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Katzelnick LC, Quentin E, Colston S, Ha TA, Andrade P, Eisenberg JNS, Ponce P, Coloma J, Cevallos V. Increasing transmission of dengue virus across ecologically diverse regions of Ecuador and associated risk factors. PLoS Negl Trop Dis 2024; 18:e0011408. [PMID: 38295108 PMCID: PMC10861087 DOI: 10.1371/journal.pntd.0011408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 02/12/2024] [Accepted: 01/15/2024] [Indexed: 02/02/2024] Open
Abstract
The distribution and intensity of viral diseases transmitted by Aedes aegypti mosquitoes, including dengue, have rapidly increased over the last century. Here, we study dengue virus (DENV) transmission across the ecologically and demographically distinct regions or Ecuador. We analyzed province-level age-stratified dengue incidence data from 2000-2019 using catalytic models to estimate the force of infection of DENV over eight decades. We found that provinces established endemic DENV transmission at different time periods. Coastal provinces with the largest and most connected cities had the earliest and highest increase in DENV transmission, starting around 1980 and continuing to the present. In contrast, remote and rural areas with reduced access, like the northern coast and the Amazon regions, experienced a rise in DENV transmission and endemicity only in the last 10 to 20 years. The newly introduced chikungunya and Zika viruses have age-specific distributions of hospital-seeking cases consistent with recent emergence across all provinces. To evaluate factors associated with geographic differences in DENV transmission potential, we modeled DENV vector risk using 11,693 Aedes aegypti presence points to the resolution of 1 hectare. In total, 56% of the population of Ecuador, including in provinces identified as having increasing DENV transmission in our models, live in areas with high risk of Aedes aegypti, with population size, trash collection, elevation, and access to water as important determinants. Our investigation serves as a case study of the changes driving the expansion of DENV and other arboviruses globally and suggest that control efforts should be expanded to semi-urban and rural areas and to historically isolated regions to counteract increasing dengue outbreaks.
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Affiliation(s)
- Leah C. Katzelnick
- Viral Epidemiology and Immunity Unit, Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Emmanuelle Quentin
- Centro de Investigación en Salud Pública y Epidemiología Clínica (CISPEC), Facultad de Ciencias de la Salud Eugenio Espejo, Universidad UTE, Quito, Ecuador
| | - Savannah Colston
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Thien-An Ha
- Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley, Berkeley, California, United States of America
| | - Paulina Andrade
- Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley, Berkeley, California, United States of America
| | - Joseph N. S. Eisenberg
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Patricio Ponce
- Centro de Investigación en Enfermedades Infeciosas y Vectoriales (CIREV), Instituto Nacional de Investigación en Salud Pública (INSPI), Quito, Ecuador
| | - Josefina Coloma
- Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley, Berkeley, California, United States of America
| | - Varsovia Cevallos
- Centro de Investigación en Enfermedades Infeciosas y Vectoriales (CIREV), Instituto Nacional de Investigación en Salud Pública (INSPI), Quito, Ecuador
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Ghahyazi K, Familiar-Lopez I, Culbert O, Uruchima J, Van Engen A, Cevallos W, Eisenberg JNS, Levy K, Lee GO. Correlates of maternal depression, anxiety and functioning across an urban-rural gradient in northern Ecuador. Glob Public Health 2024; 19:2291697. [PMID: 38084739 PMCID: PMC10787496 DOI: 10.1080/17441692.2023.2291697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 11/13/2023] [Indexed: 12/18/2023]
Abstract
Maternal depression remains under characterised in many low- and middle-income countries, especially in rural settings. We aimed to describe maternal depression and anxiety symptoms in rural and urban communities in northern Ecuador and to identify socioeconomic and demographic factors associated with these symptoms. Data from 508 mothers participating in a longitudinal cohort study were included. Depression and anxiety symptoms were assessed using the Hopkins Symptom Checklist (HSCL-25), and maternal psychological functioning was assessed using a checklist of daily activities. Tobit regression models were used to examine associations with sociodemographic variables and urbanicity. The median HSCL-25 score was 1.2 (IQR: 0.4) and 14% of women scored above the threshold for clinically relevant symptoms. Rural women reported similar food insecurity, less education, younger age of first pregnancy, and lower socio-economic status compared to their urban counterparts. After adjusting for these factors, rural women reported lower HSCL-25 scores compared to women lin urban areas (β = -0.48, 95%CI:0.65, -0.31). Rural residence was also associated with lower depression and anxiety HSCL-25 sub-scale scores, and similar levels of maternal functioning, compared to urban residence. Our results suggest that both household and community-level factors are risk factors for maternal depression and anxiety in this context.
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Affiliation(s)
- Kiana Ghahyazi
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | | | - Oriana Culbert
- Rutgers Global Health Institute and Department of Biostatistics and Epidemiology, Rutgers University, New Brunswick, New Jersey, USA
| | - Jessica Uruchima
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Amanda Van Engen
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - William Cevallos
- Instituto de Biomedicina, Facultad de Ciencias Médicas, Universidad Central del Ecuador, Quito, Ecuador
| | - Joseph N S Eisenberg
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Karen Levy
- Department of Environmental and Occupational Health Sciences, University of Washington, School of Public Health, Seattle, Washington, USA
| | - Gwenyth O Lee
- Rutgers Global Health Institute and Department of Biostatistics and Epidemiology, Rutgers University, New Brunswick, New Jersey, USA
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Yao L, Chemaitelly H, Goldman E, Gudina EK, Khalil A, Ahmed R, James AB, Roca A, Fallah MP, Macnab A, Cho WC, Eikelboom J, Qamar FN, Kremsner P, Oliu-Barton M, Sisa I, Tadesse BT, Marks F, Wang L, Kim JH, Meng X, Wang Y, Fly AD, Wang CY, Day SW, Howard SC, Graff JC, Maida M, Ray K, Franco-Paredes C, Mashe T, Ngongo N, Kaseya J, Ndembi N, Hu Y, Bottazzi ME, Hotez PJ, Ishii KJ, Wang G, Sun D, Aleya L, Gu W. Time to establish an international vaccine candidate pool for potential highly infectious respiratory disease: a community's view. EClinicalMedicine 2023; 64:102222. [PMID: 37811488 PMCID: PMC10550631 DOI: 10.1016/j.eclinm.2023.102222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 08/26/2023] [Accepted: 09/04/2023] [Indexed: 10/10/2023] Open
Abstract
In counteracting highly infectious and disruptive respiratory diseases such as COVID-19, vaccination remains the primary and safest way to prevent disease, reduce the severity of illness, and save lives. Unfortunately, vaccination is often not the first intervention deployed for a new pandemic, as it takes time to develop and test vaccines, and confirmation of safety requires a period of observation after vaccination to detect potential late-onset vaccine-associated adverse events. In the meantime, nonpharmacologic public health interventions such as mask-wearing and social distancing can provide some degree of protection. As climate change, with its environmental impacts on pathogen evolution and international mobility continue to rise, highly infectious respiratory diseases will likely emerge more frequently and their impact is expected to be substantial. How quickly a safe and efficacious vaccine can be deployed against rising infectious respiratory diseases may be the most important challenge that humanity will face in the near future. While some organizations are engaged in addressing the World Health Organization's "blueprint for priority diseases", the lack of worldwide preparedness, and the uncertainty around universal vaccine availability, remain major concerns. We therefore propose the establishment of an international candidate vaccine pool repository for potential respiratory diseases, supported by multiple stakeholders and countries that contribute facilities, technologies, and other medical and financial resources. The types and categories of candidate vaccines can be determined based on information from previous pandemics and epidemics. Each participant country or region can focus on developing one or a few vaccine types or categories, together covering most if not all possible potential infectious diseases. The safety of these vaccines can be tested using animal models. Information for effective candidates that can be potentially applied to humans will then be shared across all participants. When a new pandemic arises, these pre-selected and tested vaccines can be quickly tested in RCTs for human populations.
