The effects on public health of climate change adaptation responses: a systematic review of evidence from low- and middle-income countries

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.

Performance evaluation of QuantiBRITE phycoerythrin beads

BACKGROUND

The performance of QuantiBRITE phycoerythrin (PE) beads to standardize quantitation in terms of antibodies bound per cell (ABC) was evaluated by measuring precision, variation across multiple instruments, and variation across time.

METHODS

For CD4 quantitation, whole blood was stained with a two-color CD4 reagent using a no-wash/no-lyse format. For CD69 quantitation, whole blood was activated with either phorbol myristate acetate (PMA) or CD3 beads and then stained with a three-color CD69 reagent using a lyse-no-wash format.

RESULTS

Across 20 normal donors, the mean CD4 ABC was 51,000. Within-assay precision on quantitation of CD4 ABC on T cells had a coefficient of variance (CV) of <1.0%. Across multiple flow cytometers, quantitation of CD4 ABC had a CV of <5.0%. Within-donor CV on CD4 ABC on 20 donors across 2 months ranged from 1.3% to 3.2%. Within-assay precision on quantitation of CD69 on T cells activated with either PMA or CD3 beads had a CV of <3.0%. Within-donor CV of CD69 ABC across 1 month ranged from 2% to 18% on PMA-activated samples and from 7% to 24% on CD3 bead-activated samples.

CONCLUSIONS

Our results indicate that the QuantiBRITE PE beads provide a useful tool for standardized analysis across labs. When used in conjunction with 1:1 conjugates of PE-to-monoclonal antibody, the QuantiBRITE PE beads provide a simple yet robust means of quantitating expression levels in terms of ABC.