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Wang Q, Ma T, Ding FY, Lim A, Takaya S, Saraswati K, Hao MM, Jiang D, Fang LQ, Sartorius B, Day NPJ, Maude RJ. A systematic review of environmental covariates and methods for spatial or temporal scrub typhus distribution prediction. ENVIRONMENTAL RESEARCH 2024; 263:120067. [PMID: 39341542 DOI: 10.1016/j.envres.2024.120067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Revised: 09/22/2024] [Accepted: 09/25/2024] [Indexed: 10/01/2024]
Abstract
BACKGROUND Scrub typhus is underdiagnosed and underreported but emerging as a global public health problem. To inform future burden and prediction studies we examined through a systematic review the potential effect of environmental covariates on scrub typhus occurrence and the methods which have been used for its prediction. METHODS In this systematic review, we searched PubMed, Scopus, Web of Science, China National Knowledge Infrastructure and other databases, with no language and publication time restrictions, for studies that investigated environmental covariates or utilized methods to predict the spatial or temporal human. Data were manually extracted following a set of queries and systematic analysis was conducted. RESULTS We included 68 articles published in 1978 to 2024 with relevant data from 7 countries/regions. Significant environmental risk factors for scrub typhus include temperature (showing positive or inverted-U relationships), precipitation (with positive or inverted-U patterns), humidity (exhibiting complex positive, inverted-U, or W-shaped associations), sunshine duration (with positive, inverted-U associations), elevation, the normalized difference vegetation index (NDVI), and the proportion of cropland. Socioeconomic and biological factors were rarely explored. Autoregressive Integrated Moving Average (ARIMA) (n=8) and ecological niche modelling (ENM) approach (n=11) were the most popular methods for predicting temporal trends and spatial distribution of scrub typhus, respectively. CONCLUSIONS Our findings summarized the evidence on environmental covariates affecting scrub typhus occurrence and the methodologies used for predictive modelling. We review the existing knowledge gaps and outline recommendations for future studies modelling disease prediction and burden. TRIAL REGISTRATION PROSPERO CRD42022315209.
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Affiliation(s)
- Qian Wang
- Mahidol Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Tian Ma
- Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, China; College of Resources and Environment, University of Chinese Academy of Sciences, Beijing, China
| | - Fang-Yu Ding
- Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, China; College of Resources and Environment, University of Chinese Academy of Sciences, Beijing, China.
| | - Ahyoung Lim
- London School of Hygiene & Tropical Medicine, London, UK
| | - Saho Takaya
- London School of Hygiene & Tropical Medicine, London, UK
| | - Kartika Saraswati
- Mahidol Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore; Oxford University Clinical Research Unit Indonesia, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Meng-Meng Hao
- Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, China; College of Resources and Environment, University of Chinese Academy of Sciences, Beijing, China
| | - Dong Jiang
- Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, China; College of Resources and Environment, University of Chinese Academy of Sciences, Beijing, China
| | - Li-Qun Fang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
| | - Benn Sartorius
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK; Centre for Clinical Research (UQCCR), Faculty of Medicine, University of Queensland, Brisbane, Australia; Department of Health Metric Sciences, School of Medicine, University of Washington, Seattle, USA
| | - Nicholas P J Day
- Mahidol Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Richard J Maude
- Mahidol Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK; The Open University, Milton Keynes, UK
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Rai BD, Tessema GA, Fritschi L, Pereira G. The application of the One Health approach in the management of five major zoonotic diseases using the World Bank domains: A scoping review. One Health 2024; 18:100695. [PMID: 39010967 PMCID: PMC11247293 DOI: 10.1016/j.onehlt.2024.100695] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 02/13/2024] [Indexed: 07/17/2024] Open
Abstract
The international authorities, such as the Food and Agriculture Organization of the United Nations, World Health Organization, World Organization for Animal Health, United Nations Environment Programme, and World Bank, have endorsed the One Health concept as an effective approach to optimize the health of people, animals, and the environment. The One Health concept is considered as an integrated and unifying approach with the objective of sustainably balancing and optimizing the health of people, animals, and ecosystems. Despite variations in its definitions, the underlying principle remains consistent - recognizing the interconnected and interdependent health of humans, animals, and the environment, necessitating interdisciplinary collaboration to optimize health outcomes. The One Health approach has been applied in numerous countries for detecting, managing, and controlling diseases. Moreover, the concept has