gordo C, Rosales J, Lizárraga P, Barclay F, Okamoto T, Papoulias DM, Espinosa A, Orta-Martinez M, Kogevinas M, Astete J. Levels of Arsenic, Cadmium, and Mercury in Urine of Indigenous People Living Close to Oil Extraction Areas in the Peruvian Amazon. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:57701. [PMID: 37133291 PMCID: PMC10155608 DOI: 10.1289/ehp11932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Affiliation(s)
- Cristina O'Callaghan-Gordo
- Faculty of Health Sciences, Universitat Oberta de Catalunya, Barcelona, Spain
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
- CIBER Epidemiología y Salud Pública, Spain
| | - Jaime Rosales
- Centro Nacional de Salud Ocupacional y Protección del Ambiente para la Salud, Instituto Nacional de Salud, Lima, Peru
| | - Pilar Lizárraga
- Centro Nacional de Salud Ocupacional y Protección del Ambiente para la Salud, Instituto Nacional de Salud, Lima, Peru
| | - Frederica Barclay
- Centro de Políticas Públicas y Derechos Humanos-Perú Equidad, Lima, Peru
| | - Tami Okamoto
- Department of Geography, University of Cambridge, Cambridge, UK
| | | | - Ana Espinosa
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
- CIBER Epidemiología y Salud Pública, Spain
- Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - Martí Orta-Martinez
- Department of Evolutionary Biology, Ecology and Environmental Sciences, Faculty of Biology, University of Barcelona, Barcelona, Spain
| | - Manolis Kogevinas
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
- CIBER Epidemiología y Salud Pública, Spain
- Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - John Astete
- Centro Nacional de Salud Ocupacional y Protección del Ambiente para la Salud, Instituto Nacional de Salud, Lima, Peru
| |
Collapse
|
4
|
Bressan T, Valdivia-Gago A, Silvera-Ccallo RM, Llanos-Cuentas A, Condor DF, Padilla-Huamantinco PG, Vilcarromero S, Miranda JJ, Zavaleta-Cortijo C. Challenges of design, implementation, acceptability, and potential for, biomedical technologies in the Peruvian Amazon. Int J Equity Health 2022; 21:183. [PMID: 36536404 PMCID: PMC9762865 DOI: 10.1186/s12939-022-01773-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 10/09/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Biomedical technologies have the potential to be advantageous in remote communities. However, information about barriers faced by users of technology in general and in remote Indigenous communities is scarce. The purpose of this study was to characterize the leading challenges faced by researchers who have used biomedical technologies in the Peruvian Amazon. METHODS This exploratory, qualitative study with a phenomenological approach depicts the lived experience of participants who were researchers with experience working with biomedical technologies in the Peruvian Amazon in the past five years. Analysis was based on three core themes: design, implementation, and acceptability. Sub-themes included environment, community, and culture. Of the 24 potential participants identified and contacted, 14 agreed to participate, and 13 met inclusion criteria and completed semi-structured interviews. Results were sent to each participant with the opportunity to provide feedback and partake in a 30-minute validation meeting. Five participants consented to a follow-up meeting to validate the results and provide further understanding. RESULTS Participants recognized significant challenges, including technologies designed out-of-context, difficulty transporting the technologies through the Amazon, the impact of the physical environment (e.g., humidity, flooding), and limited existing infrastructure, such as electricity and appropriately trained health personnel. Participants also identified cultural factors, including the need to address past experiences with technology and health interventions, understand and appropriately communicate community benefits, and understand the effect of demographics (e.g., age, education) on the acceptance and uptake of technology. Complementary challenges, such as corruption in authority and waste disposal, and recommendations for technological and health interventions such as co-design were also identified. CONCLUSIONS This study proposes that technological and health interventions without efforts to respect local cultures and health priorities, or understand and anticipate contextual challenges, will not meet its goal of improving access to healthcare in remote Amazon communities. Furthermore, the implications of corruption on health services, and improper waste disposal on the environment may lead to more detrimental health inequities.
