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Austhof E, Warner S, Helfrich K, Pogreba-Brown K, Brown HE, Klimentidis YC, Scallan Walter E, Jervis RH, White AE. Exploring the association of weather variability on Campylobacter - A systematic review. ENVIRONMENTAL RESEARCH 2024; 252:118796. [PMID: 38582433 DOI: 10.1016/j.envres.2024.118796] [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: 01/17/2024] [Revised: 03/11/2024] [Accepted: 03/25/2024] [Indexed: 04/08/2024]
Abstract
BACKGROUND Previous work has found climate change-induced weather variability is suspected to increase the transmission of enteric pathogens, including Campylobacter, a leading cause of bacterial gastroenteritis. While the relationship between extreme weather events and diarrheal diseases has been documented, the specific impact on Campylobacter infections remains underexplored. OBJECTIVE To synthesize the peer-reviewed literature exploring the effect of weather variability on Campylobacter infections in humans. METHODS The review included English language, peer-reviewed articles, published up to September 1, 2022 in PubMed, Embase, GEOBASE, Agriculture and Environmental Science Database, and CABI Global Health exploring the effect of an antecedent weather event on human enteric illness caused by Campylobacter (PROSPERO Protocol # 351884). We extracted study information including data sources, methods, summary measures, and effect sizes. Quality and weight of evidence reported was summarized and bias assessed for each article. RESULTS After screening 278 articles, 47 articles (34 studies, 13 outbreak reports) were included in the evidence synthesis. Antecedent weather events included precipitation (n = 35), temperature (n = 30), relative humidity (n = 7), sunshine (n = 6), and El Niño and La Niña (n = 3). Reviewed studies demonstrated that increases in precipitation and temperature were correlated with Campylobacter infections under specific conditions, whereas low relative humidity and sunshine were negatively correlated. Articles estimating the effect of animal operations (n = 15) found presence and density of animal operations were significantly associated with infections. However, most of the included articles did not assess confounding by seasonality, presence of animal operations, or describe estimates of risk. DISCUSSION This review explores what is known about the influence of weather events on Campylobacter and identifies previously underreported negative associations between low relative humidity and sunshine on Campylobacter infections. Future research should explore pathogen-specific estimates of risk, which can be used to influence public health strategies, improve source attribution and causal pathways, and project disease burden due to climate change.
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Affiliation(s)
- Erika Austhof
- Department of Epidemiology & Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA.
| | - Shaylee Warner
- Department of Epidemiology, Colorado School of Public Health, Aurora, CO, USA
| | - Kathryn Helfrich
- Department of Epidemiology, Colorado School of Public Health, Aurora, CO, USA
| | - Kristen Pogreba-Brown
- Department of Epidemiology & Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Heidi E Brown
- Department of Epidemiology & Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Yann C Klimentidis
- Department of Epidemiology & Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | | | - Rachel H Jervis
- Colorado Department of Public Health and Environment, Denver, CO, USA
| | - Alice E White
- Department of Epidemiology, Colorado School of Public Health, Aurora, CO, USA
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Lee GO, McCormick BJ, Yori PP, Paredes-Olortegui M, Caulfield LE, Kosek MN. Short-term dynamics of linear growth among Peruvian infants in the first year of life in a population with linear growth faltering. Am J Hum Biol 2024; 36:e24039. [PMID: 38189589 PMCID: PMC11144106 DOI: 10.1002/ajhb.24039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 12/20/2023] [Accepted: 12/21/2023] [Indexed: 01/09/2024] Open
Abstract
OBJECTIVES Infant growth is recognized to vary over the short term, with periods of greater and lesser linear growth velocity. Our objectives were to (1) examine the potential differences in overall growth profiles between children who experienced cumulative growth faltering in the first year of life consistent with that seen by many children living in poverty in low- and middle-income countries, versus children without growth faltering and (2) test whether biological factors were associated with the timing of magnitude of growth saltations. METHODS Thrice-weekly measurements of length were recorded for n = 61 Peruvian infants (28 boys and 33 girls) enrolled from birth to 1 year. A total of 6040 measurements were analyzed. We tested for the evidence of saltatory growth and used hurdle models to test whether the timing and magnitude of saltations varied between children with greater or lesser growth faltering. RESULTS There were no differences in the duration of stasis periods or magnitude of growth saltations between children who were stunted at 1 year old (N = 18) versus those who were not stunted (N = 43). Children who experienced greater declines in LAZ in the first year of life trended toward longer periods between saltations than those with less of a decline (14.5 days vs. 13.4 days, p = .0512). A 1-unit increase in mid upper arm circumference for age Z-score in the 21 days prior was associated with 35% greater odds of a saltation occurring (p < .001), and a 0.128 cm greater saltation (p < .001). CONCLUSIONS After characterizing infant growth into periods of saltation and stasis, our results suggest that increases in weight preceded increases in length.
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Affiliation(s)
- Gwenyth O. Lee
- Rutgers Global Health Institute and Department of Epidemiology and Biostatistics, Rutgers University, New Brunswick, New Jersey, USA
| | | | - Pablo P. Yori
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, Virginia, USA
| | | | - Laura E. Caulfield
- Center for Human Nutrition, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Margaret N. Kosek
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, Virginia, USA
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Yazdi MS, Ardalan MA, Hosseini M, Yousefi Zoshk M, Hami Z, Heidari R, Mosaed R, Chamanara M. Infectious Diarrhea Risks as a Public Health Emergency in Floods; a Systematic Review and Meta-Analysis. ARCHIVES OF ACADEMIC EMERGENCY MEDICINE 2024; 12:e46. [PMID: 38962364 PMCID: PMC11221827 DOI: 10.22037/aaem.v12i1.2284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 07/05/2024]
Abstract
Introduction Infectious diarrhea, a significant global health challenge, is exacerbated by flooding, a consequence of climate change and environmental disruption. This comprehensive study aims to quantify the association between flooding events and the incidence of infectious diarrhea, considering diverse demographic, environmental, and pathogen-specific factors. Methods In this systematic review and meta-analysis, adhering to PROSPERO protocol (CRD42024498899), we evaluated observational studies from January 2000 to December 2023. The analysis incorporated global data from PubMed, Scopus, Embase, Web of Science, and ProQuest, focusing on the relative risk (RR) of diarrhea post-flooding. The study encompassed diverse variables like age, sex, pathogen type, environmental context, and statistical modeling approaches. Results The meta-analysis, involving 42 high-quality studies, revealed a substantial increase (RR = 1.40, 95% CI [1.29-1.52]) in the incidence of diarrhea following floods. Notably, bacterial and parasitic diarrheas demonstrated higher RRs (1.82 and 1.35, respectively) compared to viral etiologies (RR = 1.15). A significant sex disparity was observed, with women exhibiting a higher susceptibility (RR = 1.55) than men (RR = 1.35). Adults (over 15 years) faced a greater risk than younger individuals, highlighting age-dependent vulnerability. Conclusion This extensive analysis confirms a significant correlation between flood events and increased infectious diarrhea risk, varying across pathogens and demographic groups. The findings highlight an urgent need for tailored public health interventions in flood-prone areas, focusing on enhanced sanitation, disease surveillance, and targeted education to mitigate this elevated risk. Our study underscores the critical importance of integrating flood-related health risks into global public health planning and climate change adaptation strategies.
