Impacts of flood on health of Iranian population: Infectious diseases with an emphasis on parasitic infections

Most common flood-associated infectious diseases in children

Floods constitute one of the most widely described natural phenomena worldwide, and their frequency is increasing due to the consequences of climate change. Floods pose risks to the affected populations, including an increase in communicable diseases mainly due to population displacement and overcrowding, deficiencies in hygiene and dietary measures and difficulties accessing health care. The most frequently reported infectious diseases in the context of these disasters are gastrointestinal and respiratory diseases and diseases resulting from wound infection. Epidemic outbreaks of infections such as leptospirosis or vector-borne diseases, which are usually less prevalent but whose increased incidence is closely related to this type of disasters, have also been described. These events evince the need to develop epidemiological surveillance protocols and for scientific societies to establish consensus-based guidelines for the diagnosis and therapeutic management of the most prevalent communicable diseases. This consensus document was developed by the Sociedad Española de Infectología Pediátrica (SEIP) in collaboration with the Asociación Española de Pediatría (AEP) and the Sociedad Valenciana de Pediatría (SVP) to establish recommendations for the therapeutic management of the main infectious diseases that may affect children impacted by floods, which could also be applicable to other natural disasters.

Impact of Global Climate-Change on Ecology of Anopheles Mosquitoes: A Systematic Review

Background

This study investigated the impact of climate variables on the prevalence of malaria, a climate-sensitive infectious disease.

Methods

A systematic review was conducted on articles published from Mar 2000 to Aug 2023 in Persian and English languages. Overall, 10,731 articles were retrieved, and 58 studies were included in the analysis.

Results

Climate variables such as temperature, rainfall, and humidity play a significant role in predicting malaria outbreaks, with inconsistencies observed in different regions, including Iran. The study highlights the need for tailored preventive.

Conclusion

Strategies and interventions to address the impact of climate change on malaria transmission. Enhanced health system resilience is essential to combat the anticipated rise in malaria cases in the future.

Exploring the Association Between Floods and Diarrhea among Under-five Children in Rural India

OBJECTIVE

Flood is one of the major public health concerns increasing the risk of childhood diarrhea. This study aims to explore the association of floods with diarrhea among under-five children in rural India.

METHODS

A cross-sectional study was carried out using large-scale nationally representative data from the National Family Health Survey-5. The Central Water Commission reports between the years 2018 and 2020 were used to group all the districts as non-flood-affected districts or flood-affected districts. Bivariate and multivariate logistic regression models were employed to assess the association of floods with childhood diarrhea.

RESULTS

The prevalence of diarrhea was higher among children exposed to three consecutive floods during the year 2019-21 than those children not exposed to flood. Children exposed to flood three times between the year 2018-19 to 2020-21 were associated with a 34% higher likelihood of developing diarrhea than those children exposed to flood one or two times.

CONCLUSIONS

Our study suggests that community health workers should target mothers belonging to the poor wealth quintile, young mothers, and mothers with young infants and more children to receive child health related counseling in flood-prone areas.

Infectious Diarrhea Risks as a Public Health Emergency in Floods; a Systematic Review and Meta-Analysis

Introduction

Infectious diarrhea, a significant global health challenge, is exacerbated by flooding, a consequence of climate change and environmental disruption. This comprehensive study aims to quantify the association between flooding events and the incidence of infectious diarrhea, considering diverse demographic, environmental, and pathogen-specific factors.

Methods

In this systematic review and meta-analysis, adhering to PROSPERO protocol (CRD42024498899), we evaluated observational studies from January 2000 to December 2023. The analysis incorporated global data from PubMed, Scopus, Embase, Web of Science, and ProQuest, focusing on the relative risk (RR) of diarrhea post-flooding. The study encompassed diverse variables like age, sex, pathogen type, environmental context, and statistical modeling approaches.

Results

The meta-analysis, involving 42 high-quality studies, revealed a substantial increase (RR = 1.40, 95% CI [1.29-1.52]) in the incidence of diarrhea following floods. Notably, bacterial and parasitic diarrheas demonstrated higher RRs (1.82 and 1.35, respectively) compared to viral etiologies (RR = 1.15). A significant sex disparity was observed, with women exhibiting a higher susceptibility (RR = 1.55) than men (RR = 1.35). Adults (over 15 years) faced a greater risk than younger individuals, highlighting age-dependent vulnerability.