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Affiliation(s)
- Lan Yao
- Department of Nutrition and Health Science, College of Health, Ball State University, Muncie, IN 47306, USA
- Department of Orthopedic Surgery and BME-Campbell Clinic, University of Tennessee Health Science Centre, Memphis, TN 38163, USA
| | - Hiam Chemaitelly
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Doha, Qatar
- World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine–Qatar, Cornell University, Qatar Foundation – Education City, Doha, Qatar
- Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - Emanuel Goldman
- Department of Microbiology, Biochemistry and Molecular Genetics, New Jersey Medical School, Rutgers University, Newark, NJ 07103, USA
| | - Esayas Kebede Gudina
- Department of Internal Medicine, Jimma University Institute of Health, Jimma, Ethiopia
| | - Asma Khalil
- Fetal Medicine Unit, St George’s Hospital, St George’s University of London, London, UK
- Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute, St George’s University of London, London, UK
| | - Rahaman Ahmed
- Cell Biology and Genetics Department, University of Lagos, Lagos 101017, Nigeria
- Centre for Human Virology and Genomics, Microbiology Department, Nigerian Institute of Medical Research, Lagos 100001, Nigeria
| | - Ayorinde Babatunde James
- Department of Biochemistry and Nutrition, Nigerian Institute of Medical Research, Yaba, Lagos State, Nigeria
| | - Anna Roca
- Medical Research Council Unit, The Gambia at the London School of Hygiene and Tropical Medicine, Fajara 273, The Gambia
| | - Mosoka Papa Fallah
- Refuge Place International, Monrovia, Liberia
- Centre for Emerging Infectious Diseases Policy and Research, Boston University, Boston, MA, USA
- Africa Centre for Disease Control, Addis Ababa, Ethiopia
| | - Andrew Macnab
- The Stellenbosch Institute for Advanced Study (STIAS), Wallenberg Research Centre at Stellenbosch University, South Africa
| | - William C. Cho
- Department of Clinical Oncology, Queen Elizabeth Hospital, Kowloon, Hong Kong, China
| | - John Eikelboom
- Population Health Research Institute, McMaster University and Hamilton Health Sciences Hamilton, Canada
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Farah Naz Qamar
- Department of Pediatrics and Child Health, Aga Khan University Hospital, National Stadium Rd, Karachi, Sindh 74800, Pakistan
| | - Peter Kremsner
- Institut für Tropenmedizin, Universität Tübingen, Germany
- Centre de Recherches Medicales de Lambarene, Gabon
| | - Miquel Oliu-Barton
- Université Paris Dauphine – PSL, Pl. du Maréchal de Lattre de Tassigny, Paris 75016, France
- Bruegel, Rue de la Charité 33, Brussels 1210, Belgium
| | - Ivan Sisa
- College of Health Sciences, Universidad San Francisco de Quito, Quito 170901, Ecuador
| | | | - Florian Marks
- International Vaccine Institute, Seoul, Republic of Korea
| | - Lishi Wang
- Department of Basic Medicine, Inner Mongolia Medical University, Jinshan Development Zone, Huhhot, China
| | - Jerome H. Kim
- International Vaccine Institute, Seoul, Republic of Korea
- Seoul National University, College of Natural Sciences, Seoul, Republic of Korea
| | - Xia Meng
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China
| | - Yongjun Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China
| | - Alyce D. Fly
- Department of Nutrition and Health Science, College of Health, Ball State University, Muncie, IN 47306, USA
| | - Cong-Yi Wang
- NHC Key Laboratory of Respiratory Diseases, Department of Respiratory and Critical Care Medicine, The Centre for Biomedical Research, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Sara W. Day
- College of Nursing, University of Tennessee Health Science Center, Memphis, TN 38105, USA
| | - Scott C. Howard
- College of Nursing, University of Tennessee Health Science Center, Memphis, TN 38105, USA
| | - J. Carolyn Graff
- College of Nursing, University of Tennessee Health Science Center, Memphis, TN 38105, USA
| | - Marcello Maida
- Gastroenterology and Endoscopy Unit, S. Elia-Raimondi Hospital, Caltanissetta 93100, Italy
| | - Kunal Ray
- School of Biological Science, Ramkrishna Mission Vivekananda Education & Research Institute, Narendrapur 700103, West Bengal, India
| | - Carlos Franco-Paredes
- Hospital Infantil de Mexico, Federico Gomez, Mexico
- Department of Microbiology, Immunology, and Pathology, Colorado State University, USA
| | - Tapfumanei Mashe
- One Health Office, Ministry of Health and Child Care, Harare, Zimbabwe
- World Health Organization, Harare, Zimbabwe
| | | | | | | | - Yu Hu
- Institute of Haematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan 430022, China
- Hubei Clinical and Research Centre of Thrombosis and Hemostasis, Wuhan, China
| | - Maria Elena Bottazzi
- Department of Pediatrics, Texas Children's Hospital Centre for Vaccine Development, Baylor College of Medicine, Houston, TX, USA
- National School of Tropical Medicine, Baylor College of Medicine, Houston, TX, USA
- Molecular Virology & Microbiology, Baylor College of Medicine, Houston, TX, USA
| | - Peter J. Hotez
- Department of Pediatrics, Texas Children's Hospital Centre for Vaccine Development, Baylor College of Medicine, Houston, TX, USA
- National School of Tropical Medicine, Baylor College of Medicine, Houston, TX, USA
- Molecular Virology & Microbiology, Baylor College of Medicine, Houston, TX, USA
| | - Ken J. Ishii
- Division of Vaccine Science, Department of Microbiology and Immunology, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
- International Vaccine Design Centre, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
- Centre for Vaccine Adjuvant Research, National Institutes of Biomedical Innovation, Health and Nutrition, Osaka, Japan
| | - Gang Wang
- Department of Pancreatic and Biliary Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Dianjun Sun
- Centre for Endemic Disease Control, Chinese Centre for Disease Control and Prevention, Harbin Medical University; Key Laboratory of Etiologic Epidemiology, Education Bureau of Heilongjiang Province & Ministry of Health 23618104, 157 Baojian Road, Harbin, Heilongjiang 150081, China
| | - Lotfi Aleya
- Chrono-Environnement Laboratory, UMR CNRS 6249, Bourgogne Franche-Comté University, Besançon Cedex F-25030, France
| | - Weikuan Gu
- Department of Orthopedic Surgery and BME-Campbell Clinic, University of Tennessee Health Science Centre, Memphis, TN 38163, USA
- Research Service, Memphis VA Medical Centre, 1030 Jefferson Avenue, Memphis, TN 38104, USA
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4
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Rothstein AP, Jesser KJ, Feistel DJ, Konstantinidis KT, Trueba G, Levy K. Population genomics of diarrheagenic Escherichia coli uncovers high connectivity between urban and rural communities in Ecuador. INFECTION, GENETICS AND EVOLUTION : JOURNAL OF MOLECULAR EPIDEMIOLOGY AND EVOLUTIONARY GENETICS IN INFECTIOUS DISEASES 2023; 113:105476. [PMID: 37392822 PMCID: PMC10599324 DOI: 10.1016/j.meegid.2023.105476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Revised: 05/11/2023] [Accepted: 06/28/2023] [Indexed: 07/03/2023]
Abstract
Human movement may be an important driver of transmission dynamics for enteric pathogens but has largely been underappreciated except for international 'travelers' diarrhea or cholera. Phylodynamic methods, which combine genomic and epidemiological data, are used to examine rates and dynamics of disease matching underlying evolutionary history and biogeographic distributions, but these methods often are not applied to enteric bacterial pathogens. We used phylodynamics to explore the phylogeographic and evolutionary patterns of diarrheagenic E. coli in northern Ecuador to investigate the role of human travel in the geographic distribution of strains across the country. Using whole genome sequences of diarrheagenic E. coli isolates, we built a core genome phylogeny, reconstructed discrete ancestral states across urban and rural sites, and estimated migration rates between E. coli populations. We found minimal structuring based on site locations, urban vs. rural locality, pathotype, or clinical status. Ancestral states of phylogenomic nodes and tips were inferred to have 51% urban ancestry and 49% rural ancestry. Lack of structuring by location or pathotype E. coli isolates imply highly connected communities and extensive sharing of genomic characteristics across isolates. Using an approximate structured coalescent model, we estimated rates of migration among circulating isolates were 6.7 times larger for urban towards rural populations compared to rural towards urban populations. This suggests increased inferred migration rates of diarrheagenic E. coli from urban populations towards rural populations. Our results indicate that investments in water and sanitation prevention in urban areas could limit the spread of enteric bacterial pathogens among rural populations.
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Affiliation(s)
- Andrew P. Rothstein
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA
| | - Kelsey J. Jesser
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA
| | - Dorian J. Feistel
- School of a Biological Sciences, Georgia Institute of Technology, Atlanta, GA, USA
| | - Konstantinos T. Konstantinidis
- School of Civil and Environmental Engineering, Georgia Institute of Technology, Atlanta, GA, USA
- School of a Biological Sciences, Georgia Institute of Technology, Atlanta, GA, USA
| | - Gabriel Trueba
- Instituto de Microbiología, Colegio de Ciencias Biológicas y Ambientales, Universidad San Francisco de Quito, Quito, Pichincha, Ecuador
| | - Karen Levy
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA
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Katzelnick LC, Quentin E, Colston S, Ha TA, Andrade P, Eisenberg JN, Ponce P, Coloma J, Cevallos V. Increasing transmission of dengue virus across ecologically diverse regions of Ecuador and associated risk factors. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.05.25.23290519. [PMID: 37398346 PMCID: PMC10312896 DOI: 10.1101/2023.05.25.23290519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Abstract
The distribution and intensity of viral diseases transmitted by Aedes aegypti mosquitoes, including dengue, have rapidly increased over the last century. Ecuador is an interesting country to study drivers of dengue virus (DENV) transmission given it has multiple ecologically and demographically distinct regions. Here, we analyze province-level age-stratified dengue prevalence data from 2000-2019 using catalytic models to estimate the force of infection of DENV over eight decades and across provinces in Ecuador. We found that provinces established endemic DENV transmission at different time periods. Coastal provinces with the largest and most connected cities had the earliest and highest increase in DENV transmission, starting around 1980 and continuing to the present. In contrast, remote and rural areas with reduced access, like the northern coast and the Amazon regions, experienced a rise in DENV transmission and endemicity only in the last 10 to 20 years. The newly introduced chikungunya and Zika viruses have distinct age-specific prevalence distributions consistent with recent emergence across all provinces. We evaluated factors to the resolution of 1 hectare associated with geographic differences in vector suitability and arbovirus disease in the last 10 years by modeling 11,693 A aegypti presence points and 73,550 arbovirus cases. In total, 56% of the population of Ecuador lives in areas with high risk of Aedes aegypti. Most suitable provinces had hotspots for arbovirus disease risk, with population size, elevation, sewage connection, trash collection, and access to water as important determinants. Our investigation serves as a case study of the changes driving the expansion of DENV and other arboviruses globally and suggest that control efforts should be expanded to semi-urban and rural areas and to historically isolated regions to counteract increasing dengue outbreaks.
