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Chirombo J, Majamanda A, Gunsaru V, Yosefe S, Ozituosauka W, Mchoma C, Morroni C, Chipeta E, MacPherson P, Freyne B. The prevalence of gestational syphilis in Malawi between 2014 and 2022: spatiotemporal modeling of population-level factors. Front Public Health 2024; 11:1242870. [PMID: 38292384 PMCID: PMC10825961 DOI: 10.3389/fpubh.2023.1242870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 12/20/2023] [Indexed: 02/01/2024] Open
Abstract
Background Mother-to-child transmission of syphilis remains high especially in the WHO AFRO region with a prevalence of 1.62%, resulting in a congenital syphilis rate of 1,119 per 100,000 live births. Elimination efforts can be supported by an understanding of the spatial and temporal changes in disease over time, which can identify priority areas for targeted interventions aimed at reducing transmission. Methods We collated routine surveillance data from health facilities and covariate data from demographic and health surveys conducted in Malawi between 2014 and 2022. We fitted a Bayesian hierarchical mixed model with spatial and temporally structured random effects to model the district-level monthly counts of maternal syphilis notifications as a function of individual- and district-level predictors. We then generated district-level spatiotemporally explicit risk profiles to estimate the effect of individual- and district-level covariates on maternal syphilis notifications and to identify hotspot areas. Results Overall, the national prevalence of maternal syphilis increased from 0.28% (95% CI: 0.27-0.29%) in 2014 to peaking in 2021 at 1.92% (95% CI: 1.89-1.96%). Between 2020 and 2022, there was a decline in prevalence, with the most significant decline seen in Zomba District (1.40, 95% CI: 1.12-1.66%). In regression models, a one percentage point increase in district-level antenatal HIV prevalence was associated with increased maternal syphilis (prevalence ratio [PR]: 1.15, 95% credible interval [CrI]: 1.10-1.21). There was also an increased prevalence of maternal syphilis associated with an increased district-level mean number of sex partners (PR: 1.05, 95% CrI: 0.80-1.37). The number of districts with a high prevalence of maternal syphilis also increased between 2014 and 2022, especially in the southern region, where most had a high probability (approaching 100%) of having high maternal syphilis (defined as relative risk >1 compared to the standard population of women aged 15-49 years) in 2022. Conclusion Maternal syphilis prevalence in Malawi shows an increasing upward trend, with an estimated six times relative increase between 2014 and 2022 (0.28% to 1.73%) and strong associations with higher district-level HIV prevalence. Controlling syphilis depends on reaching vulnerable populations at the sub-national level, which may be disproportionately affected. Our findings support the move to integrate the elimination of mother-to-child transmission (EMTCT) of syphilis programs with existing prevention of mother-to-child transmission (PMTCT) of HIV programs.