found application in various areas, including antimicrobial resistance, food safety, and ecotoxicology, with a growing demand. There is a growing consensus that the One Health concept and the United Nations Sustainable Development Goals mutually reinforce each other. The World Bank has recommended five domains as foundational building blocks for operationalising the One Health approach, which includes: i) One Health stakeholders, roles, and responsibilities; ii) financial and personal resources; iii) communication and information; iv) technical infrastructure; and v) governance. The domains provide a generalised overview of the One Health concept and guide to its application. We conducted a scoping review following the five-staged Arksey and O'Malley's framework. The objective of the review was to map and synthesise available evidence of application of the One Health approach to five major zoonotic diseases using the World Bank domains. Publications from the year 2004, marking the inception of the term 'One Health,' to 2022 were included. Information was charted and categorised against the World Bank domains identified as a priori. We included 1132 records obtained from three databases: Embase, Medline, and Global Health; as well as other sources. After excluding duplicates, screening for titles and abstracts, and full text screening, 20 articles that contained descriptions of 29 studies that implemented the One Health approach were selected for the review. We found that included studies varied in the extent to which the five domains were utilised. Less than half the total studies (45%) used all the five domains and none of the studies used all the sub-domains. The environmental sector showed an underrepresentation in the application of the One Health approach to zoonotic diseases as 14 (48%) studies in 10 articles did not mention it as a stakeholder. Sixty two percent of the studies mentioned receiving support from international partners in implementing the One Health approach and 76% of the studies were supported by international donors to conduct the studies. The review identified disparate funding mechanisms employed in the implementation of the One Health approach. However, there were limited discussions on plans for continuity and viability of these funding mechanisms in the future.
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Affiliation(s)
- Bir Doj Rai
- Curtin School of Population Health, Curtin University, 400 Kent St, Bentley, Perth, Western Australia 6102, Australia
| | - Gizachew A Tessema
- Curtin School of Population Health, Curtin University, 400 Kent St, Bentley, Perth, Western Australia 6102, Australia
- enAble Institute, Curtin University, 400 Kent St, Bentley, Perth, Western Australia 6102, Australia
| | - Lin Fritschi
- Curtin School of Population Health, Curtin University, 400 Kent St, Bentley, Perth, Western Australia 6102, Australia
| | - Gavin Pereira
- Curtin School of Population Health, Curtin University, 400 Kent St, Bentley, Perth, Western Australia 6102, Australia
- enAble Institute, Curtin University, 400 Kent St, Bentley, Perth, Western Australia 6102, Australia
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Chang T, Min KD, Cho SI, Kim Y. Associations of meteorological factors and dynamics of scrub typhus incidence in South Korea: A nationwide time-series study. ENVIRONMENTAL RESEARCH 2024; 245:117994. [PMID: 38151145 DOI: 10.1016/j.envres.2023.117994] [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: 09/22/2023] [Revised: 12/01/2023] [Accepted: 12/18/2023] [Indexed: 12/29/2023]
Abstract
Scrub typhus, also known as Tsutsugamushi disease, is a climate-sensitive vector-borne disease that poses a growing public health threat. However, studies on the association between scrub typhus epidemics and meteorological factors in South Korea need to be complemented. Therefore, we aimed to analyze the association among ambient temperature, precipitation, and the incidence of scrub typhus in South Korea. First, we obtained data on the weekly number of scrub typhus cases and concurrent meteorological variables at the city-county level (Si-Gun) in South Korea between 2001 and 2019. Subsequently, a two-stage meta-regression analysis was conducted. In the first stage, we conducted time-series regression analyses using a distributed lag nonlinear model (DLNM) to investigate the association between temperature, precipitation, and scrub typhus incidence at each location. In the second stage, we employed a multivariate meta-regression model to combine the association estimates from all municipalities, considering regional indicators, such as mite species distribution, Normalized Difference Vegetation Index (NDVI), and urban-rural classification. Weekly mean temperature and weekly total precipitation exhibited a reversed U-shaped nonlinear association with the incidence of scrub typhus. The overall cumulative association with scrub typhus incidence peaked at 18.7 C° (with RRs of 9.73, 95% CI: 5.54-17.10) of ambient temperature (reference 9.7 C°) and 162.0 mm (with RRs of 1.87, 95% CI: 1.02-3.83) of precipitation (reference 2.8 mm), respectively. These findings suggest that meteorological factors contribute to scrub typhus epidemics by interacting with vectors, reservoir hosts, and human behaviors. This information serves as a reference for future public health policies and epidemiological research aimed at controlling scrub typhus infections.