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Affiliation(s)
- Leah C. Katzelnick
- Viral Epidemiology and Immunity Unit, Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892-3203, USA
| | - Emmanuelle Quentin
- Centro de Investigación en Salud Pública y Epidemiología Clínica, Universidad Tecnológica Equinoccial, Quito, 170129, Ecuador
| | - Savannah Colston
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, 48109-2029, USA
| | - Thien-An Ha
- Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley, Berkeley, CA, 94720-3370, USA
| | - Paulina Andrade
- Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley, Berkeley, CA, 94720-3370, USA
| | - Joseph N.S. Eisenberg
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, 48109-2029, USA
| | - Patricio Ponce
- Centro de Investigación en Enfermedades Infeciosas y Vectoriales (CIREV), Instituto Nacional de Investigación en Salud Pública (INSPI), Quito, 170136, Ecuador
| | - Josefina Coloma
- Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley, Berkeley, CA, 94720-3370, USA
| | - Varsovia Cevallos
- Centro de Investigación en Enfermedades Infeciosas y Vectoriales (CIREV), Instituto Nacional de Investigación en Salud Pública (INSPI), Quito, 170136, Ecuador
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Márquez S, Lee GO, Andrade P, Zuniga J, Trueba G, Eisenberg JNS, Coloma J. A Chikungunya Outbreak in a Dengue-endemic Region in Rural Northern Coastal Ecuador. Am J Trop Med Hyg 2022; 107:1226-1233. [PMID: 36375454 PMCID: PMC9768284 DOI: 10.4269/ajtmh.22-0296] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 09/10/2022] [Indexed: 11/16/2022] Open
Abstract
Dengue virus (DENV) reemerged in the Americas in the 1980s and 1990s, whereas chikungunya virus (CHIKV) emerged in 2014. Although CHIKV produced large epidemics from 2014 to 2017, dengue fever has been the prominent arboviral disease identified through passive surveillance, bringing to question the degree to which cases are misdiagnosed. To address this concern, we conducted an active household-based surveillance of arboviral-like illnesses in six rural and remote communities in northern coastal Ecuador from May 2019 to February 2020. Although passive surveillance conducted by the Ecuadorian Ministry of Health reported only DENV cases in the region, more than 70% of the arbovirus-like illnesses detected by active surveillance in our study were positive for CHIKV. These findings underline the need for active surveillance of arboviral infections with laboratory confirmation, especially in rural communities where arboviral illnesses are more likely to be underreported.
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Affiliation(s)
- Sully Márquez
- Instituto de Microbiología, Universidad San Francisco de Quito, Quito, Ecuador
| | - Gwenyth O. Lee
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Paulina Andrade
- Colegio de Ciencias Biológicas y Ambientales COCIBA, Universidad San Francisco de Quito, Quito, Ecuador
- Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley, Berkeley, California
| | - Julio Zuniga
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Gabriel Trueba
- Instituto de Microbiología, Universidad San Francisco de Quito, Quito, Ecuador
| | - Joseph N. S. Eisenberg
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Josefina Coloma
- Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley, Berkeley, California
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The importance of community during rapid development: The influence of social networks on acute gastrointestinal illness in rural Ecuador. SSM Popul Health 2022; 19:101159. [PMID: 35795263 PMCID: PMC9251719 DOI: 10.1016/j.ssmph.2022.101159] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 05/10/2022] [Accepted: 06/26/2022] [Indexed: 11/24/2022] Open
Abstract
Social networks are often measured as conduits of infection. Our prior cross-sectional analyses found that denser social ties among individuals reduces transmission of acute gastrointestinal illness (AGI) in coastal Ecuador; social networks can describe both risk and protection. We extend findings to examine how social connectedness influences AGI longitudinally in Ecuador from 2007 to 2013, a time of rapid development, using a two-stage Bayesian hierarchical model to estimate multiple network effects. A larger community network of people to discuss important matters with was consistently protective against AGI over time, and a network defined by people passing time together became a stronger measure of risk, due to increasing population density and travel. These networks were interdependent: the joint effect of having a small passing time network and large important matters network reduced the odds of AGI over time (2007: OR 1.16 (95% CI: 0.94, 1.44), 2013: OR 0.56 (95% CI: 0.45, 0.71)); and synergistic: the people an individual passed time with became the people they discussed important matters with. Focus groups emphasized that with greater remoteness came greater community cohesion resulting in safer WASH practices. Social networks can enhance and reduce health differently as social infrastructure evolves, highlighting the importance of community-level factors in a period of rapid development. Social connectedness, a construct often represented as social networks, plays an important role in public health. This construct can lead to both protection from and risk of infectious diseases, particularly during rapid development. Two types of longitudinal social network data from Ecuador were assessed: core discussion network and passing time network. The two types of social connections interact and contribute differentially to the reduction of acute gastrointestinal illness. In more remote areas, the strength of the community structure and organization was critical for disease reduction despite minimal road access.
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Abram NK, Lim HY, Ng CKC, Yorath S, Razi MHM, Ong CGS, Chen KO, Wilson KB. The socio-economic and cultural impacts of the Pan Borneo Highway on Indigenous and local communities in Sabah, Malaysian Borneo. PLoS One 2022; 17:e0269890. [PMID: 35759467 PMCID: PMC9236263 DOI: 10.1371/journal.pone.0269890] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 05/29/2022] [Indexed: 11/17/2022] Open
Abstract
Road and highway development can provide multiple benefits to society, but without careful planning, this development can result in negative social and environmental impacts. The 1,200 km Pan Borneo Highway project (PBH) in Sabah, Malaysian Borneo, is constructing new highways and up-grading 2-lane roads to 4-lane highways. We assessed the potential impact of the PBH on communities using three width scenarios of 50m, 75m and 100m for planned highway alignments, and identified potentially impacted dwellings and community lands. We estimated that 65–93 villages will be impacted, and that 1,712–7,093 dwellings and 3,420–6,695 ha of community lands (e.g. paddy, oil palm smallholdings and rubber) may be lost to the PBH. Due to land tenure technicalities, many affected households may not get compensation for the loss of their homes and lands. The PBH will disproportionally impact Sabah’s Indigenous Peoples, with the Kadazandusun most affected. For this study to be constructive, we provide a low impact alternative alignment for a part of the PBH; discuss the socio-economic and cultural impacts of the PBH, and offer some perspectives on current planning procedures in Sabah to support more sustainable and equitable development.
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Affiliation(s)
| | - Hong Ye Lim
- Forever Sabah, Kota Kinabalu, Sabah, Malaysia
| | | | - Sylvia Yorath
- Land Empowerment Animals People, Kota Kinabalu, Sabah, Malaysia
| | | | - Cynthia Gaik Suan Ong
- Forever Sabah, Kota Kinabalu, Sabah, Malaysia
- Land Empowerment Animals People, Kota Kinabalu, Sabah, Malaysia
| | - Kok-On Chen
- Forever Sabah, Kota Kinabalu, Sabah, Malaysia
| | - Kenneth Brockington Wilson
- Forever Sabah, Kota Kinabalu, Sabah, Malaysia
- Land Empowerment Animals People, Kota Kinabalu, Sabah, Malaysia
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9
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Espira L, Aung T, Han K, Jagger P, Eisenberg JNS. Determinants of Pathogen Contamination of the Environment in the Greater Yangon Area, Myanmar. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2021; 55:16465-16476. [PMID: 34792323 DOI: 10.1021/acs.est.1c02887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Recent results from water, sanitation, and hygiene interventions highlight the need to better understand environmental influences on enteropathogen transmission. We quantified a range of viral, bacterial, and protozoal pathogens and one indicator, Enterococcus faecalis in soil and water from urban and rural sites in and around Yangon, Myanmar. We found that environmental characteristics associated with contamination differed by pathogens and substrates. In soil, bacterial pathogen gene counts were associated with elevation and drainage ditches (compared to stagnant water) (RR = 0.96, 95% CI 0.93, 0.99 and RR = 1.70, 95% CI 1.18, 2.45, respectively), while viral gene counts were associated with the presence of sanitation facilities within 50 m of the collection point (RR = 3.99, 95% CI 1.12, 14.24). In water, E. faecalis, total pathogen, and bacterial pathogen gene counts were associated with drainage ditches (RR = 1.86, 95% CI 1.27, 2.72, RR = 1.38 95% CI 1.09, 1.74, and RR = 1.38 95% CI 1.07, 1.77, respectively). E. faecalis, total pathogen, bacterial pathogen, and viral gene counts were associated with the presence of uncollected garbage within 50 m of the collection point (RR = 1.57, 95% CI 1.00, 2.47, RR = 1.52, 95% CI 1.16, 2.00, RR = 1.52, 95% CI 1.13, 2.06, and RR = 1.75, 95% CI 1.17, 2.61 respectively). Measuring the environment provides added specificity toward identifying important environmental pathways that require mitigation.