Conclusion

This extensive analysis confirms a significant correlation between flood events and increased infectious diarrhea risk, varying across pathogens and demographic groups. The findings highlight an urgent need for tailored public health interventions in flood-prone areas, focusing on enhanced sanitation, disease surveillance, and targeted education to mitigate this elevated risk. Our study underscores the critical importance of integrating flood-related health risks into global public health planning and climate change adaptation strategies.

Prevalence and determinants of post-traumatic stress disorder five months after the 2019 huge flooding in Iran

BACKGROUND

Despite the high occurrence of floods in Iran, its psychological consequences have been less discussed. The present paper addresses the prevalence of Post-traumatic Stress Disorder (PTSD) and its determinants among the affected adults by the huge flood of 2019.

METHODS

An analytical cross-sectional study was conducted through household face-to-face surveys in August and September 2019. Individuals who were affected by floods and were at least 16 years old were randomly selected from three provinces in Iran: Lorestan and Khuzestan in the west and southwest, and Golestan in the northeast. The questionnaire of demographic and flood related variables in addition to the Impact of Event Scale-Revised (IES-R) were utilized to collect the data. We applied a complex sample analysis to describe the prevalence of PTSD and logistic regression analyses to find its determinants.

RESULTS

Out of the 2,305 individuals approached for surveys, 1,671 (72.5%) adults affected by the floods participated in the study. The majority of participants were housewives, married, had either no formal education or primary education, and resided in rural areas. The prevalence of PTSD in the participants was 24.8% (CI 95%: 20.7-28.8%) and was significantly higher in Lorestan province (39.7%, P < 0.001). Determinants of PTSD, were unemployment (adjusted odds ratio [AOR] = 3.53, CI 95%: 1.38-9.00), primary (AOR = 2.44, CI 95%: 1.10-5.41) or high school (AOR = 2.35, CI 95%: 1.25-4.40) education (vs. university), a history of mental disorders (AOR = 2.36, CI 95%: 1.22-4.58), high damage to assets (AOR = 2.29, CI 95%: 1.40-3.75), limited access to health care services after the flood (AOR = 1.95, CI 95%: 1.20-3.19), not receiving compensation for flood damage (AOR = 1.94, CI 95%: 1.01-3.83), high wealth index (AOR = 1.90, CI 95%: 1.23-2.93), and flooded house with a height of more than one meter (AOR = 1.66, CI 95%: 1.02-2.76).

CONCLUSION

Results show a notable prevalence of PTSD, especially in Lorestan province, among adults affected by floods. Determinants of PTSD include unemployment, lower education, psychiatric history, extensive property damage, limited post-flood healthcare access, lack of compensation, and increased flood exposure. We recommend adopting an inclusive screening approach for high-risk groups and developing appropriate therapeutic and supportive interventions.

Rapid detection method of bacterial pathogens in surface waters and a new risk indicator for water pathogenic pollution

In this study, a accurate, rapid quantitative PCR method for the simultaneous detection of 4 kinds of pathogenic bacteria in water was established, and the distribution of pathogenic bacteria in surface waters with different levels of pollution (Yulin region, China) was detected. The results showed that the detection accuracy was 94%; the detection limit was 2.7 in bacterial cells. Salmonella enterica subsp. enterica serovar typhimurium and Salmonella dysenteria were always present in water when the universal primer for pathogenic bacteria abundance detection was greater than 104 copies 100 mL-1. When the detection value is lower than 104 copy 100 mL-1, the bacteria in the water are rarely pathogenic bacteria, so the detection value of 104 copy 100 mL-1 can be used as a new indicator of waterborne pathogen pollution.

