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Simpson NP, Williams PA, Mach KJ, Berrang-Ford L, Biesbroek R, Haasnoot M, Segnon AC, Campbell D, Musah-Surugu JI, Joe ET, Nunbogu AM, Sabour S, Meyer AL, Andrews TM, Singh C, Siders A, Lawrence J, van Aalst M, Trisos CH. Adaptation to compound climate risks: A systematic global stocktake. iScience 2023; 26:105926. [PMID: 36866045 PMCID: PMC9971900 DOI: 10.1016/j.isci.2023.105926] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 12/15/2022] [Accepted: 01/02/2023] [Indexed: 01/06/2023] Open
Abstract
This article provides a stocktake of the adaptation literature between 2013 and 2019 to better understand how adaptation responses affect risk under the particularly challenging conditions of compound climate events. Across 39 countries, 45 response types to compound hazards display anticipatory (9%), reactive (33%), and maladaptive (41%) characteristics, as well as hard (18%) and soft (68%) limits to adaptation. Low income, food insecurity, and access to institutional resources and finance are the most prominent of 23 vulnerabilities observed to negatively affect responses. Risk for food security, health, livelihoods, and economic outputs are commonly associated risks driving responses. Narrow geographical and sectoral foci of the literature highlight important conceptual, sectoral, and geographic areas for future research to better understand the way responses shape risk. When responses are integrated within climate risk assessment and management, there is greater potential to advance the urgency of response and safeguards for the most vulnerable.
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Affiliation(s)
- Nicholas P. Simpson
- African Climate and Development Initiative, University of Cape Town, Cape Town, South Africa,Corresponding author
| | - Portia Adade Williams
- CSIR-Science and Technology Policy Research Institute, Accra, Ghana,Corresponding author
| | - Katharine J. Mach
- Department of Environmental Science and Policy, Rosenstiel School of Marine, Atmospheric, and Earth Science, and Leonard and Jayne Abess Center for Ecosystem Science and Policy, University of Miami, Miami, FL, USA
| | - Lea Berrang-Ford
- Priestley International Centre for Climate, University of Leeds, Leeds, UK
| | | | - Marjolijn Haasnoot
- Deltares, Delft, the Netherlands, Department of Physical Geography, Utrecht University, Utrecht, the Netherlands
| | - Alcade C. Segnon
- Alliance of Bioversity International and International Center for Tropical Agriculture (CIAT), Dakar, Senegal, Faculty of Agronomic Sciences, University of Abomey-Calavi, Cotonou, Benin
| | | | - Justice Issah Musah-Surugu
- United Nations University, Bonn, Germany,Department of Public Administration and Health Service Management, University of Ghana, Legon, Ghana
| | - Elphin Tom Joe
- Economics Center, World Resources Institute, New Delhi, India
| | - Abraham Marshall Nunbogu
- Department of Geography and Environmental Management, University of Waterloo, Waterloo, ON, Canada
| | - Salma Sabour
- Faculty of Engineering and Physical Sciences, University of Southampton, Highfield, Southampton, UK
| | - Andreas L.S. Meyer
- African Climate and Development Initiative, University of Cape Town, Cape Town, South Africa
| | - Talbot M. Andrews
- Department of Political Science, University of Connecticut, Storrs, CT, USA
| | - Chandni Singh
- School of Environment and Sustainability, Indian Institute for Human Settlements, Bangalore, India
| | - A.R. Siders
- Disaster Research Center, Climate Change Science and Policy Hub, Biden School of Public Policy, Department of Geography and Spatial Sciences; University of Delaware; Newark, DE, USA
| | - Judy Lawrence
- Climate Change Research Institute, Victoria University of Wellington, Wellington, New Zealand
| | - Maarten van Aalst
- Faculty of Geo-information Science and Earth Observation, University of Twente, Twente, the Netherlands,Red Cross Red Crescent Climate Centre, The Hague, The Netherlands
| | - Christopher H. Trisos
- African Climate and Development Initiative, University of Cape Town, Cape Town, South Africa,Centre for Statistics in Ecology, Environment and Conservation, University of Cape Town, Cape Town, South Africa
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Ford JD, Zavaleta-Cortijo C, Ainembabazi T, Anza-Ramirez C, Arotoma-Rojas I, Bezerra J, Chicmana-Zapata V, Galappaththi EK, Hangula M, Kazaana C, Lwasa S, Namanya D, Nkwinti N, Nuwagira R, Okware S, Osipova M, Pickering K, Singh C, Berrang-Ford L, Hyams K, Miranda JJ, Naylor A, New M, van Bavel B. Interactions between climate and COVID-19. Lancet Planet Health 2022; 6:e825-e833. [PMID: 36208645 PMCID: PMC9534524 DOI: 10.1016/s2542-5196(22)00174-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 06/25/2022] [Accepted: 07/12/2022] [Indexed: 05/22/2023]
Abstract
In this Personal View, we explain the ways that climatic risks affect the transmission, perception, response, and lived experience of COVID-19. First, temperature, wind, and humidity influence the transmission of COVID-19 in ways not fully understood, although non-climatic factors appear more important than climatic factors in explaining disease transmission. Second, climatic extremes coinciding with COVID-19 have affected disease exposure, increased susceptibility of people to COVID-19, compromised emergency responses, and reduced health system resilience to multiple stresses. Third, long-term climate change and prepandemic vulnerabilities have increased COVID-19 risk for some populations (eg, marginalised communities). The ways climate and COVID-19 interact vary considerably between and within populations and regions, and are affected by dynamic and complex interactions with underlying socioeconomic, political, demographic, and cultural conditions. These conditions can lead to vulnerability, resilience, transformation, or collapse of health systems, communities, and livelihoods throughout varying timescales. It is important that COVID-19 response and recovery measures consider climatic risks, particularly in locations that are susceptible to climate extremes, through integrated planning that includes public health, disaster preparedness, emergency management, sustainable development, and humanitarian response.
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Affiliation(s)
- James D Ford
- Priestley International Centre for Climate, University of Leeds, Leeds, UK.
| | - Carol Zavaleta-Cortijo
- Intercultural Citizenship and Indigenous Health Unit, Cayetano Heredia University, Lima, Peru
| | - Triphini Ainembabazi
- Department of Geography, Geo-Informatics, and Climatic Sciences, Makerere University, Kampala, Uganda
| | - Cecilia Anza-Ramirez
- Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | | | - Joana Bezerra
- Community Engagement, Rhodes University, Makhanda, South Africa
| | | | | | - Martha Hangula
- Department of Livestock Production, Agribusiness, and Economics, University of Namibia, Oshakati, Namibia
| | | | - Shuaib Lwasa
- Department of Geography, Geo-Informatics, and Climatic Sciences, Makerere University, Kampala, Uganda
| | | | - Nosipho Nkwinti
- Community Engagement, Rhodes University, Makhanda, South Africa
| | | | - Samuel Okware
- Uganda National Health Research Organisation, Entebbe, Uganda
| | - Maria Osipova
- Arctic State Institute of Culture and Arts, North-Eastern Federal University, Yakutsk, Russia
| | - Kerrie Pickering
- Sustainability Research Centre, University of the Sunshine Coast, Buderim, QLD, Australia
| | - Chandni Singh
- School of Environment and Sustainability, Indian Institute for Human Settlements, Bangalore, India
| | - Lea Berrang-Ford
- Priestley International Centre for Climate, University of Leeds, Leeds, UK
| | - Keith Hyams
- Department of Politics and International Studies, University of Warwick, Coventry, UK
| | - J Jaime Miranda
- Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Angus Naylor
- School of Public Health and Social Policy, University of Victoria, Victoria, BC, Canada
| | - Mark New
- Environmental and Geographical Science, University of Cape Town, Cape Town, South Africa
| | - Bianca van Bavel
- Priestley International Centre for Climate, University of Leeds, Leeds, UK
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Ost K, Berrang-Ford L, Bishop-Williams K, Charette M, Harper SL, Lwasa S, Namanya DB, Huang Y, Katz AB, Ebi K. Do socio-demographic factors modify the effect of weather on malaria in Kanungu District, Uganda? Malar J 2022; 21:98. [PMID: 35317835 PMCID: PMC8939205 DOI: 10.1186/s12936-022-04118-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 03/05/2022] [Indexed: 11/25/2022] Open
Abstract
Background There is concern in the international community regarding the influence of climate change on weather variables and seasonality that, in part, determine the rates of malaria. This study examined the role of sociodemographic variables in modifying the association between temperature and malaria in Kanungu District (Southwest Uganda). Methods Hospital admissions data from Bwindi Community Hospital were combined with meteorological satellite data from 2011 to 2014. Descriptive statistics were used to describe the distribution of malaria admissions by age, sex, and ethnicity (i.e. Bakiga and Indigenous Batwa). To examine how sociodemographic variables modified the association between temperature and malaria admissions, this study used negative binomial regression stratified by age, sex, and ethnicity, and negative binomial regression models that examined interactions between temperature and age, sex, and ethnicity. Results Malaria admission incidence was 1.99 times greater among Batwa than Bakiga in hot temperature quartiles compared to cooler temperature quartiles, and that 6–12 year old children had a higher magnitude of association of malaria admissions with temperature compared to the reference category of 0–5 years old (IRR = 2.07 (1.40, 3.07)). Discussion Results indicate that socio-demographic variables may modify the association between temperature and malaria. In some cases, such as age, the weather-malaria association in sub-populations with the highest incidence of malaria in standard models differed from those most sensitive to temperature as found in these stratified models. Conclusion The effect modification approach used herein can be used to improve understanding of how changes in weather resulting from climate change might shift social gradients in health. Supplementary Information The online version contains supplementary material available at 10.1186/s12936-022-04118-5.
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Affiliation(s)
- Katarina Ost
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada.
| | - Lea Berrang-Ford
- Priestley International Centre for Climate, University of Leeds, Leeds, UK
| | | | - Margot Charette
- Department of Geography, McGill University, Montreal, Canada
| | | | - Shuaib Lwasa
- Department of Geography, Geo-Informatics and Climatic Sciences, School of Forestry, Environmental and Geographical Sciences, College of Agricultural and Environmental Sciences, Makerere University, Kampala, Uganda
| | - Didacus B Namanya
- Indigenous Health Adaptation To Climate Change, Research Team, Edmonton, Canada.,Uganda Martyrs University, Kampala, Uganda.,Faculty of Health Sciences, Uganda Martyrs University, Kampala, Uganda
| | - Yi Huang
- Department of Atmospheric and Ocean Sciences, McGill University, Montreal, Canada
| | - Aaron B Katz
- Department of Health Services, University of Washington, Seattle, USA
| | | | | | - Kristie Ebi
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada.,Priestley International Centre for Climate, University of Leeds, Leeds, UK.,School of Interdisciplinary Science, McMaster University, Hamilton, Canada.,Department of Geography, McGill University, Montreal, Canada.,School of Public Health, University of Alberta, Edmonton, Canada.,Department of Geography, Geo-Informatics and Climatic Sciences, School of Forestry, Environmental and Geographical Sciences, College of Agricultural and Environmental Sciences, Makerere University, Kampala, Uganda.,Indigenous Health Adaptation To Climate Change, Research Team, Edmonton, Canada.,Uganda Martyrs University, Kampala, Uganda.,Faculty of Health Sciences, Uganda Martyrs University, Kampala, Uganda.,Department of Atmospheric and Ocean Sciences, McGill University, Montreal, Canada.,Department of Health Services, University of Washington, Seattle, USA.,Bwindi Community Hospital, Kanungu, Uganda.,Center for Health and the Global Environment, University of Washington, Seattle, USA
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4
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Patterson KA, Yang S, Sargeant J, Lwasa S, Berrang-Ford L, Kesande C, Communities B, Twesigomwe S, Anyango Rhoda J, Nkalubo J, Harper SL. Socio-demographic associations with pregnancy loss among Bakiga and Indigenous Batwa women in Southwestern Uganda. Sexual & Reproductive Healthcare 2022; 32:100700. [DOI: 10.1016/j.srhc.2022.100700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 01/02/2022] [Accepted: 02/11/2022] [Indexed: 11/30/2022]
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Steele V, Patterson K, Berrang-Ford L, King N, Kulkarni M, Lwasa S, Namanya DB, Harper SL. Antenatal Care Research in East Africa During the Millennium Development Goals Initiative: A Scoping Review. Matern Child Health J 2022; 26:469-480. [PMID: 35028892 DOI: 10.1007/s10995-021-03355-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/09/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION The global burden of maternal mortality remains high and inequitably distributed between countries. Antenatal care (ANC) was identified as critical component in achieving the Millennium Development Goal of improving maternal health. This scoping review aimed to summarize trends and critically explore research about ANC attendance for East African women conducted during the Millennium Development Goals initiative, with a specific focus on barriers to ANC access. METHODS Using a scoping review methodology, aggregator databases were searched for relevant articles. Articles were screened by independent reviewers using a priori inclusion criteria. Eligible articles were retained for data charting and analysis. RESULTS Following screening, 211 articles were analyzed. The number of relevant articles increased over time; utilized primarily quantitative methods; and involved authors with affiliations from various African countries. Many interrelated physical, social, and cultural factors influenced women's seeking, reaching, and receiving of quality ANC. The extent of studies identified suggest that ANC is a priority research area, yet key gaps in the literature exist. Limited qualitative research, and few articles examining ANC experiences of women from vulnerable groups (e.g. adolescents, women with a disability, and Indigenous women) were identified. DISCUSSION These context-specific findings are important considering the Sustainable Development Goals aim to nearly triple the maternal mortality reductions by 2030. In order to achieve this goal, interventions should focus on improving the quality of ANC care and patient-provider interactions. Furthermore, additional qualitative research examining vulnerable populations of women and exploring the inclusion of men in ANC would help inform interventions intended to improve ANC attendance in East Africa.
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Affiliation(s)
- Vivienne Steele
- Department of Population Medicine, University of Guelph, 50 Stone Road East, Guelph, ON, N1G 2W1, Canada.
| | - Kaitlin Patterson
- Department of Population Medicine, University of Guelph, 50 Stone Road East, Guelph, ON, N1G 2W1, Canada.
| | - Lea Berrang-Ford
- Priestley Centre for Climate Change, Leeds University, Leeds, LS2 9JT, York, UK
| | - Nia King
- School of Medicine, Queen's University, 15 Arch Street, Kingston, ON, K7L 3L4, Canada.
| | - Manisha Kulkarni
- School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand Crescent, Ottawa, ON, K1G 5Z3, Canada
| | - Shuaib Lwasa
- Department of Geography, Makerere University, P.O. Box 7062, Kampala, Uganda
| | | | - Sherilee L Harper
- Department of Population Medicine, University of Guelph, 50 Stone Road East, Guelph, ON, N1G 2W1, Canada. .,School of Public Health, University of Alberta, 116 St & 85 Ave, Edmonton, AB, T6G 1C9, Canada.