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Affiliation(s)
- James Chirombo
- Statistical Support Unit, Malawi Liverpool Wellcome Programme, Blantyre, Malawi
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | | | - Vester Gunsaru
- Statistical Support Unit, Malawi Liverpool Wellcome Programme, Blantyre, Malawi
| | - Simeon Yosefe
- Digital Health Department, Ministry of Health, Lilongwe, Malawi
| | | | - Christina Mchoma
- Reproductive Health Department, Ministry of Health of Malawi, Lilongwe, Malawi
| | - Chelsea Morroni
- Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
- MRC Centre for Reproductive Health, University of Edinburgh, Edinburgh, United Kingdom
| | - Effie Chipeta
- Kamuzu University of Health Sciences, Blantyre, Malawi
| | - Peter MacPherson
- School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
- Clinical Research Department, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Bridget Freyne
- Department of Paediatric Infectious Diseases, Children’s Health Ireland, Dublin, Ireland
- Division of Women and Children’s Health, School of Medicine, University College Dublin, Dublin, Ireland
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, United Kingdom
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Vital CL, Reis RB, Soares JFDS, Miranda DLP, Reis MG. Spatial distribution of congenital syphilis in the state of Bahia, Brazil from 2009 to 2018. FRONTIERS IN EPIDEMIOLOGY 2023; 3:1234580. [PMID: 38516337 PMCID: PMC10956362 DOI: 10.3389/fepid.2023.1234580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 07/31/2023] [Indexed: 03/23/2024]
Abstract
Objective To describe the temporal trend and spatial distribution of congenital syphilis (CS) cases in the state of Bahia, Brazil between 2009 and 2018. Method Mixed ecological study conducted through the analysis of data obtained from the Notifiable Diseases Information System and the Live Birth Information System. Global Moran Index I was performed in order to analyze spatial autocorrelation of CS cases in the municipalities of Bahia and the Local Spatial Association Indicator (LISA) was used to identify the formation of spatial regimes in the GeoDA software. Results 8,786 cases of CS were registered in the period. An increasing growth in CS incidence, with a 511% increase between 2009 and 2018. Spatial autocorrelation was observed between the municipalities (I Moran = 0.452; p < 0.001) and four clusters were identified. More frequently, mothers were aged 20-29 years (50.7%); had incomplete primary education (54.9%); were Black and multiracial (93.2%); received prenatal care (82.2%); 49.0% were diagnosed with syphilis during prenatal care; 68.8% were not adequately treated, and 81.1% of their partners were not treated. Conclusion The results showed that CS consolidates as a serious public health problem in Bahia, with an incidence 8.4 times higher in the period than the WHO target of 0.5/1,000 live births, predominantly related to inadequate prenatal care and social vulnerability indicators: young mothers with low education levels, as well as individuals identified as Black and multiracial. Thus, programs aimed at women of childbearing age and pregnant women need to be intensified.
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Affiliation(s)
- Caroline Luz Vital
- Pathology and Molecular Biology Laboratory, Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil
- Department of Medicine of Bahia of Federal University of Bahia, Salvador, Bahia, Brazil
| | - Renato Barbosa Reis
- Pathology and Molecular Biology Laboratory, Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil
- Post-Graduate Program in Regional and Urban Development, Salvador University, Salvador, Brazil
- National Industrial Learning Service University Center and Integrated Center for Manufacturing and Technology (SENAI CIMATEC), Salvador, Bahia, Brazil
| | - Jorgana Fernanda de Souza Soares
- Department of Preventive and Social Medicine of Faculty of Medicine, Federal University of Bahia, Salvador, Bahia, Brazil
- PhD in Public Health from the Post-Graduate Program of Collective Health at Federal University of Bahia, Salvador, Bahia, Brazil
| | - Diego Lopes Paim Miranda
- Post-Graduate Program in Medicine and Health at the Federal University of Bahia, Salvador, Bahia, Brazil
| | - Mitermayer Galvão Reis
- Pathology and Molecular Biology Laboratory, Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil
- Department of Medicine of Bahia of Federal University of Bahia, Salvador, Bahia, Brazil
- Department of Epidemiology of Microbial Diseases, School of Public Health, Yale University, New Haven, CT, United States