Mitigating infectious disease risks through non-stationary flood frequency analysis: a case study in Malaysia based on natural disaster reduction strategy

The occurrence of floods has the potential to escalate the transmission of infectious diseases. To enhance our comprehension of the health impacts of flooding and facilitate effective planning for mitigation strategies, it is necessary to explore the flood risk management. The variability present in hydrological records is an important and neglecting non-stationary patterns in flood data can lead to significant biases in estimating flood quantiles. Consequently, adopting a non-stationary flood frequency analysis appears to be a suitable approach to challenge the assumption of independent and identically distributed observations in the sample. This research employed the generalized extreme value (GEV) distribution to examine annual maximum flood series. To estimate non-stationary models in the flood data, several statistical tests, including the TL-moment method was utilized on the data from ten stream-flow stations in Johor, Malaysia, which revealed that two stations, namely Kahang and Lenggor, exhibited non-stationary behaviour in their annual maximum streamflow. Two non-stationary models efficiently described the data series from these two specific stations, the control of which could reduce outbreak of infectious diseases when used for controlling the development measures of the hydraulic structures. Thus, the application of these models may help prevent biased prediction of flood occurrences leading to lower number of cases infected by disease.

Infectious diseases following hydrometeorological disasters: current scenario, prevention, and control measures

Natural disasters are catastrophic occurrences that can seriously harm infrastructure, inflict property damage, and even result in fatalities. Water supply and sanitation systems can be disrupted in flooded areas, raising the risk of infectious diseases. It is advised that public health responders do a disease risk assessment of such a catastrophic event to ascertain the disaster's consequences and the health requirements. This editorial provides an overview of the transmission of infectious illnesses after hydrometeorological disasters. It also discusses the effects of such catastrophes on individuals' psychological and physical health who live in disaster-prone locations.

Cutaneous leishmaniasis situation analysis in the Islamic Republic of Iran in preparation for an elimination plan

Iran has invariably been under the growing public health threat of cutaneous leishmaniasis (CL), a significant barrier to local development that hinders the prevention and control efforts toward eliminating the disease. So far, no comprehensive and in-depth epidemiological analysis of the CL situation has been carried out nationwide. This study aimed to employ advanced statistical models to analyze the data collected through the Center for Diseases Control and Prevention of Communicable Diseases during 1989-2020. However, we emphasized the current trends, 2013-2020, to study temporal and spatial CL patterns. In the country, the epidemiology of CL is incredibly intricate due to various factors. This fact indicates that the basic infrastructure, the preceding supports, and the implementation plan related to preventive and therapeutic measures need crucial support. The leishmaniasis situation analysis is consistent with desperate requirements for efficient information on the control program in the area. This review provides evidence of temporally regressive and spatially expanding incidence of CL with characteristic geographical patterns and disease hotspots, signifying an urgent need for comprehensive control strategies. This information could be a suitable model and practical experience in the Eastern Mediterranean Region, where over 80% of CL is reported.

Comments and recommendations on Sponge City - China's solutions to prevent flooding risks

Background

/Objective: Flooding risk is a global issue, and various approaches have been established to prevent flooding risk around the world. China is one of the heavily flood-affected countries and has been implementing the Sponge City program since 2015 to defend against flooding. Unfortunately, flooding has been common in China in recent years, causing severe health risks to citizens. This research mainly focuses on (a) evaluating the implementation of China's Sponge City program and the associated impacts on human health and (b) exploring the future improvement of the Sponge City program in China.

Methods

The Interpretive Document Approach was used to explore an inclusive review of the Sponge City program and its implications on human health.

Results

/Findings: The Sponge City program in China is still insufficient to prevent flooding risks effectively. In the past eight years, 24/34 provinces have recorded flooding, which caused a total of 4701 deaths and over 525.5 billion RMB (around 72.9 billion US$) in economic loss. Till now, only 64/654 cities have promulgated local legislation to manage sponge city construction, although the Sponge City was implemented in 2015. Besides, the completed Sponge City program constructions cannot fully prevent flooding risks, the flood prevention capacity is limited. The Sponge City program is not granted priority, lacking national legislation hinders Sponge City program implementation in China.

Conclusions

China needs to make national legislation on the Sponge City program and update the Sponge City program technology guidelines. Local governments should implement Sponge City construction according to local geographic environments.