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6
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Scarpa G, Berrang-Ford L, Twesigomwe S, Kakwangire P, Galazoula M, Zavaleta-Cortijo C, Patterson K, Namanya DB, Lwasa S, Nowembabazi E, Kesande C, Cade JE. Socio-economic and environmental factors affecting breastfeeding and complementary feeding practices among Batwa and Bakiga communities in south-western Uganda. PLOS Glob Public Health 2022; 2:e0000144. [PMID: 36962281 PMCID: PMC10021580 DOI: 10.1371/journal.pgph.0000144] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 01/19/2022] [Indexed: 11/19/2022]
Abstract
Improving breastfeeding and complementary feeding practices is needed to support good health, enhance child growth, and reduce child mortality. Limited evidence is available on child feeding among Indigenous communities and in the context of environmental changes. We investigate past and present breastfeeding and complementary feeding practices within Indigenous Batwa and neighbouring Bakiga populations in south-western Uganda. Specifically, we describe the demographic and socio-economic characteristics of breastfeeding mothers and their children, and individual experiences of breastfeeding and complementary feeding practices. We investigate the factors that have an impact on breastfeeding and complementary feeding at community and societal levels, and we analysed how environments, including weather variability, affect breastfeeding and complementary feeding practices. We applied a mixed-method design to the study, and we used a community-based research approach. We conducted 94 individual interviews (n = 47 Batwa mothers/caregivers & n = 47 Bakiga mothers/caregivers) and 12 focus group discussions (n = 6 among Batwa & n = 6 among Bakiga communities) from July to October 2019. Ninety-nine per cent of mothers reported that their youngest child was currently breastfed. All mothers noted that the child experienced at least one episode of illness that had an impact on breastfeeding. From the focus groups, we identified four key factors affecting breastfeeding and nutrition practices: marginalisation and poverty; environmental change; lack of information; and poor support. Our findings contribute to the field of global public health and nutrition among Indigenous communities, with a focus on women and children. We present recommendations to improve child feeding practices among the Batwa and Bakiga in south-western Uganda. Specifically, we highlight the need to engage with local and national authorities to improve breastfeeding and complementary feeding practices, and work on food security, distribution of lands, and the food environment. Also, we recommend addressing the drivers and consequences of alcoholism, and strengthening family planning programs.
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Affiliation(s)
- Giulia Scarpa
- School of Environment, University of Leeds, Leeds, United Kingdom
- School of Food Science and Nutrition, University of Leeds, Leeds, United Kingdom
| | - Lea Berrang-Ford
- School of Environment, University of Leeds, Leeds, United Kingdom
- Indigenous Health Adaptation to Climate Change Research Team, Kanungu District, Buhoma, Uganda
| | - Sabastian Twesigomwe
- Indigenous Health Adaptation to Climate Change Research Team, Kanungu District, Buhoma, Uganda
| | - Paul Kakwangire
- Indigenous Health Adaptation to Climate Change Research Team, Kanungu District, Buhoma, Uganda
| | - Maria Galazoula
- Leeds Institute for Data Analytics, University of Leeds, Leeds, United Kingdom
| | - Carol Zavaleta-Cortijo
- Facultad de Salud Publica y Administracion, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Kaitlin Patterson
- Department of Population Medicine, University of Guelph, Guelph, Canada
| | - Didacus B Namanya
- Indigenous Health Adaptation to Climate Change Research Team, Kanungu District, Buhoma, Uganda
- Ministry of Health, Kampala, Uganda
| | - Shuaib Lwasa
- Indigenous Health Adaptation to Climate Change Research Team, Kanungu District, Buhoma, Uganda
- Department of Geography, Makerere University, Kampala, Uganda
- The Global Center on Adaptation, Rotterdam, Netherlands
| | - Ester Nowembabazi
- Indigenous Health Adaptation to Climate Change Research Team, Kanungu District, Buhoma, Uganda
| | - Charity Kesande
- Indigenous Health Adaptation to Climate Change Research Team, Kanungu District, Buhoma, Uganda
| | | | - Janet E Cade
- School of Food Science and Nutrition, University of Leeds, Leeds, United Kingdom
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Renwick KA, Sanmartin C, Dasgupta K, Berrang-Ford L, Ross N. The Influence of Psychosocial Factors on Hospital Length of Stay Among Aging Canadians. Gerontol Geriatr Med 2022; 8:23337214221138442. [DOI: 10.1177/23337214221138442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 09/08/2022] [Accepted: 10/26/2022] [Indexed: 11/27/2022] Open
Abstract
Background: Hospital stays that are prolonged due to non-clinical factors are costly to health care systems and are likely suboptimal for patient well-being. We assessed the influence of psychosocial factors on hospital length of stay (LOS) for older Canadians in a retrospective cohort study. Data and Methods: Data from the Canadian Community Health Survey were linked with the Discharge Abstract Database. Analyses were stratified by age, 55–64 ( n = 1,060) and 65 and older ( n = 2,718). Main predictor variables of interest included four measures of social support, sense of belonging, and living alone. Multivariate models of LOS adjusted for age, sex, income, smoking, and frailty. Results: Among the younger respondents, low positive social interactions, low emotional/informational support, and living alone were associated with a longer LOS. Among respondents 65 and older, low affection, low positive social interactions, low emotional/informational support, and a weak sense of belonging were associated with a longer LOS. Discussion: Having low social support is associated with longer hospital stays in this Canadian cohort. Social support may influence LOS as risk factors for poor health and precarious care in the community. Mitigating these risk factors could reduce the economic burden that is played out through longer hospital stays.
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Affiliation(s)
- Kelly Ann Renwick
- McGill University, Montréal, QC, Canada
- Appalachian State University, Boone, NC, USA
| | | | | | - Lea Berrang-Ford
- McGill University, Montréal, QC, Canada
- University of Leeds, Leeds, UK
| | - Nancy Ross
- McGill University, Montréal, QC, Canada
- Queen’s University, Kingston, ON, Canada
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Patterson K, Sargeant J, Yang S, McGuire-Adams T, Berrang-Ford L, Lwasa S, Communities B, Steele V, Harper SL. Are Indigenous research principles incorporated into maternal health research? A scoping review of the global literature. Soc Sci Med 2021; 292:114629. [PMID: 34896728 DOI: 10.1016/j.socscimed.2021.114629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 11/05/2021] [Accepted: 12/01/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Indigenous women world-wide are diverse and heterogenous, yet many have similar experiences of colonization, land dispossession, and discrimination. These experiences along with inequitable access to, and quality of, maternal healthcare increase adverse maternal health outcomes. To improve health outcomes for Indigenous women, studies must be conducted with Indigenous involvement and reflect Indigenous research principles. Objectives/Aim: The aim of this review was to explore the range, extent, and nature of Indigenous maternal health research and to assess the reporting of Indigenous research principles in the global Indigenous maternal health literature. METHODS Following a systematic scoping review protocol, four scholarly electronic databases were searched. Articles were included if they reported empirical research published between 2000 and 2019 and had a focus on Indigenous maternal health. Descriptive data were extracted from relevant articles and descriptive analysis was conducted. Included articles were also assessed for reporting of Indigenous research principles, including Indigenous involvement, context of colonization, Indigenous conceptualizations of health, community benefits, knowledge dissemination to participants or communities, and policy or intervention recommendations. RESULTS Four-hundred and forty-one articles met the inclusion criteria. While studies were conducted in all continents except Antarctica, less than 3% of articles described research in low-income countries. The most researched topics were access to and quality of maternity care (25%), pregnancy outcome and/or complications (18%), and smoking, alcohol and/or drug use during pregnancy (14%). The most common study design was cross-sectional (49%), and the majority of articles used quantitative methods only (68%). Less than 2% of articles described or reported all Indigenous research principles, and 71% of articles did not report on Indigenous People's involvement. CONCLUSIONS By summarizing the trends in published literature on Indigenous maternal health, we highlight the need for increased geographic representation of Indigenous women, expansion of research to include important but under-researched topics, and meaningful involvement of Indigenous Peoples.
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Affiliation(s)
- Kaitlin Patterson
- Department of Population Medicine, University of Guelph, 50 Stone Road East, Guelph, Ontario, N1G 2W1, Canada.
| | - Jan Sargeant
- Department of Population Medicine, University of Guelph, 50 Stone Road East, Guelph, Ontario, N1G 2W1, Canada.
| | - Seungmi Yang
- Department of Epidemiology, Biostatistics and Occupational Health, Purvis Hall, McGill University, 1020 Pine Avenue West, Montreal, Quebec, H3A 1A2, Canada.
| | - Tricia McGuire-Adams
- Faculty of Education, University of Ottawa, 145 Jean-Jacques-Lussier Private, Ottawa, Ontario, K1N 6N5, Canada
| | - Lea Berrang-Ford
- Priestley International Centre for Climate, University of Leeds, Leeds, LS2 9JT, United Kingdom.
| | - Shuaib Lwasa
- Department of Geography, Geo-Informatics and Climatic Sciences, School of Forestry, Environmental and Geographical Sciences, College of Agricultural and Environmental Sciences, Makerere University, Arts Building, South Wing Ground Floor, P.O Box, 7062, Kampala, Uganda.
| | | | - Vivienne Steele
- Department of Population Medicine, University of Guelph, 50 Stone Road East, Guelph, Ontario, N1G 2W1, Canada.
| | - Sherilee L Harper
- Department of Population Medicine, University of Guelph, 50 Stone Road East, Guelph, Ontario, N1G 2W1, Canada; School of Public Health, Edmonton Clinic Health Academy, University of Alberta, Edmonton, Alberta, T6G 1C9, Canada.
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9
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Rippin HL, Cade JE, Berrang-Ford L, Benton TG, Hancock N, Greenwood DC. Variations in greenhouse gas emissions of individual diets: Associations between the greenhouse gas emissions and nutrient intake in the United Kingdom. PLoS One 2021; 16:e0259418. [PMID: 34813623 PMCID: PMC8610494 DOI: 10.1371/journal.pone.0259418] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 10/19/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Food production accounts for 30% of global greenhouse gas (GHG) emissions. Less environmentally sustainable diets are also often more processed, energy-dense and nutrient-poor. To date, the environmental impact of diets have mostly been based on a limited number of broad food groups. OBJECTIVES We link GHG emissions to over 3000 foods, assessing associations between individuals' GHG emissions, their nutrient requirements and their demographic characteristics. We also identify additional information required in dietary assessment to generate more accurate environmental impact data for individual-level diets. METHODS GHG emissions of individual foods, including process stages prior to retail, were added to the UK Composition Of Foods Integrated Dataset (COFID) composition tables and linked to automated online dietary assessment for 212 adults over three 24-hour periods. Variations in GHG emissions were explored by dietary pattern, demographic characteristics and World Health Organization Recommended Nutrient Intakes (RNIs). RESULTS GHG emissions estimates were linked to 98% (n = 3233) of food items. Meat explained 32% of diet-related GHG emissions; 15% from drinks; 14% from dairy; and 8% from cakes, biscuits and confectionery. Non-vegetarian diets had GHG emissions 59% (95% CI 18%, 115%) higher than vegetarian. Men had 41% (20%, 64%) higher GHG emissions than women. Individuals meeting RNIs for saturated fats, carbohydrates and sodium had lower GHG emissions compared to those exceeding the RNI. DISCUSSION Policies encouraging sustainable diets should focus on plant-based diets. Substituting tea, coffee and alcohol with more sustainable alternatives, whilst reducing less nutritious sweet snacks, presents further opportunities. Healthier diets had lower GHG emissions, demonstrating consistency between planetary and personal health. Further detail could be gained from incorporating brand, production methods, post-retail emissions, country of origin, and additional environmental impact indicators.
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Affiliation(s)
- Holly L. Rippin
- School of Medicine, University of Leeds, Leeds, United Kingdom
- * E-mail:
| | - Janet E. Cade
- School of Food Science and Nutrition, University of Leeds, Leeds, United Kingdom
| | - Lea Berrang-Ford
- Priestley International Centre for Climate, University of Leeds, Leeds, United Kingdom
| | - Tim G. Benton
- School of Biology, University of Leeds, Leeds, United Kingdom
- Royal Institute of International Affairs, Chatham House, London, United Kingdom
| | - Neil Hancock
- School of Food Science and Nutrition, University of Leeds, Leeds, United Kingdom
| | - Darren C. Greenwood
- School of Medicine, University of Leeds, Leeds, United Kingdom
- Leeds Institute for Data Analytics, University of Leeds, Leeds, United Kingdom
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Scarpa G, Berrang-Ford L, Twesigomwe S, Kakwangire P, Peters R, Zavaleta-Cortijo C, Patterson K, Namanya DB, Lwasa S, Nowembabazi E, Kesande C, Harris-Fry H, Cade JE. A Community-Based Approach to Integrating Socio, Cultural and Environmental Contexts in the Development of a Food Database for Indigenous and Rural Populations: The Case of the Batwa and Bakiga in South-Western Uganda. Nutrients 2021; 13:nu13103503. [PMID: 34684504 PMCID: PMC8537349 DOI: 10.3390/nu13103503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 09/24/2021] [Accepted: 09/30/2021] [Indexed: 11/16/2022] Open
Abstract
Comprehensive food lists and databases are a critical input for programs aiming to alleviate undernutrition. However, standard methods for developing them may produce databases that are irrelevant for marginalised groups where nutritional needs are highest. Our study provides a method for identifying critical contextual information required to build relevant food lists for Indigenous populations. For our study, we used mixed-methods study design with a community-based approach. Between July and October 2019, we interviewed 74 participants among Batwa and Bakiga communities in south-western Uganda. We conducted focus groups discussions (FGDs), individual dietary surveys and markets and shops assessment. Locally validated information on foods consumed among Indigenous populations can provide results that differ from foods listed in the national food composition tables; in fact, the construction of food lists is influenced by multiple factors such as food culture and meaning of food, environmental changes, dietary transition, and social context. Without using a community-based approach to understanding socio-environmental contexts, we would have missed 33 commonly consumed recipes and foods, and we would not have known the variety of ingredients’ quantity in each recipe, and traditional foraged foods. The food culture, food systems and nutrition of Indigenous and vulnerable communities are unique, and need to be considered when developing food lists.
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Affiliation(s)
- Giulia Scarpa
- School of Environment, University of Leeds, Leeds LS2 9JT, UK;
- School of Food Science and Nutrition, University of Leeds, Leeds LS2 9JT, UK;
- Correspondence: ; +44-74-15966075
| | - Lea Berrang-Ford
- School of Environment, University of Leeds, Leeds LS2 9JT, UK;
- Indigenous Health Adaptation to Climate Change Research Team, Kanungu District, Buhoma, Uganda; (S.T.); (P.K.); (D.B.N.); (S.L.); (E.N.); (C.K.)
| | - Sabastian Twesigomwe
- Indigenous Health Adaptation to Climate Change Research Team, Kanungu District, Buhoma, Uganda; (S.T.); (P.K.); (D.B.N.); (S.L.); (E.N.); (C.K.)
| | - Paul Kakwangire
- Indigenous Health Adaptation to Climate Change Research Team, Kanungu District, Buhoma, Uganda; (S.T.); (P.K.); (D.B.N.); (S.L.); (E.N.); (C.K.)
| | - Remco Peters
- School for Policy Studies, University of Bristol, Bristol BS8 1TH, UK;
| | - Carol Zavaleta-Cortijo
- Facultad de Salud Publica y Administracion, Universidad Peruana Cayetano Heredia, San Martín de Porres 15102, Peru;
| | - Kaitlin Patterson
- Department of Population Medicine, University of Guelph, Guelph, ON N1G 2W1, Canada;
| | - Didacus B. Namanya
- Indigenous Health Adaptation to Climate Change Research Team, Kanungu District, Buhoma, Uganda; (S.T.); (P.K.); (D.B.N.); (S.L.); (E.N.); (C.K.)
- Ministry of Health, Lourdel Road, Nakasero P.O. Box 7272, Uganda
| | - Shuaib Lwasa
- Indigenous Health Adaptation to Climate Change Research Team, Kanungu District, Buhoma, Uganda; (S.T.); (P.K.); (D.B.N.); (S.L.); (E.N.); (C.K.)