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Lopes de Oliveira G, Ferreira AJ, Teles CADS, Paixao ES, Fiaccone R, Lana R, Aquino R, Cardoso AM, Soares MA, Oliveira dos Santos I, Pereira M, Barreto ML, Ichihara MY. Estimating the real burden of gestational syphilis in Brazil, 2007-2018: a Bayesian modeling study. LANCET REGIONAL HEALTH. AMERICAS 2023; 25:100564. [PMID: 37575963 PMCID: PMC10415804 DOI: 10.1016/j.lana.2023.100564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 07/16/2023] [Accepted: 07/17/2023] [Indexed: 08/15/2023]
Abstract
Background Although several studies have estimated gestational syphilis (GS) incidence in several countries, underreporting correction is rarely considered. This study aimed to estimate the level of under-registration and correct the GS incidence rates in the 557 Brazilian microregions. Methods Brazilian GS notifications between 2007 and 2018 were obtained from the SINAN-Syphilis system. A cluster analysis was performed to group microregions according to the quality of GS notification. A Bayesian hierarchical Poisson regression model was applied to estimate the reporting probabilities among the clusters and to correct the associated incidence rates. Findings We estimate that 45,196 (90%-HPD: 13,299; 79,310) GS cases were underreported in Brazil from 2007 to 2018, representing a coverage of 87.12% (90%-HPD: 79.40%; 95.83%) of registered cases, where HPD stands for the Bayesian highest posterior density credible interval. Underreporting levels differ across the country, with microregions in North and Northeast regions presenting the highest percentage of missed cases. After underreporting correction, Brazil's estimated GS incidence rate increased from 8.74 to 10.02 per 1000 live births in the same period. Interpretation Our findings highlight disparities in the registration level and incidence rate of GS in Brazil, reflecting regional heterogeneity in the quality of syphilis surveillance, access to prenatal care, and childbirth assistance services. This study provides robust evidence to enhance national surveillance systems, guide specific policies for GS detection disease control, and potentially mitigate the harmful consequences of mother-to-child transmission. The methodology might be applied in other regions to correct disease underreporting. Funding National Council for Scientific and Technological Development; The Bill Melinda Gates Foundation and Wellcome Trust.
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Affiliation(s)
- Guilherme Lopes de Oliveira
- Centre of Data and Knowledge Integration for Health (CIDACS), Instituto Gonçalo Moniz, Fiocruz, Salvador, Bahia, Brazil
- Department of Computing, Federal Centre of Technological Education of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Andrêa J.F. Ferreira
- Centre of Data and Knowledge Integration for Health (CIDACS), Instituto Gonçalo Moniz, Fiocruz, Salvador, Bahia, Brazil
- The Ubuntu Center on Racism, Global Movement, Population and Equity, School of Public Health, Drexel University, Pennsylvania, USA
| | - Carlos Antônio de S.S. Teles
- Centre of Data and Knowledge Integration for Health (CIDACS), Instituto Gonçalo Moniz, Fiocruz, Salvador, Bahia, Brazil
| | - Enny S. Paixao
- Centre of Data and Knowledge Integration for Health (CIDACS), Instituto Gonçalo Moniz, Fiocruz, Salvador, Bahia, Brazil
- London School of Hygiene and Tropical Medicine, London, UK
| | - Rosemeire Fiaccone
- Centre of Data and Knowledge Integration for Health (CIDACS), Instituto Gonçalo Moniz, Fiocruz, Salvador, Bahia, Brazil
- Statistics Department, Institute of Mathematics, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Raquel Lana
- Centre of Data and Knowledge Integration for Health (CIDACS), Instituto Gonçalo Moniz, Fiocruz, Salvador, Bahia, Brazil
- Barcelona Supercomputing Center, Catalonia, Spain
| | - Rosana Aquino
- Centre of Data and Knowledge Integration for Health (CIDACS), Instituto Gonçalo Moniz, Fiocruz, Salvador, Bahia, Brazil
- Institute of Collective Health, Federal University of Bahia, Salvador, Bahia, Brazil
| | | | - Maria Auxiliadora Soares
- Centre of Data and Knowledge Integration for Health (CIDACS), Instituto Gonçalo Moniz, Fiocruz, Salvador, Bahia, Brazil
- Institute of Collective Health, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Idália Oliveira dos Santos
- Centre of Data and Knowledge Integration for Health (CIDACS), Instituto Gonçalo Moniz, Fiocruz, Salvador, Bahia, Brazil
- Institute of Collective Health, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Marcos Pereira