Detection of Atypical Motile Staphylococcus aureus from Rain Floods

Abstract: Heavy rain floods is one of the primary risk factors for human health, and it can significantly regulate microbial communities and enhance the transfer of infections within the affected areas. Recently, the flood crisis is becoming one of the severe natural events in Mosul / Iraq. It may continue for months during which samples of accumulated rainwater were collected. Twelve Staphylococcus aureus were isolated by using two selective media: Mannitol Salt agar and Vogel-Johnson media in addition to Blood agar. An unusual colony spreading which resembles. "Bacillus colonies in twelve Staphylococcus aureus isolates was observed on Mannitol Salt agar and semisolid nutrient agar. Actively motile cocci in single and cluster arrangements that is not characteristic of brownian movement was shown in wet mount microscopic observation Furthermore, biosurfactant detection by oil spreading method ( oil displacement activity) showed that all isolates demonstrated various degrees of surfactant production which has beeen reported. to be responsible for stimulating "colony spreading" phenomenon in S. aureux. Motility can play a crucial role for survival bacterial species by which they get nutrients, avoid toxins and predators, and genetic information exchange by mating. The present study highlights for the first time. Mosul city a motile opportunistic aureus obtained from harvested rainwater samples during high-rainfall periods. Utilization of untreated harvested rainwater could thus offer a significant health threat to consumers, especially children. and immunocompromised individuals.

Risks to the Health of Russian Population from Floods and Droughts in 2010‒2020: A Scoping Review

Climate change and natural disasters caused by hydrological, meteorological, and climatic causes have a significant and increasing direct and indirect impact on human health, leading to increased mortality and morbidity. Russia is a country that suffers from frequent climatic and weather disasters. This is mainly due to its vast territory, complex geographical and ecological environment, and widely varying climatic conditions. This review provides information on climatological and hydrological extremes in Russia in 2010–2020, floods and droughts, and their impact on the health and well-being of the country’s population. A literature search was conducted using electronic databases Web of Science, Pubmed, Science Direct, Scopus, and e-Library, focusing on peer-reviewed journal articles published in English and in Russian from 2010 to 2021. Four conceptual categories were used: “floods”, “droughts”, “human health”, and “Russia”. It is concluded that while most hazardous weather events cannot be completely avoided, many health impacts can potentially be prevented. The recommended measures include early warning systems and public health preparedness and response measures, building climate resilient health systems and other management structures.

From the One Health Perspective: Schistosomiasis Japonica and Flooding

Schistosomiasis is a water-borne parasitic disease distributed worldwide, while schistosomiasis japonica localizes in the People’s Republic of China, the Philippines, and a few regions of Indonesia. Although significant achievements have been obtained in these endemic countries, great challenges still exist to reach the elimination of schistosomiasis japonica, as the occurrence of flooding can lead to several adverse consequences on the prevalence of schistosomiasis. This review summarizes the influence of flooding on the transmission of schistosomiasis japonica and interventions responding to the adverse impacts from the One Health perspective in human beings, animals, and the environment. For human and animals, behavioral changes and the damage of water conservancy and sanitary facilities will increase the intensity of water contact. For the environment, the density of Oncomelania snails significantly increases from the third year after flooding, and the snail habitats can be enlarged due to active and passive diffusion. With more water contact of human and other reservoir hosts, and larger snail habitats with higher density of living snails, the transmission risk of schistosomiasis increases under the influence of flooding. With the agenda set for global schistosomiasis elimination, interventions from the One Health perspective are put forward to respond to the impacts of increased flooding. For human beings, conducting health education to increase the consciousness of self-protection, preventive chemotherapy for high-risk populations, supply of safe water, early case finding, timely reporting, and treating cases will protect people from infection and prevent the outbreak of schistosomiasis. For animals, culling susceptible domestic animals, herding livestock in snail-free areas, treating livestock with infection or at high risk of infection, harmless treatment of animal feces to avoid water contamination, and monitoring the infection status of wild animals in flooding areas are important to cut off the transmission chain from the resources. For the environment, early warning of flooding, setting up warning signs and killing cercaria in risk areas during and post flooding, reconstructing damaged water conservancy facilities, developing hygiene and sanitary facilities, conducting snail surveys, using molluscicide, and predicting areas with high risk of schistosomiasis transmission after flooding all contribute to reducing the transmission risk of schistosomiasis. These strategies need the cooperation of the ministry of health, meteorological administration, water resources, agriculture, and forestry to achieve the goal of minimizing the impact of flooding on the transmission of schistosomiasis. In conclusion, flooding is one of the important factors affecting the transmission of schistosomiasis japonica. Multi-sectoral cooperation is needed to effectively prevent and control the adverse impacts of flooding on human beings, animals, and the environment.