- Department of Geography, Makerere University, Kampala, Uganda
- The Global Center on Adaptation, 3072 Rotterdam, The Netherlands
| | - Ester Nowembabazi
- Indigenous Health Adaptation to Climate Change Research Team, Kanungu District, Buhoma, Uganda; (S.T.); (P.K.); (D.B.N.); (S.L.); (E.N.); (C.K.)
| | - Charity Kesande
- Indigenous Health Adaptation to Climate Change Research Team, Kanungu District, Buhoma, Uganda; (S.T.); (P.K.); (D.B.N.); (S.L.); (E.N.); (C.K.)
| | - Helen Harris-Fry
- Department of Population Health, London School of Hygiene & Tropical Medicine, Keppel St, London WC1E 7HT, UK;
| | - Janet E. Cade
- School of Food Science and Nutrition, University of Leeds, Leeds LS2 9JT, UK;
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Berrang-Ford L, Sietsma AJ, Callaghan M, Minx JC, Scheelbeek PFD, Haddaway NR, Haines A, Dangour AD. Systematic mapping of global research on climate and health: a machine learning review. Lancet Planet Health 2021; 5:e514-e525. [PMID: 34270917 PMCID: PMC8358978 DOI: 10.1016/s2542-5196(21)00179-0] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 06/17/2021] [Accepted: 06/18/2021] [Indexed: 05/28/2023]
Abstract
BACKGROUND The global literature on the links between climate change and human health is large, increasing exponentially, and it is no longer feasible to collate and synthesise using traditional systematic evidence mapping approaches. We aimed to use machine learning methods to systematically synthesise an evidence base on climate change and human health. METHODS We used supervised machine learning and other natural language processing methods (topic modelling and geoparsing) to systematically identify and map the scientific literature on climate change and health published between Jan 1, 2013, and April 9, 2020. Only literature indexed in English were included. We searched Web of Science Core Collection, Scopus, and PubMed using title, abstract, and keywords only. We searched for papers including both a health component and an explicit mention of either climate change, climate variability, or climate change-relevant weather phenomena. We classified relevant publications according to the fields of climate research, climate drivers, health impact, date, and geography. We used supervised and unsupervised machine learning to identify and classify relevant articles in the field of climate and health, with outputs including evidence heat maps, geographical maps, and narrative synthesis of trends in climate health-related publications. We included empirical literature of any study design that reported on health pathways associated with climate impacts, mitigation, or adaptation. FINDINGS We predict that there are 15 963 studies in the field of climate and health published between 2013 and 2019. Climate health literature is dominated by impact studies, with mitigation and adaptation responses and their co-benefits and co-risks remaining niche topics. Air quality and heat stress are the most frequently studied exposures, with all-cause mortality and infectious disease incidence being the most frequently studied health outcomes. Seasonality, extreme weather events, heat, and weather variability are the most frequently studied climate-related hazards. We found major gaps in evidence on climate health research for mental health, undernutrition, and maternal and child health. Geographically, the evidence base is dominated by studies from high-income countries and China, with scant evidence from low-income counties, which often suffer most from the health consequences of climate change. INTERPRETATION Our findings show the importance and feasibility of using automated machine learning to comprehensively map the science on climate change and human health in the age of big literature. These can provide key inputs into global climate and health assessments. The scant evidence on climate change response options is concerning and could significantly hamper the design of evidence-based pathways to reduce the effects on health of climate change. In the post-2015 Paris Agreement era of climate solutions, we believe much more attention should be given to climate adaptation and mitigation options and their effects on human health. FUNDING Foreign, Commonwealth & Development Office.
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Affiliation(s)
- Lea Berrang-Ford
- Priestley International Centre for Climate, University of Leeds, Leeds, UK.
| | - Anne J Sietsma
- Priestley International Centre for Climate, University of Leeds, Leeds, UK
| | - Max Callaghan
- Priestley International Centre for Climate, University of Leeds, Leeds, UK; Mercator Research Institute on Global Commons and Climate Change, Berlin, Germany
| | - Jan C Minx
- Priestley International Centre for Climate, University of Leeds, Leeds, UK; Mercator Research Institute on Global Commons and Climate Change, Berlin, Germany
| | - Pauline F D Scheelbeek
- Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, UK
| | - Neal R Haddaway
- Mercator Research Institute on Global Commons and Climate Change, Berlin, Germany; Stockholm Environment Institute, Stockholm, Sweden; Africa Centre for Evidence, University of Johannesburg, Johannesburg, South Africa
| | - Andy Haines
- Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, UK
| | - Alan D Dangour
- Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, UK
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Steele V, Patterson K, Berrang-Ford L, King N, Kulkarni M, Namanya D, Kesande C, Twesigomwe S, Asaasira G, Harper SL. Factors influencing antenatal care attendance for Bakiga and Indigenous Batwa women in Kanungu District, Southwestern Uganda. Rural Remote Health 2021; 21:6510. [PMID: 34218663 DOI: 10.22605/rrh6510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION The number of maternal deaths remains high in sub-Saharan Africa. Effective antenatal care (ANC) reduces maternal morbidity and mortality; therefore, provision of improved antenatal care services has been prioritised across sub-Saharan Africa. Yet, research is limited on the ANC experiences of Indigenous women in sub-Saharan Africa. This study characterised ANC attendance patterns at a hospital, and characterised factors influencing attendance among Bakiga and Indigenous Batwa women in Kanungu District, Uganda. METHODS A community-based, mixed-methods approach was used. Quantitative data were collected from a local hospital (records for 2299 ANC visits) and analysed by using descriptive statistics and multivariable regression analysis. Qualitative data from eight key informant interviews (n=9 healthcare providers) and 16 focus group discussions (n=120 Batwa and Bakiga women) were analysed by thematic analysis. RESULTS Most ANC patients attended between one and three ANC visits per pregnancy (n=1259; 92.57%), and few attended the recommended four or more visits (n=101; 7.43%). Distance from a woman's home to the hospital was significantly associated with lower ANC attendance (p<0.05, 95% confidence interval 0.01-0.96), after adjusting for maternal age and number of previous pregnancies. The qualitative data revealed that many factors influenced ANC attendance for both Batwa and Bakiga: long distances from the home to a health centre, high direct and indirect costs of ANC, lack of power in household decision-making, and poor interactions with healthcare providers. While the types of barriers were similar among Batwa and Bakiga, some were more pronounced for Indigenous Batwa women. CONCLUSION This study partnered with and collected in-depth data with Indigenous Peoples who remain underrepresented in the literature. The findings indicated that Indigenous Batwa continue to face unique and more pronounced barriers to accessing ANC in Kanungu District, Uganda. Ensuring access to ANC for these populations requires an in-depth understanding of their experiences within the local healthcare context. To reduce health inequities that Indigenous Peoples experience, policy-makers and healthcare workers need to adequately understand, effectively address, and appropriately prioritise factors influencing ANC attendance.
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Affiliation(s)
- Vivienne Steele
- Department of Population Medicine, University of Guelph, Guelph, Ontario N1G 2W1, Canada
| | - Kaitlin Patterson
- Department of Population Medicine, University of Guelph, Guelph, Ontario N1G 2W1, Canada
| | - Lea Berrang-Ford
- Priestly Centre for Climate Change, Leeds University, Leeds, York LS2 9JT, United Kingdom
| | - Nia King
- School of Medicine, Queen's University, Kingston, Ontario K7L 3L4, Canada; and School of Public Health, University of Alberta, Edmonton, Alberta T6G 1C9, Canada
| | - Manisha Kulkarni
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario K1G 5Z3, Canada
| | - Didacus Namanya
- Ministry of Health, Kampala, Uganda; and Faculty of Health Sciences, Uganda Martyrs University, Kampala, Uganda
| | | | | | | | - Grace Asaasira
- Department of Psychology, Makerere University, Kampala, Uganda
| | - Sherilee L Harper
- Department of Population Medicine, University of Guelph, Guelph, Ontario N1G 2W1, Canada; and School of Public Health, University of Alberta, Edmonton, Alberta T6G 1C9, Canada
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Scheelbeek PFD, Dangour AD, Jarmul S, Turner G, Sietsma AJ, Minx JC, Callaghan M, Ajibade I, Austin SE, Biesbroek R, Bowen KJ, Chen T, Davis K, Ensor T, Ford JD, Galappaththi EK, Joe ET, Musah-Surugu IJ, Alverio GN, Schwerdtle PN, Pokharel P, Salubi EA, Scarpa G, Segnon AC, Siña M, Templeman S, Xu J, Zavaleta-Cortijo C, Berrang-Ford L. The effects on public health of climate change adaptation responses: a systematic review of evidence from low- and middle-income countries. Environ Res Lett 2021; 16:073001. [PMID: 34267795 PMCID: PMC8276060 DOI: 10.1088/1748-9326/ac092c] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 04/30/2021] [Accepted: 06/08/2021] [Indexed: 05/11/2023]
Abstract
Climate change adaptation responses are being developed and delivered in many parts of the world in the absence of detailed knowledge of their effects on public health. Here we present the results of a systematic review of peer-reviewed literature reporting the effects on health of climate change adaptation responses in low- and middle-income countries (LMICs). The review used the 'Global Adaptation Mapping Initiative' database (comprising 1682 publications related to climate change adaptation responses) that was constructed through systematic literature searches in Scopus, Web of Science and Google Scholar (2013-2020). For this study, further screening was performed to identify studies from LMICs reporting the effects on human health of climate change adaptation responses. Studies were categorised by study design and data were extracted on geographic region, population under investigation, type of adaptation response and reported health effects. The review identified 99 studies (1117 reported outcomes), reporting evidence from 66 LMICs. Only two studies were ex ante formal evaluations of climate change adaptation responses. Papers reported adaptation responses related to flooding, rainfall, drought and extreme heat, predominantly through behaviour change, and infrastructural and technological improvements. Reported (direct and intermediate) health outcomes included reduction in infectious disease incidence, improved access to water/sanitation and improved food security. All-cause mortality was rarely reported, and no papers were identified reporting on maternal and child health. Reported maladaptations were predominantly related to widening of inequalities and unforeseen co-harms. Reporting and publication-bias seems likely with only 3.5% of all 1117 health outcomes reported to be negative. Our review identified some evidence that climate change adaptation responses may have benefits for human health but the overall paucity of evidence is concerning and represents a major missed opportunity for learning. There is an urgent need for greater focus on the funding, design, evaluation and standardised reporting of the effects on health of climate change adaptation responses to enable evidence-based policy action.
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Affiliation(s)
- Pauline F D Scheelbeek
- Centre on Climate Change and Planetary Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Alan D Dangour
- Centre on Climate Change and Planetary Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Stephanie Jarmul
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Grace Turner
- Department of Public Health, Environment and Society, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Anne J Sietsma
- University of Leeds, Priestley International Centre for Climate, Leeds, United Kingdom
| | - Jan C Minx
- University of Leeds, Priestley International Centre for Climate, Leeds, United Kingdom
- Mercator Research Institute on Global Commons and Climate Change, Berlin, Germany
| | - Max Callaghan
- Mercator Research Institute on Global Commons and Climate Change, Berlin, Germany
| | - Idowu Ajibade
- Department of Geography, Portland State University, Portland, OR, United States of America
| | | | - Robbert Biesbroek
- Wageningen University and Research Centre, Wageningen, The Netherlands
| | - Kathryn J Bowen
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
- Institute for Advanced Sustainability Studies, Potsdam, Germany
| | - Tara Chen
- E-Da Hospital, Kaohsiung City, Taiwan
| | - Katy Davis
- University of Leeds, Priestley International Centre for Climate, Leeds, United Kingdom
| | - Tim Ensor
- University of Leeds, Priestley International Centre for Climate, Leeds, United Kingdom
| | - James D Ford
- University of Leeds, Priestley International Centre for Climate, Leeds, United Kingdom
| | - Eranga K Galappaththi
- Department of Fisheries and Oceans Canada, Winnipeg, Manitoba, Canada
- Department of Geography, Virginia Tech, Blacksburg, VA, United States of America
| | | | | | - Gabriela Nagle Alverio
- Nicholas School of the Environment, Sanford School of Public Policy, Duke University, Durham, NC, United States of America
| | | | | | | | - Giulia Scarpa
- University of Leeds, Priestley International Centre for Climate, Leeds, United Kingdom
| | - Alcade C Segnon
- CGIAR Research Program on Climate Change, Agriculture and Food Security, International Crops Research Institute for the Semi-Arid Tropics, Bamako, Mali
- Faculty of Agronomic Sciences, University of Abomey-Calavi, Cotonou, Benin
| | | | | | - Jiren Xu
- University of Glasgow, Glasgow, United Kingdom
| | | | - Lea Berrang-Ford
- University of Leeds, Priestley International Centre for Climate, Leeds, United Kingdom
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14
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Brubacher LJ, Berrang-Ford L, Clark S, Patterson K, Lwasa S, Namanya DB, Twesigomwe S, Harper SL. 'We don't use the same ways to treat the illness:' A qualitative study of heterogeneity in health-seeking behaviour for acute gastrointestinal illness among the Ugandan Batwa. Glob Public Health 2021; 17:1757-1772. [PMID: 34097579 DOI: 10.1080/17441692.2021.1937273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The Batwa (Twa), an Indigenous People of southwest Uganda, were evicted from their ancestral forest lands in 1991 due to establishment of the Bwindi Impenetrable Forest. This land dispossession forced Batwa to transition from a semi-nomadic, hunting-gathering livelihood to an agricultural livelihood; eliminated access to Indigenous food, medicines, and shelter; and shifted their healthcare options. Therefore, this exploratory study investigated why Batwa choose Indigenous or biomedical treatment, or no treatment, when experiencing acute gastrointestinal illness. Ten gender-stratified focus groups were conducted in five Batwa settlements in Kanungu District, Uganda (n = 63 participants), alongside eleven semi-structured interviews (2014). Qualitative data were analysed thematically, using a constant comparative method. Batwa emphasised that health-seeking behaviour for acute gastrointestinal illness was diverse: some Batwa used only Indigenous or biomedical healthcare, while others preferred a combination, or no healthcare. Physical and economic access to care, and also perceived efficacy and quality of care, influenced their healthcare decisions. This study provides insight into the Kanungu District Batwa's perceptions of biomedical and Indigenous healthcare, and barriers they experience to accessing either. This study is intended to inform public health interventions to reduce their burden of acute gastrointestinal illness and ensure adequate healthcare, biomedical or Indigenous, for Batwa.