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Affiliation(s)
- Taehee Chang
- Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, 08826, Republic of Korea
| | - Kyung-Duk Min
- College of Veterinary Medicine, Chungbuk National University, 28644, Republic of Korea
| | - Sung-Il Cho
- Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, 08826, Republic of Korea; Institute of Health and Environment, Seoul National University, Seoul, 08826, Republic of Korea.
| | - Yoonhee Kim
- Department of Global Environmental Health, Graduate School of Medicine, University of Tokyo, Tokyo, 113-0033, Japan.
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Konyak BM, Soni M, Saikia S, Chang T, Gogoi I, Khongstid I, Chang CM, Sharma M, Pandey RP. Scrub typhus in Northeast India: epidemiology, clinical presentations, and diagnostic approaches. Trans R Soc Trop Med Hyg 2024; 118:206-222. [PMID: 37972992 DOI: 10.1093/trstmh/trad082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 09/29/2023] [Indexed: 11/19/2023] Open
Abstract
Scrub typhus is one of the most neglected tropical diseases, a leading cause of acute undifferentiated febrile illness in areas of the 'tsutsugamushi triangle', diagnosed frequently in South Asian countries. The bacteria Orientia tsutsugamushi is the causative agent of the disease, which enters the human body through the bite of trombiculid mites (also known as chiggers) of the genus Leptotrombidium deliense. Diagnosis of the disease is challenging, as its early symptoms mimic other febrile illnesses like dengue, influenza and corona viruses. Lack of rapid, reliable and cost-effective diagnostic methods further complicates the identification process. Northeast India, a mountainous region with a predominantly rural tribal population, has witnessed a resurgence of scrub typhus cases in recent years. Various ecological factors, including rodent populations, habitat characteristics and climatic conditions, influence its prevalence. Entomological investigations have confirmed the abundance of vector mites, highlighting the importance of understanding their distribution and the probability of transmission of scrub typhus in the region. Proper diagnosis, awareness campaigns and behavioural interventions are essential for controlling scrub typhus outbreaks and reducing its impact on public health in Northeast India. Further research and community-based studies are necessary to accurately assess the disease burden and implement effective prevention strategies.
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Affiliation(s)
- Beyau M Konyak
- Integrated Molecular Diagnostic and Research Laboratory (BSL-2), District Hospital Tuensang, Tuensang-798612, Nagaland, India
- Department of Biosciences, Assam Don Bosco University, Tapesia Garden, Sonapur, Guwahati-782402, Assam, India
| | - Monika Soni
- Department of Biosciences, Assam Don Bosco University, Tapesia Garden, Sonapur, Guwahati-782402, Assam, India
| | - Shyamalima Saikia
- Department of Life Sciences, Dibrugarh University, Dibrugarh-786004, Assam, India
| | - Tochi Chang
- Integrated Molecular Diagnostic and Research Laboratory (BSL-2), District Hospital Tuensang, Tuensang-798612, Nagaland, India
| | - Indrani Gogoi
- Department of Life Sciences, Dibrugarh University, Dibrugarh-786004, Assam, India
| | - Ibakmensi Khongstid
- Department of Biosciences, Assam Don Bosco University, Tapesia Garden, Sonapur, Guwahati-782402, Assam, India
| | - Chung-Ming Chang
- Master's and PhD Program in Biotechnology Industry, Chang Gung University, No. 259, Wenhua 1st Rd, Guishan District, Taoyuan City-33302, Taiwan (ROC)
- Graduate Institute of Biomedical Sciences, Chang Gung University, No. 259, Wenhua 1st Rd, Guishan District, Taoyuan City-33302, Taiwan (ROC)
| | - Mohan Sharma
- Integrated Molecular Diagnostic and Research Laboratory (BSL-2), District Hospital Tuensang, Tuensang-798612, Nagaland, India
| | - Ramendra Pati Pandey
- School of Health Sciences and Technology, UPES, Dehradun-248007, Uttarakhand, India
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Peng PY, Duan HY, Xu L, Zhang LT, Sun JQ, Zu Y, Ma LJ, Sun Y, Yan TL, Guo XG. Epidemiologic changes of a longitudinal surveillance study spanning 51 years of scrub typhus in mainland China. Sci Rep 2024; 14:3138. [PMID: 38326459 PMCID: PMC10850489 DOI: 10.1038/s41598-024-53800-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 02/05/2024] [Indexed: 02/09/2024] Open
Abstract