Collapse
Affiliation(s)
- Tiana Bressan
- grid.34429.380000 0004 1936 8198School of Engineering, University of Guelph, 50 Stone Rd E, Guelph, ON N1G 2W1 Canada
| | - Andrea Valdivia-Gago
- grid.11100.310000 0001 0673 9488Escuela de Nutrición, Universidad Peruana Cayetano Heredia, Lima, Peru Av. Honorio Delgado 430, 15102
| | - Rosa M. Silvera-Ccallo
- grid.11100.310000 0001 0673 9488Unidad de Ciudadania Intercultural y Salud Indigena, Facultad de Salud Publica y Administracion, Universidad Peruana Cayetano Heredia, Lima, Peru Av. Honorio Delgado 430, 15102
| | - Alejandro Llanos-Cuentas
- grid.11100.310000 0001 0673 9488Unidad de Ciudadania Intercultural y Salud Indigena, Facultad de Salud Publica y Administracion, Universidad Peruana Cayetano Heredia, Lima, Peru Av. Honorio Delgado 430, 15102 ,grid.11100.310000 0001 0673 9488Instituto de Medicina Tropical Alexander von Humboldt, Lima, Peru Av. Honorio Delgado 430, 15102
| | - Daniel F. Condor
- grid.11100.310000 0001 0673 9488School of Nursing, Universidad Peruana Cayetano Heredia, Lima, Peru Av. Honorio Delgado 430, 15102 ,grid.11100.310000 0001 0673 9488Biomedical Informatics in Global Health Unit, Universidad Peruana Cayetano Heredia, Lima, Peru Av. Honorio Delgado 430, 15102 ,grid.11100.310000 0001 0673 9488 CuidART-e Research Group, Universidad Peruana Cayetano Heredia, Lima, Peru Av. Honorio Delgado 430, 15102
| | - Pierre G. Padilla-Huamantinco
- grid.11100.310000 0001 0673 9488Instituto de Medicina Tropical Alexander von Humboldt, Lima, Peru Av. Honorio Delgado 430, 15102 ,Health Innovation Lab, Institute of Tropical Medicine Alexander von Humboldt, Lima, Peru Av. Honorio Delgado 430, 15102 ,grid.7870.80000 0001 2157 0406Institute for Biological and Medical Engineering, Schools of Engineering, Medicine, and Biological Sciences, Pontificia Universidad Católica de Chile, Santiago, Chile Av Vicuña Mackenna 4860,
| | - Stalin Vilcarromero
- grid.420173.30000 0000 9677 5193Hospital Nacional Edgardo Rebagliati Martins (HNERM), EsSalud, Lima, Peru Av. Edgardo Rebagliati 490, 15072
| | - J. Jaime Miranda
- grid.11100.310000 0001 0673 9488CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru Av. Honorio Delgado 430, 15102 ,grid.11100.310000 0001 0673 9488 School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru Av. Honorio Delgado 430, 15102 ,grid.1005.40000 0004 4902 0432The George Institute for Global Health, UNSW, Sydney, Australia
| | - Carol Zavaleta-Cortijo
- grid.11100.310000 0001 0673 9488Unidad de Ciudadania Intercultural y Salud Indigena, Facultad de Salud Publica y Administracion, Universidad Peruana Cayetano Heredia, Lima, Peru Av. Honorio Delgado 430, 15102 ,grid.11100.310000 0001 0673 9488Unidad de Ciudadanía Intercultural y Salud Indígena (UCISI), Universidad Peruana Cayetano Heredia, Lima, Peru Av. Honorio Delgado 430, 15102
| |
Collapse
|
5
|
Espinoza-Guillen JA, Alderete-Malpartida MB, Escobar-Mendoza JE, Navarro-Abarca UF, Silva-Castro KA, Martinez-Mercado PL. Identifying contamination of heavy metals in soils of Peruvian Amazon plain: use of multivariate statistical techniques. ENVIRONMENTAL MONITORING AND ASSESSMENT 2022; 194:817. [PMID: 36131105 DOI: 10.1007/s10661-022-10494-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 09/10/2022] [Indexed: 06/15/2023]
Abstract
The Peruvian Amazon plain has abundant natural resources and is home to great biodiversity, which makes it an area with high economic potential. However, the use of its resources through various activities has contributed to the release of heavy metals (HMs) into its soils, generating severe pollution problems which have mainly affected the health of local populations and their ecosystems. Currently, there are no comprehensive studies that have identified the specific sources of contamination by HMs in the soils of this part of the Peruvian territory. In this sense, this research aims to identify the possible sources of contamination by HMs in the soils of the Peruvian