Climate Change Perception and Uptake of Climate-Smart Agriculture in Rice Production in Ebonyi State, Nigeria

Rice production in Nigeria is vulnerable to climate risks and rice farmers over time have experienced the risks and their respective impacts on rice farming. Rice farmers have also responded to perceived climate risks with strategies believed to be climate-smart. Farmers’ perception of climate risks is an important first step of determining any action to be taken to counteract the negative effects of climate change on agriculture. Studies on the link between perceived climate risks and farmers’ response strategies are increasing. However, there are limited studies on the determinants of rice farmers’ perception of climate events. The paper therefore examined climate change perception and uptake of climate-smart agriculture in rice production in Ebonyi State, Nigeria using cross-sectional data from 347 rice farmers in an important rice-producing area in Nigeria. Principal component analysis, multivariate probit regression model and descriptive statistics were adopted for data analysis. Perceived climate events include increased rainfall intensity, prolonged dry seasons, frequent floods, rising temperature, severe windstorms, unpredictable rainfall pattern and distribution, late onset rain, and early cessation of rain. Farmers’ socioeconomic, farm and institutional characteristics influenced their perception of climate change. Additionally, rice farmers used a variety of climate-smart practices and technologies to respond to the perceived climate events. Such climate-smart practices include planting improved rice varieties, insurance, planting different crops, livelihood diversification, soil and water conservation techniques, adjusting planting and harvesting dates, irrigation, reliance on climate information and forecasts, planting on the nursery, appropriate application of fertilizer and efficient and effective use of pesticides. These climate-smart agricultural measures were further delineated into five broad packages using principal component analysis. These packages include crop and land management practices, climate-based services and irrigation, livelihood diversification and soil fertility management, efficient and effective use of pesticide and planting on the nursery. High fertilizer costs, lack of access to inputs, insufficient land, insufficient capital, pests and diseases, floods, scorching sun, high labour cost, insufficient climate information, and poor extension services were the barriers to uptake of climate-smart agriculture in rice production. Rice farmers should be supported to implement climate-smart agriculture in rice production in order to achieve the objectives of increased rice productivity and income, food security, climate resilience and mitigation.

Influence of extraordinary floods on wildlife parasites: the case of gastrointestinal helminths and protozoa of wild canids from the Iberá Ecoregion, Argentina

Parasites are natural components of ecosystems and play a significant role in the dynamics of wild animal populations. Although the environment of parasites is primarily defined by the host, most life cycles involve stages that must endure external conditions. Rainfall and flooding events are important factors that might influence the transport of parasitic stages, altering soil moisture levels, and resulting in a favorable environment for parasite survival and development. We assessed whether an extraordinary flood event modified the occurrence of gastrointestinal parasites (nematodes and protozoa) in wild canids in two protected areas in northern Argentina. From 2016 to 2018, we collected fecal samples of two fox species, Lycalopex gymnocercus and Cerdocyon thous, and examined the presence of nematodes and protozoa. We assessed changes in the occurrence of these parasites after a flood event, while adjusting for potential confounders (i.e., monthly average temperature, season, host species, site). In a second stage of the analysis, we evaluated whether part of the effect was caused by changes in soil moisture, by adding normalized difference water index as an independent variable. We found that the presence of nematodes in foxes was higher after flooding than before flooding, and this association was not explained by changes in the soil moisture. On the other hand, the flood event was not relevant for protozoa. Stronger and long-lasting flood events are expected due to the effect of global warming on El Niño events, and this may increase and intensify the spread of some parasites affecting wildlife, which could also be of public health concern.

Climate Change and Enteric Infections in the Canadian Arctic: Do We Know What’s on the Horizon?