Scrub typhus may be one of the world's most prevalent, neglected and serious, but easily treatable, febrile diseases. It has become a significant potential threat to public health in China. In this study we used national disease surveillance data to analyze the incidence and spatial-temporal distribution of scrub typhus in mainland China during 1952-1989 and 2006-2018. Descriptive epidemiological methods and spatial-temporal epidemiological methods were used to investigate the epidemiological trends and identify high-risk regions of scrub typhus infection. Over the 51-year period, a total of 182,991 cases and 186 deaths were notified. The average annual incidence was 0.13 cases/100,000 population during 1952-1989. The incidence increased sharply from 0.09/100,000 population in 2006 to 1.93/100,000 population in 2018 and then exponentially increased after 2006. The incidence was significantly higher in females than males (χ2 = 426.32, P < 0.001). Farmers had a higher incidence of scrub typhus than non-farmers (χ2 = 684.58, P < 0.001). The majority of cases each year were reported between July and November with peak incidence occurring during October each year. The trend surface analysis showed that the incidence of scrub typhus increased gradually from north to south, and from east and west to the central area. The spatial autocorrelation analysis showed that a spatial positive correlation existed in the prevalence of scrub typhus on a national scale, which had the characteristic of aggregated distribution (I = 0.533, P < 0.05). LISA analysis showed hotspots (High-High) were primarily located in the southern and southwestern provinces of China with the geographical area expanding annually. These findings provide scientific evidence for the surveillance and control of scrub typhus which may contribute to targeted strategies and measures for the government.
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Affiliation(s)
- Pei-Ying Peng
- Institute of Microbiology of Qujing Medical College, Qujing, 655011, Yunnan Province, China.
| | - Hui-Ying Duan
- Institute of Microbiology of Qujing Medical College, Qujing, 655011, Yunnan Province, China
| | - Lei Xu
- Institute of Microbiology of Qujing Medical College, Qujing, 655011, Yunnan Province, China
| | - Lin-Tao Zhang
- Institute of Microbiology of Qujing Medical College, Qujing, 655011, Yunnan Province, China
| | - Ji-Qin Sun
- Department of Clinical Laboratory, Qujing Second People's Hospital, Qujing, 655011, Yunnan Province, China
| | - Ya Zu
- Department of Clinical Laboratory, Qujing Second People's Hospital, Qujing, 655011, Yunnan Province, China
| | - Li-Juan Ma
- Department of Clinical Laboratory, Qujing Second People's Hospital, Qujing, 655011, Yunnan Province, China
| | - Yan Sun
- Institute of Microbiology of Qujing Medical College, Qujing, 655011, Yunnan Province, China
| | - Ting-Liang Yan
- Institute of Microbiology of Qujing Medical College, Qujing, 655011, Yunnan Province, China
| | - Xian-Guo Guo
- Institute of Pathogens and Vectors, Yunnan Provincial Key Laboratory for Zoonosis Control and Prevention, Dali University, Dali, 671000, Yunnan, China
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Nam HK, Min KD, Jo S, Cho SI. Association of Deforestation With Severe Fever With Thrombocytopenia Syndrome. J Infect Dis 2023; 228:1730-1738. [PMID: 37265042 PMCID: PMC10733741 DOI: 10.1093/infdis/jiad196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Revised: 05/08/2023] [Accepted: 06/01/2023] [Indexed: 06/03/2023] Open
Abstract
BACKGROUND Severe fever with thrombocytopenia syndrome (SFTS) virus was first isolated in China in 2009 and has since spread to several Asian countries. SFTS is closely related to environmental factors that accelerate vector growth. We evaluated the associations of SFTS and deforestation with environmental variables. METHODS For this observational study, we generated multiple Poisson models using national SFTS outbreak data (2013-2018) and official environmental data for Korea. We included established risk factors as variables. Deforestation was used as the main variable. All variables were analyzed according to their spatial characteristics using the R-INLA package. RESULTS SFTS cases increased over time and peaked in 2017, at 272, followed by a decrease in 2018. Disease mapping showed a high incidence of SFTS nationwide, with particular risks in Gangwon and Gyeonggi Provinces in the north, and Jeju in the south of South Korea. Deforestation was significantly associated with a higher risk of SFTS in the final model (relative risk, 1.751 [95% confidence interval, 1.125-2.743]). CONCLUSIONS SFTS outbreaks are associated with deforestation. Therefore, deforestation in Gyeonggi, Gangwon, and Jeju provinces of South Korea needs to be considered in vector-control strategies and active surveillance of SFTS occurrence.