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Affiliation(s)
| | - Mohammad Afshar Ardalan
- Clinical Biomechanics and Ergonomics Research Center, AJA University of Medical Sciences, Tehran, Iran
- Department of Internal Medicine, School of Medicine, AJA University of Medical Sciences, Tehran, Iran
| | - Mohsen Hosseini
- The Institute of Pharmaceutical Sciences (TIPS), Tehran University of Medical Sciences, Tehran, Iran
| | - Mojtaba Yousefi Zoshk
- Trauma and Surgery Research Center, AJA University of Medical Sciences, Tehran, Iran
| | - Zahra Hami
- Toxicology Research Center, AJA University of Medical Sciences, Tehran, Iran
| | - Reza Heidari
- Cancer Epidemiology Research Center (AJA-CERTC), AJA University of Medical Sciences, Tehran, Iran
- 7Medical Biotechnology Research Center, AJA University of Medical Sciences, Tehran, Iran
| | - Reza Mosaed
- Infectious Diseases Research Center, AJA University of Medical Sciences, Tehran, Iran
- Student Research Committee, AJA University of Medical Sciences, Tehran, Iran
| | - Mohsen Chamanara
- Toxicology Research Center, AJA University of Medical Sciences, Tehran, Iran
- Student Research Committee, AJA University of Medical Sciences, Tehran, Iran
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Khoo MS, Ahmad Azman AH, Ismail NAS, Abdul Wahab A, Ali A. Associations between meteorological variation and hospitalisations for rotavirus infections in Kuala Lumpur, Malaysia. Heliyon 2024; 10:e28574. [PMID: 38596105 PMCID: PMC11002053 DOI: 10.1016/j.heliyon.2024.e28574] [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: 09/22/2023] [Revised: 03/11/2024] [Accepted: 03/20/2024] [Indexed: 04/11/2024] Open
Abstract
Objectives Rotavirus (RoV) infections have emerged as a significant public health concern around the world. Understanding the relationship between climatic conditions and hospitalisations due to RoV infections can help engage effective prevention strategies. This study aims to investigate the potential associations between meteorological variability and RoV-related hospitalisations in Kuala Lumpur, Malaysia. Methods Hospitalization data from a tertiary teaching hospital in Kuala Lumpur over a twelve-year period were retrospectively collected. Concurrently, meteorological data were obtained from the Malaysian Meteorological Department (MetMalaysia) including variables of temperature, humidity, precipitation, and atmospheric pressure to further demonstrate relationship with RoV-associated hospitalisations. Results The results indicated positive correlations between increased rainfall, rainy days, humidity, and RoV-related hospitalisations, suggesting the influence of environmental factors on the transmission of RoV. Conclusions This study highlights positive associations between meteorological variations and hospitalizations for RoV infections in Kuala Lumpur, Malaysia. Further investigations, including national-level data, are needed to deepen our understanding of these associations, particularly within the context of Malaysia and to develop targeted interventions for disease prevention and control.
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Affiliation(s)
- Mohammad Shukri Khoo
- Department of Paediatrics, Faculty of Medicine, Universiti Kebangsaan Malaysia Specialist Children's Hospital, The National University of Malaysia, 56000, Kuala Lumpur, Malaysia
- Clinical Research Unit, Universiti Kebangsaan Malaysia Specialist Children's Hospital, The National University of Malaysia, 56000, Kuala Lumpur, Malaysia
| | - Ahmad Hathim Ahmad Azman
- Department of Paediatrics, Faculty of Medicine, Universiti Kebangsaan Malaysia Specialist Children's Hospital, The National University of Malaysia, 56000, Kuala Lumpur, Malaysia
| | - Noor Akmal Shareela Ismail
- Department of Biochemistry, Faculty of Medicine, The National University of Malaysia, 56000, Kuala Lumpur, Malaysia
| | - Asrul Abdul Wahab
- Department of Medical Microbiology & Immunology, Faculty of Medicine, The National University of Malaysia, 56000, Kuala Lumpur, Malaysia
| | - Adli Ali
- Department of Paediatrics, Faculty of Medicine, Universiti Kebangsaan Malaysia Specialist Children's Hospital, The National University of Malaysia, 56000, Kuala Lumpur, Malaysia
- Clinical Research Unit, Universiti Kebangsaan Malaysia Specialist Children's Hospital, The National University of Malaysia, 56000, Kuala Lumpur, Malaysia
- Institute of IR4.0, The National University of Malaysia, 43600, Bangi, Malaysia
- Infection and Immunology Health and Advanced Medicine Cluster, The National University of Malaysia, 56000, Kuala Lumpur, Malaysia
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Weeda LJZ, Bradshaw CJA, Judge MA, Saraswati CM, Le Souëf PN. How climate change degrades child health: A systematic review and meta-analysis. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 920:170944. [PMID: 38360325 DOI: 10.1016/j.scitotenv.2024.170944] [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: 11/01/2023] [Revised: 02/08/2024] [Accepted: 02/11/2024] [Indexed: 02/17/2024]
Abstract
BACKGROUND Children are more vulnerable than adults to climate-related health threats, but reviews examining how climate change affects human health have been mainly descriptive and lack an assessment of the magnitude of health effects children face. This is the first systematic review and meta-analysis that identifies which climate-health relationships pose the greatest threats to children. OBJECTIVES We reviewed epidemiologic studies to analyse various child health outcomes due to climate change and identify the relationships with the largest effect size. We identify population-specific risks and provide recommendations for future research. METHODS We searched four large online databases for observational studies published up to 5 January 2023 following PRISMA (systematic review) guidelines. We evaluated each included study individually and aggregated relevant quantitative data. We used quantitative data in our meta-analysis, where we standardised effect sizes and compared them among different groupings of climate variables and health outcomes. RESULTS Of 1301 articles we identified, 163 studies were eligible for analysis. We identified many relationships between climate change and child health, the strongest of which was increasing risk (60 % on average) of preterm birth from exposure to temperature extremes. Respiratory disease, mortality, and morbidity, among others, were also influenced by climate changes. The effects of different air pollutants on health outcomes were considerably smaller compared to temperature effects, but with most (16/20 = 80 %) pollutant studies indicating at least a weak effect. Most studies occurred in high-income regions, but we found no geographical clustering according to health outcome, climate variable, or magnitude of risk. The following factors were protective of climate-related child-health threats: (i) economic stability and strength, (ii) access to quality healthcare, (iii) adequate infrastructure, and (iv) food security. Threats to these services vary by local geographical, climate, and socio-economic conditions. Children will have increased prevalence of disease due to anthropogenic climate change, and our quantification of the impact of various aspects of climate change on child health can contribute to the planning of mitigation that will improve the health of current and future generations.
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Affiliation(s)
- Lewis J Z Weeda
- School of Medicine, University of Western Australia, Perth, Western Australia, Australia.
| | - Corey J A Bradshaw
- Global Ecology | Partuyarta Ngadluku Wardli Kuu, College of Science and Engineering, Flinders University, Adelaide, South Australia, Australia; Australian Research Council Centre of Excellence for Australian Biodiversity and Heritage, EpicAustralia.org.au, Australia
| | - Melinda A Judge
- Telethon Kids Institute, Perth, Western Australia, Australia; Department of Mathematics and Statistics, University of Western Australia, Perth, Western Australia, Australia
| | | | - Peter N Le Souëf
- School of Medicine, University of Western Australia, Perth, Western Australia, Australia; Telethon Kids Institute, Perth, Western Australia, Australia
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Manzanares Villanueva K, Pinedo Vasquez T, Peñataro Yori P, Romaina Cacique L, Garcia Bardales PF, Shapiama Lopez WV, Zegarra Paredes F, Perez KF, Rengifo Pinedo S, Silva Delgado H, Flynn T, Schiaffino F, Colston JM, Paredes Olortegui MP, Kosek MN. The Enterics for Global Health (EFGH) Shigella Surveillance Study in Peru. Open Forum Infect Dis 2024; 11:S121-S128. [PMID: 38532951 PMCID: PMC10962730 DOI: 10.1093/ofid/ofad655] [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] [Indexed: 03/28/2024] Open
Abstract
Background The Enterics for Global Health (EFGH) Peru site will enroll subjects in a periurban area of the low Amazon rainforest. The political department of Loreto lags behind most of Peru in access to improved sources of water and sanitation, per capita income, children born <2.5 kg, and infant and child mortality. Chronic undernutrition as manifested by linear growth shortfalls is common, but wasting and acute malnutrition are not. Methods The recruitment of children seeking care for acute diarrheal disease takes place at a geographic cluster of government-based primary care centers in an area where most residents are beneficiaries of free primary healthcare. Results Rates of diarrheal disease, dysentery, and Shigella are known to be high in the region, with some of the highest rates of disease documented in the literature and little evidence in improvement over the last 2 decades. This study will update estimates of shigellosis by measuring the prevalence of Shigella by polymerase chain reaction and culture in children seeking care and deriving population-based estimates by measuring healthcare seeking at the community level. Conclusions Immunization has been offered universally against rotavirus in the region since 2009, and in a context where adequate water and sanitation are unlikely to obtain high standards in the near future, control of principal enteropathogens through immunization may be the most feasible way to decrease the high burden of disease in the area in the near future.