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Affiliation(s)
| | | | - Sierra Clark
- Department of Epidemiology and Biostatistics, Imperial College London, London, UK
| | - Kaitlin Patterson
- Department of Population Medicine, University of Guelph, Guelph, Canada
| | - Shuaib Lwasa
- Department of Geography, Makerere University, Kampala, Uganda
| | - Didacus B Namanya
- Ugandan Ministry of Health, Kampala, Uganda.,Faculty of Health Sciences, Uganda Martyrs University, Kampala, Uganda
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- School of Public Health, University of Alberta, Edmonton, Canada
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15
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Scarpa G, Berrang-Ford L, Bawajeeh AO, Twesigomwe S, Kakwangire P, Peters R, Beer S, Williams G, Zavaleta-Cortijo C, Namanya DB, Lwasa S, Nowembabazi E, Kesande C, Rippin H, Cade JE. Developing an online food composition database for an Indigenous population in south-western Uganda. Public Health Nutr 2021; 24:2455-2464. [PMID: 33843552 PMCID: PMC8145457 DOI: 10.1017/s1368980021001397] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 03/10/2021] [Accepted: 03/22/2021] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To develop an online food composition database of locally consumed foods among an Indigenous population in south-western Uganda. DESIGN Using a community-based approach and collaboration with local nutritionists, we collected a list of foods for inclusion in the database through focus group discussions, an individual dietary survey and markets and shops assessment. The food database was then created using seven steps: identification of foods for inclusion in the database; initial data cleaning and removal of duplicate items; linkage of foods to existing generic food composition tables; mapping and calculation of the nutrient content of recipes and foods; allocating portion sizes and accompanying foods; quality checks with local and international nutritionists; and translation into relevant local languages. SETTING Kanungu District, south-western Uganda. PARTICIPANTS Seventy-four participants, 36 Indigenous Batwa and 38 Bakiga, were randomly selected and interviewed to inform the development of a food list prior the construction of the food database. RESULTS We developed an online food database for south-western Uganda including 148 commonly consumed foods complete with values for 120 micronutrients and macronutrients. This was for use with the online dietary assessment tool myfood24. Of the locally reported foods included, 56 % (n 82 items) of the items were already available in the myfood24 database, while 25 % (n 37 items) were found in existing Ugandan and Tanzanian food databases, 18 % (n 27 items) came from generated recipes and 1 % (n 2 items) from food packaging labels. CONCLUSION Locally relevant food databases are sparse for African Indigenous communities. Here, we created a tool that can be used for assessing food intake and for tracking undernutrition among the communities living in Kanungu District. This will help to develop locally relevant food and nutrition policies.
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Affiliation(s)
- Giulia Scarpa
- School of Environment, University of Leeds, LS2 9JT, UK
- School of Food Science and Nutrition, University of Leeds, UK
| | - Lea Berrang-Ford
- School of Environment, University of Leeds, LS2 9JT, UK
- Department of Food and Nutrition, Faculty of Human Sciences and Design, King Abdulaziz University, Jeddah, Saudi Arabia
- Indigenous Health Adaptation to Climate Change Research Team, Kanungu District, Uganda
| | - Areej O Bawajeeh
- School of Food Science and Nutrition, University of Leeds, UK
- Department of Food and Nutrition, Faculty of Human Sciences and Design, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Sabastian Twesigomwe
- Indigenous Health Adaptation to Climate Change Research Team, Kanungu District, Uganda
| | - Paul Kakwangire
- Indigenous Health Adaptation to Climate Change Research Team, Kanungu District, Uganda
| | - Remco Peters
- Leeds Institute of Health Sciences, University of Leeds, UK
| | | | | | | | - Didacus B Namanya
- Indigenous Health Adaptation to Climate Change Research Team, Kanungu District, Uganda
- Ministry of Health, Uganda
| | - Shuaib Lwasa
- Indigenous Health Adaptation to Climate Change Research Team, Kanungu District, Uganda
- Department of Geography, Makerere University, Kampala, Uganda
- The Global Center on Adaptation, Rotterdam, Netherlands
| | - Ester Nowembabazi
- Indigenous Health Adaptation to Climate Change Research Team, Kanungu District, Uganda
| | - Charity Kesande
- Indigenous Health Adaptation to Climate Change Research Team, Kanungu District, Uganda
| | - Holly Rippin
- WHO European Office for Prevention and Control of Non-communicable Diseases (NCD Office), Moscow, Russian Federation
| | - Janet E Cade
- School of Food Science and Nutrition, University of Leeds, UK
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16
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Bryson JM, Patterson K, Berrang-Ford L, Lwasa S, Namanya DB, Twesigomwe S, Kesande C, Ford JD, Harper SL. Seasonality, climate change, and food security during pregnancy among Indigenous and non-Indigenous women in rural Uganda: Implications for maternal-infant health. PLoS One 2021; 16:e0247198. [PMID: 33760848 PMCID: PMC7990176 DOI: 10.1371/journal.pone.0247198] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 02/02/2021] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Climate change is expected to decrease food security globally. Many Indigenous communities have heightened sensitivity to climate change and food insecurity for multifactorial reasons including close relationships with the local environment and socioeconomic inequities which increase exposures and challenge adaptation to climate change. Pregnant women have additional sensitivity to food insecurity, as antenatal undernutrition is linked with poor maternal-infant health. This study examined pathways through which climate change influenced food security during pregnancy among Indigenous and non-Indigenous women in rural Uganda. Specific objectives were to characterize: 1) sensitivities to climate-associated declines in food security for pregnant Indigenous women; 2) women's perceptions of climate impacts on food security during pregnancy; and 3) changes in food security and maternal-infant health over time, as observed by women. METHODS Using a community-based research approach, we conducted eight focus group discussions-four in Indigenous Batwa communities and four in non-Indigenous communities-in Kanungu District, Uganda, on the subject of climate and food security during pregnancy. Thirty-six women with ≥1 pregnancy participated. Data were analysed using a constant comparative method and thematic analysis. RESULTS Women indicated that food insecurity was common during pregnancy and had a bidirectional relationship with antenatal health issues. Food security was thought to be decreasing due to weather changes including extended droughts and unpredictable seasons harming agriculture. Women linked food insecurity with declines in maternal-infant health over time, despite improved antenatal healthcare. While all communities described food security struggles, the challenges Indigenous women identified and described were more severe. CONCLUSIONS Programs promoting women's adaptive capacity to climate change are required to improve food security for pregnant women and maternal-infant health. These interventions are particularly needed in Indigenous communities, which often face underlying health inequities. However, resiliency among mothers was strong and, with supports, they can reduce food security challenges in a changing climate.
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Affiliation(s)
- Julia M. Bryson
- Department of Population Medicine, University of Guelph, Guelph, Ontario, Canada
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Kaitlin Patterson
- Department of Population Medicine, University of Guelph, Guelph, Ontario, Canada
| | - Lea Berrang-Ford
- Priestley International Centre for Climate, University of Leeds, Leeds, United Kingdom
| | - Shuaib Lwasa
- Department of Geography, Geo-Informatics and Climatic Sciences, Makerere University, Kampala, Uganda
| | - Didacus B. Namanya
- Department of Community Health, Ugandan Ministry of Health, Kampala, Uganda
| | | | | | - James D. Ford
- Priestley International Centre for Climate, University of Leeds, Leeds, United Kingdom
| | | | - Sherilee L. Harper
- Department of Population Medicine, University of Guelph, Guelph, Ontario, Canada
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
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Patterson K, Berrang-Ford L, Lwasa S, Namanya DB, Ford J, Research Team IHACC, Harper SL. Food security variation among Indigenous communities in South-western Uganda. Journal of Hunger & Environmental Nutrition 2021. [DOI: 10.1080/19320248.2020.1852146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Kaitlin Patterson
- Dept. Of Population Medicine, University of Guelph, Guelph, Ontario, Canada
- School of Public Health, University of Alberta, Edmonton, Alberta
| | - Lea Berrang-Ford
- Priestley International Centre for Climate, University of Leeds, Leeds, UK
- Indigenous Health Adaptation to Climate Change Research Group, School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Shuaib Lwasa
- Indigenous Health Adaptation to Climate Change Research Group, School of Public Health, University of Alberta, Edmonton, Alberta, Canada
- Dept. Of Geography Geoinformatics and Climatic Sciences, Makerere University, Kampala, Uganda
| | - Didacus B. Namanya
- Indigenous Health Adaptation to Climate Change Research Group, School of Public Health, University of Alberta, Edmonton, Alberta, Canada
- Ugandan Ministry of Health, Kampala, Uganda
| | - James Ford
- Priestley International Centre for Climate, University of Leeds, Leeds, UK
- Indigenous Health Adaptation to Climate Change Research Group, School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - IHACC Research Team
- Indigenous Health Adaptation to Climate Change Research Group, School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Sherilee L. Harper
- Indigenous Health Adaptation to Climate Change Research Group, School of Public Health, University of Alberta, Edmonton, Alberta, Canada
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
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Berrang-Ford L, Sietsma AJ, Callaghan M, Minx JC, Scheelbeek P, Haddaway NR, Haines A, Belesova K, Dangour AD. Mapping global research on climate and health using machine learning (a systematic evidence map). Wellcome Open Res 2021; 6:7. [PMID: 35252587 PMCID: PMC8889042 DOI: 10.12688/wellcomeopenres.16415.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2020] [Indexed: 01/29/2023] Open
Abstract
Climate change is already affecting health in populations around the world, threatening to undermine the past 50 years of global gains in public health. Health is not only affected by climate change via many causal pathways, but also by the emissions that drive climate change and their co-pollutants. Yet there has been relatively limited synthesis of key insights and trends at a global scale across fragmented disciplines. Compounding this, an exponentially increasing literature means that conventional evidence synthesis methods are no longer sufficient or feasible. Here, we outline a protocol using machine learning approaches to systematically synthesize global evidence on the relationship between climate change, climate variability, and weather (CCVW) and human health. We will use supervised machine learning to screen over 300,000 scientific articles, combining terms related to CCVW and human health. Our inclusion criteria comprise articles published between 2013 and 2020 that focus on empirical assessment of: CCVW impacts on human health or health-related outcomes or health systems; relate to the health impacts of mitigation strategies; or focus on adaptation strategies to the health impacts of climate change. We will use supervised machine learning (topic modeling) to categorize included articles as relevant to impacts, mitigation, and/or adaptation, and extract geographical location of studies. Unsupervised machine learning using topic modeling will be used to identify and map key topics in the literature on climate and health, with outputs including evidence heat maps, geographic maps, and narrative synthesis of trends in climate-health publishing. To our knowledge, this will represent the first comprehensive, semi-automated, systematic evidence synthesis of the scientific literature on climate and health.
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Affiliation(s)
- Lea Berrang-Ford
- Priestley International Centre for Climate, University of Leeds, Leeds, LS2 9JT, UK
| | - Anne J. Sietsma
- Priestley International Centre for Climate, University of Leeds, Leeds, LS2 9JT, UK
| | - Max Callaghan
- Priestley International Centre for Climate, University of Leeds, Leeds, LS2 9JT, UK
- Mercator Research Institute on Global Commons and Climate Change, Torgauer Straße 12–15, EUREF Campus #19, Berlin, 10829, Germany
| | - Ja C. Minx
- Priestley International Centre for Climate, University of Leeds, Leeds, LS2 9JT, UK
- Mercator Research Institute on Global Commons and Climate Change, Torgauer Straße 12–15, EUREF Campus #19, Berlin, 10829, Germany
| | - Pauline Scheelbeek
- Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Neal R. Haddaway
- Mercator Research Institute on Global Commons and Climate Change, Torgauer Straße 12–15, EUREF Campus #19, Berlin, 10829, Germany
- Stockholm Environment Institute, Linnégatan 87D, Stockholm, Sweden
- Africa Centre for Evidence, University of Johannesburg, Johannesburg, South Africa
| | - Andy Haines
- Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Kristine Belesova
- Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Alan D. Dangour
- Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
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Berrang-Ford L, Döbbe F, Garside R, Haddaway N, Lamb WF, Minx JC, Viechtbauer W, Welch V, White H. Editorial: Evidence synthesis for accelerated learning on climate solutions. Campbell Syst Rev 2020; 16:e1128. [PMID: 37016618 PMCID: PMC8356307 DOI: 10.1002/cl2.1128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Affiliation(s)
- Lea Berrang-Ford
- Priestley International Centre for Climate University of Leeds Leeds UK
| | | | | | - Neal Haddaway
- Mercator Research Institute on Global Commons and Climate Change Berlin Germany
| | - William F Lamb
- Mercator Research Institute on Global Commons and Climate Change Berlin Germany
| | - Jan C Minx
- Priestley International Centre for Climate University of Leeds Leeds UK
- Mercator Research Institute on Global Commons and Climate Change Berlin Germany
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Zavaleta-Cortijo C, Ford JD, Arotoma-Rojas I, Lwasa S, Lancha-Rucoba G, García PJ, Miranda JJ, Namanya DB, New M, Wright CJ, Berrang-Ford L, Harper SL. Climate change and COVID-19: reinforcing Indigenous food systems. Lancet Planet Health 2020; 4:e381-e382. [PMID: 32777205 PMCID: PMC7413660 DOI: 10.1016/s2542-5196(20)30173-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 07/22/2020] [Indexed: 05/18/2023]
Affiliation(s)
- Carol Zavaleta-Cortijo
- Universidad Peruana Cayetano Heredia, Urbanización Ingeniería, San Martín de Porres, Lima 31, Peru.
| | - James D Ford
- Priestley International Centre for Climate, University of Leeds, Leeds, UK
| | | | - Shuaib Lwasa
- Department of Geography, Geo-Informatics and Climatic Sciences, Makerere University, Kampala, Uganda
| | | | - Patricia J García
- Universidad Peruana Cayetano Heredia, Urbanización Ingeniería, San Martín de Porres, Lima 31, Peru
| | - J Jaime Miranda
- Universidad Peruana Cayetano Heredia, Urbanización Ingeniería, San Martín de Porres, Lima 31, Peru
| | | | - Mark New
- African Climate Development Initiative, University of Cape Town, Rondebosch, South Africa; School of International Development, University of East Anglia, Norwich, UK
| | - Carlee J Wright
- School of Public Health, University of Alberta, Edmonton, AB, Canada
| | - Lea Berrang-Ford
- Priestley International Centre for Climate, University of Leeds, Leeds, UK
| | - Sherilee L Harper
- School of Public Health, University of Alberta, Edmonton, AB, Canada
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Bussalleu A, Di-Liberto A, Carcamo C, Carrasco-Escobar G, Zavaleta-Cortijo C, King M, Berrang-Ford L, Maurtua D, Llanos-Cuentas A. Cultural Values and the Coliform Bacterial Load of "Masato," an Amazon Indigenous Beverage. Ecohealth 2020; 17:370-380. [PMID: 33216234 PMCID: PMC7719114 DOI: 10.1007/s10393-020-01498-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 04/28/2020] [Accepted: 09/27/2020] [Indexed: 06/11/2023]
Abstract
Access to safe drinking water is limited in many isolated areas, such as the Amazon where Indigenous peoples frequently reside. Identifying safe forms of drinking water accepted by the communities could have positive health benefits for Indigenous peoples. Many Amazon Indigenous peoples traditionally prepare and consume a fermented beverage called masato, which is frequently the only form of water consumption. Despite its widespread consumption and evidence of the health benefits of fermentation, masato remains poorly investigated. We partnered with a Shawi Indigenous community in the Peruvian Amazon to conduct participatory photography to research masato preparation, and to characterize key cultural features and to assess the presence of total and fecal coliform bacteria by using a membrane filter technique. Pictures show that masato preparation is a key part of cultural practices and that there are clear gender roles in the preparation process. We found that 100% of communal water sources (26/26) were contaminated with coliform bacteria; by contrast, fewer, 18% of masato samples (2/11), were positive for coliform. This exploratory study suggests that fermented beverages like masato merit further investigation as they represent an Indigenous method to improve water quality in Amazonian communities where water safety cannot be assured.
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Affiliation(s)
- Alejandra Bussalleu
- Facultad de Salud Pública y Administración, Universidad Peruana Cayetano Heredia, Av. Honorio Delgado 430, Lima 31, Peru
| | - Aldo Di-Liberto
- Facultad de Salud Pública y Administración, Universidad Peruana Cayetano Heredia, Av. Honorio Delgado 430, Lima 31, Peru
| | - Cesar Carcamo
- Facultad de Salud Pública y Administración, Universidad Peruana Cayetano Heredia, Av. Honorio Delgado 430, Lima 31, Peru
| | - Gabriel Carrasco-Escobar
- Facultad de Salud Pública y Administración, Universidad Peruana Cayetano Heredia, Av. Honorio Delgado 430, Lima 31, Peru
- Division of Infectious Diseases, Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Carol Zavaleta-Cortijo
- Department of Population Medicine, University of Guelph, 50 Stone Road East, Guelph, ON, N1G 2W1, Canada.