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Affiliation(s)
- Hee-kyoung Nam
- Department of Public Health Science, Graduate School of Public Health, Seoul National University
| | - Kyung-Duk Min
- College of Veterinary Medicine, Chungbuk National University
| | - Suyoung Jo
- Department of Public Health Science, Graduate School of Public Health, Seoul National University
| | - Sung-il Cho
- Department of Public Health Science, Graduate School of Public Health, Seoul National University
- Institute of Health and Environment, Seoul National University, Republic of Korea
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Meena P, Jha V. Environmental Change, Changing Biodiversity, and Infections-Lessons for Kidney Health Community. Kidney Int Rep 2023; 8:1714-1729. [PMID: 37705916 PMCID: PMC10496083 DOI: 10.1016/j.ekir.2023.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 07/12/2023] [Indexed: 09/15/2023] Open
Abstract
There is a direct and accelerating connection between ongoing environmental change, the unprecedented decline in biodiversity, and the increase in infectious disease epidemiology worldwide. Rising global temperatures are threatening the biodiversity that underpins the richness and diversity of flora and fauna species in our ecosystem. Anthropogenic activities such as burning fossil fuels, deforestation, rapid urbanization, and expanding population are the primary drivers of environmental change resulting in biodiversity collapse. Climate change is influencing the emergence, prevalence, and transmission of infectious diseases both directly and through its impact on biodiversity. The environment is gradually becoming more suitable for infectious diseases by affecting a variety of pathogens, hosts, and vectors and by favoring transmission rates in many parts of the world that were until recently free of these infections. The acute effects of these zoonotic, vector and waterborne diseases are well known; however, evidence is emerging about their role in the development of chronic kidney disease. The pathways linking environmental change and biodiversity loss to infections impacting kidney health are diverse and complex. Climate change and biodiversity loss disproportionately affect the vulnerable and limit their ability to access healthcare. The kidney health community needs to contribute to the issue of environmental change and biodiversity loss through multisectoral action alongside government, policymakers, advocates, businesses, and the general population. We describe various aspects of the environmental change effects on the transmission and emergence of infectious diseases particularly focusing on its potential impact on kidney health. We also discuss the adaptive and mitigation measures and the gaps in research and policy action.