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Affiliation(s)
| | | | - Pablo Peñataro Yori
- Division of Infectious Diseases and International Health, School of Medicine, University of Virginia, Charlottesville, Virginia, USA
| | | | | | | | | | - Karin F Perez
- Asociación Benéfica Prisma, Unidad de Investigaciones Biomedicas, Iquitos, Loreto, Peru
| | - Silvia Rengifo Pinedo
- Asociación Benéfica Prisma, Unidad de Investigaciones Biomedicas, Iquitos, Loreto, Peru
| | - Hermann Silva Delgado
- Facultad de Medicina Humana, Universidad Nacional de la Amazonia Peruana, Iquitos, Loreto, Peru
| | - Thomas Flynn
- Division of Infectious Diseases and International Health, School of Medicine, University of Virginia, Charlottesville, Virginia, USA
| | - Francesca Schiaffino
- Division of Infectious Diseases and International Health, School of Medicine, University of Virginia, Charlottesville, Virginia, USA
- Faculty of Veterinary Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Josh M Colston
- Division of Infectious Diseases and International Health, School of Medicine, University of Virginia, Charlottesville, Virginia, USA
| | | | - Margaret N Kosek
- Division of Infectious Diseases and International Health, School of Medicine, University of Virginia, Charlottesville, Virginia, USA
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Colston JM, Fang B, Houpt E, Chernyavskiy P, Swarup S, Gardner LM, Nong MK, Badr HS, Zaitchik BF, Lakshmi V, Kosek MN. The Planetary Child Health & Enterics Observatory (Plan-EO): A protocol for an interdisciplinary research initiative and web-based dashboard for mapping enteric infectious diseases and their risk factors and interventions in LMICs. PLoS One 2024; 19:e0297775. [PMID: 38412156 PMCID: PMC10898779 DOI: 10.1371/journal.pone.0297775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 01/12/2024] [Indexed: 02/29/2024] Open
Abstract
BACKGROUND Diarrhea remains a leading cause of childhood illness throughout the world that is increasing due to climate change and is caused by various species of ecologically sensitive pathogens. The emerging Planetary Health movement emphasizes the interdependence of human health with natural systems, and much of its focus has been on infectious diseases and their interactions with environmental and human processes. Meanwhile, the era of big data has engendered a public appetite for interactive web-based dashboards for infectious diseases. However, enteric infectious diseases have been largely overlooked by these developments. METHODS The Planetary Child Health & Enterics Observatory (Plan-EO) is a new initiative that builds on existing partnerships between epidemiologists, climatologists, bioinformaticians, and hydrologists as well as investigators in numerous low- and middle-income countries. Its objective is to provide the research and stakeholder community with an evidence base for the geographical targeting of enteropathogen-specific child health interventions such as novel vaccines. The initiative will produce, curate, and disseminate spatial data products relating to the distribution of enteric pathogens and their environmental and sociodemographic determinants. DISCUSSION As climate change accelerates there is an urgent need for etiology-specific estimates of diarrheal disease burden at high spatiotemporal resolution. Plan-EO aims to address key challenges and knowledge gaps by making and disseminating rigorously obtained, generalizable disease burden estimates. Pre-processed environmental and EO-derived spatial data products will be housed, continually updated, and made publicly available for download to the research and stakeholder communities. These can then be used as inputs to identify and target priority populations living in transmission hotspots and for decision-making, scenario-planning, and disease burden projection. STUDY REGISTRATION PROSPERO protocol #CRD42023384709.
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Affiliation(s)
- Josh M. Colston
- Division of Infectious Diseases and International Health, University of Virginia School of Medicine, Charlottesville, Virginia, United States of America
- Department of Public Health Sciences, University of Virginia School of Medicine, Charlottesville, Virginia, United States of America
| | - Bin Fang
- Department of Civil and Environmental Engineering, University of Virginia, Charlottesville, Virginia, United States of America
| | - Eric Houpt
- Division of Infectious Diseases and International Health, University of Virginia School of Medicine, Charlottesville, Virginia, United States of America
| | - Pavel Chernyavskiy
- Department of Public Health Sciences, University of Virginia School of Medicine, Charlottesville, Virginia, United States of America
| | - Samarth Swarup
- Biocomplexity Institute, University of Virginia, Charlottesville, Virginia, United States of America
| | - Lauren M. Gardner
- Department of Civil and Systems Engineering, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Malena K. Nong
- University of Virginia College of Arts & Sciences, Charlottesville, Virginia, United States of America
| | - Hamada S. Badr
- Department of Earth and Planetary Sciences, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Benjamin F. Zaitchik
- Department of Earth and Planetary Sciences, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Venkataraman Lakshmi
- Department of Civil and Environmental Engineering, University of Virginia, Charlottesville, Virginia, United States of America
| | - Margaret N. Kosek
- Division of Infectious Diseases and International Health, University of Virginia School of Medicine, Charlottesville, Virginia, United States of America
- Department of Public Health Sciences, University of Virginia School of Medicine, Charlottesville, Virginia, United States of America
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Colston JM, Chernyavskiy P, Gardner L, Nong M, Fang B, Houpt E, Swarup S, Badr H, Zaitchik B, Lakshmi V, Kosek M. The Planetary Child Health & Enterics Observatory (Plan-EO): a protocol for an interdisciplinary research initiative and web-based dashboard for mapping enteric infectious diseases and their risk factors and interventions in LMICs. RESEARCH SQUARE 2024:rs.3.rs-2640564. [PMID: 36993232 PMCID: PMC10055683 DOI: 10.21203/rs.3.rs-2640564/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
Abstract
Background Diarrhea remains a leading cause of childhood illness throughout the world that is increasing due to climate change and is caused by various species of ecologically sensitive pathogens. The emerging Planetary Health movement emphasizes the interdependence of human health with natural systems, and much of its focus has been on infectious diseases and their interactions with environmental and human processes. Meanwhile, the era of big data has engendered a public appetite for interactive web-based dashboards for infectious diseases. However, enteric infectious diseases have been largely overlooked by these developments. Methods The Planetary Child Health and Enterics Observatory (Plan-EO) is a new initiative that builds on existing partnerships between epidemiologists, climatologists, bioinformaticians, and hydrologists as well as investigators in numerous low- and middle-income countries. Its objective is to provide the research and stakeholder community with an evidence base for the geographical targeting of enteropathogen-specific child health interventions such as novel vaccines. The initiative will produce, curate, and disseminate spatial data products relating to the distribution of enteric pathogens and their environmental and sociodemographic determinants. Discussion As climate change accelerates there is an urgent need for etiology-specific estimates of diarrheal disease burden at high spatiotemporal resolution. Plan-EO aims to address key challenges and knowledge gaps by making rigorously obtained, generalizable disease burden estimates freely available and accessible to the research and stakeholder communities. Pre-processed environmental and EO-derived spatial data products will be housed, continually updated, and made publicly available to the research and stakeholder communities both within the webpage itself and for download. These inputs can then be used to identify and target priority populations living in transmission hotspots and for decision-making, scenario-planning, and disease burden projection. Study registration PROSPERO protocol #CRD42023384709.
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Affiliation(s)
| | | | | | - Malena Nong
- University of Virginia College of Arts & Sciences
| | | | - Eric Houpt
- University of Virginia School of Medicine
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Colston JM, Chernyavskiy P, Gardner L, Nong M, Fang B, Houpt E, Swarup S, Badr H, Zaitchik B, Lakshmi V, Kosek M. The Planetary Child Health & Enterics Observatory (Plan-EO): a protocol for an interdisciplinary research initiative and web-based dashboard for mapping enteric infectious diseases and their risk factors and interventions in LMICs. RESEARCH SQUARE 2024:rs.3.rs-2640564. [PMID: 36993232 PMCID: PMC10055683 DOI: 10.21203/rs.3.rs-2640564/v3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
Background Diarrhea remains a leading cause of childhood illness throughout the world that is increasing due to climate change and is caused by various species of ecologically sensitive pathogens. The emerging Planetary Health movement emphasizes the interdependence of human health with natural systems, and much of its focus has been on infectious diseases and their interactions with environmental and human processes. Meanwhile, the era of big data has engendered a public appetite for interactive web-based dashboards for infectious diseases. However, enteric infectious diseases have been largely overlooked by these developments. Methods The Planetary Child Health and Enterics Observatory (Plan-EO) is a new initiative that builds on existing partnerships between epidemiologists, climatologists, bioinformaticians, and hydrologists as well as investigators in numerous low- and middle-income countries. Its objective is to provide the research and stakeholder community with an evidence base for the geographical targeting of enteropathogen-specific child health interventions such as novel vaccines. The initiative will produce, curate, and disseminate spatial data products relating to the distribution of enteric pathogens and their environmental and sociodemographic determinants. Discussion As climate change accelerates there is an urgent need for etiology-specific estimates of diarrheal disease burden at high spatiotemporal resolution. Plan-EO aims to address key challenges and knowledge gaps by making rigorously obtained, generalizable disease burden estimates freely available and accessible to the research and stakeholder communities. Pre-processed environmental and EO-derived spatial data products will be housed, continually updated, and made publicly available to the research and stakeholder communities both within the webpage itself and for download. These inputs can then be used to identify and target priority populations living in transmission hotspots and for decision-making, scenario-planning, and disease burden projection. Study registration PROSPERO protocol #CRD42023384709.