- Facultad de Salud Pública y Administración, Universidad Peruana Cayetano Heredia, Av. Honorio Delgado 430, Lima 31, Peru.
| | - Matthew King
- Geography Department, McGill University, Burnside Hall Building, Room 705, 805 Sherbrooke Street West, Montreal, QC, H3A0B9, Canada
| | - Lea Berrang-Ford
- Priestley International Centre for Climate, University of Leeds, Woodhouse Lane, Leeds, LS2 9JT, UK
| | - Dora Maurtua
- Laboratorio de Bacteriología de los Laboratorios de Investigación y Desarrollo, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Av. Honorio Delgado 430, Lima 31, Peru
| | - Alejandro Llanos-Cuentas
- Facultad de Salud Pública y Administración, Universidad Peruana Cayetano Heredia, Av. Honorio Delgado 430, Lima 31, Peru
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Bryson JM, Bishop-Williams KE, Berrang-Ford L, Nunez EC, Lwasa S, Namanya DB, Indigenous Health Adaptation To Climate Change Research Team, Harper SL. Neglected Tropical Diseases in the Context of Climate Change in East Africa: A Systematic Scoping Review. Am J Trop Med Hyg 2020; 102:1443-1454. [PMID: 32228798 DOI: 10.4269/ajtmh.19-0380] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
East Africa is highly affected by neglected tropical diseases (NTDs), which are projected to be exacerbated by climate change. Consequently, understanding what research has been conducted and what knowledge gaps remain regarding NTDs and climate change is crucial to informing public health interventions and climate change adaptation. We conducted a systematic scoping review to describe the extent, range, and nature of publications examining relationships between NTDs and climatic factors in East Africa. We collated all relevant English and French publications indexed in PubMed®, Web of Science™ Core Collection, and CAB Direct© databases published prior to 2019. Ninety-six publications were included for review. Kenya, Tanzania, and Ethiopia had high rates of publication, whereas countries in the Western Indian Ocean region were underrepresented. Most publications focused on schistosomiasis (n = 28, 29.2%), soil-transmitted helminthiases (n = 16, 16.7%), or human African trypanosomiasis (n = 14, 14.6%). Precipitation (n = 91, 94.8%) and temperature (n = 54, 56.3%) were frequently investigated climatic factors, whereas consideration of droughts (n = 10, 10.4%) and floods (n = 4, 4.2%) was not prominent. Publications reporting on associations between NTDs and changing climate were increasing over time. There was a decrease in the reporting of Indigenous identity and age factors over time. Overall, there were substantial knowledge gaps for several countries and for many NTDs. To better understand NTDs in the context of a changing climate, it would be helpful to increase research on underrepresented diseases and regions, consider demographic and social factors in research, and characterize how these factors modify the effects of climatic variables on NTDs in East Africa.
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Affiliation(s)
- Julia M Bryson
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Canada.,Department of Population Medicine, University of Guelph, Guelph, Canada
| | | | - Lea Berrang-Ford
- Priestley International Centre for Climate, University of Leeds, Leeds, United Kingdom
| | - Emily C Nunez
- Department of Epidemiology and Biostatistics, Western University, London, Canada.,Department of Population Medicine, University of Guelph, Guelph, Canada
| | - Shuaib Lwasa
- Department of Geography, Geo-Informatics and Climatic Sciences, Makerere University, Kampala, Uganda
| | - Didacus B Namanya
- Department of Community Health, Ugandan Ministry of Health, Kampala, Uganda
| | | | - Sherilee L Harper
- Department of Population Medicine, University of Guelph, Guelph, Canada.,School of Public Health, University of Alberta, Edmonton, Canada
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Helwig JE, Bishop-Williams KE, Berrang-Ford L, Lwasa S, Namanya DB, Bwindi Community Hospital. Doing More Than Asking for Opinions. International Journal of Healthcare Information Systems and Informatics 2020. [DOI: 10.4018/ijhisi.2020070102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Health information systems (HIS) are used to manage information related to population health. The goal of this research was to conduct an evaluation of a HIS used at a hospital in south-western Uganda using participatory approaches. The evaluation structure was based on guidelines generated by the Center for Disease Control and Prevention and a series of theoretical and methodological concepts regarding participatory engagement that encouraged stakeholder participation throughout the evaluation. The primary objectives were to describe the areas of strength and limitations of the HIS, and develop potential system enhancements. Ultimately, engagement of local staff members throughout each stage of the evaluation resulted in the development of a series of recommendations considered relevant and feasible by local stakeholders. We build on these results by highlighting the value of stakeholder engagement and opportunities to apply participatory and community-based research methods and an Ecohealth framework to an HIS evaluation.
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Affiliation(s)
| | | | - Lea Berrang-Ford
- IHACC Research Group, Priestley International Centre for Climate, University of Leeds, Leeds, UK
| | - Shuaib Lwasa
- IHACC Research Group, Makerere University, Kampala, Uganda
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Renwick KA, Sanmartin C, Dasgupta K, Berrang-Ford L, Ross N. The influence of low social support and living alone on premature mortality among aging Canadians. Can J Public Health 2020; 111:594-605. [PMID: 32170647 DOI: 10.17269/s41997-020-00310-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 02/19/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Among older Canadians, we examined the influence of low social support, a weak sense of belonging, and living alone to understand their role on mortality risk in Canada. METHODS We conducted a retrospective cohort study of older Canadians surveyed in 2001 from the Canadian Community Health Survey and followed up with death events through December 31, 2011 from the Canadian Vital Statistics Database. Analyses were stratified by age: 55-64 and 65 and older. Social support was assessed using measures developed for the Medical Outcomes Study. A sense of belonging, a binary measure, measured community integration. Living alone was a binary measure. Survival analysis was applied using a Cox proportional hazards model, adjusted for age, sex, income, smoking, and frailty. RESULTS Among respondents 55-64 (n = 6822), low affection (HR = 1.37; 95% CI 1.07, 1.75), low emotional/informational support (HR = 1.36; 95% CI 1.06, 1.74), and low positive social interactions (HR = 1.36; 95% CI 1.06, 1.75) were associated with mortality risk. Among respondents 65 and older (n = 8966), low affection (HR = 1.17; 95% CI 1.04, 1.31), low positive social interactions (HR = 1.20; 95% CI 1.07, 1.34), low emotional/informational support (HR = 1.19; 95% CI 1.06, 1.33), and a weak sense of belonging (HR = 1.13; 95% CI 1.05, 1.22) were associated with mortality risk. CONCLUSION Low social support and a weak sense of belonging are important risk factors among older Canadians and should be part of the dialogue in Canada about their roles in healthy aging.
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Affiliation(s)
- Kelly Ann Renwick
- Department of Interdisciplinary Studies, Appalachian State University, 301 Bodenheimer Drive, Boone, NC, 28608, USA.
| | - Claudia Sanmartin
- Statistics Canada, R.H. Coats Building, Floor 24 A, 100 Tunney's Pasture, Driveway, Ottawa, ON, K1A 0T6, Canada
| | - Kaberi Dasgupta
- Centre for Outcomes Research and Evaluation (CORE), Research Institute of the MUHC, McGill University, 5252 Boulevard de Maisonneuve Ouest, Office 3E.09, Montréal, QC, H4A 3S5, Canada
| | - Lea Berrang-Ford
- Priestley International Centre for Climate, University of Leeds, Leeds, LS2 9JT, UK
| | - Nancy Ross
- Department of Geography, McGill University, Burnside Hall, Room 705, 805, Sherbrooke Street West, Montreal, QC, H3A 0B9, Canada
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Patterson K, Clark S, Berrang-Ford L, Lwasa S, Namanya D, Twebaze F, Team IR, Harper SL. Acute gastrointestinal illness in an African Indigenous population: the lived experience of Uganda's Batwa. Rural Remote Health 2020; 20:5141. [PMID: 31958233 DOI: 10.22605/rrh5141] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Indigenous populations in low-income regions are often the most acutely affected by social gradients that impact health, including high burdens of infectious disease. Using a mixed methods approach, this study characterized the lived experience of acute gastrointestinal illness (AGI) in an Indigenous Batwa population in south-western Uganda. METHODS Quantitative data analyses were conducted on data from three cross-sectional census surveys of Batwa conducted in January 2013 (n=583), January 2014 (n=569) and April 2014 (n=540). Using a 14-day recall period, cases of AGI were defined as three or more loose stools or any vomiting in a 24-hour period. These analyses were supplemented by qualitative data from key informant interviews (n=11 interviews) and Batwa focus group discussions (n=61 participants). RESULTS From the surveys, episodes of diarrhea and episodes of vomiting lasted on average 3.6 (95%CI 2.3-4.3) and 3.0 (95%CI 2.1-3.9) days, and individuals experienced an average of 4.3 (95%CI 3.9-4.8) and 2.6 (95%CI 2.1-3.1) loose stools and vomiting episodes in 24 hours. Focus group participants and key informants indicated that episodes of AGI for Batwa were not limited to symptom-based consequences for the individual, but also had economic, social and nutritional impacts. CONCLUSION Despite efforts to increase health literacy in disease transmission dynamics, risks and prevention measures, the perceived barriers and a lack of benefits still largely underscored adopting positive AGI prevention behaviors. This study moved beyond surveillance and provided information on the broader community-level burden of AGI and highlighted the current challenges and opportunities for improved uptake of AGI prevention measures for the Batwa.
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Affiliation(s)
- Kaitlin Patterson
- Dept of Population Medicine, University of Guelph, 50 Stone Rd E, Guelph, Ontario N1G 2W1, Canada
| | - Sierra Clark
- School of Public Health, Imperial College, London, UK
| | - Lea Berrang-Ford
- Priestley International Centre for Climate, University of Leeds, Leeds, UK
| | - Shuaib Lwasa
- Department of Geography, Makerere University, Kampala, Uganda
| | | | | | - Ihacc Research Team
- Indigenous Health Adaptation to Climate Change (IHACC) Research Team: James Ford, Cesar Carcamo, Alejandro Llanos, Victoria Edge, Lea Berrang-Ford, Shuaib Lwasa, Didacus Namanya and Sherilee Harper, School of Public Health, University of Alberta, Edmonton, Alberta T6G 2R3, Canada
| | - Sherilee L Harper
- School of Public Health, University of Alberta, Edmonton, Alberta T6G 2R3, Canada
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Charette M, Berrang-Ford L, Coomes O, Llanos-Cuentas EA, Cárcamo C, Kulkarni M, Harper SL. Dengue Incidence and Sociodemographic Conditions in Pucallpa, Peruvian Amazon: What Role for Modification of the Dengue-Temperature Relationship? Am J Trop Med Hyg 2019; 102:180-190. [PMID: 31701852 DOI: 10.4269/ajtmh.19-0033] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Dengue is a climate-sensitive disease with an increasing global burden. Although the relationship between meteorological conditions and dengue incidence is well established, less is known about the modifying nature of sociodemographic variables on that relationship. We assess the strength and direction of sociodemographic effect modification of the temperature-dengue relationship in the second largest city of the Peruvian Amazon to identify populations that may have heightened vulnerability to dengue under varying climate conditions. We used weekly dengue counts and averaged meteorological variables to evaluate the association between disease incidence, meteorological exposures, and sociodemographic effect modifiers (gender, age, and district) in negative binomial regression models. District was included to consider geographical effect modification. We found that being a young child or elderly, being female, and living in the district of Manantay increased dengue's incidence rate ratio (IRR) as a result of 1°C increase in weekly mean temperature (IRR = 2.99, 95% CI: 1.99-4.50 for women less than 5 years old and IRR = 2.86, 95% CI: = 1.93-4.22 for women older than 65 years, both estimates valid for the rainy season). The effect of temperature on dengue depended on season, with stronger effects during rainy seasons. Sociodemographic variables can provide options for intervention to mitigate health impacts with a changing climate. Our results indicate that patterns of baseline risk between regions and sociodemographic conditions can differ substantially from trends in climate sensitivity. These results challenge the assumption that the distribution of climate change impacts will be patterned similarly to existing social gradients in health.
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Affiliation(s)
- Margot Charette
- Department of Geography, McGill University, Montreal, Canada
| | - Lea Berrang-Ford
- Priestley International Centre for Climate, University of Leeds, Leeds, United Kingdom
| | - Oliver Coomes
- Department of Geography, McGill University, Montreal, Canada
| | | | - César Cárcamo
- School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Manisha Kulkarni
- School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Canada
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Busch J, Berrang-Ford L, Clark S, Patterson K, Windfeld E, Donnelly B, Lwasa S, Namanya D, Harper SL. Is the effect of precipitation on acute gastrointestinal illness in southwestern Uganda different between Indigenous and non-Indigenous communities? PLoS One 2019; 14:e0214116. [PMID: 31048893 PMCID: PMC6497252 DOI: 10.1371/journal.pone.0214116] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 03/07/2019] [Indexed: 11/25/2022] Open
Abstract
Acute gastrointestinal illness (AGI) is a global public health priority that often disproportionately effects Indigenous populations. While previous research examines the association between meteorological conditions and AGI, little is known about how socio-cultural factors may modify this relationship. This present study seeks to address this research gap by comparing AGI prevalence and determinants between an Indigenous and non-Indigenous population in Uganda. We estimate the 14-day self-reported prevalence of AGI among adults in an Indigenous Batwa population and their non-Indigenous neighbours using cross-sectional panel data collected over four periods spanning typically rainy and dry seasons (January 2013 to April 2014). The independent associations between Indigenous status, precipitation, and AGI are examined with multivariable multi-level logistic regression models, controlling for relative wealth status and clustering at the community level. Estimated prevalence of AGI among the Indigenous Batwa was greater than among the non-Indigenous Bakiga. Our models indicate that both Indigenous identity and decreased levels of precipitation in the weeks preceding the survey period were significantly associated with increased AGI, after adjusting for confounders. Multivariable models stratified by Indigenous identity suggest that Indigenous identity may not modify the association between precipitation and AGI in this context. Our results suggest that short-term changes in precipitation affect both Indigenous and non-Indigenous populations similarly, though from different baseline AGI prevalences, maintaining rather than exacerbating this socially patterned health disparity. In the context of climate change, these results may challenge the assumption that changing weather patterns will necessarily exacerbate existing socially patterned health disparities.