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Affiliation(s)
- Leon Espira
- Department of Epidemiology, University of Michigan, Ann Arbor, Michigan 48109, United States
| | - Ther Aung
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27516, United States
| | - Khin Han
- Department of Geography, West Yangon University, Yangon 13393, Myanmar
| | - Pamela Jagger
- School for Environment and Sustainability, University of Michigan, Ann Arbor, Michigan 48109, United States
| | - Joseph N S Eisenberg
- Department of Epidemiology, University of Michigan, Ann Arbor, Michigan 48109, United States
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10
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Malhotra SK, White H, Dela Cruz NAO, Saran A, Eyers J, John D, Beveridge E, Blöndal N. Studies of the effectiveness of transport sector interventions in low- and middle-income countries: An evidence and gap map. CAMPBELL SYSTEMATIC REVIEWS 2021; 17:e1203. [PMID: 36951810 PMCID: PMC8724647 DOI: 10.1002/cl2.1203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
BACKGROUND There are great disparities in the quantity and quality of infrastructure. European countries such as Denmark, Germany, Switzerland, and the UK have close to 200 km of road per 100 km2, and the Netherlands over 300 km per 100 km2. By contrast, Kenya and Indonesia have <30, Laos and Morocco <20, Tanzania and Bolivia <10, and Mauritania only 1 km per 100 km2. As these figures show, there is a significant backlog of transport infrastructure investment in both rural and urban areas, especially in sub-Saharan Africa. This situation is often exacerbated by weak governance and an inadequate regulatory framework with poor enforcement which lead to high costs and defective construction.The wellbeing of many poor people is constrained by lack of transport, which is called "transport poverty". Lucas et al. suggest that up to 90% of the world's population are transport poor when defined as meeting at least one of the following criteria: (1) lack of available suitable transport, (2) lack of transport to necessary destinations, (3) cost of necessary transport puts household below the income poverty line, (4) excessive travel time, or (5) unsafe or unhealthy travel conditions. OBJECTIVES The aim of this evidence and gap map (EGM) is to identify, map, and describe existing evidence from studies reporting the quantitative effects of transport sector interventions related to all means of transport (roads, rail, trams and monorail, ports, shipping, and inland waterways, and air transport). METHODS The intervention framework of this EGM reframes Berg et al's three categories (infrastructure, prices, and regulations) broadly as infrastructure, incentives, and institutions as subcategories for each intervention category which are each mode of transport (road, rail trams and monorail, ports, shipping, and inlands waterways, and air transport). This EGM identifies the area where intervention studies have been conducted as well as the current gaps in the evidence base.This EGM includes ongoing and completed impact evaluations and systematic reviews (SRs) of the effectiveness of transport sector interventions. This is a map of effectiveness studies (impact evaluations). The impact evaluations include experimental designs, nonexperimental designs, and regression designs. We have not included the before versus after studies and qualitative studies in this map. The search strategies included both academic and grey literature search on organisational websites, bibliographic searches and hand search of journals.An EGM is a table or matrix which provides a visual presentation of the evidence in a particular sector or a subsector. The map is presented as a matrix in which rows are intervention categories (e.g., roads) and subcategories (e.g., infrastructure) and the column outcome domains (e.g., environment) and subcategories as (e.g., air quality). Each cell contains studies of the corresponding intervention for the relevant outcome, with links to the available studies. Included studies were coded according to the intervention and outcomes assessed and additional filters as region, population, and study design. Critical appraisal of included SR was done using A Measurement Tool to Assess Systematic Reviews (AMSTAR -2) rating scale. SELECTION CRITERIA The search included both academic and grey literature available online. We included impact evaluations and SRs that assessed the effectiveness of transport sector interventions in low- and middle-income countries. RESULTS This EGM on the transport sector includes 466 studies from low- and middle-income countries, of which 34 are SRs and 432 impact evaluations. There are many studies of the effects of roads intervention in all three subcategories-infrastructure, incentives, and institutions, with the most studies in the infrastructure subcategories. There are no or fewer studies on the interventions category ports, shipping, and waterways and for civil aviation (Air Transport).In the outcomes, the evidence is most concentrated on transport infrastructure, services, and use, with the greatest concentration of evidence on transport time and cost (193 studies) and transport modality (160 studies). There is also a concentration of evidence on economic development and health and education outcomes. There are 139 studies on economic development, 90 studies on household income and poverty, and 101 studies on health outcomes.The major gaps in evidence are from all sectors except roads in the intervention. And there is a lack of evidence on outcome categories such as cultural heritage and cultural diversity and very little evidence on displacement (three studies), noise pollution (four studies), and transport equity (2). There is a moderate amount of evidence on infrastructure quantity (32 studies), location, land use and prices (49 studies), market access (29 studies), access to education facilities (23 studies), air quality (50 studies), and cost analysis including ex post CBA (21 studies).The evidence is mostly from East Asia and the Pacific Region (223 studies (40%), then the evidence is from the sub-Saharan Africa (108 studies), South Asia (96 studies), Latin America & Caribbean (79 studies). The least evidence is from Middle East & North Africa (30 studies) and Europe & Central Asia (20 studies). The most used study design is other regression design in all regions, with largest number from East Asia and Pacific (274). There is total 33 completed SRs identified and one ongoing, around 85% of the SR are rated low confidence, and 12% rated as medium confidence. Only one review was rated as high confidence. This EGM contains the available evidence in English. CONCLUSION This map shows the available evidence and gaps on the effectiveness of transport sector intervention in low- and middle-income countries. The evidence is highly concentrated on the outcome of transport infrastructure (especially roads), service, and use (351 studies). It is also concentrated in a specific region-East Asia and Pacific (223 studies)-and more urban populations (261 studies). Sectors with great development potential, such as waterways, are under-examined reflecting also under-investment.The available evidence can guide the policymakers, and government-related to transport sector intervention and its effects on many outcomes across sectors. There is a need to conduct experimental studies and quality SRs in this area. Environment, gender equity, culture, and education in low- and middle-income countries are under-researched areas in the transport sector.
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11
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Lee GO, Eisenberg JNS, Uruchima J, Vasco G, Smith SM, Van Engen A, Victor C, Reynolds E, MacKay R, Jesser KJ, Castro N, Calvopiña M, Konstantinidis KT, Cevallos W, Trueba G, Levy K. Gut microbiome, enteric infections and child growth across a rural-urban gradient: protocol for the ECoMiD prospective cohort study. BMJ Open 2021; 11:e046241. [PMID: 34686548 PMCID: PMC8543627 DOI: 10.1136/bmjopen-2020-046241] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 09/29/2021] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION The functional consequences of the bacterial gut microbiome for child health are not well understood. Characteristics of the early child gut microbiome may influence the course of enteric infections, and enteric infections may change the composition of the gut microbiome, all of which may have long-term implications for child growth and development. METHODS AND ANALYSIS We are conducting a community-based birth cohort study to examine interactions between gut microbiome conditions and enteric infections, and how environmental conditions affect the development of the gut microbiome. We will follow 360 newborns from 3 sites along a rural-urban gradient in northern coastal Ecuador, characterising enteric infections and gut microbial communities in the children every 3 to 6 months over their first 2 years of life. We will use longitudinal regression models to assess the correlation between environmental conditions and gut microbiome diversity and presence of specific taxa, controlling for factors that are known to be associated with the gut microbiome, such as diet. From 6 to 12 months of age, we will collect weekly stool samples to compare microbiome conditions in diarrhoea stools versus stools from healthy children prior to, during and after acute enteric infections, using principal-coordinate analysis and other multivariate statistical methods. ETHICS AND DISSEMINATION Ethics approvals have been obtained from Emory University and the Universidad San Francisco de Quito institutional review boards. The findings will be disseminated through conference presentations and peer-reviewed journals.
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Affiliation(s)
- Gwenyth O Lee
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Joseph N S Eisenberg
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Jessica Uruchima
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Gabriela Vasco
- Instituto de Microbiología, Universidad San Francisco de Quito, Quito, Pichincha, Ecuador
- Facultad de Ciencias Médicas, Universidad Central del Ecuador, Quito, Ecuador
| | - Shanon M Smith
- Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, Georgia, USA
| | - Amanda Van Engen
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Courtney Victor
- Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, Georgia, USA
| | - Elise Reynolds
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Rebecca MacKay
- Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, Georgia, USA
| | - Kelsey J Jesser
- Department of Environmental and Occupational Health Sciences, University of Washington School of Public Health, Seattle, Washington, USA
| | - Nancy Castro
- Carrera de Nutrición y Dietética, Universidad San Francisco de Quito, Quito, Pichincha, Ecuador
| | - Manuel Calvopiña
- Carrera de Medicina, Universidad de Las Americas Facultad de Ciencias de la Salud, Quito, Pichincha, Ecuador
| | | | - William Cevallos
- Instituto de Biomedicina, Facultad de Ciencias Médicas, Universidad Central del Ecuador, Quito, Ecuador
| | - Gabriel Trueba
- Instituto de Microbiología, Universidad San Francisco de Quito, Quito, Pichincha, Ecuador
| | - Karen Levy
- Department of Environmental and Occupational Health Sciences, University of Washington School of Public Health, Seattle, Washington, USA
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12
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Wang LP, Han JY, Zhou SX, Yu LJ, Lu QB, Zhang XA, Zhang HY, Ren X, Zhang CH, Wang YF, Lin SH, Xu Q, Jiang BG, Lv CL, Chen JJ, Li CJ, Li ZJ, Yang Y, Liu W, Fang LQ, Hay SI, Gao GF, Yang WZ. The changing pattern of enteric pathogen infections in China during the COVID-19 pandemic: a nation-wide observational study. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2021; 16:100268. [PMID: 34568854 PMCID: PMC8450280 DOI: 10.1016/j.lanwpc.2021.100268] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 08/12/2021] [Accepted: 08/19/2021] [Indexed: 02/06/2023]
Abstract
Background Non pharmaceutical interventions (NPI) including hand washing directives were implemented in China and worldwide to combat the COVID-19 pandemic, which are likely to have had impacted a broad spectrum of enteric pathogen infections. Methods Etiologically diagnostic data from 45 937 and 67 395 patients with acute diarrhea between 2012 and 2020, who were tested for seven viral pathogens and 13 bacteria respectively, were analyzed to assess the changes of enteric pathogen infections in China during the first COVID-19 pandemic year compared to pre-pandemic years. Findings Test positive rates of all enteric viruses decreased during 2020, compared to the average levels during 2012−2019, with a relative decrease of 71•75% for adenovirus, 58•76% for norovirus, 53•50% for rotavirus A, and 72•07% for the combination of other four uncommon viruses. In general, a larger reduction of positive rate in viruses was seen among adults than pediatric patients. A rebound of rotavirus A was seen after September 2020 in North China rather than South China. Test positive rates of bacteria decreased during 2020, compared to the average levels during 2012−2019, excepting for nontyphoidal Salmonella and Campylobacter coli with 66•53% and 90•48% increase respectively. This increase was larger for pediatric patients than for adult patients. Interpretation The activity of enteric pathogens changed profoundly alongside the NPIs implemented during the COVID-19 pandemic in China. Greater reductions of the test positive rates were found for almost all enteric viruses than for bacteria among acute diarrhea patients, with further large differences by age and geography. Lifting of NPIs will lead to resurgence of enteric pathogen infections, particularly in children whose immunity may not have been developed and/or waned. Funding China Mega-Project on Infectious Disease Prevention; National Natural Science Funds.