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Affiliation(s)
| | | | | | - Malena Nong
- University of Virginia College of Arts & Sciences
| | | | - Eric Houpt
- University of Virginia School of Medicine
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Palmeiro-Silva YK, Lescano AG, Flores EC, Astorga E Y, Rojas L, Chavez MG, Mora-Rivera W, Hartinger SM. Identifying gaps on health impacts, exposures, and vulnerabilities to climate change on human health and wellbeing in South America: a scoping review. LANCET REGIONAL HEALTH. AMERICAS 2023; 26:100580. [PMID: 37876675 PMCID: PMC10593580 DOI: 10.1016/j.lana.2023.100580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 05/29/2023] [Accepted: 08/04/2023] [Indexed: 10/26/2023]
Abstract
There is an important gap in regional information on climate change and health, limiting the development of science-based climate policies in South American countries. This study aims to identify the main gaps in the existing scientific literature on the impacts, exposure, and vulnerabilities of climate change on population health. A scoping review was performed guided by four sub-questions focused on the impacts of climate change on physical and mental health, exposure and vulnerability factors of population to climate hazards. The main findings showed that physical impacts mainly included infectious diseases, while mental health impacts included trauma, depression, and anxiety. Evidence on population exposure to climate hazards is limited, and social determinants of health and individual factors were identified as vulnerability factors. Overall, evidence on the intersection between climate change and health is limited in South America and has been generated in silos, with limited transdisciplinary research. More formal and systematic information should be generated to inform public policy. Funding None.
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Affiliation(s)
- Yasna K. Palmeiro-Silva
- Institute for Global Health, University College London, London, United Kingdom
- Centro de Políticas Públicas, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - 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
| | - Elaine C. Flores
- Centre on Climate Change and Planetary Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
- The Stanford Center for Innovation in Global Health, Stanford University, Stanford, CA, USA
| | - Yamileth Astorga E
- Escuela de Tecnologías en Salud, Universidad de Costa Rica, San Pedro, San José, Costa Rica
| | - Luciana Rojas
- Clima, Latin American Center of Excellence for Climate Change and Health, Universidad Peruana Cayetano Heredia, Lima, Peru
- Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Mario G. Chavez
- Emerge, Emerging Diseases and Climate Change Research Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
- Sociedad Científica de San Fernando, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Wendel Mora-Rivera
- InterAmerican Center for Global Health (CISG), Puntarenas, Costa Rica
- Escuela de Enfermería, Universidad Latina de Costa Rica, San José, Costa Rica
| | - Stella M. Hartinger
- Clima, Latin American Center of Excellence for Climate Change and Health, Universidad Peruana Cayetano Heredia, Lima, Peru
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11
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Bhutta ZA, Ved R, Twum-Danso N, Saad A, Hodgins S. Ten Years for GHSP: Where Are We Now? Where Will We Go? GLOBAL HEALTH, SCIENCE AND PRACTICE 2023; 11:GHSP-D-23-00102. [PMID: 37116935 PMCID: PMC10141436 DOI: 10.9745/ghsp-d-23-00102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 04/05/2023] [Indexed: 04/30/2023]
Affiliation(s)
- Zulfiqar A Bhutta
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada; Centre for Global Child Health, Hospital for Sick Children, Toronto, Canada; Centre for Excellence in Women and Child Health and Institute of Global Health and Development, The Aga Khan University, Karachi, Pakistan
| | - Rajani Ved
- Bill & Melinda Gates Foundation, New Delhi, India
| | | | | | - Stephen Hodgins
- Editor-in-Chief, Global Health: Science and Practice Journal; Associate Professor, School of Public Health, University of Alberta, Edmonton, Alberta, Canada
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12
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Badr HS, Colston JM, Nguyen NLH, Chen YT, Burnett E, Ali SA, Rayamajhi A, Satter SM, Van Trang N, Eibach D, Krumkamp R, May J, Adegnika AA, Manouana GP, Kremsner PG, Chilengi R, Hatyoka L, Debes AK, Ateudjieu J, Faruque ASG, Hossain MJ, Kanungo S, Kotloff KL, Mandomando I, Nisar MI, Omore R, Sow SO, Zaidi AKM, Lambrecht N, Adu B, Page N, Platts-Mills JA, Mavacala Freitas C, Pelkonen T, Ashorn P, Maleta K, Ahmed T, Bessong P, Bhutta ZA, Mason C, Mduma E, Olortegui MP, Peñataro Yori P, Lima AAM, Kang G, Humphrey J, Ntozini R, Prendergast AJ, Okada K, Wongboot W, Langeland N, Moyo SJ, Gaensbauer J, Melgar M, Freeman M, Chard AN, Thongpaseuth V, Houpt E, Zaitchik BF, Kosek MN. Spatiotemporal variation in risk of Shigella infection in childhood: a global risk mapping and prediction model using individual participant data. Lancet Glob Health 2023; 11:e373-e384. [PMID: 36796984 PMCID: PMC10020138 DOI: 10.1016/s2214-109x(22)00549-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 11/18/2022] [Accepted: 12/14/2022] [Indexed: 02/16/2023]
Abstract
BACKGROUND Diarrhoeal disease is a leading cause of childhood illness and death globally, and Shigella is a major aetiological contributor for which a vaccine might soon be available. The primary objective of this study was to model the spatiotemporal variation in paediatric Shigella infection and map its predicted prevalence across low-income and middle-income countries (LMICs). METHODS Individual participant data for Shigella positivity in stool samples were sourced from multiple LMIC-based studies of children aged 59 months or younger. Covariates included household-level and participant-level factors ascertained by study investigators and environmental and hydrometeorological variables extracted from various data products at georeferenced child locations. Multivariate models were fitted and prevalence predictions obtained by syndrome and age stratum. FINDINGS 20 studies from 23 countries (including locations in Central America and South America, sub-Saharan Africa, and south and southeast Asia) contributed 66 563 sample results. Age, symptom status, and study design contributed most to model performance followed by temperature, wind speed, relative humidity, and soil moisture. Probability of Shigella infection exceeded 20% when both precipitation and soil moisture were above average and had a 43% peak in uncomplicated diarrhoea cases at 33°C temperatures, above which it decreased. Compared with unimproved sanitation, improved sanitation decreased the odds of Shigella infection by 19% (odds ratio [OR]=0·81 [95% CI 0·76-0·86]) and open defecation decreased them by 18% (OR=0·82 [0·76-0·88]). INTERPRETATION The distribution of Shigella is more sensitive to climatological factors, such as temperature, than previously recognised. Conditions in much of sub-Saharan Africa are particularly propitious for Shigella transmission, although hotspots also occur in South America and Central America, the Ganges-Brahmaputra Delta, and the island of New Guinea. These findings can inform prioritisation of populations for future vaccine trials and campaigns. FUNDING NASA, National Institutes of Health-The National Institute of Allergy and Infectious Diseases, and Bill & Melinda Gates Foundation.