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Affiliation(s)
- Priti Meena
- Department of Nephrology, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Vivekanand Jha
- George Institute for Global Health, UNSW, New Delhi, India
- Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, India
- School of Public Health, Imperial College, London, UK
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Rouabhia R, Dinh DT, Kua SC, Washington MA. Lessons Learned From the U.S. Military Experience With Hantavirus During the Korean War. Mil Med 2023; 188:3205-3209. [PMID: 36099403 DOI: 10.1093/milmed/usac255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 07/21/2022] [Accepted: 08/18/2022] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION The Korean War (1950-1953) consisted of two phases. The first was a rapid mobile phase, and the second was a slow and stationary phase. During the stationary phase, approximately 3,000 UN troops became infected with a then unknown agent. The resulting illness began with flu-like symptoms and often progressed to a severe hemorrhagic fever leading to kidney failure and death. However, the cause was not to be identified until well over 20 years following the conclusion of the war when Dr. Ho Wang Lee succeeded in isolating Hantavirus from field rodents. The U.S. Military experience with Hantavirus during the Korean War is a case study of the potential impact of war-related environmental change on disease transmission. The lessons learned from this experience should inform future military medical planning and serve as a reminder of the impact that an unknown agent can have on military operations. MATERIALS AND METHODS A literature review of all available records with respect to the U.S. Military experience with Hantavirus was conducted. PubMed was the primary search engine used for this review. However, primary literature and historical accounts were also evaluated. All records were examined for environmental, epidemiological, and public health data regarding hemorrhagic fever outbreaks among U.S. forces during the Korean War. The quantitative and qualitative data from these sources were analyzed and evaluated within the context of military medical planning and force health protection to derive lessons learned that should be applied to the management and mitigation of viral disease in future wars. RESULTS Widespread deforestation resulting from war-related efforts most likely played a significant role in the outbreaks of Hantavirus among UN forces during the war. A lack of cultural literacy and an overreliance on erroneous assumptions most likely delayed the identification of the true causative agent. It is conceivable that these delays led to an increased casualty rate and that they had a negative impact on military operations during the war. CONCLUSIONS A basic understanding of the ecological mechanisms that maintain species diversity in the local environment coupled with an appreciation for the impact of environmental change on this diversity is of paramount importance for the prevention and mitigation of viral disease outbreaks in the deployed setting. Military medical planners should become familiar with the medical literature of the region in which they will be operating as this literature often describes the agents that will most likely be encountered by U.S. forces.
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Affiliation(s)
- Ramsey Rouabhia
- Department of History, United States Military Academy, West Point, NY 10996, USA
| | - Dung T Dinh
- Department of Clinical Investigation, Dwight D. Eisenhower Army Medical Center, Fort Gordon, GA 30905, USA
| | - Siang C Kua
- Department of Clinical Investigation, Dwight D. Eisenhower Army Medical Center, Fort Gordon, GA 30905, USA
| | - Michael A Washington
- Department of Clinical Investigation, Dwight D. Eisenhower Army Medical Center, Fort Gordon, GA 30905, USA
- Department of Chemistry and Life Science, United States Military Academy, West Point, NY 10996, USA
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Study on Spatiotemporal Characteristic and Mechanism of Forest Loss in Urban Agglomeration in the Middle Reaches of the Yangtze River. FORESTS 2021. [DOI: 10.3390/f12091242] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Under the backdrop of achieving carbon neutrality and accelerating urbanization, China’s forests face unprecedented pressures. This study explored the spatiotemporal characteristics of forest loss in the urban agglomeration in the middle reaches of the Yangtze River (UAMRYR). The dynamic mechanism of forest loss caused by fire, logging, construction, and pollution was also analyzed using spatial database development, polygon superposition analysis, grid system construction, and coordinate system calculation. The results show that the forest loss in the UAMRYR experienced three stages: continuous acceleration (1990–2010), peak (2010–2015), and slight decline (2015–2020). Rapid urban expansion is the primary cause of forest loss, and the three metropolitan areas had the fastest urban expansion and the most severe forest loss. Due to the success of afforestation efforts, the forest loss caused by fire, logging, and pollution was restored by 80%, while most of the forest losses caused by construction are permanent. Given the current forest loss trends, large expanses of forests in the UAMRYR are at risk of being destroyed and causing serious damage to the region’s ecological environment. Forest losses can be significantly reduced by guiding the rational expansion of cities, supporting afforestation for urban construction projects, strengthening forest fire risk investigation, and implementing ecological reconstruction of polluted areas.