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Affiliation(s)
- Johanna Busch
- Department of Geography, McGill University, Montreal, Canada
| | - Lea Berrang-Ford
- Department of Geography, McGill University, Montreal, Canada
- Priestley International Centre for Climate, University of Leeds, Leeds, United Kingdom
- * E-mail:
| | - Sierra Clark
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada
| | - Kaitlin Patterson
- Department of Population Medicine, University of Guelph, Guelph, Canada
| | - Emma Windfeld
- Department of Geography, McGill University, Montreal, Canada
| | - Blanaid Donnelly
- Department of Geography, McGill University, Montreal, Canada
- Community Veterinary Outreach, Ottawa, Canada
| | - Shuaib Lwasa
- Department of Geography, Makerere University, Kampala, Uganda
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Austin SE, Ford JD, Berrang-Ford L, Biesbroek R, Ross NA. Enabling local public health adaptation to climate change. Soc Sci Med 2019; 220:236-244. [DOI: 10.1016/j.socscimed.2018.11.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 10/01/2018] [Accepted: 11/01/2018] [Indexed: 10/27/2022]
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Zavaleta C, Berrang-Ford L, Ford J, Llanos-Cuentas A, Cárcamo C, Ross NA, Lancha G, Sherman M, Harper SL. Multiple non-climatic drivers of food insecurity reinforce climate change maladaptation trajectories among Peruvian Indigenous Shawi in the Amazon. PLoS One 2018; 13:e0205714. [PMID: 30325951 PMCID: PMC6191111 DOI: 10.1371/journal.pone.0205714] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2018] [Accepted: 10/01/2018] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Climate change is affecting food systems globally, with implications for food security, nutrition, and the health of human populations. There are limited data characterizing the current and future consequences of climate change on local food security for populations already experiencing poor nutritional indicators. Indigenous Amazonian populations have a high reported prevalence of nutritional deficiencies. This paper characterizes the food system of the Shawi of the Peruvian Amazon, climatic and non-climatic drivers of their food security vulnerability to climate change, and identifies potential maladaptation trajectories. METHODS AND FINDINGS Semi-structured interviews with key informants (n = 24), three photovoice workshops (n = 17 individuals), transect walks (n = 2), a food calendar exercise, and two community dissemination meetings (n = 30 individuals), were conducted within two Shawi communities in Balsapuerto District in the Peruvian Loreto region between June and September of 2014. The Shawi food system was based on three main food sub-systems (forest, farming and externally-sourced). Shawi reported collective, gendered, and emotional notions related to their food system activities. Climatic and non-climatic drivers of food security vulnerability among Shawi participants acted at proximal and distal levels, and mutually reinforced key maladaptation trajectories, including: 1) a growing population and natural resource degradation coupled with limited opportunities to increase incomes, and 2) a desire for education and deforestation reinforced by governmental social and food interventions. CONCLUSION A series of maladaptive trajectories have the potential to increase social and nutritional inequities for the Shawi. Transformational food security adaptation should include consideration of Indigenous perceptions and priorities, and should be part of Peruvian food and socioeconomic development policies.
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Affiliation(s)
- Carol Zavaleta
- Department of Geography, McGill University, Montreal, Quebec, Canada
- Facultad de Salud Pública, Universidad Peruana Cayetano Heredia, Lima, Perú
- * E-mail:
| | - Lea Berrang-Ford
- Department of Geography, McGill University, Montreal, Quebec, Canada
| | - James Ford
- Department of Geography, McGill University, Montreal, Quebec, Canada
| | | | - César Cárcamo
- Facultad de Salud Pública, Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Nancy A. Ross
- Department of Geography, McGill University, Montreal, Quebec, Canada
| | | | - Mya Sherman
- Department of Geography, McGill University, Montreal, Quebec, Canada
| | - Sherilee L. Harper
- Department of Population Medicine, University of Guelph, Ontario, Canada
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MacVicar S, Berrang-Ford L, Harper S, Steele V, Lwasa S, Bambaiha DN, Twesigomwe S, Asaasira G, Ross N. How seasonality and weather affect perinatal health: Comparing the experiences of indigenous and non-indigenous mothers in Kanungu District, Uganda. Soc Sci Med 2017. [DOI: 10.1016/j.socscimed.2017.06.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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MacVicar S, Berrang-Ford L, Harper S, Huang Y, Namanya Bambaiha D, Yang S. Whether weather matters: Evidence of association between in utero meteorological exposures and foetal growth among Indigenous and non-Indigenous mothers in rural Uganda. PLoS One 2017; 12:e0179010. [PMID: 28591162 PMCID: PMC5462429 DOI: 10.1371/journal.pone.0179010] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Accepted: 05/23/2017] [Indexed: 11/28/2022] Open
Abstract
Pregnancy and birth outcomes have been found to be sensitive to meteorological variation, yet few studies explore this relationship in sub-Saharan Africa where infant mortality rates are the highest in the world. We address this research gap by examining the association between meteorological factors and birth weight in a rural population in southwestern Uganda. Our study included hospital birth records (n = 3197) from 2012 to 2015, for which we extracted meteorological exposure data for the three trimesters preceding each birth. We used linear regression, controlling for key covariates, to estimate the timing, strength, and direction of meteorological effects on birth weight. Our results indicated that precipitation during the third trimester had a positive association with birth weight, with more frequent days of precipitation associated with higher birth weight: we observed a 3.1g (95% CI: 1.0–5.3g) increase in birth weight per additional day of exposure to rainfall over 5mm. Increases in average daily temperature during the third trimester were also associated with birth weight, with an increase of 41.8g (95% CI: 0.6–82.9g) per additional degree Celsius. When the sample was stratified by season of birth, only infants born between June and November experienced a significant associated between meteorological exposures and birth weight. The association of meteorological variation with foetal growth seemed to differ by ethnicity; effect sizes of meteorological were greater among an Indigenous subset of the population, in particular for variation in temperature. Effects in all populations in this study are higher than estimates of the African continental average, highlighting the heterogeneity in the vulnerability of infant health to meteorological variation in different contexts. Our results indicate that while there is an association between meteorological variation and birth weight, the magnitude of these associations may vary across ethnic groups with differential socioeconomic resources, with implications for interventions to reduce these gradients and offset the health impacts predicted under climate change.
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Affiliation(s)
- Sarah MacVicar
- Department of Geography, McGill University, Montréal, Quebec, Canada
- * E-mail:
| | - Lea Berrang-Ford
- Department of Geography, McGill University, Montréal, Quebec, Canada
| | - Sherilee Harper
- Department of Population Medicine, University of Guelph, Guelph, Ontario, Canada
| | - Yi Huang
- Department of Atmospheric & Oceanic Sciences, McGill University, Montréal, Quebec, Canada
| | | | - Seungmi Yang
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montréal, Quebec, Canada
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Bishop-Williams KE, Sargeant JM, Berrang-Ford L, Edge VL, Cunsolo A, Harper SL. A protocol for a systematic literature review: comparing the impact of seasonal and meteorological parameters on acute respiratory infections in Indigenous and non-Indigenous peoples. Syst Rev 2017; 6:19. [PMID: 28122603 PMCID: PMC5267362 DOI: 10.1186/s13643-016-0399-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Accepted: 12/19/2016] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Acute respiratory infections (ARI) are a leading cause of morbidity and mortality globally, and are often linked to seasonal and/or meteorological conditions. Globally, Indigenous peoples may experience a different burden of ARI compared to non-Indigenous peoples. This protocol outlines our process for conducting a systematic review to investigate whether associations between ARI and seasonal or meteorological parameters differ between Indigenous and non-Indigenous groups residing in the same geographical region. METHODOLOGY A search string will be used to search PubMed®, CAB Abstracts/CAB Direct©, and Science Citation Index® aggregator databases. Articles will be screened using inclusion/exclusion criteria applied first at the title and abstract level, and then at the full article level by two independent reviewers. Articles maintained after full article screening will undergo risk of bias assessment and data will be extracted. Heterogeneity tests, meta-analysis, and forest and funnel plots will be used to synthesize the results of eligible studies. DISCUSSION AND REGISTRATION This protocol paper describes our systematic review methods to identify and analyze relevant ARI, season, and meteorological literature with robust reporting. The results are intended to improve our understanding of potential associations between seasonal and meteorological parameters and ARI and, if identified, whether this association varies by place, population, or other characteristics. The protocol is registered in the PROSPERO database (#38051).
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Affiliation(s)
| | - Jan M Sargeant
- Department of Population Medicine, University of Guelph, 50 Stone Rd E, Guelph, ON, N1G 2W1, Canada.,Centre for Public Health and Zoonoses, University of Guelph, Guelph, ON, Canada
| | - Lea Berrang-Ford
- Department of Geography, McGill University, Montreal, QC, Canada
| | - Victoria L Edge
- Department of Population Medicine, University of Guelph, 50 Stone Rd E, Guelph, ON, N1G 2W1, Canada
| | - Ashlee Cunsolo
- Labrador Institute, Memorial University, Happy Valley-Goose Bay, NL, Canada
| | - Sherilee L Harper
- Department of Population Medicine, University of Guelph, 50 Stone Rd E, Guelph, ON, N1G 2W1, Canada
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Kulkarni MA, Garrod G, Berrang-Ford L, Ssewanyana I, Harper SL, Baraheberwa N, Donnelly B, Patterson K, Namanya DB, Lwasa S, Drakeley C. Examination of Antibody Responses as a Measure of Exposure to Malaria in the Indigenous Batwa and Their Non-Indigenous Neighbors in Southwestern Uganda. Am J Trop Med Hyg 2016; 96:330-334. [PMID: 27895271 DOI: 10.4269/ajtmh.16-0559] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Accepted: 10/20/2016] [Indexed: 01/27/2023] Open
Abstract
Understanding variations in malaria transmission and exposure is critical to identify populations at risk and enable better targeting of interventions. The indigenous Batwa of southwestern Uganda have a disproportionate burden of malaria infection compared with their non-indigenous neighbors. To better understand the individual- and community-level determinants of malaria exposure, a seroepidemiological study was conducted in 10 local council cells in Kanungu District, Uganda, in April 2014. The Batwa had twice the odds of being seropositive to two Plasmodium falciparum-specific antigens, apical membrane antigen-1 and merozoite surface protein-119, compared with the non-indigenous Bakiga (odds ratio = 2.08, 95% confidence interval = 1.51-2.88). This trend was found irrespective of altitude level and after controlling for cell location. Seroconversion rates in the Batwa were more than twice those observed in the Bakiga. For the Batwa, multiple factors may be associated with higher exposure to malaria and antibody levels relative to their non-indigenous neighbors.
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Affiliation(s)
- Manisha A Kulkarni
- School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Canada.
| | - Gala Garrod
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Lea Berrang-Ford
- Department of Geography, McGill University, Montreal, Canada.,Indigenous Health Adaptation to Climate Change (IHACC) Research Team
| | - Isaac Ssewanyana
- London School of Hygiene and Tropical Medicine, London, United Kingdom.,Infectious Diseases Research Collaboration, Kampala, Uganda
| | - Sherilee L Harper
- Indigenous Health Adaptation to Climate Change (IHACC) Research Team.,Department of Population Medicine, University of Guelph, Guelph, Canada
| | | | | | - Kaitlin Patterson
- Department of Geography, McGill University, Montreal, Canada.,Department of Population Medicine, University of Guelph, Guelph, Canada
| | - Didacus B Namanya
- Indigenous Health Adaptation to Climate Change (IHACC) Research Team.,Department of Population Medicine, University of Guelph, Guelph, Canada.,Infectious Diseases Research Collaboration, Kampala, Uganda.,Ministry of Health, Kampala, Uganda
| | - Shuaib Lwasa
- Indigenous Health Adaptation to Climate Change (IHACC) Research Team.,Infectious Diseases Research Collaboration, Kampala, Uganda.,Makerere University, Kampala, Uganda
| | - Chris Drakeley
- London School of Hygiene and Tropical Medicine, London, United Kingdom
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Berry I, Berrang-Ford L. Leishmaniasis, conflict, and political terror: A spatio-temporal analysis. Soc Sci Med 2016; 167:140-9. [DOI: 10.1016/j.socscimed.2016.04.038] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2015] [Revised: 03/06/2016] [Accepted: 04/27/2016] [Indexed: 11/26/2022]
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Clark DG, Ford JD, Pearce T, Berrang-Ford L. Vulnerability to unintentional injuries associated with land-use activities and search and rescue in Nunavut, Canada. Soc Sci Med 2016; 169:18-26. [PMID: 27669121 DOI: 10.1016/j.socscimed.2016.09.026] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Revised: 08/25/2016] [Accepted: 09/15/2016] [Indexed: 11/27/2022]
Abstract
Injury is the leading cause of death for Canadians aged 1 to 44, occurring disproportionately across regions and communities. In the Inuit territory of Nunavut, for instance, unintentional injury rates are over three times the Canadian average. In this paper, we develop a framework for assessing vulnerability to injury and use it to identify and characterize the determinants of injuries on the land in Nunavut. We specifically examine unintentional injuries on the land (outside of hamlets) because of the importance of land-based activities to Inuit culture, health, and well-being. Semi-structured interviews (n = 45) were conducted in three communities that have varying rates of search and rescue (SAR), complemented by an analysis of SAR case data for the territory. We found that risk of land-based injuries is affected by socioeconomic status, Inuit traditional knowledge, community organizations, and territorial and national policies. Notably, by moving beyond common conceptualizations of unintentional injury, we are able to better assess root causes of unintentional injury and outline paths for prevention.
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Affiliation(s)
- Dylan G Clark
- Department of Geography, McGill University, Montreal, QC, Canada.
| | - James D Ford
- Department of Geography, McGill University, Montreal, QC, Canada
| | - Tristan Pearce
- Sustainability Research Centre, University of the Sunshine Coast, Sippy Downs, Qld, Australia; Department of Geography, University of Guelph, ON, Canada
| | - Lea Berrang-Ford
- Department of Geography, McGill University, Montreal, QC, Canada
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Austin SE, Biesbroek R, Berrang-Ford L, Ford JD, Parker S, Fleury MD. Public Health Adaptation to Climate Change in OECD Countries. Int J Environ Res Public Health 2016; 13:ijerph13090889. [PMID: 27618074 PMCID: PMC5036722 DOI: 10.3390/ijerph13090889] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2016] [Revised: 08/23/2016] [Accepted: 08/24/2016] [Indexed: 11/25/2022]
Abstract
Climate change is a major challenge facing public health. National governments play a key role in public health adaptation to climate change, but there are competing views on what responsibilities and obligations this will—or should—include in different nations. This study aims to: (1) examine how national-level public health adaptation is occurring in Organization for Economic Cooperation and Development (OECD) countries; (2) examine the roles national governments are taking in public health adaptation; and (3) critically appraise three key governance dimensions of national-level health adaptation—cross-sectoral collaboration, vertical coordination and national health adaptation planning—and identify practical examples suited to different contexts. We systematically reviewed publicly available public health adaptation to climate change documents and webpages by national governments in ten OECD countries using systematic web searches, assessment of self-reporting, and content analysis. Our findings suggest national governments are primarily addressing infectious disease and heat-related risks posed by climate change, typically emphasizing capacity building or information-based groundwork initiatives. We find national governments are taking a variety of approaches to public health adaptation to climate change that do not follow expected convergence and divergence by governance structure. We discuss practical options for incorporating cross-sectoral collaboration, vertical coordination and national health adaptation planning into a variety of contexts and identify leaders national governments can look to to inform their public health adaptation planning. Following the adoption of the Paris Agreement and subsequent increased momentum for adaptation, research tracking adaptation is needed to define what health adaptation looks like in practice, reveal insights that can be taken up across states and sectors, and ensure policy orientated learning.
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Affiliation(s)
- Stephanie E Austin
- Department of Geography, McGill University, Burnside Hall Building Room 705, 805 Sherbrooke Street West, Montreal, QC H3A 0B9, Canada.
- Tracking Adaptation to Climate Change Collaboration (TRAC3), McGill University, Burnside Hall Building Room 705, 805 Sherbrooke Street West, Montreal, QC H3A 0B9, Canada.
| | - Robbert Biesbroek
- Tracking Adaptation to Climate Change Collaboration (TRAC3), McGill University, Burnside Hall Building Room 705, 805 Sherbrooke Street West, Montreal, QC H3A 0B9, Canada.
- Public Administration and Policy Group, Wageningen University and Research Centre, P.O. Box 8130, 6700EW Wageningen, The Netherlands.
| | - Lea Berrang-Ford
- Department of Geography, McGill University, Burnside Hall Building Room 705, 805 Sherbrooke Street West, Montreal, QC H3A 0B9, Canada.