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Affiliation(s)
- Hamada S Badr
- Department of Earth and Planetary Sciences, Johns Hopkins Krieger School of Arts and Sciences, Baltimore, MA, USA
| | - Josh M Colston
- Division of Infectious Diseases and International Health, University of Virginia School of Medicine, Charlottesville, VA, USA
| | | | - Yen Ting Chen
- Department of Emergency Medicine, Chi-Mei Medical Center, Tainan, Taiwan
| | - Eleanor Burnett
- Division of Viral Diseases, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Syed Asad Ali
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Ajit Rayamajhi
- Department of Pediatrics, National Academy of Medical Sciences, Kanti Children's Hospital, Kathmandu, Nepal
| | - Syed M Satter
- Programme for Emerging Infections, Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | | | - Daniel Eibach
- Department of Infectious Disease Epidemiology, Bernhard Nocht Institute for Tropical Medicine (BNITM), Hamburg, Germany
| | - Ralf Krumkamp
- Department of Infectious Disease Epidemiology, Bernhard Nocht Institute for Tropical Medicine (BNITM), Hamburg, Germany
| | - Jürgen May
- Department of Infectious Disease Epidemiology, Bernhard Nocht Institute for Tropical Medicine (BNITM), Hamburg, Germany
| | - Ayola Akim Adegnika
- Institute of Tropical Medicine, Universitätsklinikum Tübingen, Tübingen, Germany
| | | | | | - Roma Chilengi
- Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - Luiza Hatyoka
- Enteric diseases and Vaccines Unit, Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - Amanda K Debes
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jerome Ateudjieu
- Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, Cameroon; Department of Health Research, M A SANTE (Meileur Acces aux Soins en Santé), Yaoundé, Cameroon; Division of Health Operations Research, Cameroon Ministry of Public Health, Yaoundé, Cameroon
| | - Abu S G Faruque
- Centre for Nutrition & Food Security, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - M Jahangir Hossain
- Medical Research Council Unit, The Gambia at the London School of Hygiene & Tropical Medicine, Banjul, The Gambia
| | - Suman Kanungo
- National Institute of Cholera and Enteric Diseases, Kolkota, India
| | - Karen L Kotloff
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD, USA
| | | | - M Imran Nisar
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Richard Omore
- Kenya Medical Research Institute, Center for Global Health Research, Kisumu, Nyanza, Kenya
| | - Samba O Sow
- Centre pour le Développement des Vaccins, Mali, Bamako, Mali
| | - Anita K M Zaidi
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Nathalie Lambrecht
- Institute of Public Health, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Research Department 2, Potsdam Institute for Climate Impact Research (PIK), Member of the Leibniz Association, Potsdam, Germany
| | - Bright Adu
- Department of Immunology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - Nicola Page
- Centre for Enteric Diseases, National Institute for Communicable Diseases, Pretoria, South Africa
| | - James A Platts-Mills
- Division of Infectious Diseases and International Health, University of Virginia School of Medicine, Charlottesville, VA, USA
| | | | - Tuula Pelkonen
- New Children's Hospital, Pediatric Research Center and Helsinki University Hospital, Helsinki, Finland
| | - Per Ashorn
- Centre for Child, Adolescent, and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Tampere, Finland
| | - Kenneth Maleta
- College of Medicine, University of Malawi, Blantyre, Malawi
| | - Tahmeed Ahmed
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Pascal Bessong
- HIV/AIDS & Global Health Research Programme, University of Venda, Thohoyandou, Limpopo, South Africa
| | - Zulfiqar A Bhutta
- Center of Excellence in Women and Child Health, Aga Khan University, Karachi, Pakistan
| | - Carl Mason
- Department of Enteric Diseases, Armed Forces Research Institute of Medical Sciences (AFRIMS), Bangkok, Thailand
| | | | | | - Pablo Peñataro Yori
- Division of Infectious Diseases and International Health, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Aldo A M Lima
- Department of Physiology and Pharmacology, Faculty of Medicine, Federal University of Ceará, Fortaleza, Brazil
| | - Gagandeep Kang
- Department of Gastrointestinal Sciences, Christian Medical College, Vellore, India
| | - Jean Humphrey
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Robert Ntozini
- Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe
| | | | - Kazuhisa Okada
- Research Institute for Microbial Diseases, Osaka University, Osaka, Japan
| | - Warawan Wongboot
- Department of Medical Sciences, National Institute of Health, Nonthaburi, Thailand
| | - Nina Langeland
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Sabrina J Moyo
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - James Gaensbauer
- Center for Global Health, Department of Epidemiology, Colorado School of Public Health, Aurora, CO, USA
| | - Mario Melgar
- Pediatric Infectious Diseases, Hospital Roosevelt, Guatemala City, Guatemala
| | - Matthew Freeman
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, 30322, GA, USA
| | - Anna N Chard
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, 30322, GA, USA
| | - Vonethalom Thongpaseuth
- Laboratory and Treatment Unit, Center for Malariology, Parasitology, and Entomology, Ministry of Health, Vientiane, Lao PDR
| | - Eric Houpt
- Division of Infectious Diseases and International Health, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Benjamin F Zaitchik
- Department of Earth and Planetary Sciences, Johns Hopkins Krieger School of Arts and Sciences, Baltimore, MA, USA.
| | - Margaret N Kosek
- Division of Infectious Diseases and International Health, University of Virginia School of Medicine, Charlottesville, VA, USA
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13
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Lan T, Hu Y, Cheng L, Chen L, Guan X, Yang Y, Guo Y, Pan J. Floods and diarrheal morbidity: Evidence on the relationship, effect modifiers, and attributable risk from Sichuan Province, China. J Glob Health 2022; 12:11007. [PMID: 35871400 PMCID: PMC9308977 DOI: 10.7189/jogh.12.11007] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Background Although studies have provided the estimates of floods-diarrhoea associations, little is known about the lag effect, effect modification, and attributable risk. Based on Sichuan, China, an uneven socio-economic development province with plateau, basin, and mountain terrains spanning different climatic zones, we aimed to systematically examine the impacts of floods on diarrheal morbidity. Methods We retrieved information on daily diarrheal cases, floods, meteorological variables, and annual socio-economic characteristics for 21 cities in Sichuan from January 1, 2017 to December 31, 2019. We fitted time-series Poisson models to estimate the city-specific floods-diarrhoea relation over the lags of 0-14 days, and then pooled them using meta-analysis for cumulative and lag effects. We further employed meta-regression to explore potential effect modifiers and identify effect modification. We calculated the attributable diarrheal cases and fraction of attributable morbidity within the framework of the distributed lag model. Results Floods had a significant cumulative association with diarrhoea at the provincial level, but varied by regions and cities. The effects of the floods appeared on the second day after the floods and lasted for 5 days. Floods-diarrhoea relations were modified by three effect modifiers, with stronger flood effects on diarrhoea found in areas with higher air pressure, lower diurnal temperature range, or warmer temperature. Floods were responsible for advancing a fraction of diarrhoea, corresponding to 0.25% within the study period and 0.48% within the flood season. Conclusions The impacts imposed by floods were mainly distributed within the first week. The floods-diarrhoea relations varied by geographic and climatic conditions. The diarrheal burden attributable to floods is currently low in Sichuan, but this figure could increase with the exposure more intensive and the effect modifiers more detrimental in the future. Our findings are expected to provide evidence for the formulation of temporal- and spatial-specific strategies to reduce potential risks of flood-related diarrhoea.
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Affiliation(s)
- Tianjiao Lan
- HEOA Group, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
- Institute for Healthy Cities and West China Research Center for Rural Health Development, Sichuan University, Chengdu, China
| | - Yifan Hu
- HEOA Group, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Liangliang Cheng
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Lingwei Chen
- HEOA Group, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
- Institute for Healthy Cities and West China Research Center for Rural Health Development, Sichuan University, Chengdu, China
| | - Xujing Guan
- Sichuan Center for Disease Control and Prevention, Chengdu, China
| | - Yili Yang
- Institute for Healthy Cities and West China Research Center for Rural Health Development, Sichuan University, Chengdu, China
| | - Yuming Guo
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Jay Pan
- HEOA Group, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
- Institute for Healthy Cities and West China Research Center for Rural Health Development, Sichuan University, Chengdu, China
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14
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Zhao Q, Yu P, Mahendran R, Huang W, Gao Y, Yang Z, Ye T, Wen B, Wu Y, Li S, Guo Y. Global climate change and human health: Pathways and possible solutions. ECO-ENVIRONMENT & HEALTH (ONLINE) 2022; 1:53-62. [PMID: 38075529 PMCID: PMC10702927 DOI: 10.1016/j.eehl.2022.04.004] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 04/13/2022] [Accepted: 04/28/2022] [Indexed: 12/13/2023]
Abstract
Global warming has been changing the planet's climate pattern, leading to increasing frequency, intensity and duration of extreme weather events and natural disasters. These climate-changing events affect various health outcomes adversely through complicated pathways. This paper reviews the main signs of climate change so far, e.g., suboptimal ambient temperature, sea-level rise and other conditions, and depicts the interactive pathways between different climate-changing events such as suboptimal temperature, wildfires, and floods with a broad range of health outcomes. Meanwhile, the modifying effect of socioeconomic, demographic and environmental factors on the pathways is summarised, such that the youth, elderly, females, poor and those living in coastal regions are particularly susceptible to climate change. Although Earth as a whole is expected to suffer from climate change, this review article discusses some potential benefits for certain regions, e.g., a more liveable environment and sufficient food supply. Finally, we summarise certain mitigation and adaptation strategies against climate change and how these strategies may benefit human health in other ways. This review article provides a comprehensive and concise introduction of the pathways between climate change and human health and possible solutions, which may map directions for future research.