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Lu CT, Wang LS, Hsueh PR. Scrub typhus and antibiotic-resistant Orientia tsutsugamushi. Expert Rev Anti Infect Ther 2021; 19:1519-1527. [PMID: 34109905 DOI: 10.1080/14787210.2021.1941869] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Introduction: Scrub typhus is one of the most underdiagnosed and under-reported febrile illnesses requiring hospitalization, mainly occurring in Southeast and East Asia and the Pacific Islands, in an area referred to as the 'Tsutsugamushi Triangle.' Scrub typhus is a zoonotic rickettsial disease that is transmitted to humans by trombiculid mites.Areas covered: A MEDLINE/PubMed search of the available literature was performed to describe the role of antibiotic-resistant scrub typhus in therapy failure.Expert opinion: Scrub typhus is characterized by an eschar that may appear 2-3 days before sudden-onset fever with chills, headache, backache, myalgia, profuse sweating, vomiting, and enlarged lymph nodes. A macular or maculopapular skin rash can develop within 3-8 days after the onset of fever. Various antibiotics, such as chloramphenicol, tetracycline, doxycycline, macrolides, quinolones, and rifampicin, have been used to treat scrub typhus. Resistance to tetracycline has been proposed to underlie delayed clinical improvement since 1996, but recent reports have questioned the existence of doxycycline resistance. Nevertheless, the existence and importance of antibiotic-resistant scrub typhus remain uncertain and require further study.
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Affiliation(s)
- Chin-Te Lu
- Department of Infectious Diseases, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan, Taiwan
| | - Lih-Shinn Wang
- Division of Infectious Diseases, Department of Internal Medicine, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan
| | - Po-Ren Hsueh
- Department of Laboratory Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.,Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
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Overview of snakebite in Brazil: Possible drivers and a tool for risk mapping. PLoS Negl Trop Dis 2021; 15:e0009044. [PMID: 33513145 PMCID: PMC7875335 DOI: 10.1371/journal.pntd.0009044] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 02/10/2021] [Accepted: 12/18/2020] [Indexed: 11/19/2022] Open
Abstract
Snakebite envenoming affects close to 2.7 million people globally every year. In Brazil, snakebites are reported to the Ministry of Health surveillance system and cases receive antivenom free of charge. There is an urgent need to identify higher risk areas for antivenom distribution, and to develop prevention activities. The objective of this study is to provide an overview of the epidemiological situation of snakebite envenoming in Brazil and explore possible drivers; as well as to create a flowchart tool to support decision-makers identify higher risk areas. An ecological-type study was carried out using data by municipality (2013–2017). Study parts: 1) Create a geocoded database and perform a descriptive and cluster analysis; 2) Statistical analysis to measure the association of snakebite and possible environmental and socioeconomic drivers; 3) Develop a flowchart to support decision-makers and the application of this tool in one state (Rio Grande do Sul) as an example. An average of 27,120 snakebite cases per year were reported at the country level. Clusters of municipalities with high numbers of snakebites are mostly found in the Amazon Legal Region. The negative binomial regression model showed association with the snakebite case count: the type of major habitat, tropical or non-tropical; temperature; percentage of urbanization; precipitation; elevation; GDP per capita; a weaker relation with forest loss; and with venomous snake richness. The state where the instrument was applied reported 4,227 snakebites in the period. Most municipalities were considered as medium risk and 56/496 as high risk according to the tool created. Snakebite cases are distributed across the entire country with the highest concentration in the Legal Amazon Region. This creates a complex situation both for better understanding of the association of environmental and socioeconomic factors with snakebites and for the distribution and maintenance of antivenom to remote areas. Research into types of antivenom with a longer shelf life without the need for refrigeration is needed. It is estimated that snakebite envenoming affects around 2.7 million people every year worldwide. In Brazil, snakebite is part of the Ministry of Health surveillance system and cases receive antivenom free of charge. With a vast territory and limited production of antivenom, there is need to identify higher risk areas for its distribution and to develop preventative actions. The objective of this study is to provide an overview of the epidemiological situation of snakebite envenoming in Brazil and explore possible environmental and socioeconomic factors related to snakebites. On the basis of this information, a flowchart tool to support decision-makers identify higher risk areas was created and applied in one state as an example. An average of 27,120 snakebite cases per year were reported in Brazil, with the highest number of cases and rates in the Legal Amazon Region. The multivariable statistics analysis showed association of snakebite with environmental factors (type of major habitat, tropical or non-tropical; temperature; precipitation; elevation) and socioeconomic (lower percentage of urbanization; lower GDP per capita); also, a weaker relation with forest loss, and with venomous snake richness. The tool created to support decision-makers was applied in the state of Rio Grande do Sul, with 4,227 reported snakebites during the period. According to this tool, the majority of municipalities in this state were considered as medium risk and 56/496 as high risk. Snakebite cases are distributed across the entire country; however, the highest concentration is in the Legal Amazon Region. This creates a complex situation both for better understanding of the association of environmental and socioeconomic factors with snakebites and for the distribution and maintenance of antivenom to remote areas.