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Affiliation(s)
- Li-Ping Wang
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jia-Yi Han
- School of Mathematical Sciences, Ocean University of China, Qingdao, China
| | - Shi-Xia Zhou
- Anhui Medical University, Hefei, China.,State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, P. R. China
| | - Lin-Jie Yu
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, P. R. China
| | - Qing-Bin Lu
- Department of Laboratorial Science and Technology, School of Public Health, Peking University, Beijing, P. R. China
| | - Xiao-Ai Zhang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, P. R. China
| | - Hai-Yang Zhang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, P. R. China
| | - Xiang Ren
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Cui-Hong Zhang
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yi-Fei Wang
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Sheng-Hong Lin
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Qiang Xu
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, P. R. China
| | - Bao-Gui Jiang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, P. R. China
| | - Chen-Long Lv
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, P. R. China
| | - Jin-Jin Chen
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, P. R. China
| | - Chang-Jun Li
- School of Mathematical Sciences, Ocean University of China, Qingdao, China
| | - Zhong-Jie Li
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yang Yang
- Department of Biostatistics, College of Public Health and Health Professions, and Emerging Pathogens Institute, University of Florida, Gainesville, Florida, U. S. A
| | - Wei Liu
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, P. R. China.,Department of Laboratorial Science and Technology, School of Public Health, Peking University, Beijing, P. R. China
| | - Li-Qun Fang
- Anhui Medical University, Hefei, China.,State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, P. R. China
| | - Simon I Hay
- Department of Health Metrics Sciences, School of Medicine, University of Washington.,Institute for Health Metrics and Evaluation, University of Washington
| | - George F Gao
- Chinese Centre for Disease Control and Prevention, Beijing, China
| | - Wei-Zhong Yang
- Chinese Centre for Disease Control and Prevention, Beijing, China
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13
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"Chicken dumping": Motivations and perceptions in shifting poultry production practices. One Health 2021; 13:100296. [PMID: 34381865 PMCID: PMC8333137 DOI: 10.1016/j.onehlt.2021.100296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 07/20/2021] [Accepted: 07/21/2021] [Indexed: 11/23/2022] Open
Abstract
Non-governmental organizations (NGOs) often implement overseas development aid through intensive small-scale animal agriculture to alleviate food insecurity in low- and middle-income countries. Intensive animal farming can pose unclear outcomes to households engaged in the practice because of the reliance on industrial animal breeds that are reared with antibiotics and raised in higher densities compared to traditional scavenging husbandry systems. As a result, intensive small-scale farming operations that lack proper infrastructure, training, and financial resources could facilitate the spread of antimicrobial resistance and infectious diseases. We applied a mixed-methods framework towards analyzing the effectiveness of small-scale broiler chicken farming in northern Ecuador. First, from May 2016 – May 2017, our observational surveys indicated that intensive small-scale poultry farming follows a boom-and-bust cycle that is extremely vulnerable to environmental stressors. Second, in May 2016, we followed a cohort of households enrolled in a poultry development project led by an NGO. We observed a substantial decline in chicken survivorship from Survey period 1 to 2 (mean chicken count decrease from 50 to 35 corresponding to a 70% survivorship) and from Survey period 2 to 3 (mean chicken count decrease from 35 to 20.3 corresponding to a 58% survivorship). Heads of households were self-reporting broiler chicken survivorship substantially higher than our recorded observations during survey period two (46 compared to 35 respectively) and three (44.3 compared to 20.3 respectively). We speculate that if households continue to inaccurately report poultry demographics, then it could perpetuate a negative feedback loop where NGOs continue to conduct the same intervention practices without receiving accurate outcome metrics. Third, we used semi-structured questionnaires to determine that access to financial resources was the major motivation for determining when to farm broiler chickens. Intensive small-scale poultry farming can be unreliable and disease-enhancing, yet also associated with dubious self-reports of success.
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14
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Kraay ANM, Ionides EL, Lee GO, Trujillo WFC, Eisenberg JNS. Effect of childhood rotavirus vaccination on community rotavirus prevalence in rural Ecuador, 2008-13. Int J Epidemiol 2021; 49:1691-1701. [PMID: 32844206 DOI: 10.1093/ije/dyaa124] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/24/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Although live attenuated monovalent human rotavirus vaccine (Rotarix) efficacy has been characterized through randomized studies, its effectiveness, especially in non-clinical settings, is less clear. In this study, we estimate the impact of childhood Rotarix® vaccination on community rotavirus prevalence. METHODS We analyse 10 years of serial population-based diarrhoea case-control study, which also included testing for rotavirus infection (n = 3430), and 29 months of all-cause diarrhoea active surveillance from a child cohort (n = 376) from rural Ecuador during a period in which Rotarix vaccination was introduced. We use weighted logistic regression from the case-control data to assess changes in community rotavirus prevalence (both symptomatic and asymptomatic) and all-cause diarrhoea after the vaccine was introduced. We also assess changes in all-cause diarrhoea rates in the child cohort (born 2008-13) using Cox regression, comparing time to first all-cause diarrhoea case by vaccine status. RESULTS Overall, vaccine introduction among age-eligible children was associated with a 82.9% reduction [95% confidence interval (CI): 49.4%, 94.2%] in prevalence of rotavirus in participants without diarrhoea symptoms and a 46.0% reduction (95% CI: 6.2%, 68.9%) in prevalence of rotavirus infection among participants experiencing diarrhoea. Whereas all age groups benefited, this reduction was strongest among the youngest age groups. For young children, prevalence of symptomatic diarrhoea also decreased in the post-vaccine period in both the case-control study (reduction in prevalence for children <1 year of age = 69.3%, 95% CI: 8.7%, 89.7%) and the cohort study (reduction in hazard for receipt of two Rotarix doses among children aged 0.5-2 years = 57.1%, 95% CI: 16.6, 77.9%). CONCLUSIONS Rotarix vaccination may suppress transmission, including asymptomatic transmission, in low- and middle-income settings. It was highly effective among children in a rural community setting and provides population-level benefits through indirect protection among adults.
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Affiliation(s)
- Alicia N M Kraay
- Department of Epidemiology, University of Michigan-Ann Arbor, Ann Arbor, MI, USA
| | - Edward L Ionides
- Department of Statistics, University of Michigan-Ann Arbor, Ann Arbor, MI, USA
| | - Gwenyth O Lee
- Department of Epidemiology, University of Michigan-Ann Arbor, Ann Arbor, MI, USA
| | | | - Joseph N S Eisenberg
- Department of Epidemiology, University of Michigan-Ann Arbor, Ann Arbor, MI, USA
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15
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Soto-Girón MJ, Peña-Gonzalez A, Hatt JK, Montero L, Páez M, Ortega E, Smith S, Cevallos W, Trueba G, Konstantinidis KT, Levy K. Gut Microbiome Changes with Acute Diarrheal Disease in Urban Versus Rural Settings in Northern Ecuador. Am J Trop Med Hyg 2021; 104:2275-2285. [PMID: 33872206 DOI: 10.4269/ajtmh.20-0831] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 02/15/2021] [Indexed: 12/12/2022] Open
Abstract
Previous studies have reported lower fecal bacterial diversity in urban populations compared with those living in rural settings. However, most of these studies compare geographically distant populations from different countries and even continents. The extent of differences in the gut microbiome in adjacent rural versus urban populations, and the role of such differences, if any, during enteric infections remain poorly understood. To provide new insights into these issues, we sampled the gut microbiome of young children with and without acute diarrheal disease (ADD) living in rural and urban areas in northern Ecuador. Shotgun metagenomic analyses of non-ADD samples revealed small but significant differences in the abundance of microbial taxa, including a greater abundance of Prevotella and a lower abundance of Bacteroides and Alistipes in rural populations. Greater and more significant shifts in taxon abundance, metabolic pathway abundance, and diversity were observed between ADD and non-ADD status when comparing urban to rural sites (Welch's t-test, P < 0.05). Collectively our data show substantial functional, diversity, and taxonomic shifts in the gut microbiome of urban populations with, ADD supporting the idea that the microbiome of rural populations may be more resilient to ADD episodes.
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Affiliation(s)
- Maria J Soto-Girón
- 1School of Biological Sciences, Georgia Institute of Technology, Atlanta, Georgia
| | - Angela Peña-Gonzalez
- 1School of Biological Sciences, Georgia Institute of Technology, Atlanta, Georgia
| | - Janet K Hatt
- 2School of Civil and Environmental Engineering, Georgia Institute of Technology, Atlanta, Georgia
| | - Lorena Montero
- 3Instituto de Microbiologia, Universidad San Francisco de Quito, Quito, Ecuador
| | - Maritza Páez
- 3Instituto de Microbiologia, Universidad San Francisco de Quito, Quito, Ecuador
| | - Estefania Ortega
- 3Instituto de Microbiologia, Universidad San Francisco de Quito, Quito, Ecuador
| | - Shanon Smith
- 4School of Public Health, University of Washington, Seattle, Washington
| | - William Cevallos
- 5Centro de Biomedicina, Universidad Central del Ecuador, Quito, Ecuador
| | - Gabriel Trueba
- 3Instituto de Microbiologia, Universidad San Francisco de Quito, Quito, Ecuador
| | - Konstantinos T Konstantinidis
- 1School of Biological Sciences, Georgia Institute of Technology, Atlanta, Georgia.,2School of Civil and Environmental Engineering, Georgia Institute of Technology, Atlanta, Georgia
| | - Karen Levy
- 4School of Public Health, University of Washington, Seattle, Washington
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16
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Kwok CYT, Wong MS, Chan KL, Kwan MP, Nichol JE, Liu CH, Wong JYH, Wai AKC, Chan LWC, Xu Y, Li H, Huang J, Kan Z. Spatial analysis of the impact of urban geometry and socio-demographic characteristics on COVID-19, a study in Hong Kong. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 764:144455. [PMID: 33418356 PMCID: PMC7738937 DOI: 10.1016/j.scitotenv.2020.144455] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Revised: 11/04/2020] [Accepted: 12/06/2020] [Indexed: 05/11/2023]
Abstract
The World Health Organization considered the wide spread of COVID-19 over the world as a pandemic. There is still a lack of understanding of its origin, transmission, and treatment methods. Understanding the influencing factors of COVID-19 can help mitigate its spread, but little research on the spatial factors has been conducted. Therefore, this study explores the effects of urban geometry and socio-demographic factors on the COVID-19 cases in Hong Kong. For each patient, the places they visited during the incubation period before going to hospital were identified, and matched with corresponding attributes of urban geometry (i.e., building geometry, road network and greenspace) and socio-demographic factors (i.e., demographic, educational, economic, household and housing characteristics) based on the coordinates. The local cases were then compared with the imported cases using stepwise logistic regression, logistic regression with case-control of time, and least absolute shrinkage and selection operator regression to identify factors influencing local disease transmission. Results show that the building geometry, road network and certain socio-economic characteristics are significantly associated with COVID-19 cases. In addition, the results indicate that urban geometry is playing a more important role than socio-demographic characteristics in affecting COVID-19 incidence. These findings provide a useful reference to the government and the general public as to the spatial vulnerability of COVID-19 transmission and to take appropriate preventive measures in high-risk areas.