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Affiliation(s)
- Qi Zhao
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, 3004, Australia
| | - Pei Yu
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, 3004, Australia
| | - Rahini Mahendran
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, 3004, Australia
| | - Wenzhong Huang
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, 3004, Australia
| | - Yuan Gao
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, 3004, Australia
| | - Zhengyu Yang
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, 3004, Australia
| | - Tingting Ye
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, 3004, Australia
| | - Bo Wen
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, 3004, Australia
| | - Yao Wu
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, 3004, Australia
| | - Shanshan Li
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, 3004, Australia
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, 3004, Australia
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15
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Adams N, Dhimal M, Mathews S, Iyer V, Murtugudde R, Liang XZ, Haider M, Cruz-Cano R, Thu DTA, Hashim JH, Gao C, Wang YC, Sapkota A. El Niño Southern Oscillation, monsoon anomaly, and childhood diarrheal disease morbidity in Nepal. PNAS NEXUS 2022; 1:pgac032. [PMID: 36713319 PMCID: PMC9802392 DOI: 10.1093/pnasnexus/pgac032] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 02/02/2022] [Accepted: 03/25/2022] [Indexed: 02/01/2023]
Abstract
Climate change is adversely impacting the burden of diarrheal diseases. Despite significant reduction in global prevalence, diarrheal disease remains a leading cause of morbidity and mortality among young children in low- and middle-income countries. Previous studies have shown that diarrheal disease is associated with meteorological conditions but the role of large-scale climate phenomena such as El Niño-Southern Oscillation (ENSO) and monsoon anomaly is less understood. We obtained 13 years (2002-2014) of diarrheal disease data from Nepal and investigated how the disease rate is associated with phases of ENSO (El Niño, La Niña, vs. ENSO neutral) monsoon rainfall anomaly (below normal, above normal, vs. normal), and changes in timing of monsoon onset, and withdrawal (early, late, vs. normal). Monsoon season was associated with a 21% increase in diarrheal disease rates (Incident Rate Ratios [IRR]: 1.21; 95% CI: 1.16-1.27). El Niño was associated with an 8% reduction in risk while the La Niña was associated with a 32% increase in under-5 diarrheal disease rates. Likewise, higher-than-normal monsoon rainfall was associated with increased rates of diarrheal disease, with considerably higher rates observed in the mountain region (IRR 1.51, 95% CI: 1.19-1.92). Our findings suggest that under-5 diarrheal disease burden in Nepal is significantly influenced by ENSO and changes in seasonal monsoon dynamics. Since both ENSO phases and monsoon can be predicted with considerably longer lead time compared to weather, our findings will pave the way for the development of more effective early warning systems for climate sensitive infectious diseases.
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Affiliation(s)
- Nicholas Adams
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD 20742, USA
| | - Meghnath Dhimal
- Health Research Section, Nepal Health Research Council, Kathmandu 44600, Nepal
| | - Shifali Mathews
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD 20742, USA
| | - Veena Iyer
- Indian Institute of Public Health Gandhinagar (IIPHG), Gandhinagar 382042, Gujrat, India
| | - Raghu Murtugudde
- Department of Atmospheric and Oceanic Science, University of Maryland, College Park, MD 20742, USA
| | - Xin-Zhong Liang
- Department of Atmospheric and Oceanic Science, University of Maryland, College Park, MD 20742, USA
| | - Muhiuddin Haider
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD 20742, USA
| | - Raul Cruz-Cano
- Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, MD 20742, USA
| | - Dang Thi Anh Thu
- Institute for Community Health Research, Hue University of Medicine and Pharmacy, Hue City 52000, Vietnam
| | - Jamal Hisham Hashim
- Department of Health Sciences, University Selangor Shah Alam Campus, Selangor 40000, Malaysia
| | - Chuansi Gao
- Division of Ergonomics and Aerosol Technology, Faculty of Engineering, Lund University, Lund 223 62, Sweden
| | - Yu-Chun Wang
- Department of Environmental Engineering, Chung Yuan Christian University, Taoyuan City 320314, Taiwan
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16
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Colston JM, Zaitchik BF, Badr HS, Burnett E, Ali SA, Rayamajhi A, Satter SM, Eibach D, Krumkamp R, May J, Chilengi R, Howard LM, Sow SO, Jahangir Hossain M, Saha D, Imran Nisar M, Zaidi AKM, Kanungo S, Mandomando I, Faruque ASG, Kotloff KL, Levine MM, Breiman RF, Omore R, Page N, Platts‐Mills JA, Ashorn U, Fan Y, Shrestha PS, Ahmed T, Mduma E, Yori PP, Bhutta Z, Bessong P, Olortegui MP, Lima AAM, Kang G, Humphrey J, Prendergast AJ, Ntozini R, Okada K, Wongboot W, Gaensbauer J, Melgar MT, Pelkonen T, Freitas CM, Kosek MN. Associations Between Eight Earth Observation-Derived Climate Variables and Enteropathogen Infection: An Independent Participant Data Meta-Analysis of Surveillance Studies With Broad Spectrum Nucleic Acid Diagnostics. GEOHEALTH 2022; 6:e2021GH000452. [PMID: 35024531 PMCID: PMC8729196 DOI: 10.1029/2021gh000452] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 10/12/2021] [Accepted: 11/18/2021] [Indexed: 05/10/2023]
Abstract
Diarrheal disease, still a major cause of childhood illness, is caused by numerous, diverse infectious microorganisms, which are differentially sensitive to environmental conditions. Enteropathogen-specific impacts of climate remain underexplored. Results from 15 studies that diagnosed enteropathogens in 64,788 stool samples from 20,760 children in 19 countries were combined. Infection status for 10 common enteropathogens-adenovirus, astrovirus, norovirus, rotavirus, sapovirus, Campylobacter, ETEC, Shigella, Cryptosporidium and Giardia-was matched by date with hydrometeorological variables from a global Earth observation dataset-precipitation and runoff volume, humidity, soil moisture, solar radiation, air pressure, temperature, and wind speed. Models were fitted for each pathogen, accounting for lags, nonlinearity, confounders, and threshold effects. Different variables showed complex, non-linear associations with infection risk varying in magnitude and direction depending on pathogen species. Rotavirus infection decreased markedly following increasing 7-day average temperatures-a relative risk of 0.76 (95% confidence interval: 0.69-0.85) above 28°C-while ETEC risk increased by almost half, 1.43 (1.36-1.50), in the 20-35°C range. Risk for all pathogens was highest following soil moistures in the upper range. Humidity was associated with increases in bacterial infections and decreases in most viral infections. Several virus species' risk increased following lower-than-average rainfall, while rotavirus and ETEC increased with heavier runoff. Temperature, soil moisture, and humidity are particularly influential parameters across all enteropathogens, likely impacting pathogen survival outside the host. Precipitation and runoff have divergent associations with different enteric viruses. These effects may engender shifts in the relative burden of diarrhea-causing agents as the global climate changes.
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17
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Lim KY, Foo KY. Hazard identification and risk assessment of the organic, inorganic and microbial contaminants in the surface water after the high magnitude of flood event. ENVIRONMENT INTERNATIONAL 2021; 157:106851. [PMID: 34560322 DOI: 10.1016/j.envint.2021.106851] [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: 05/29/2021] [Revised: 08/24/2021] [Accepted: 08/26/2021] [Indexed: 06/13/2023]
Abstract
The present work has been oriented to the qualitative and quantitative assessments of the aftermath effects of 2014 flood tragedy on the organic, inorganic and microbial contaminants in the floodwater, with a particular emphasis on their relative health risks and microbial infectious hazards to the flood-affected population, using average daily dose, hazard quotient, hazard index (HI), cancer risk (CR) and quantitative microbial risk assessment. Statistical comparison of the organic and inorganic contents was performed using the paired t-tests, while the predominant socio-demographic profiles and health attributes of the respondents to flood-induced health risks (HI) were verified by the chi-square test and binary logistic regression analysis. Among all, Fe, Cu, Pb, Ni, Zn, Cr, Cd, chlorpyrifos, diazinon, polycyclic aromatic hydrocarbons, estriol, 17α-ethinylestradiol, estrone, β-estradiol and bisphenol A were detected at the study area after flooding. The microbiological quality of the floodwater samples has been tracked positive for Escherichia coli, Salmonella typhimurium and Shigella flexneri, with the mean concentrations of 6500, 50 and 180 CFU/100 mL, respectively. Exposure and health risk assessments revealed that the overall HI value for organic and inorganic contaminants in the water samples was 1.19, exceeding the USEPA maximum limit of 1, after the flood incidence. The largest CR contributors were Ni, Cr and Cd, while the infection risks (Pinf,single) associated with the exposure of E. coli, Salmonella spp. and Shigella spp. were identified to be 3.1 × 10-2, 1.2 × 10-4 and 3.2 × 10-5 for incidental scenario; and 8.3 × 10-1, 3.9 × 10-1 and 1.9 × 10-1 for intentional scenario, respectively. The findings of these integrated tools are critically important to provide a more reliable quantitative assessment of human health hazards and microbial risks for different environmental settings, to safeguard water resource, and preservation of public health and the overall river ecosystem.