The Canadian Arctic has a long history with diarrheal disease, including outbreaks of campylobacteriosis, giardiasis, and salmonellosis. Due to climate change, the Canadian Arctic is experiencing rapid environmental transformation, which not only threatens the livelihood of local Indigenous Peoples, but also supports the spread, frequency, and intensity of enteric pathogen outbreaks. Advances in diagnostic testing and detection have brought to attention the current burden of disease due to Cryptosporidium, Campylobacter, and Helicobacter pylori. As climate change is known to influence pathogen transmission (e.g., food and water), Arctic communities need support in developing prevention and surveillance strategies that are culturally appropriate. This review aims to provide an overview of how climate change is currently and is expected to impact enteric pathogens in the Canadian Arctic.

Epidemiologic Impacts in Acute Infectious Disease Associated with Catastrophic Climate Events Related to Global Warming in the Northeast of Mexico

Rising global temperatures and seawater temperatures have led to an increase in extreme weather patterns leading to droughts and floods. These natural phenomena, in turn, affect the supply of drinking water in some communities, which causes an increase in the prevalence of diseases related to the supply of drinking water. The objective of this work is to demonstrate the effects of global warming on human health in the population of Monterrey, Mexico after Hurricane Alex. We interpolated data using statistical downscaling of climate projection data for 2050 and 2080 and correlated it with disease occurrence. We found a remarkable rise in the incidence of transmissible infectious disease symptoms. Gastrointestinal symptoms predominated and were associated with drinking of contaminated water like tap water or water from communal mobile water tanks, probably because of the contamination of clean water, the disruption of water sanitation, and the inability to maintain home hygiene practices.

Cutaneous leishmaniasis in Iran: A systematic review and meta-analysis

Cutaneous leishmaniasis as a public health concern that attracts many attentions in endemic area. There is no exact estimation of cutaneous leishmaniasis in Iran. This study aimed to assess the exact prevalence of disease and carried out in databases including: Pub Med, Google Scholar, Science Direct, Scopus, Web of Science, Magiran, Iran doc, Barakatkns and Scientific Information Database (SID) from 2000 to 2019. Totally 84 studies were eligible to be included in this systematic review and Meta-analysis study. Based on a random effect model the pooled prevalence of leishmaniasis was estimated 45% (95% CI: 39%-51%; I^2 = 99.8%P < 0.001). The highest prevalence of CL was related to Isfahan 66% (53%-78%), Golestan 64% (62%-65%) and Fars province 63% (38%-84%) and the lowest prevalence was estimated in Kermanshah province 4% (4%-5%), Hormozgan 10% (8%-11%), Bushehr 12% (1%-35%) and Kerman 15% (9%-22%) provinces respectively. The lowest prevalence was associated with L. trapica spices 23% (11%-38%) and the highest was associated with L. major spices 32% (21%-45%). The prevalence with both L. trapica and L. major spices was achieved 60% (48%-71%). It is essential for health authorities to take steps to control and prevent the epidemic by rapid treatment of patients, destroying gerbils and promotion of general and health education for the local population.

A crisis within the crisis: The mental health situation of refugees in the world during the 2019 coronavirus (2019-nCoV) outbreak

BACKGROUND

68.5 million people around the world have been forced to leave their houses. Refugees have mainly to face their adaption in a host country, which involves bureaucracy, different culture, poverty, and racism. The already fragile situation of refugees becomes worrying and challenged in the face of the new coronavirus (COVID-19) epidemic. Therefore, we aimed to describe the factors that can worsen the mental health of refugees.

METHOD

The studies were identified in well-known international journals found in three electronic databases: PubMed, Scopus, and Embase. The data were cross-checked with information from the main international newspapers.

RESULTS

According to the literature, the difficulties faced by refugees with the COVID-19 pandemic are potentiated by the pandemic state. There are several risk factors common to coronavirus and psychiatric illnesses as overcrowding, disruption of sewage disposal, poor standards of hygiene, poor nutrition, negligible sanitation, lack of access to shelter, health care, public services, and safety. These associated with fear and uncertainty create a closed ground for psychological sickness and COVID-19 infection.

CONCLUSIONS

There should be not only a social mobilization to contain the virus, but also a collective effort on behalf of the most vulnerable populations.