Amazon plain to focus efforts on the establishment of adequate measures for the protection of the health of people and the ecosystem. In the present study, samples of topsoils (0-20 cm depth) and subsoils (100-150 cm depth) were collected for the analysis of 11 HMs (Co, Cr, Cu, Fe, Mn, Ni, Pb, V, Zn, Be, and Hg) in 48 sites located in four regions of the Peruvian Amazon plain (Loreto, Amazonas, San Martín, and Ucayali), over the year 2019. The enrichment factor and geoaccumulation index were applied to assess contamination levels of HMs. The results indicated that topsoils and subsoils presented a greater enrichment by the elements Be and Pb, and were classified as moderately contaminated. Likewise, the integral analysis of these indexes together with principal component analysis, hierarchical cluster analysis, correlation analysis, and coefficient of variation allowed the identification of potential sources of contamination by HMs. As a result, Fe, Co, Zn, Ni, V, and Cr were associated with natural or lithogenic sources (parent material, crude oil deposits, and organic matter decomposition). Hg was attributed to anthropogenic sources (illegal gold mining, atmospheric deposition, and vehicle emissions). Be, Pb, Cu, and Mn originated from natural sources (parent material, crude oil deposits, decomposition of organic matter, and forest fires) and anthropogenic (areas degraded by solid waste, illegal gold mining, agriculture, and hydrocarbons). These findings provide essential information to establish regulations and prevent and control HM contamination in soils of the Peruvian Amazon plain.
Collapse
Affiliation(s)
- José Abel Espinoza-Guillen
- Programa de Maestría en Ciencias Ambientales, Universidad Nacional Agraria La Molina, Av. La Molina s/n, Lima, Perú.
| | | | - Jessica Emily Escobar-Mendoza
- Departamento Académico de Ingeniería Ambiental, Universidad Nacional Agraria La Molina, Av. La Molina s/n, Lima, Perú
| | - Ursula Fiorela Navarro-Abarca
- Departamento Académico de Ingeniería Ambiental, Universidad Nacional Agraria La Molina, Av. La Molina s/n, Lima, Perú
| | - Katya Angelot Silva-Castro
- Departamento Académico de Ingeniería Ambiental, Universidad Nacional Agraria La Molina, Av. La Molina s/n, Lima, Perú
| | | |
Collapse
|
6
|
Extractivism and Unjust Food Insecurity for Peru’s Loreto Indigenous Communities. SUSTAINABILITY 2022. [DOI: 10.3390/su14126954] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Background. Many scholars have examined Indigenous food security and sovereignty yet the topic still represents a small share of environmental justice scholarship. Therefore, we completed a case study of the environmental justice challenges concerning food security faced by the Indigenous communities of Peru’s Loreto region. Methods. During 2019, we conducted fieldwork in 64 Indigenous communities of Kukama Kukamiria and Urarina in the Amazon rainforests of Loreto, Peru. Based on a semi-stratified sample and snowball sampling method, we combined participant observation with 139 interviews focused on feeding habits, production and availability, access, utilization, food stability, and perception of food insecurity with the Food Insecurity Experience Scale (FIES) method. Results. Analyzing these themes led to worrisome assessments of the food insecurity and institutional limits of Indigenous communities. Because of their geographic location, these communities experience a degraded and unhealthy environment with water and food contaminated by hydrocarbon extraction activity. Furthermore, Peru’s policy of food and nutrition security has public management deficiencies especially in the Loreto region. Thus, many of the efforts adopted remain ineffective. Conclusion. Indigenous communities that live following ancestral culture often lack resources to change their diets. Thus, they frequently suffer the most following the contamination of an environment with which they experience an interdependent relation.