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Affiliation(s)
- Coco Yin Tung Kwok
- Department of Land Surveying and Geo-Informatics, The Hong Kong Polytechnic University, Kowloon, Hong Kong, China
| | - Man Sing Wong
- Department of Land Surveying and Geo-Informatics, The Hong Kong Polytechnic University, Kowloon, Hong Kong, China; Research Institute for Sustainable Urban Development, The Hong Kong Polytechnic University, Kowloon, Hong Kong, China.
| | - Ka Long Chan
- Department of Land Surveying and Geo-Informatics, The Hong Kong Polytechnic University, Kowloon, Hong Kong, China
| | - Mei-Po Kwan
- Department of Geography and Resource Management, and Institute of Space and Earth Information Science, The Chinese University of Hong Kong, Hong Kong, China; Department of Human Geography and Spatial Planning, Faculty of Geosciences, Utrecht University, 3584 CB Utrecht, The Netherlands
| | | | - Chun Ho Liu
- Department of Mechanical Engineering, The University of Hong Kong, Hong Kong, China
| | - Janet Yuen Ha Wong
- School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | | | - Lawrence Wing Chi Chan
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Kowloon, Hong Kong, China
| | - Yang Xu
- Department of Land Surveying and Geo-Informatics, The Hong Kong Polytechnic University, Kowloon, Hong Kong, China
| | - Hon Li
- Department of Land Surveying and Geo-Informatics, The Hong Kong Polytechnic University, Kowloon, Hong Kong, China
| | - Jianwei Huang
- Institute of Space and Earth Information Science, The Chinese University of Hong Kong, Hong Kong, China
| | - Zihan Kan
- Institute of Space and Earth Information Science, The Chinese University of Hong Kong, Hong Kong, China
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Multiple burdens of malnutrition and relative remoteness in rural Ecuadorian communities. Public Health Nutr 2020; 24:4591-4602. [PMID: 33155533 DOI: 10.1017/s1368980020004462] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Social and economic changes associated with new roads can bring about rapid nutritional transitions. To study this process, we: (1) describe trends in adult overweight and obesity (OW/OB) among rural Afro-Ecuadorians over time and across a gradient of community remoteness from the nearest commercial centre; (2) examine the relationship between male and female adult OW/OB and factors associated with market integration such as changing livelihoods and (3) examine the co-occurrence of adult OW/OB and under-five stunting and anaemia. DESIGN Adult anthropometry was collected through serial case-control studies repeated over a decade across twenty-eight communities. At the same time, anthropometry and Hb were measured for all children under 5 years of age in every community. SETTING Northern coastal Ecuador. PARTICIPANTS Adults (n 1665) and children under 5 years of age (n 2618). RESULTS From 2003 and 2013, OW/OB increased from 25·1 % to 44·8 % among men and 59·9 % to 70·2 % among women. The inverse relationship between remoteness and OW/OB in men was attenuated when adjusting for urban employment, suggesting that livelihoods mediated the remoteness-OW/OB relationship. No such relationship was observed among women. Communities with a higher prevalence of male OW/OB also had a greater prevalence of stunting, but not anaemia, in children under 5 years of age. CONCLUSIONS The association between male OW/OB and child stunting at the community level, but not the household level, suggests that changing food environments, rather than household- or individual-level factors, drove these trends. A closer examination of changing socio-economic structures and food environments in communities undergoing rapid development could help mitigate future public health burdens.
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Rosenthal J, Arku RE, Baumgartner J, Brown J, Clasen T, Eisenberg JN, Hovmand P, Jagger P, Luke DA, Quinn A, Yadama GN. Systems Science Approaches for Global Environmental Health Research: Enhancing Intervention Design and Implementation for Household Air Pollution (HAP) and Water, Sanitation, and Hygiene (WASH) Programs. ENVIRONMENTAL HEALTH PERSPECTIVES 2020; 128:105001. [PMID: 33035121 PMCID: PMC7546437 DOI: 10.1289/ehp7010] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 09/13/2020] [Accepted: 09/15/2020] [Indexed: 05/23/2023]
Abstract
BACKGROUND Two of the most important causes of global disease fall in the realm of environmental health: household air pollution (HAP) and poor water, sanitation, and hygiene (WASH) conditions. Interventions, such as clean cookstoves, household water treatment, and improved sanitation facilities, have great potential to yield reductions in disease burden. However, in recent trials and implementation efforts, interventions to improve HAP and WASH conditions have shown few of the desired health gains, raising fundamental questions about current approaches. OBJECTIVES We describe how the failure to consider the complex systems that characterize diverse real-world conditions may doom promising new approaches prematurely. We provide examples of the application of systems approaches, including system dynamics, network analysis, and agent-based modeling, to the global environmental health priorities of HAP and WASH research and programs. Finally, we offer suggestions on how to approach systems science. METHODS Systems science applied to environmental health can address major challenges by a) enhancing understanding of existing system structures and behaviors that accelerate or impede aims; b) developing understanding and agreement on a problem among stakeholders; and c) guiding intervention and policy formulation. When employed in participatory processes that engage study populations, policy makers, and implementers, systems science helps ensure that research is responsive to local priorities and reflect real-world conditions. Systems approaches also help interpret unexpected outcomes by revealing emergent properties of the system due to interactions among variables, yielding complex behaviors and sometimes counterintuitive results. DISCUSSION Systems science offers powerful and underused tools to accelerate our ability to identify barriers and facilitators to success in environmental health interventions. This approach is especially useful in the context of implementation research because it explicitly accounts for the interaction of processes occurring at multiple scales, across social and environmental dimensions, with a particular emphasis on linkages and feedback among these processes. https://doi.org/10.1289/EHP7010.
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Affiliation(s)
- Joshua Rosenthal
- Division of Epidemiology and Population Studies, Fogarty International Center, National Institutes of Health, Department of Health and Human Services, Washington, DC, USA
| | - Raphael E. Arku
- Department of Environmental Health Sciences, Department of Environmental Health Sciences, University of Massachusetts, Amherst, Amherst, Massachusetts, USA
| | - Jill Baumgartner
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Joe Brown
- Department of Environmental Engineering, Georgia Institute of Technology, Atlanta, Georgia, USA
| | - Thomas Clasen
- Department of Environmental Health, Emory University, Atlanta, Georgia, USA
| | | | - Peter Hovmand
- Center for Community Health Integration, School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
| | - Pamela Jagger
- School for Environment and Sustainability, University of Michigan, Ann Arbor, Michigan, USA
| | - Douglas A. Luke
- Center for Public Health Systems Science, Brown School, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Ashlinn Quinn
- Division of Epidemiology and Population Studies, Fogarty International Center, National Institutes of Health, Department of Health and Human Services, Washington, DC, USA
| | - Gautam N. Yadama
- School of Social Work, Boston College, Boston, Massachusetts, USA
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19
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Lee GO, Whitney HJ, Blum AG, Lybik N, Cevallos W, Trueba G, Levy K, Eisenberg JNS. Household coping strategies associated with unreliable water supplies and diarrhea in Ecuador, an upper-middle-income country. WATER RESEARCH 2020; 170:115269. [PMID: 31739243 PMCID: PMC6962559 DOI: 10.1016/j.watres.2019.115269] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 10/29/2019] [Accepted: 11/01/2019] [Indexed: 06/10/2023]
Abstract
The Sustainable Development Goals recognize that the availability and quality of improved water sources affect how households use and benefit from these sources. Although unreliability in piped water supplies in low- and middle-income countries (LMICs) has been described, few studies have assessed household coping strategies in response to unreliable water supplies and associated health outcomes. We characterized unreliability in the piped water supply of the town of Borbón, Ecuador over the twelve years following a major upgrade, as well as household coping strategies and associations with diarrhea. We examined trends in primary and secondary drinking water sources, water storage, and water treatment using longitudinal data collected from 2005 to 2012. In 2017, a follow-up survey was administered (N = 202) and a subset of 84 household water samples were tested for chlorine residual levels and microbial contamination. From 2005 to 2017, access to a household water connection increased from 19.4% to 90.3%. However, reliability decreased over time, as in the latter half of 2009, households had access to piped water 79% of the time, compared to 63% by 2017. Piped water samples were highly contaminated with total coliforms (100% of samples) and Escherichia coli (89% of samples). From 2005 to 2017, households less likely to report drinking water treatment (50.6%-5.0%). And from 2009 to 2017, bottled water was increasingly consumed as the primary drinking water source (18.8%-62.4%). From 2005 to 2012, having a household connection was not statistically significantly associated with diarrhea case status (OR: 0.86 95%CI: 0.53, 1.39). Neither household water treatment nor bottled water consumption were negatively associated with diarrhea. Increased water storage was associated with diarrhea (OR: 1.33 per 10L of water stored, 95%CI: 1.05, 1.69). Household water treatment, and consumption of purchased bottled water, two coping strategies that households may have undertaken in response to an unreliable water supply, were not associated with a reduced likelihood of diarrhea. These data suggest a need to understand how impoverished rural households in LMICs respond to unreliable water supplies, and to develop heath messaging appropriate for this context.