- Tracking Adaptation to Climate Change Collaboration (TRAC3), McGill University, Burnside Hall Building Room 705, 805 Sherbrooke Street West, Montreal, QC H3A 0B9, Canada.
| | - James D Ford
- Department of Geography, McGill University, Burnside Hall Building Room 705, 805 Sherbrooke Street West, Montreal, QC H3A 0B9, Canada.
- Tracking Adaptation to Climate Change Collaboration (TRAC3), McGill University, Burnside Hall Building Room 705, 805 Sherbrooke Street West, Montreal, QC H3A 0B9, Canada.
| | - Stephen Parker
- Enteric Surveillance and Population Studies Division, Centre for Food-Borne, Environmental and Zoonotic Infectious Diseases, Public Health Agency of Canada, 255 Woodlawn Road West, Unit 120, Guelph, ON N1H 8J1, Canada.
| | - Manon D Fleury
- Enteric Surveillance and Population Studies Division, Centre for Food-Borne, Environmental and Zoonotic Infectious Diseases, Public Health Agency of Canada, 255 Woodlawn Road West, Unit 120, Guelph, ON N1H 8J1, Canada.
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Clark DG, Ford JD, Berrang-Ford L, Pearce T, Kowal S, Gough WA. The role of environmental factors in search and rescue incidents in Nunavut, Canada. Public Health 2016; 137:44-9. [PMID: 27423419 DOI: 10.1016/j.puhe.2016.06.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 05/30/2016] [Accepted: 06/06/2016] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Unintentional injury is a leading cause of morbidity and mortality in Nunavut, where the importance of land-based activities and reliance on semi-permanent trails create unique risk profiles. Climate change is believed to be exacerbating these risks, although no studies have quantitatively examined links between environmental conditions and injury and distress in the Canadian Arctic. We examine the correlation between environmental conditions and land-based search and rescue (SAR) incidents across Nunavut. STUDY DESIGN Case study. METHODS Case data were acquired from the Canadian National Search and Rescue Secretariat. Gasoline sales from across the territory are then used to model land-use and exposure. We compare weather and ice conditions during 202 SAR incidents to conditions during 755 non-SAR days (controls) between 2013 and 2014. RESULTS We show daily ambient temperature, ice concentration, ice thickness, and variation in types of ice to be correlated with SAR rates across the territory during the study period. CONCLUSIONS These conditions are projected to be affected by future climate change, which could increase demand for SAR and increase injury rates in the absence of targeted efforts aimed at prevention and treatment. This study provides health practitioners and public health communities with clearer understanding to prepare, respond to, and prevent injuries across the Arctic.
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Affiliation(s)
- D G Clark
- Department of Geography, McGill University, Montreal, QC, Canada.
| | - J D Ford
- Department of Geography, McGill University, Montreal, QC, Canada
| | - L Berrang-Ford
- Department of Geography, McGill University, Montreal, QC, Canada
| | - T Pearce
- Department of Geography, Sustainability Research Centre, University of the Sunshine Coast, Sippy Downs, Qld, Australia; Department of Geography, University of Guelph, ON, Canada
| | - S Kowal
- Department of Physical and Environmental Sciences, University of Toronto, Scarborough, ON, Canada
| | - W A Gough
- Department of Physical and Environmental Sciences, University of Toronto, Scarborough, ON, Canada
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Clark S, Berrang-Ford L, Lwasa S, Namanya D, Twesigomwe S, Kulkarni M. A Longitudinal Analysis of Mosquito Net Ownership and Use in an Indigenous Batwa Population after a Targeted Distribution. PLoS One 2016; 11:e0154808. [PMID: 27145034 PMCID: PMC4856310 DOI: 10.1371/journal.pone.0154808] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Accepted: 04/19/2016] [Indexed: 11/18/2022] Open
Abstract
Major efforts for malaria prevention programs have gone into scaling up ownership and use of insecticidal mosquito nets, particularly in sub-Saharan Africa where the malaria burden is high. Socioeconomic inequities in access to long lasting insecticidal nets (LLINs) are reduced with free distributions of nets. However, the relationship between social factors and retention of nets after a free distribution has been less studied, particularly using a longitudinal approach. Our research aimed to estimate the ownership and use of LLINs, and examine the determinants of LLIN retention, within an Indigenous Batwa population after a free LLIN distribution. Two LLINs were given free of charge to each Batwa household in Kanungu District, Uganda in November 2012. Surveyors collected data on LLIN ownership and use through six cross-sectional surveys pre- and post-distribution. Household retention, within household access, and individual use of LLINs were assessed over an 18-month period. Socioeconomic determinants of household retention of LLINs post-distribution were modelled longitudinally using logistic regression with random effects. Direct house-to-house distribution of free LLINs did not result in sustainable increases in the ownership and use of LLINs. Three months post-distribution, only 73% of households owned at least one LLIN and this period also saw the greatest reduction in ownership compared to other study periods. Eighteen-months post distribution, only a third of households still owned a LLIN. Self-reported age-specific use of LLINs was generally higher for children under five, declined for children aged 6–12, and was highest for older adults aged over 35. In the model, household wealth was a significant predictor of LLIN retention, controlling for time and other variables. This research highlights on-going socioeconomic inequities in access to malaria prevention measures among the Batwa in southwestern Uganda, even after free distribution of LLINs, and provides critical information to inform local malaria programs on possible intervention entry-points to increase access and use among this marginalized population.
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Affiliation(s)
- Sierra Clark
- Dept of Epidemiology, McGill University, Montreal, Quebec, Canada
- * E-mail: (LBF); (SC)
| | - Lea Berrang-Ford
- Dept of Geography, McGill University, Montreal, Quebec, Canada
- * E-mail: (LBF); (SC)
| | - Shuaib Lwasa
- Dept of Geography, Makerere University, Kampala, Uganda
| | | | | | - IHACC Research Team
- Indigenous Health Adaptation to Climate Change Research Team, McGill University, Montreal, Canada
| | - Manisha Kulkarni
- School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Ontario, Canada
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Donnelly B, Berrang-Ford L, Labbé J, Twesigomwe S, Lwasa S, Namanya DB, Harper SL, Kulkarni M, Ross NA, Michel P. Plasmodium falciparum malaria parasitaemia among indigenous Batwa and non-indigenous communities of Kanungu district, Uganda. Malar J 2016; 15:254. [PMID: 27146298 PMCID: PMC4855715 DOI: 10.1186/s12936-016-1299-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Accepted: 04/18/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The indigenous Batwa of southwestern Uganda are among the most highly impoverished populations in Uganda, yet there is negligible research on the prevalence of malaria in this population. Plasmodium falciparum malaria parasitaemia prevalence was estimated in an indigenous Batwa and a non-indigenous neighbouring population, and an exploration of modifiable risk factors was carried out to identify potential entry points for intervention. Additionally, evidence of zooprophylaxis was assessed, hypothesizing that livestock ownership may play a role in malaria risk. METHODS Two cross-sectional surveys of Batwa and non-Batwa communities were carried out in Kanungu District, Uganda in July 2013 and April 2014 based on a census of adult Batwa and a two-stage systematic random sample of adult non-Batwa in ten Local Councils where Batwa settlements are located. A community-based questionnaire and antigen rapid diagnostic test for P. falciparum were carried out in the cross-sectional health surveys. A multivariable logistic regression model was built to identify risk factors associated with positive malaria diagnostic test. A subset analysis of livestock owners tested for zooprophylaxis. RESULTS Batwa experienced higher prevalence of malaria parasitaemia than non-Batwa (9.35 versus 4.45 %, respectively) with over twice the odds of infection (OR 2.21, 95 % CI 1.23-3.98). Extreme poverty (OR 1.96, 95 % CI 0.98-3.94) and having an iron sheet roof (OR 2.54, 95 % CI 0.96-6.72) increased the odds of infection in both Batwa and non-Batwa. Controlling for ethnicity, wealth, and bed net ownership, keeping animals inside the home at night decreased the odds of parasitaemia among livestock owners (OR 0.29, 95 % CI 0.09-0.94). CONCLUSION A health disparity exists between indigenous Batwa and non-indigenous community members with Batwa having higher prevalence of malaria relative to non-Batwa. Poverty was associated with increased odds of malaria infection for both groups. Findings suggest that open eaves and gaps in housing materials associated with iron sheet roofing represent a modifiable risk factor for malaria, and may facilitate mosquito house entry; larger sample sizes will be required to confirm this finding. Evidence for possible zooprophylaxis was observed among livestock owners in this population for those who sheltered animals inside the home at night.
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Affiliation(s)
- Blánaid Donnelly
- />Department of Geography, McGill University, Burnside Hall Building, 805 Sherbrooke St West, Montreal, QC H3A 0B9 Canada
| | - Lea Berrang-Ford
- />Department of Geography, McGill University, Burnside Hall Building, 805 Sherbrooke St West, Montreal, QC H3A 0B9 Canada
| | - Jolène Labbé
- />Department of Geography, McGill University, Burnside Hall Building, 805 Sherbrooke St West, Montreal, QC H3A 0B9 Canada
| | | | - Shuaib Lwasa
- />Department of Geography, Geoinformatics and Climatic Sciences, School of Forestry, Environmental and Geographical Sciences, CAES, Makerere University, P.O Box 7062, Kampala, Uganda
| | | | - Sherilee L. Harper
- />Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON N1G 2W1 Canada
| | - Manisha Kulkarni
- />School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, 600 Peter Morand Cres., 301E, Ottawa, ON K1H 8M5 Canada
| | - Nancy A. Ross
- />Department of Geography, McGill University, Burnside Hall Building, 805 Sherbrooke St West, Montreal, QC H3A 0B9 Canada
| | - IHACC Research Team
- />Department of Geography, McGill University, Burnside Hall Building, 805 Sherbrooke St West, Montreal, QC H3A 0B9 Canada
- />Batwa Development Program, Buhoma, Kanungu District, Uganda
- />Department of Geography, Geoinformatics and Climatic Sciences, School of Forestry, Environmental and Geographical Sciences, CAES, Makerere University, P.O Box 7062, Kampala, Uganda
- />Ministry of Health, Plot 6 Lourdel Rd, P.O Box 7272, Kampala, Uganda
- />Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON N1G 2W1 Canada
- />School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, 600 Peter Morand Cres., 301E, Ottawa, ON K1H 8M5 Canada
- />Office of the Chief Science Officer, Public Health Agency of Canada, 130 Colonnade Road, Ottawa, ON K1A 0K9 Canada
| | - Pascal Michel
- />Office of the Chief Science Officer, Public Health Agency of Canada, 130 Colonnade Road, Ottawa, ON K1A 0K9 Canada
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Ford JD, Berrang-Ford L. The 4Cs of adaptation tracking: consistency, comparability, comprehensiveness, coherency. Mitig Adapt Strateg Glob Chang 2016; 21:839-859. [PMID: 30197563 PMCID: PMC6108005 DOI: 10.1007/s11027-014-9627-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Accepted: 11/25/2014] [Indexed: 05/20/2023]
Abstract
Adaptation tracking seeks to characterize, monitor, and compare general trends in climate change adaptation over time and across nations. Recognized as essential for evaluating adaptation progress, there have been few attempts to develop systematic approaches for tracking adaptation. This is reflected in polarized opinions, contradictory findings, and lack of understanding on the state of adaptation globally. In this paper, we outline key methodological considerations necessary for adaptation tracking research to produce systematic, rigorous, comparable, and usable insights that can capture the current state of adaptation globally, provide the basis for characterizing and evaluating adaptations taking place, facilitate examination of what conditions explain differences in adaptation action across jurisdictions, and can underpin the monitoring of change in adaptation over time. Specifically, we argue that approaches to adaptation tracking need to (i) utilize a consistent and operational conceptualization of adaptation, (ii) focus on comparable units of analysis, (iii) use and develop comprehensive datasets on adaptation action, and (iv) be coherent with our understanding of what constitutes real adaptation. Collectively, these form the 4Cs of adaptation tracking (consistency, comparability, comprehensiveness, and coherency).
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Affiliation(s)
- James D. Ford
- Department of Geography, McGill University, Montreal, QC H3A0B9 Canada
| | - Lea Berrang-Ford
- Department of Geography, McGill University, Montreal, QC H3A0B9 Canada
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Araos M, Austin SE, Berrang-Ford L, Ford JD. Public Health Adaptation to Climate Change in Large Cities: A Global Baseline. Int J Health Serv 2016; 46:53-78. [PMID: 26705309 DOI: 10.1177/002073141562145] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
Climate change will have significant impacts on human health, and urban populations are expected to be highly sensitive. The health risks from climate change in cities are compounded by rapid urbanization, high population density, and climate-sensitive built environments. Local governments are positioned to protect populations from climate health risks, but it is unclear whether municipalities are producing climate-adaptive policies. In this article, we develop and apply systematic methods to assess the state of public health adaptation in 401 urban areas globally with more than 1 million people, creating the first global baseline for urban public health adaptation. We find that only 10% of the sampled urban areas report any public health adaptation initiatives. The initiatives identified most frequently address risks posed by extreme weather events and involve direct changes in management or behavior rather than capacity building, research, or long-term investments in infrastructure. Based on our characterization of the current urban health adaptation landscape, we identify several gaps: limited evidence of reporting of institutional adaptation at the municipal level in urban areas in the Global South; lack of information-based adaptation initiatives; limited focus on initiatives addressing infectious disease risks; and absence of monitoring, reporting, and evaluation.
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Affiliation(s)
- Malcolm Araos
- Department of Geography, McGill University, Montreal, Quebec, Canada
| | | | - Lea Berrang-Ford
- Department of Geography, McGill University, Montreal, Quebec, Canada
| | - James D Ford
- Department of Geography, McGill University, Montreal, Quebec, Canada
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Abstract
Climate change will have significant impacts on human health, and urban populations are expected to be highly sensitive. The health risks from climate change in cities are compounded by rapid urbanization, high population density, and climate-sensitive built environments. Local governments are positioned to protect populations from climate health risks, but it is unclear whether municipalities are producing climate-adaptive policies. In this article, we develop and apply systematic methods to assess the state of public health adaptation in 401 urban areas globally with more than 1 million people, creating the first global baseline for urban public health adaptation. We find that only 10% of the sampled urban areas report any public health adaptation initiatives. The initiatives identified most frequently address risks posed by extreme weather events and involve direct changes in management or behavior rather than capacity building, research, or long-term investments in infrastructure. Based on our characterization of the current urban health adaptation landscape, we identify several gaps: limited evidence of reporting of institutional adaptation at the municipal level in urban areas in the Global South; lack of information-based adaptation initiatives; limited focus on initiatives addressing infectious disease risks; and absence of monitoring, reporting, and evaluation.