- Centre of Data and Knowledge Integration for Health (CIDACS), Instituto Gonçalo Moniz, Fiocruz, Salvador, Bahia, Brazil
- Institute of Collective Health, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Maurício L. Barreto
- Centre of Data and Knowledge Integration for Health (CIDACS), Instituto Gonçalo Moniz, Fiocruz, Salvador, Bahia, Brazil
- Institute of Collective Health, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Maria Yury Ichihara
- Centre of Data and Knowledge Integration for Health (CIDACS), Instituto Gonçalo Moniz, Fiocruz, Salvador, Bahia, Brazil
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Spatiotemporal distribution analysis of syphilis in Brazil: Cases of congenital and syphilis in pregnant women from 2001-2017. PLoS One 2022; 17:e0275731. [PMID: 36201505 PMCID: PMC9536537 DOI: 10.1371/journal.pone.0275731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Accepted: 09/22/2022] [Indexed: 11/09/2022] Open
Abstract
In Brazil, the notification of congenital (CS) and syphilis in pregnant women (SiP) is compulsory. Notification data provided by the Ministry of Health in combination with the mapping of vulnerable geographic areas is essential to forecasting possible outbreaks and more effectively combating infection through monitoring. We aim to evaluate the spatiotemporal distribution and epidemiological aspects of reported cases of CS and SiP in Brazil. A retrospective ecological study was carried out using secondary surveillance data obtained from the Brazilian National Notifiable Diseases Information System (SINAN) database, considering all reported cases of CS and SiP between 2001 to 2017. Epidemiological characteristics and time trends were analyzed using joinpoint regression models and spatial distribution, considering microregions or states/macroregions as units of analysis. A total of 188,630 (359/100,000 birth lives) CS and 235,895 of SiP (6.3/100,000 inhabitants) were reported during the period studied. In general, the epidemiologic profile of Brazil indicates most reported CS cases occurred in "mixed-race" newborns who were diagnosed within seven days of birth and whose mothers had received prenatal care, but the epidemiologic profile varies by Brazilian macroregion. Regarding SiP, most cases were among women who self-reported 'mixed-race', were aged 20-39 years, had up to eight years of formal education and were diagnosed with primary or latent syphilis. Approximately 549 (98.4%) and 558 (100%) microregions reported at least one case of CS and SiP, respectively. From 2012 to 2016, CS cases increased significantly in almost all Brazilian states, most notably in the South, Southeast, and Central-West macroregions, from 2001-2017 and the relative risk (RR) of SiP increased around 400% (RR: 1,00 to 445,50). Considering the epidemiological scenario of the infection in Brazil, it is necessary to enhance preventive, control and eradication measures.
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Spatiotemporal dynamics of syphilis in pregnant women and congenital syphilis in the state of São Paulo, Brazil. Sci Rep 2022; 12:585. [PMID: 35022472 PMCID: PMC8755837 DOI: 10.1038/s41598-021-04530-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 12/17/2021] [Indexed: 11/17/2022] Open
Abstract
We aimed to estimate the occurrence of syphilis in pregnant women (SPW) and congenital syphilis (CS) in the municipalities of the state of São Paulo (SP) and evaluate their relationship with socioeconomic, demographic, and health care variables. We developed an ecological study based on secondary data of SPW and CS with spatiotemporal components from 645 municipalities in SP including data from 2007 to 2018. We modeled the data in a Bayesian context, considered spatial and temporal random effects, and used binomial negative probability distributions. We found a continuous increase in the relative temporal risk of SPW, from 2007 to 2018, and CS, from 2007 to 2017, when their incidences increased by 8.6 and 6.6 times, respectively. This increase occurred en bloc in practically all municipalities of SP. The increase in SPW was associated with teenage pregnancy, municipalities with a large number of inhabitants, and acquired immunodeficiency syndrome (AIDS) incidence. The increase in CS was associated with municipalities with a large number of inhabitants, incomplete antenatal care, and AIDS incidence. Although actions to control these diseases are required in all municipalities of SP, the identification of high-risk areas points to priority regions for development.