Collapse
|
7
|
Carrillo-Larco RM, Guzman-Vilca WC, Leon-Velarde F, Bernabe-Ortiz A, Jimenez MM, Penny ME, Gianella C, Leguía M, Tsukayama P, Hartinger SM, Lescano AG, Cuba-Fuentes MS, Cutipé Y, Diez-Canseco F, Mendoza W, Ugarte-Gil C, Valdivia-Gago A, Zavaleta-Cortijo C, Miranda JJ. Peru - Progress in health and sciences in 200 years of independence. LANCET REGIONAL HEALTH. AMERICAS 2022; 7:100148. [PMID: 36777656 PMCID: PMC9904031 DOI: 10.1016/j.lana.2021.100148] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Peru celebrates 200 years of independence in 2021. Over this period of independent life, and despite the turbulent socio-political scenarios, from internal armed conflict to economic crisis to political instability over the last 40 years, Peru has experienced major changes on its epidemiological and population health profile. Major advancements in maternal and child health as well as in communicable diseases have been achieved in recent decades, and today Peru faces an increasing burden of non-communicable diseases including mental health conditions. In terms of the configuration of the public health system, Peru has also strived to secure country-wide optimal health care, struggling in particular to improve primary health care and intercultural services. The science and technology infrastructure has also evolved, although the need for substantial investments remains if advancing science is to be a national priority. Climate change will also bring significant challenges to population health given Peru's geographical and microclimates diversity. Looking back over the 200-years of independence, we present a summary of key advances in selected health-related fields, thus serving as the basis for reflections on pending agendas and future challenges, in order to look forward to ensuring the future health and wellbeing of the Peruvian population. Resumen translated abstract El Perú cumple 200 años de independencia en 2021. Durante estos dos siglos de vida independiente, junto con periodos sociales y políticos turbulentos, incluyendo un conflicto armado interno, hiperinflación y la inestabilidad política de los últimos 40 años, el Perú ha experimentado importantes cambios en su perfil epidemiológico con repercusiones directas en la salud de la población. En las últimas décadas, los indicadores de salud materno-infantil y de las enfermedades transmisibles muestran mejoría importante, pero el país se enfrenta de manera simultánea a una carga cada vez mayor de enfermedades no transmisibles y de salud mental. En cuanto a los sistemas de salud pública, se han realizado esfuerzos por aumentar la cobertura y calidad de la atención de salud en todo el país, apostándose en particular por mejorar la atención primaria. La ciencia y tecnología relacionadas con la salud también han mejorado, aunque si se quiere que la ciencia sea una prioridad nacional, son necesarias inversiones sustanciales. El cambio climático traerá importantes desafíos para la salud de la población, dada la diversidad geográfica y de microclimas del país. Para conmemorar los 200 años de vida independiente del Perú, presentamos un resumen de avances clave en diversas áreas y temas relacionados con la salud. Este repaso sirve como base para reflexionar sobre agendas y desafíos pendientes y futuros, con el fin de asegurar la salud y el bienestar de la población peruana en las próximas décadas.
Collapse
Affiliation(s)
- Rodrigo M. Carrillo-Larco
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, London, United Kingdom
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | | | - Fabiola Leon-Velarde
- Departamento de Ciencias Biológicas y Fisiológicas, Facultad de Ciencias y Filosofia, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Antonio Bernabe-Ortiz
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | | | | | - Camila Gianella
- Departmento de Psicología, Facultad de Psicología, Pontificia Universidad Católica del Perú, Lima, Peru
- Chr. Michelsen Institute, Bergen, Norway
| | - Mariana Leguía
- Laboratorio de Genómica, Pontificia Universidad Católica del Perú, Lima, Peru
| | - Pablo Tsukayama
- Laboratorio de Genómica Microbiana, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru
- Parasites and Microbes Programme, Wellcome Sanger Institute, Hinxton, United Kingdom
| | - Stella M. Hartinger
- Clima, Latin American Center of Excellence for Climate Change and Health, Universidad Peruana Cayetano Heredia, Lima, Peru
- University of Basel, Basel, Switzerland
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Andres G. Lescano
- Clima, Latin American Center of Excellence for Climate Change and Health, Universidad Peruana Cayetano Heredia, Lima, Peru
- Emerge, Emerging Diseases and Climate Change Research Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | | | | | - Francisco Diez-Canseco
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Walter Mendoza
- Fondo de Población de las Naciones Unidas (UNFPA), Lima, Peru
| | - Cesar Ugarte-Gil
- Department of Medicine, School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
- Instituto de Medicina Tropical “Alexander von Humboldt”, Universidad Peruana Cayetano Heredia, Lima, Peru
- TB Center, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Center for Global Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States
| | - Andrea Valdivia-Gago
- Faculty of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
- Intercultural Citizenship and Indigenous Health Unit (UCISI), Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Carol Zavaleta-Cortijo
- Faculty of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
- Intercultural Citizenship and Indigenous Health Unit (UCISI), Universidad Peruana Cayetano Heredia, Lima, Peru
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, United Kingdom
| | - J. Jaime Miranda
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
- Department of Medicine, School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
- Department of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| |
Collapse
|