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Affiliation(s)
- Kah Yee Lim
- River Engineering and Urban Drainage Research Centre (REDAC), Universiti Sains Malaysia (USM), Engineering Campus, Seri Ampangan, 14300 Nibong Tebal, Penang, Malaysia.
| | - Keng Yuen Foo
- River Engineering and Urban Drainage Research Centre (REDAC), Universiti Sains Malaysia (USM), Engineering Campus, Seri Ampangan, 14300 Nibong Tebal, Penang, Malaysia.
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Molecular Epidemiology of Sapovirus in Children Living in the Northwest Amazon Region. Pathogens 2021; 10:pathogens10080965. [PMID: 34451429 PMCID: PMC8400878 DOI: 10.3390/pathogens10080965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 07/24/2021] [Accepted: 07/26/2021] [Indexed: 11/17/2022] Open
Abstract
Sapovirus is an important etiological agent of acute gastroenteritis (AGE), mainly in children under 5 years old living in lower-income communities. Eighteen identified sapovirus genotypes have been observed to infect humans. The aim of this study was to identify sapovirus genotypes circulating in the Amazon region. Twenty-eight samples were successfully genotyped using partial sequencing of the capsid gene. The genotypes identified were GI.1 (n = 3), GI.2 (n = 7), GII.1 (n = 1), GII.2 (n = 1), GII.3 (n = 5), GII.5 (n = 1), and GIV.1 (n = 10). The GIV genotype was the most detected genotype (35.7%, 10/28). The phylogenetic analysis identified sapovirus genotypes that had no similarity with other strains reported from Brazil, indicating that these genotypes may have entered the Amazon region via intense tourism in the Amazon rainforest. No association between histo-blood group antigen expression and sapovirus infection was observed.
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Abstract
PURPOSE OF REVIEW Sapovirus, a genus in the Caliciviridae family alongside norovirus, is increasingly recognized as an important cause of childhood diarrhea. Some challenges exist in our ability to better understand sapovirus infections, including the inability to grow sapovirus in cell culture, which has hindered diagnosis and studies of immunity. Another challenge is that individuals with sapovirus infection are commonly coinfected with other enteric pathogens, complicating our ability to attribute the diarrhea episode to a single pathogen. RECENT FINDINGS Development of molecular methods for sapovirus detection has increased our ability to measure disease prevalence. The prevalence of sapovirus varies between 1 and 17% of diarrhea episodes worldwide, with the highest burden in young children and older adults. Further, epidemiological studies have used novel approaches to account for the presence of coinfections with other enteric pathogens; one multisite cohort study of children under two years of age found that sapovirus had the second-highest attributable incidence among all diarrheal pathogens studied. SUMMARY Especially in settings where rotavirus vaccines have been introduced, efforts to reduce the overall burden of childhood diarrhea should focus on the reduction of sapovirus transmission and disease burden.
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Kim JH, Sung J, Kwon HJ, Cheong HK. Effects of El Niño/La Niña on the Number of Imported Shigellosis Cases in the Republic of Korea, 2004-2017. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 18:ijerph18010211. [PMID: 33396622 PMCID: PMC7795629 DOI: 10.3390/ijerph18010211] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 12/17/2020] [Accepted: 12/25/2020] [Indexed: 12/27/2022]
Abstract
Shigellosis is a major diarrheal disease in low- and middle-income countries. Although the incidence of such diseases in South and Southeast Asia has been associated with climate fluctuations linked to the El Niño-Southern Oscillation (ENSO), the impact of ENSO on shigellosis infections remains unknown. Data reported to being infected with shigellosis while traveling abroad from 2004 to 2017 were obtained from the Korea Centers for Disease Control and Prevention. We investigated the relationship between the Oceanic Niño Index (ONI) and Indian Ocean Dipole Mode Index and the relative risk of shigellosis in outbound travelers using distributed lag linear and non-linear models. From 2004 to 2017, 87.1% of imported shigellosis was infected in South and Southeast Asian countries. The relative risk of imported shigellosis infection in outbound travelers increased as the ONI decreased. In the association with the five-month cumulative ONI, the relative risk of infection continuously increased as the La Niña index gained strength. Climate fluctuations associated with the La Niña phenomenon in South and Southeast Asian countries can lead to issues in sanitation and water safety. Our findings suggest that the decreasing trend in the ONI is associated with an increased incidence of shigellosis in these countries.
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Affiliation(s)
- Jong-Hun Kim
- Department of Social and Preventive Medicine, Sungkyunkwan University School of Medicine, Suwon 16419, Korea; (J.-H.K.); (J.S.)
| | - Jisun Sung
- Department of Social and Preventive Medicine, Sungkyunkwan University School of Medicine, Suwon 16419, Korea; (J.-H.K.); (J.S.)
| | - Ho-Jang Kwon
- Department of Preventive Medicine, Dankook University College of Medicine, Cheonan 31116, Korea;
| | - Hae-Kwan Cheong
- Department of Social and Preventive Medicine, Sungkyunkwan University School of Medicine, Suwon 16419, Korea; (J.-H.K.); (J.S.)
- Correspondence: ; Tel.: +82-31-299-6300
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Kraay ANM, Man O, Levy MC, Levy K, Ionides E, Eisenberg JNS. Understanding the Impact of Rainfall on Diarrhea: Testing the Concentration-Dilution Hypothesis Using a Systematic Review and Meta-Analysis. ENVIRONMENTAL HEALTH PERSPECTIVES 2020; 128:126001. [PMID: 33284047 PMCID: PMC7720804 DOI: 10.1289/ehp6181] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 10/26/2020] [Accepted: 11/09/2020] [Indexed: 05/07/2023]
Abstract
BACKGROUND Projected increases in extreme weather may change relationships between rain-related climate exposures and diarrheal disease. Whether rainfall increases or decreases diarrhea rates is unclear based on prior literature. The concentration-dilution hypothesis suggests that these conflicting results are explained by the background level of rain: Rainfall following dry periods can flush pathogens into surface water, increasing diarrhea incidence, whereas rainfall following wet periods can dilute pathogen concentrations in surface water, thereby decreasing diarrhea incidence. OBJECTIVES In this analysis, we explored the extent to which the concentration-dilution hypothesis is supported by published literature. METHODS To this end, we conducted a systematic search for articles assessing the relationship between rain, extreme rain, flood, drought, and season (rainy vs. dry) and diarrheal illness. RESULTS A total of 111 articles met our inclusion criteria. Overall, the literature largely supports the concentration-dilution hypothesis. In particular, extreme rain was associated with increased diarrhea when it followed a dry period [incidence rate ratio ( IRR ) = 1.26 ; 95% confidence interval (CI): 1.05, 1.51], with a tendency toward an inverse association for extreme rain following wet periods, albeit nonsignificant, with one of four relevant studies showing a significant inverse association (IRR = 0.911 ; 95% CI: 0.771, 1.08). Incidences of bacterial and parasitic diarrhea were more common during rainy seasons, providing pathogen-specific support for a concentration mechanism, but rotavirus diarrhea showed the opposite association. Information on timing of cases within the rainy season (e.g., early vs. late) was lacking, limiting further analysis. We did not find a linear association between nonextreme rain exposures and diarrheal disease, but several studies found a nonlinear association with low and high rain both being associated with diarrhea. DISCUSSION Our meta-analysis suggests that the effect of rainfall depends on the antecedent conditions. Future studies should use standard, clearly defined exposure variables to strengthen understanding of the relationship between rainfall and diarrheal illness. https://doi.org/10.1289/EHP6181.