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Affiliation(s)
- Gwenyth O Lee
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA.
| | - Holly J Whitney
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Annalise G Blum
- Department of Earth and Planetary Science, Johns Hopkins University, Baltimore, MD, USA
| | - Noah Lybik
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - William Cevallos
- Instituto de Biomedicina, Carrera e Medicina, Universidad Central de Ecuador, Ecuador
| | - Gabriel Trueba
- Institutito de Microbiología, Colegio de Ciencias Biológicas y Ambientales, Universidad San Francisco de Quito, Quito, Ecuador
| | - Karen Levy
- Department of Environmental Health, Emory University, Atlanta, GA, USA
| | - Joseph N S Eisenberg
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
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20
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ELLWANGER JOELHENRIQUE, KULMANN-LEAL BRUNA, KAMINSKI VALÉRIAL, VALVERDE-VILLEGAS JACQUELINEMARÍA, VEIGA ANABEATRIZGDA, SPILKI FERNANDOR, FEARNSIDE PHILIPM, CAESAR LÍLIAN, GIATTI LEANDROLUIZ, WALLAU GABRIELL, ALMEIDA SABRINAE, BORBA MAUROR, HORA VANUSAPDA, CHIES JOSÉARTURB. Beyond diversity loss and climate change: Impacts of Amazon deforestation on infectious diseases and public health. ACTA ACUST UNITED AC 2020; 92:e20191375. [DOI: 10.1590/0001-3765202020191375] [Citation(s) in RCA: 99] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 02/17/2020] [Indexed: 12/15/2022]
Affiliation(s)
| | | | | | | | | | | | | | - LÍLIAN CAESAR
- Universidade Federal do Rio Grande do Sul/UFRGS, Brazil
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21
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Jin S, Peng J, Li Z, Shen Q. Bidirectional approximate reasoning-based approach for decision support. Inf Sci (N Y) 2020. [DOI: 10.1016/j.ins.2019.08.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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22
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Protecting environmental and socio-economic values of selectively logged tropical forests in the Anthropocene. ADV ECOL RES 2020. [DOI: 10.1016/bs.aecr.2020.01.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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23
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Cherng ST, Cangemi I, Trostle JA, Remais J, Eisenberg JNS. Social cohesion and passive adaptation in relation to climate change and disease. GLOBAL ENVIRONMENTAL CHANGE : HUMAN AND POLICY DIMENSIONS 2019; 58:101960. [PMID: 32863604 PMCID: PMC7448570 DOI: 10.1016/j.gloenvcha.2019.101960] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Climate change affects biophysical processes related to the transmission of many infectious diseases, with potentially adverse consequences for the health of communities. While our knowledge of biophysical associations between meteorological factors and disease is steadily improving, our understanding of the social processes that shape adaptation to environmental perturbations lags behind. Using computational modeling methods, we explore the ways in which social cohesion can affect adaptation of disease prevention strategies when communities are exposed to different environmental scenarios that influence transmission pathways for diseases such as diarrhea. We developed an agent-based model in which household agents can choose between two behavioral strategies that offer different levels of protection against environmentally mediated disease transmission. One behavioral strategy is initially set as more protective, leading households to adopt it widely, but its efficacy is sensitive to variable weather conditions and stressors such as floods or droughts that modify the disease transmission system. The efficacy of the second strategy is initially moderate relative to the first and is insensitive to environmental changes. We examined how social cohesion (defined as average number of household social network connections) influences health outcomes when households attempt to identify an optimal strategy by copying the behaviors of socially connected neighbors who seem to have adapted successfully in the past. Our simulation experiments suggest that high-cohesion communities are able to rapidly disseminate the initially optimal behavioral strategy compared to low-cohesion communities. This rapid and pervasive change, however, decreases behavioral diversity; i.e., once a high cohesion community settles on a strategy, most or all households adopt that behavior. Following environmental changes that reduce the efficacy of the initially optimal strategy, rendering it suboptimal relative to the alternative strategy, high-cohesion communities can fail to adapt. As a result, despite faring better early in the course of computational experiments, high-cohesion communities may ultimately experience worse outcomes. In the face of uncertainty in predicting future environmental stressors due to climate change, strategies to improve effective adaptation to optimal disease prevention strategies should balance between intervention efforts that promote protective behaviors based on current scientific understanding and the need to guard against the crystallization of inflexible norms. Developing generalizable models allows us to integrate a wide range of theories multiple datasets pertaining to the relationship between social mechanisms and adaptation, which can provide further understanding of future climate change impacts. Models such as the one we present can generate hypotheses about the mechanisms that underlie the dynamics of adaptation events and suggest specific points of measurement to assess the impact of these mechanisms. They can be incorporated as modules within predictive simulations for specific socio-ecological contexts.
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Affiliation(s)
- Sarah T Cherng
- Johns Hopkins University Bloomberg School of Public Health, Department of Epidemiology (Baltimore, MD, USA)
| | - Ivan Cangemi
- University of Michigan School of Public Health, Department of Epidemiology (Ann Arbor, MI, USA)
| | - James A Trostle
- Trinity College, Department of Anthropology (Hartford, CT, USA)
| | - Justin Remais
- University of California Berkeley School of Public Health, Department of Environmental Health Sciences (Berkeley, CA, USA)
| | - Joseph N S Eisenberg
- University of Michigan School of Public Health, Department of Epidemiology (Ann Arbor, MI, USA)
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24
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Collender PA, Morris C, Glenn-Finer R, Acevedo A, Chang HH, Trostle JA, Eisenberg JNS, Remais JV. Mass Gatherings and Diarrheal Disease Transmission Among Rural Communities in Coastal Ecuador. Am J Epidemiol 2019; 188:1475-1483. [PMID: 31094412 DOI: 10.1093/aje/kwz102] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 04/17/2019] [Accepted: 04/18/2019] [Indexed: 12/17/2022] Open
Abstract
Mass gatherings exacerbate infectious disease risks by creating crowded, high-contact conditions and straining the capacity of local infrastructure. While mass gatherings have been extensively studied in the context of epidemic disease transmission, the role of gatherings in incidence of high-burden, endemic infections has not been previously studied. Here, we examine diarrheal incidence among 17 communities in Esmeraldas, Ecuador, in relation to recurrent gatherings characterized using ethnographic data collected during and after the epidemiologic surveillance period (2004-2007). Using distributed-lag generalized estimating equations, adjusted for seasonality, trend, and heavy rainfall events, we found significant increases in diarrhea risk in host villages, peaking 2 weeks after an event's conclusion (incidence rate ratio, 1.21; confidence interval, adjusted for false coverage rate of ≤0.05: 1.02, 1.43). Stratified analysis revealed heightened risks associated with events where crowding and travel were most likely (2-week-lag incidence rate ratio, 1.51; confidence interval, adjusted for false coverage rate of ≤0.05: 1.09, 2.10). Our findings suggest that community-scale mass gatherings might play an important role in endemic diarrheal disease transmission and could be an important focus for interventions to improve community health in low-resource settings.
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Affiliation(s)
- Philip A Collender
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, California
| | - Christa Morris
- Joint Medical Program of University of California, Berkeley, Berkeley, California, and University of California, San Francisco, San Francisco, California
| | - Rose Glenn-Finer
- Division of Epidemiology, School of Public Health, University of California, Berkeley, Berkeley, California
| | - Andrés Acevedo
- Instituto de Microbiología, Universidad de San Francisco de Quito, Quito, Ecuador
| | - Howard H Chang
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - James A Trostle
- Department of Anthropology, Trinity College, Hartford, Connecticut
| | | | - Justin V Remais
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, California
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25
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Chen SM, Barman D. Adaptive fuzzy interpolative reasoning based on similarity measures of polygonal fuzzy sets and novel move and transformation techniques. Inf Sci (N Y) 2019. [DOI: 10.1016/j.ins.2019.03.034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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26
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Adaptive weighted fuzzy rule interpolation based on ranking values and similarity measures of rough-fuzzy sets. Inf Sci (N Y) 2019. [DOI: 10.1016/j.ins.2019.03.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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27
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Bui T MA, Papoulias N, Stinckwich S, Ziane M, Roche B. The Kendrick modelling platform: language abstractions and tools for epidemiology. BMC Bioinformatics 2019; 20:312. [PMID: 31185887 PMCID: PMC6560906 DOI: 10.1186/s12859-019-2843-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Accepted: 04/24/2019] [Indexed: 12/24/2022] Open
Abstract
Background Mathematical and computational models are widely used to study the transmission, pathogenicity, and propagation of infectious diseases. Unfortunately, complex mathematical models are difficult to define, reuse and reproduce because they are composed of several concerns that are intertwined. The problem is even worse for computational models because the epidemiological concerns are also intertwined with low-level implementation details that are not easily accessible to non-computing scientists. Our goal is to make compartmental epidemiological models easier to define, reuse and reproduce by facilitating implementation of different simulation approaches with only very little programming knowledge. Results We achieve our goal through the definition of a domain-specific language (DSL), Kendrick, that relies on a very general mathematical definition of epidemiological concerns as stochastic automata that are combined using tensor-algebra operators. A very large class of epidemiological concerns, including multi-species, spatial concerns, control policies, sex or age structures, are supported and can be defined independently of each other and combined into models to be simulated by different methods. Implementing models does not require sophisticated programming skills any more. The various concerns involved within a model can be changed independently of the others as well as reused within other models. They are not plagued by low-level implementation details. Conclusions Kendrick is one of the few DSLs for epidemiological modelling that does not burden its users with implementation details or required sophisticated programming skills. It is also currently the only language for epidemiology modelling that supports modularity through clear separation of concerns hence fostering reproducibility and reuse of models and simulations. Future work includes extending Kendrick to support non-compartmental models and improving its interoperability with existing complementary tools. Electronic supplementary material The online version of this article (10.1186/s12859-019-2843-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Mai Anh Bui T
- Software Engineering Department, School of Information and Communication Technology, Hanoi University of Science and Technology, Hanoi, Vietnam.