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Affiliation(s)
- Malcolm Araos
- Department of Geography, McGill University, Montreal, Quebec, Canada
| | | | - Lea Berrang-Ford
- Department of Geography, McGill University, Montreal, Quebec, Canada
| | - James D Ford
- Department of Geography, McGill University, Montreal, Quebec, Canada
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Abstract
BACKGROUND Integrated vector management (IVM) is recommended as a sustainable approach to malaria control. IVM consists of combining vector control methods based on scientific evidence to maximize efficacy and cost-effectiveness while minimizing negative impacts, such as insecticide resistance and environmental damage. Zooprophylaxis has been identified as a possible component of IVM as livestock may draw mosquitoes away from humans, decreasing human-vector contact and malaria transmission. It is possible, however, that livestock may actually draw mosquitoes to humans, increasing malaria transmission (zoopotentiation). The goal of this paper is to take a realist approach to a systematic review of peer-reviewed literature to understand the contexts under which zooprophylaxis or zoopotentiation occur. METHODS Three electronic databases were searched using the keywords 'zooprophylaxis' and 'zoopotentiation', and forward and backward citation tracking employed, to identify relevant articles. Only empirical, peer-reviewed articles were included. Critical appraisal was applied to articles retained for full review. RESULTS Twenty empirical studies met inclusion criteria after critical appraisal. A range of experimental and observational study designs were reported. Outcome measures included human malaria infection and mosquito feeding behaviour. Two key factors were consistently associated with zooprophylaxis and zoopotentiation: the characteristics of the local mosquito vector, and the location of livestock relative to human sleeping quarters. These associations were modified by the use of bed nets and socio-economic factors. DISCUSSION This review suggests that malaria risk is reduced (zooprophylaxis) in areas where predominant mosquito species do not prefer human hosts, where livestock are kept at a distance from human sleeping quarters at night, and where mosquito nets or other protective measures are used. Zoopotentiation occurs where livestock are housed within or near human sleeping quarters at night and where mosquito species prefer human hosts. CONCLUSION The evidence suggests that zooprophylaxis could be part of an effective strategy to reduce malaria transmission under specific ecological and geographical conditions. The current scientific evidence base is inconclusive on understanding the role of socio-economic factors, optimal distance between livestock and human sleeping quarters, and the effect of animal species and number on zooprophylaxis.
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Affiliation(s)
- Blánaid Donnelly
- Department of Geography, McGill University, Burnside Hall Building, 805 Sherbrooke St West, Montreal, QC, H3A 0B9, Canada.
| | - Lea Berrang-Ford
- Department of Geography, McGill University, Burnside Hall Building, 805 Sherbrooke St West, Montreal, QC, H3A 0B9, Canada.
| | - Nancy A Ross
- Department of Geography, McGill University, Burnside Hall Building, 805 Sherbrooke St West, Montreal, QC, H3A 0B9, Canada.
| | - Pascal Michel
- Public Health Risk Sciences Division, Public Health Agency of Canada, 3200 Sicotte, PO Box 5000, Saint-Hyacinthe, QC, J2S 7C6, Canada.
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Guo Y, Berrang-Ford L, Ford J, Lardeau MP, Edge V, Patterson K, Harper SL. Seasonal prevalence and determinants of food insecurity in Iqaluit, Nunavut. Int J Circumpolar Health 2015; 74:27284. [PMID: 26248959 PMCID: PMC4528079 DOI: 10.3402/ijch.v74.27284] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Revised: 04/30/2015] [Accepted: 06/30/2015] [Indexed: 11/14/2022] Open
Abstract
Background Food insecurity is an ongoing problem in the Canadian Arctic. Although most studies have focused on smaller communities, little is known about food insecurity in larger centres. Objectives This study aimed to estimate the prevalence of food insecurity during 2 different seasons in Iqaluit, the territorial capital of Nunavut, as well as identify associated risk factors. Designs A modified United States Department of Agriculture Food Security Survey was applied to 532 randomly selected households in September 2012 and 523 in May 2013. Chi-square tests and multivariable logistic regression were used to examine potential associations between food security and 9 risk factors identified in the literature. Results In September 2012, 28.7% of surveyed households in Iqaluit were food insecure, a rate 3 times higher than the national average, but lower than smaller Inuit communities in Nunavut. Prevalence of food insecurity in September 2012 was not significantly different in May 2013 (27.2%). When aggregating results from Inuit households from both seasons (May and September), food insecurity was associated with poor quality housing and reliance on income support (p<0.01). Unemployment and younger age of the person in charge of food preparation were also significantly associated with food insecurity. In contrast to previous research among Arctic communities, gender and consumption of country food were not positively associated with food security. These results are consistent with research describing high food insecurity across the Canadian Arctic. Conclusion The factors associated with food insecurity in Iqaluit differed from those identified in smaller communities, suggesting that experiences with, and processes of, food insecurity may differ between small communities and larger commercial centres. These results suggest that country food consumption, traditional knowledge and sharing networks may play a less important role in larger Inuit communities.
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Affiliation(s)
- Yang Guo
- McGill School of Environment, McGill University, Montreal, Canada
| | - Lea Berrang-Ford
- Department of Geography, McGill University, Montreal, Canada.,Indigenous Health Adaptation to Climate Change Research Team: Cesar Carcamo, Alejandro Llanos, Shuaib Lwasa, Didacus Bambaiha Namanya;
| | - James Ford
- Department of Geography, McGill University, Montreal, Canada.,Indigenous Health Adaptation to Climate Change Research Team: Cesar Carcamo, Alejandro Llanos, Shuaib Lwasa, Didacus Bambaiha Namanya
| | - Marie-Pierre Lardeau
- Department of Geography, McGill University, Montreal, Canada.,Indigenous Health Adaptation to Climate Change Research Team: Cesar Carcamo, Alejandro Llanos, Shuaib Lwasa, Didacus Bambaiha Namanya
| | - Victoria Edge
- Indigenous Health Adaptation to Climate Change Research Team: Cesar Carcamo, Alejandro Llanos, Shuaib Lwasa, Didacus Bambaiha Namanya.,Department of Population Medicine, University of Guelph, Guelph, Canada
| | | | | | - Sherilee L Harper
- Indigenous Health Adaptation to Climate Change Research Team: Cesar Carcamo, Alejandro Llanos, Shuaib Lwasa, Didacus Bambaiha Namanya.,Department of Population Medicine, University of Guelph, Guelph, Canada;
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Shah L, Choi HW, Berrang-Ford L, Henostroza G, Krapp F, Zamudio C, Heymann SJ, Kaufman JS, Ciampi A, Seas C, Gotuzzo E, Brewer TF. Geographic predictors of primary multidrug-resistant tuberculosis cases in an endemic area of Lima, Peru. Int J Tuberc Lung Dis 2015; 18:1307-14. [PMID: 25299862 DOI: 10.5588/ijtld.14.0011] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING Peru reports among the highest multidrug-resistant tuberculosis (MDR-TB) rates in the Americas, with a growing proportion in previously untreated tuberculosis (TB) cases. The identification of clusters of primary MDR-TB compared with drug-susceptible TB (DS-TB) could help prioritize interventions. OBJECTIVE To examine the clustering of primary MDR-TB case residences and their proximity to high-risk locations in San Juan de Lurigancho District, Lima, Peru. DESIGN Enrolled primary MDR-TB and primary DS-TB cases were interviewed and their primary residence was recorded using handheld Global Positioning System devices. Kuldorff's spatial scan statistic was used for cluster detection (SaTScan(TM), v. 9.1.1). Identified clusters were visualized in Quantum Geographic Information Systems software (v1.8.0). The following cluster centers were tested: a health centre with the highest TB and MDR-TB rates (Clinic X), a hospital and two prisons. Using regression analyses, we examined predictors of primary MDR-TB cases. RESULTS A statistically significant cluster of primary MDR-TB cases was identified within a 2.29 km radius around Clinic X. Proximity to Clinic X remained a significant predictor of primary MDR-TB in adjusted regression analyses. CONCLUSION We identified a hotspot of primary MDR-TB cases around Clinic X in a TB-endemic area. Causes of this clustering require investigation; targeted interventions for this high-risk area should be considered.
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Affiliation(s)
- L Shah
- Department of Epidemiology, Biostatistics & Occupational Health, McGill University, Montreal, Quebec, Canada
| | - H W Choi
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - L Berrang-Ford
- Department of Geography, McGill University, Montreal, Quebec, Canada
| | - G Henostroza
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - F Krapp
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - C Zamudio
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - S J Heymann
- Department of Epidemiology, Jonathan and Karin Fielding School of Public Health, University of California, Los Angeles, USA
| | - J S Kaufman
- Department of Epidemiology, Biostatistics & Occupational Health, McGill University, Montreal, Quebec, Canada
| | - A Ciampi
- Department of Epidemiology, Biostatistics & Occupational Health, McGill University, Montreal, Quebec, Canada
| | - C Seas
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - E Gotuzzo
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - T F Brewer
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, California, USA
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Farrell MJ, Stephens PR, Berrang-Ford L, Gittleman JL, Davies TJ. The path to host extinction can lead to loss of generalist parasites. J Anim Ecol 2015; 84:978-84. [DOI: 10.1111/1365-2656.12342] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Accepted: 01/12/2015] [Indexed: 12/29/2022]
Affiliation(s)
- Maxwell J. Farrell
- Biology Department; McGill University; 1205 Docteur Penfield Montreal QC H3A 1B1 Canada
| | | | - Lea Berrang-Ford
- Geography Department; McGill University; 805 Sherbrooke Street O. Montreal QC H3A 0B9 Canada
| | | | - T. Jonathan Davies
- Biology Department; McGill University; 1205 Docteur Penfield Montreal QC H3A 1B1 Canada
- African Centre for DNA Barcoding; University of Johannesburg; PO Box 524 Auckland Park 2006 Johannesburg South Africa
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Austin SE, Ford JD, Berrang-Ford L, Araos M, Parker S, Fleury MD. Public health adaptation to climate change in Canadian jurisdictions. Int J Environ Res Public Health 2015; 12:623-51. [PMID: 25588156 PMCID: PMC4306883 DOI: 10.3390/ijerph120100623] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Accepted: 12/22/2014] [Indexed: 11/24/2022]
Abstract
Climate change poses numerous risks to the health of Canadians. Extreme weather events, poor air quality, and food insecurity in northern regions are likely to increase along with the increasing incidence and range of infectious diseases. In this study we identify and characterize Canadian federal, provincial, territorial and municipal adaptation to these health risks based on publically available information. Federal health adaptation initiatives emphasize capacity building and gathering information to address general health, infectious disease and heat-related risks. Provincial and territorial adaptation is varied. Quebec is a leader in climate change adaptation, having a notably higher number of adaptation initiatives reported, addressing almost all risks posed by climate change in the province, and having implemented various adaptation types. Meanwhile, all other Canadian provinces and territories are in the early stages of health adaptation. Based on publically available information, reported adaptation also varies greatly by municipality. The six sampled Canadian regional health authorities (or equivalent) are not reporting any adaptation initiatives. We also find little relationship between the number of initiatives reported in the six sampled municipalities and their provinces, suggesting that municipalities are adapting (or not adapting) autonomously.
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Affiliation(s)
- Stephanie E Austin
- Department of Geography, McGill University, Burnside Hall Building Room 705, 805 Sherbrooke Street West, Montreal, QC H3A 0B9, Canada.
| | - James D Ford
- Department of Geography, McGill University, Burnside Hall Building Room 705, 805 Sherbrooke Street West, Montreal, QC H3A 0B9, Canada.
| | - Lea Berrang-Ford
- Department of Geography, McGill University, Burnside Hall Building Room 705, 805 Sherbrooke Street West, Montreal, QC H3A 0B9, Canada.
| | - Malcolm Araos
- Department of Geography, McGill University, Burnside Hall Building Room 705, 805 Sherbrooke Street West, Montreal, QC H3A 0B9, Canada.
| | - Stephen Parker
- Enteric Surveillance and Population Studies Division, Centre for Food-borne, Environmental and Zoonotic Infectious Diseases, Public Health Agency of Canada, 255 Woodlawn Road West, Unit 120, Guelph, ON N1H 8J1, Canada.
| | - Manon D Fleury
- Environmental Issues Division, Public Health Agency of Canada, 255 Woodlawn Road West, Unit 120, Guelph, ON N1H 8J1, Canada.
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Lewnard JA, Berrang-Ford L, Lwasa S, Namanya DB, Patterson KA, Donnelly B, Kulkarni MA, Harper SL, Ogden NH, Carcamo CP. Relative undernourishment and food insecurity associations with Plasmodium falciparum among Batwa pygmies in Uganda: evidence from a cross-sectional survey. Am J Trop Med Hyg 2014; 91:39-49. [PMID: 24821844 PMCID: PMC4080566 DOI: 10.4269/ajtmh.13-0422] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Although malnutrition and malaria co-occur among individuals and populations globally, effects of nutritional status on risk for parasitemia and clinical illness remain poorly understood. We investigated associations between Plasmodium falciparum infection, nutrition, and food security in a cross-sectional survey of 365 Batwa pygmies in Kanungu District, Uganda in January of 2013. We identified 4.1% parasite prevalence among individuals over 5 years old. Severe food insecurity was associated with increased risk for positive rapid immunochromatographic test outcome (adjusted relative risk [ARR] = 13.09; 95% confidence interval [95% CI] = 2.23–76.79). High age/sex-adjusted mid-upper arm circumference was associated with decreased risk for positive test among individuals who were not severely food-insecure (ARR = 0.37; 95% CI = 0.19–0.69). Within Batwa pygmy communities, where malnutrition and food insecurity are common, individuals who are particularly undernourished or severely food-insecure may have elevated risk for P. falciparum parasitemia. This finding may motivate integrated control of malaria and malnutrition in low-transmission settings.
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Affiliation(s)
- Joseph A. Lewnard
- *Address correspondence to Joseph A. Lewnard, Department of Geography, McGill University, 805 Sherbrooke W, Burnside 705, Montreal, Quebec, Canada H3A 0B9. E-mail:
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Lewnard JA, Berrang-Ford L. Internet-based partner selection and risk for unprotected anal intercourse in sexual encounters among men who have sex with men: a meta-analysis of observational studies. Sex Transm Infect 2014; 90:290-6. [DOI: 10.1136/sextrans-2013-051332] [Citation(s) in RCA: 91] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
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Berrang-Ford L, Garton K. Expert knowledge sourcing for public health surveillance: national tsetse mapping in Uganda. Soc Sci Med 2013; 91:246-55. [PMID: 23608601 DOI: 10.1016/j.socscimed.2013.03.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2012] [Revised: 03/04/2013] [Accepted: 03/04/2013] [Indexed: 11/16/2022]
Abstract
In much of sub-Saharan Africa, availability of standardized and reliable public health data is poor or negligible. Despite continued calls for the prioritization of improved health datasets in poor regions, public health surveillance remains a significant global health challenge. Alternate approaches to surveillance and collection of public health data have thus garnered increasing interest, though there remains relatively limited research evaluating these approaches for public health. Herein, we present a case study applying and evaluating the use of expert knowledge sources for public health dataset development, using the case of vector distributions of Human African Trypanosomiasis (HAT) in Uganda. Specific objectives include: 1) Review the use of expert knowledge sourcing methods for public health surveillance, 2) Review current knowledge on tsetse vector distributions of public health importance in Uganda and the methods used for tsetse mapping in Africa; 3) Quantify confidence of the presence or absence of tsetse flies in Uganda based on expert informant reports, and 4) Assess the reliability and potential utility of expert knowledge sourcing as an alternative or complimentary method for public health surveillance in general and tsetse mapping in particular. Information on tsetse presence or absence, and associated confidence, was collected through interviews with District Entomologist and Veterinary Officers to develop a database of tsetse distributions for 952 sub-counties in Uganda. Results show high consistency with existing maps, indicating potential reliability of modeling approaches, though failing to provide evidence for successful tsetse control in past decades. Expert-sourcing methods provide a novel, low-cost and rapid complimentary approach for triangulating data from prediction modeling where field-based validation is not feasible. Data quality is dependent, however, on the level of expertise and documentation to support confidence levels for data reporting. Results highlight the need for increased evaluation of alternate approaches and methods to data collection.
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Affiliation(s)
- Lea Berrang-Ford
- Department of Geography, McGill University, 805 Sherbrooke Street Ouest, Montreal, Quebec, H3A0B9, Canada.
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