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Cambou MC, Saad E, McBride K, Fuller T, Swayze E, Nielsen-Saines K. Maternal HIV and syphilis are not syndemic in Brazil: Hot spot analysis of the two epidemics. PLoS One 2021; 16:e0255590. [PMID: 34343219 PMCID: PMC8330908 DOI: 10.1371/journal.pone.0255590] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Accepted: 07/19/2021] [Indexed: 11/18/2022] Open
Abstract
While the annual incidence of HIV diagnosis in pregnancy in Brazil remains relatively stable, rates of maternal syphilis increased over six-fold in the past decade. We hypothesized that maternal HIV and syphilis are two distinct epidemics. Data on all cases of maternal HIV or syphilis detected in pregnancy between January 1, 2010 to December 31, 2018 were requested from the Brazilian Ministry of Health. In order to evaluate how the epidemics evolved over the time period, ArcGIS software was used to generate spatiotemporal maps of annual rates of detection of maternal HIV and syphilis in 2010 and 2018. We utilized Euclidean-distance hot spot analysis to identify state-specific clusters in 2010 and 2018. From 2010 to 2018, there were 66,631 cases of maternal HIV, 225,451 cases of maternal syphilis, and 150,414 cases of congenital syphilis in Brazil. The state of Rio Grande do Sul had the highest rate of maternal HIV detection in both 2010 and 2018. Hot spots of maternal HIV were identified in the three most Southern states in both 2010 and 2018 (99% confidence, z-score >2.58, p <0.01). While syphilis incidence >30 per 1,000 live births in 2018 in four states, only the two coastal states of Rio de Janeiro and Espirito Santo in Southeastern Brazil were significant hot spots (90% confidence, z-score 1.65-1.95, p <0.10). Contrary to the general assumption, HIV and syphilis epidemics in Brazil are not syndemic in pregnant women. There is a spatial cluster of maternal HIV in the South, while syphilis is increasing throughout the country, more recently on the coast. Focusing on maternal HIV hot spots in the Southern states is insufficient to curtail the maternal and congenital syphilis epidemics throughout the country. New strategies, including ongoing hot spot analysis, are urgently needed to monitor, identify and treat maternal syphilis.
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Affiliation(s)
- Mary Catherine Cambou
- Department of Medicine, Division of Infectious Diseases, UCLA David Geffen School of Medicine, Los Angeles, California, United States of America
- Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, California, United States of America
| | - Eduardo Saad
- Department of Pediatrics, Division of Pediatric Infectious Diseases, UCLA David Geffen School of Medicine, Los Angeles, California, United States of America
| | - Kaitlyn McBride
- Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, California, United States of America
| | - Trevon Fuller
- Department of Pediatrics, Division of Pediatric Infectious Diseases, UCLA David Geffen School of Medicine, Los Angeles, California, United States of America
| | - Emma Swayze
- Department of Medicine, Western Michigan University Homer Stryker School of Medicine, Kalamazoo, Michigan, United States of America
| | - Karin Nielsen-Saines
- Department of Pediatrics, Division of Pediatric Infectious Diseases, UCLA David Geffen School of Medicine, Los Angeles, California, United States of America
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Marques dos Santos M, Lopes AKB, Roncalli AG, de Lima KC. Trends of syphilis in Brazil: A growth portrait of the treponemic epidemic. PLoS One 2020; 15:e0231029. [PMID: 32271807 PMCID: PMC7145144 DOI: 10.1371/journal.pone.0231029] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 03/15/2020] [Indexed: 11/18/2022] Open
Abstract
Syphilis is a chronic infectious disease with its prevalence being described since the 15th century. Although its etiological agent and also the treatment measures are widely known, syphilis is still a great public health problem worldwide, mainly in countries with limited resources associated to low investments in health primary care. The aim of the present study was to analyze the trend and regional distribution of syphilis in Brazil between 2007 and 2017. This is an ecological study using secondary data from the Brazilian notification system. The Ministry of Health selected 100 municipalities which presented the worse outcomes related to syphilis from the 5,570 Brazilian municipalities as a target for a comprehensive project in order to tackle the prevalence of syphilis, called the "No Syphilis Project". These priority municipalities represent 57.7% of syphilis cases and about one third of the Brazilian population. They were compared with other 189 non-priority municipalities with more than 100 thousand inhabitants among the Brazilian regions (North, Northeast, Southeast, South and Center-West). Polynomial regression methods and Joinpoint analyses were used to analyze the trend, from which the Annual Average Percent Change (AACP) for each time period was calculated. There was a significant growth trend in all regions for the main three forms of syphilis (in pregnancy, congenital and acquired), especially in the South. The ratio between syphilis in pregnancy and congenital syphilis increased in both priority (AAPC: 8.54%; p<0.001) and non-priority municipalities (AAPC: 2.61%; p = 0.005), as well as in the regions, except the Center-West. High growth trends in syphilis prevalence were found in all municipalities, as well as all five regions between 2007 and 2017, showing that the challenge to reduce or even eliminate syphilis in Brazil is still difficult.