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Min KD, Kim H, Hwang SS, Cho S, Schneider MC, Hwang J, Cho SI. Protective effect of predator species richness on human hantavirus infection incidence. Sci Rep 2020; 10:21744. [PMID: 33303876 PMCID: PMC7728771 DOI: 10.1038/s41598-020-78765-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 11/30/2020] [Indexed: 11/09/2022] Open
Abstract
Are predators of rodents beneficial for public health? This question focuses on whether predators regulate the spillover transmission of rodent-borne diseases. No clear answer has emerged because of the complex linkages across multiple trophic levels and the lack of accessible data. Although previous empirical findings have suggested ecological mechanisms, such as resource partitioning, which implies protective effects from predator species richness, epidemiological evidence is needed to bolster these arguments. Thus, we investigated the association between predator species richness and incidence of rodent-borne haemorrhagic fever with renal syndrome in the human population using district-level longitudinal data of 13 years for South Korea. With the exception of districts with low species richness, we found a significant negative association between the incidence of haemorrhagic fever with renal syndrome and the species richness of both avian and mammalian predators; the trends for both predator types were similar. Thus, biodiversity conservation may benefit public health.
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Affiliation(s)
- Kyung-Duk Min
- Institute of Health and Environment, Graduate School of Public Health, Seoul National University, Seoul, South Korea
| | - Ho Kim
- Institute of Health and Environment, Graduate School of Public Health, Seoul National University, Seoul, South Korea.,Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, South Korea
| | - Seung-Sik Hwang
- Institute of Health and Environment, Graduate School of Public Health, Seoul National University, Seoul, South Korea.,Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, South Korea
| | - Seongbeom Cho
- College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University, Seoul, South Korea
| | - Maria Cristina Schneider
- Department of International Health, School of Nursing and Health Sciences, Georgetown University, Washington, DC, USA.,Institute of Collective Health Studies, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Jusun Hwang
- Wildlife Conservation Society, New York, USA
| | - Sung-Il Cho
- Institute of Health and Environment, Graduate School of Public Health, Seoul National University, Seoul, South Korea. .,Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, South Korea.
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Mapping Environmental Suitability of Scrub Typhus in Nepal Using MaxEnt and Random Forest Models. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16234845. [PMID: 31810239 PMCID: PMC6926588 DOI: 10.3390/ijerph16234845] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 11/26/2019] [Accepted: 11/28/2019] [Indexed: 11/17/2022]
Abstract
Being a globally emerging mite-borne zoonotic disease, scrub typhus is a serious public health concern in Nepal. Mapping environmental suitability and quantifying the human population under risk of the disease is important for prevention and control efforts. In this study, we model and map the environmental suitability of scrub typhus using the ecological niche approach, machine learning modeling techniques, and report locations of scrub typhus along with several climatic, topographic, Normalized Difference Vegetation Index (NDVI), and proximity explanatory variables and estimated population under the risk of disease at a national level. Both MaxEnt and RF technique results reveal robust predictive power with test The area under curve (AUC) and true skill statistics (TSS) of above 0.8 and 0.6, respectively. Spatial prediction reveals that environmentally suitable areas of scrub typhus are widely distributed across the country particularly in the low-land Tarai and less elevated river valleys. We found that areas close to agricultural land with gentle slopes have higher suitability of scrub typhus occurrence. Despite several speculations on the association between scrub typhus and proximity to earthquake epicenters, we did not find a significant role of proximity to earthquake epicenters in the distribution of scrub typhus in Nepal. About 43% of the population living in highly suitable areas for scrub typhus are at higher risk of infection, followed by 29% living in suitable areas of moderate-risk, and about 22% living in moderately suitable areas of lower risk. These findings could be useful in selecting priority areas for surveillance and control strategies effectively.
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