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Affiliation(s)
- Alicia N. M. Kraay
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Olivia Man
- Department of Epidemiology, University of Michigan–Ann Arbor, Ann Arbor, Michigan, USA
| | - Morgan C. Levy
- Scripps Institution of Oceanography, University of California San Diego, La Jolla, California, USA
- School of Global Policy and Strategy, University of California San Diego, La Jolla, California, USA
| | - Karen Levy
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington, USA
| | - Edward Ionides
- Department of Epidemiology, University of Michigan–Ann Arbor, Ann Arbor, Michigan, USA
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Colston JM, Faruque ASG, Hossain MJ, Saha D, Kanungo S, Mandomando I, Nisar MI, Zaidi AKM, Omore R, Breiman RF, Sow SO, Roose A, Levine MM, Kotloff KL, Ahmed T, Bessong P, Bhutta Z, Mduma E, Penatero Yori P, Sunder Shrestha P, Olortegui MP, Kang G, Lima AAM, Humphrey J, Prendergast A, Schiaffino F, Zaitchik BF, Kosek MN. Associations between Household-Level Exposures and All-Cause Diarrhea and Pathogen-Specific Enteric Infections in Children Enrolled in Five Sentinel Surveillance Studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8078. [PMID: 33147841 PMCID: PMC7663028 DOI: 10.3390/ijerph17218078] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 09/16/2020] [Accepted: 09/25/2020] [Indexed: 12/17/2022]
Abstract
Diarrheal disease remains a major cause of childhood mortality and morbidity causing poor health and economic outcomes. In low-resource settings, young children are exposed to numerous risk factors for enteric pathogen transmission within their dwellings, though the relative importance of different transmission pathways varies by pathogen species. The objective of this analysis was to model associations between five household-level risk factors-water, sanitation, flooring, caregiver education, and crowding-and infection status for endemic enteric pathogens in children in five surveillance studies. Data were combined from 22 sites in which a total of 58,000 stool samples were tested for 16 specific enteropathogens using qPCR. Risk ratios for pathogen- and taxon-specific infection status were modeled using generalized linear models along with hazard ratios for all-cause diarrhea in proportional hazard models, with the five household-level variables as primary exposures adjusting for covariates. Improved drinking water sources conferred a 17% reduction in diarrhea risk; however, the direction of its association with particular pathogens was inconsistent. Improved sanitation was associated with a 9% reduction in diarrhea risk with protective effects across pathogen species and taxa of around 10-20% risk reduction. A 9% reduction in diarrhea risk was observed in subjects with covered floors, which were also associated with decreases in risk for zoonotic enteropathogens. Caregiver education and household crowding showed more modest, inconclusive results. Combining data from diverse sites, this analysis quantified associations between five household-level exposures on risk of specific enteric infections, effects which differed by pathogen species but were broadly consistent with hypothesized transmission mechanisms. Such estimates may be used within expanded water, sanitation, and hygiene (WASH) programs to target interventions to the particular pathogen profiles of individual communities and prioritize resources.
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Affiliation(s)
- Josh M. Colston
- Division of Infectious Diseases and International Health, University of Virginia School of Medicine, Charlottesville, VA 22903, USA; (J.M.C.); (P.P.Y.)
| | - Abu S. G. Faruque
- Centre for Nutrition & Food Security, International Centre for Diarrhoeal Disease Research, Dhaka 1212, Bangladesh;
| | - M. Jahangir Hossain
- Medical Research Council Unit—The Gambia at the London School of Hygiene & Tropical Medicine, Banjul P.O. Box 273, Republic of Gambia;
| | - Debasish Saha
- Epidemiology and Health Economics, GSK Vaccines, 1300 Wavre, Belgium;
| | - Suman Kanungo
- Suman Kanungo—National Institute of Cholera and Enteric Diseases, Kolkota 700010, India;
| | - Inácio Mandomando
- Centro de Investigação em Saúde de Manhiça, Manhica CP 1929, Mozambique;
| | - M. Imran Nisar
- Department of Pediatrics and Child Health, The Aga Khan University, Karachi 74800, Pakistan; (M.I.N.); (A.K.M.Z.)
| | - Anita K. M. Zaidi
- Department of Pediatrics and Child Health, The Aga Khan University, Karachi 74800, Pakistan; (M.I.N.); (A.K.M.Z.)
| | - Richard Omore
- Kenya Medical Research Institute, Center for Global Health Research, Kisumu, Nyanza 40100, Kenya;
| | - Robert F. Breiman
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA;
| | - Samba O. Sow
- Centre pour le Développement des Vaccins, Bamako BP 251, Mali;
| | - Anna Roose
- Indiana University School of Medicine, Indianapolis, IN 46202, USA;
| | - Myron M. Levine
- Departments of Medicine and Pediatrics, Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, MD 21201, USA;
| | - Karen L. Kotloff
- Department of Pediatrics, Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, MD 21201, USA;
| | - Tahmeed Ahmed
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka 1212, Bangladesh;
| | - Pascal Bessong
- HIV/AIDS & Global Health Research Programme, University of Venda, Thohoyandou, Limpopo 0950, South Africa;
| | - Zulfiqar Bhutta
- Department of Pediatrics and Child Health, Aga Khan University, Karachi 74800, Pakistan;
| | - Estomih Mduma
- Haydom Global Health Institute, Haydom P.O. Box 9000, Tanzania;
| | - Pablo Penatero Yori
- Division of Infectious Diseases and International Health, University of Virginia School of Medicine, Charlottesville, VA 22903, USA; (J.M.C.); (P.P.Y.)
| | - Prakash Sunder Shrestha
- Department of Child Health, Institute of Medicine of Tribhuvan University, Kirtipur 44618, Nepal;
| | | | - Gagandeep Kang
- Department of Gastrointestinal Sciences, Christian Medical College, Vellore 632004, India;
| | - Aldo A. M. Lima
- Department of Physiology and Pharmacology, Faculty of Medicine, Federal University of Ceará, Fortaleza 60020-181, Brazil;
| | - Jean Humphrey
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MA 21205, USA;
| | - Andrew Prendergast
- Centre for Paediatrics, Blizard Institute, Queen Mary University of London, London E1 2AT, UK;
| | - Francesca Schiaffino
- Faculty of Veterinary Medicine, Universidad Peruana Cayetano Heredia, Lima 15102, Peru;
| | - Benjamin F. Zaitchik
- Department of Earth and Planetary Sciences, Johns Hopkins Krieger School of Arts and Sciences, Baltimore, MA 21218, USA;
| | - Margaret N. Kosek
- Division of Infectious Diseases, International Health and Public Health Sciences, Department of Internal Medicine, University of Virginia, Charlottesville, VA 22903, USA
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La Niña weather impacts dietary patterns and dietary diversity among children in the Peruvian Amazon. Public Health Nutr 2020; 24:3477-3487. [PMID: 33106207 PMCID: PMC8314922 DOI: 10.1017/s1368980020003705] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective: In 2011–2012, severe El Niño Southern Oscillation (ENSO) conditions (La Niña) led to massive flooding and temporarily displacement in the Peruvian Amazon. Our aims were to examine the impact of this ENSO exposure on child diets, in particular: (1) frequency of food consumption patterns, (2) the amount of food consumed (g/d), (3) dietary diversity (DD), (4) consumption of donated foods, among children aged 9–36 months living in the outskirts of City of Iquitos in the Amazonian Peru. Design: This was a longitudinal study that used quantitative 24-h recall dietary data collection from children aged 9–36 months from 2010 to 2014 as part of the MAL-ED birth cohort study. Setting: Iquitos, Loreto, Peru. Participants: Two hundred and fifty-two mother–child dyads. Results: The frequency of grains, rice, dairy and sugar in meals reduced by 5–7 %, while the frequency of plantain in meals increased by 24 % after adjusting for covariates. ENSO exposure reduced girl’s intake of plantains and sugar. Despite seasonal fluctuations in the availability of fruits, vegetables and fish, DD remained constant across seasons and as children aged. However, DD was significantly reduced under moderate La Niña conditions by 0·32 (P < 0·05) food groups. Adaptive social strategies such as consumption of donated foods were significantly higher among households with girls. Conclusions: This is the first empirical study to show differential effect of the ENSO on the dietary patterns of children, highlighting differences by gender. Public health nutrition programmes should be climate- and gender-sensitive in their efforts to safeguard the diets of vulnerable populations.
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