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Affiliation(s)
- Marquiony Marques dos Santos
- Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
- Programa de pós-graduação em Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
- Doutorado em Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
- * E-mail:
| | - Ana Karla Bezerra Lopes
- Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
- Programa de pós-graduação em Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
- Doutorado em Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
- Laboratório de Microbiologia, Maternidade Escola Januário Cicco, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Angelo Giuseppe Roncalli
- Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
- Programa de pós-graduação em Saúde Coletiva, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Kenio Costa de Lima
- Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
- Programa de pós-graduação em Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
- Programa de pós-graduação em Saúde Coletiva, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
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Elimination of Mother-to-child Transmission of Syphilis: Challenge and Solution. MATERNAL-FETAL MEDICINE 2019. [DOI: 10.1097/fm9.0000000000000018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Ruszkiewicz JA, Tinkov AA, Skalny AV, Siokas V, Dardiotis E, Tsatsakis A, Bowman AB, da Rocha JBT, Aschner M. Brain diseases in changing climate. ENVIRONMENTAL RESEARCH 2019; 177:108637. [PMID: 31416010 PMCID: PMC6717544 DOI: 10.1016/j.envres.2019.108637] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 08/06/2019] [Accepted: 08/07/2019] [Indexed: 05/12/2023]
Abstract
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.
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Affiliation(s)
- Joanna A Ruszkiewicz
- Molecular Toxicology Group, Department of Biology, University of Konstanz, Konstanz, Germany
| | - Alexey A Tinkov
- Yaroslavl State University, Yaroslavl, Russia; IM Sechenov First Moscow State Medical University, Moscow, Russia; Institute of Cellular and Intracellular Symbiosis, Russian Academy of Sciences, Orenburg, Russia
| | - Anatoly V Skalny
- Yaroslavl State University, Yaroslavl, Russia; IM Sechenov First Moscow State Medical University, Moscow, Russia; Trace Element Institute for UNESCO, Lyon, France
| | - Vasileios Siokas
- Department of Neurology, Laboratory of Neurogenetics, University of Thessaly, University Hospital of Larissa, Larissa, Greece
| | - Efthimios Dardiotis
- Department of Neurology, Laboratory of Neurogenetics, University of Thessaly, University Hospital of Larissa, Larissa, Greece
| | - Aristidis Tsatsakis
- Laboratory of Toxicology, School of Medicine, University of Crete, 71003, Heraklion, Greece
| | - Aaron B Bowman
- School of Health Sciences, Purdue University, West Lafayette, IN, United States
| | - João B T da Rocha
- Department of Biochemistry, Federal University of Santa Maria, Santa Maria, Brazil
| | - Michael Aschner
- Department of Molecular Pharmacology, Albert Einstein College of Medicine, Bronx, NY, United States.
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