| | - Nick Papoulias
- Université de La Rochelle, UMR 7266 LIENSs, CNRS, La Rochelle, France
| | - Serge Stinckwich
- Sorbonne Université, IRD, Unité de Modélisation Mathématiques et Informatique des Systèmes Complexes, UMMISCO, F-93143, Bondy, France.,Université de Yaoundé I, IRD, UMMISCO, Yaoundé, Cameroon.,Université de Caen Normandie, Caen, France
| | - Mikal Ziane
- Université de Paris, Paris, France.,Sorbonne Université, CNRS, Laboratoire d'Informatique de Paris 6, LIP6, F-75005, Paris, France
| | - Benjamin Roche
- Sorbonne Université, IRD, Unité de Modélisation Mathématiques et Informatique des Systèmes Complexes, UMMISCO, F-93143, Bondy, France
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28
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Rohr JR, Barrett CB, Civitello DJ, Craft ME, Delius B, DeLeo GA, Hudson PJ, Jouanard N, Nguyen KH, Ostfeld RS, Remais JV, Riveau G, Sokolow SH, Tilman D. Emerging human infectious diseases and the links to global food production. NATURE SUSTAINABILITY 2019; 2:445-456. [PMID: 32219187 PMCID: PMC7091874 DOI: 10.1038/s41893-019-0293-3] [Citation(s) in RCA: 211] [Impact Index Per Article: 42.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 04/17/2019] [Indexed: 05/07/2023]
Abstract
Infectious diseases are emerging globally at an unprecedented rate while global food demand is projected to increase sharply by 2100. Here, we synthesize the pathways by which projected agricultural expansion and intensification will influence human infectious diseases and how human infectious diseases might likewise affect food production and distribution. Feeding 11 billion people will require substantial increases in crop and animal production that will expand agricultural use of antibiotics, water, pesticides and fertilizer, and contact rates between humans and both wild and domestic animals, all with consequences for the emergence and spread of infectious agents. Indeed, our synthesis of the literature suggests that, since 1940, agricultural drivers were associated with >25% of all - and >50% of zoonotic - infectious diseases that emerged in humans, proportions that will likely increase as agriculture expands and intensifies. We identify agricultural and disease management and policy actions, and additional research, needed to address the public health challenge posed by feeding 11 billion people.
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Affiliation(s)
- Jason R. Rohr
- Department of Biological Sciences, Eck Institute for Global Health, and Environmental Change Initiative, University of Notre Dame, Notre Dame, IN USA
- Department of Integrative Biology, University of South Florida, Tampa, FL USA
| | | | | | - Meggan E. Craft
- Department of Veterinary Population Medicine, University of Minnesota, St Paul, MN USA
| | - Bryan Delius
- Department of Integrative Biology, University of South Florida, Tampa, FL USA
| | - Giulio A. DeLeo
- Department of Biology and Woods Institute for the Environment, Hopkins Marine Station, Stanford University, Pacific Grove, CA USA
| | - Peter J. Hudson
- Center for Infectious Disease Dynamics, Pennsylvania State University, College Station, PA USA
| | - Nicolas Jouanard
- Laboratoire de Recherches Biomédicales, Espoir pour la Santé, Saint-Louis, Senegal
| | - Karena H. Nguyen
- Department of Integrative Biology, University of South Florida, Tampa, FL USA
| | | | - Justin V. Remais
- Division of Environmental Health Sciences, University of California, Berkeley, Berkeley, CA USA
| | - Gilles Riveau
- Laboratoire de Recherches Biomédicales, Espoir pour la Santé, Saint-Louis, Senegal
| | - Susanne H. Sokolow
- Department of Biology and Woods Institute for the Environment, Hopkins Marine Station, Stanford University, Pacific Grove, CA USA
- Marine Science Institute, University of California, Santa Barbara, Santa Barbara, CA USA
| | - David Tilman
- Department of Ecology, Evolution and Behavior, University of Minnesota, St Paul, MN USA
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29
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Levy MC, Collender PA, Carlton EJ, Chang HH, Strickland MJ, Eisenberg JNS, Remais JV. Spatiotemporal Error in Rainfall Data: Consequences for Epidemiologic Analysis of Waterborne Diseases. Am J Epidemiol 2019; 188:950-959. [PMID: 30689681 DOI: 10.1093/aje/kwz010] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 01/09/2019] [Accepted: 01/10/2019] [Indexed: 11/14/2022] Open
Abstract
The relationship between rainfall, especially extreme rainfall, and increases in waterborne infectious diseases is widely reported in the literature. Most of this research, however, has not formally considered the impact of exposure measurement error contributed by the limited spatiotemporal fidelity of precipitation data. Here, we evaluate bias in effect estimates associated with exposure misclassification due to precipitation data fidelity, using extreme rainfall as an example. We accomplished this via a simulation study, followed by analysis of extreme rainfall and incident diarrheal disease in an epidemiologic study in Ecuador. We found that the limited fidelity typical of spatiotemporal rainfall data sets biases effect estimates towards the null. Use of spatial interpolations of rain-gauge data or satellite data biased estimated health effects due to extreme rainfall (occurrence) and wet conditions (accumulated totals) downwards by 35%-45%. Similar biases were evident in the Ecuadorian case study analysis, where spatial incompatibility between exposed populations and rain gauges resulted in the association between extreme rainfall and diarrheal disease incidence being approximately halved. These findings suggest that investigators should pay greater attention to limitations in using spatially heterogeneous environmental data sets to assign exposures in epidemiologic research.
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Affiliation(s)
- Morgan C Levy
- School of Global Policy and Strategy, University of California, San Diego, San Diego, California
| | - Philip A Collender
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, California
| | - Elizabeth J Carlton
- Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado, Aurora, Colorado
| | - Howard H Chang
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | | | - Joseph N S Eisenberg
- Department of Epidemiology, University of Michigan, Ann Arbor, Ann Arbor, Michigan
| | - Justin V Remais
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, California
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30
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Chen SM, Barman D. Adaptive weighted fuzzy interpolative reasoning based on representative values and similarity measures of interval type-2 fuzzy sets. Inf Sci (N Y) 2019. [DOI: 10.1016/j.ins.2018.11.013] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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31
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Lopez VK, Berrocal VJ, Corozo Angulo B, Ram PK, Trostle J, Eisenberg JNS. Determinants of Latrine Use Behavior: The Psychosocial Proxies of Individual-Level Defecation Practices in Rural Coastal Ecuador. Am J Trop Med Hyg 2019; 100:733-741. [PMID: 30675841 PMCID: PMC6402891 DOI: 10.4269/ajtmh.18-0144] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 12/08/2018] [Indexed: 01/24/2023] Open
Abstract
There is increasing appreciation that latrine access does not imply use-many individuals who own latrines do not consistently use them. Little is known, however, about the determinants of latrine use, particularly among those with variable defecation behaviors. Using the integrated behavior model of water, sanitation, and hygiene framework, we sought to characterize determinants of latrine use in rural Ecuador. We interviewed 197 adults living in three communities with a survey consisting of 70 psychosocial defecation-related questions. Questions were excluded from analysis if responses lacked variability or at least 10% of respondents did not provide a definitive answer. All interviewed individuals had access to a privately owned or shared latrine. We then applied adaptive elastic nets (ENET) and supervised principal component analysis (SPCA) to a reduced dataset of 45 questions among 154 individuals with complete data to select determinants that predict self-reported latrine use. Latrine use was common, but not universal, in the sample (76%). The SPCA model identified six determinants and adaptive ENET selected five determinants. Three indicators were represented in both models-latrine users were more likely to report that their latrine is clean enough to use and also more likely to report daily latrine use; while those reporting that elderly men were not latrine users were less likely to use latrines themselves. Our findings suggest that social norms are important predictors of latrine use, whereas knowledge of the health benefits of sanitation may not be as important. These determinants are informative for promotion of latrine adoption.
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Affiliation(s)
- Velma K. Lopez
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan
| | - Veronica J. Berrocal
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, Michigan
| | | | - Pavani K. Ram
- Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, New York
| | - James Trostle
- Department of Anthropology, Trinity College, Hartford, Connecticut
| | - Joseph N. S. Eisenberg
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan
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Lopez VK, West BT, Clarke PJ, Quentin E, Eisenberg JNS. Latent variable modeling to develop a robust proxy for sensitive behaviors: application to latrine use behavior and its association with sanitation access in a middle-income country. BMC Public Health 2019; 19:90. [PMID: 30660198 PMCID: PMC6339309 DOI: 10.1186/s12889-018-6373-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Accepted: 12/27/2018] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Globally, diarrhea is a leading cause of child morbidity and mortality. Although latrines are integral for reducing enteric pathogen transmission, several studies have shown no evidence that latrine ownership improved child health. There are a number of explanations for these results. One explanation is that latrine access does not equate to latrine use. Latrine use, however, is difficult to accurately ascertain, as defecation behavior is often stigmatized. To address this measurement issue, we measure latrine use as a latent variable, indicated by a suite of psychosocial variables. METHODS We administered a survey of 16 defecation-related psychosocial questions to 251 individuals living in rural Ecuador. We applied latent class analysis (LCA) to these data to model the probability of latrine use as a latent variable. To account for uncertainty in predicted latent class membership, we used a pseudo-class approach to impute five different probabilities of latrine use for each respondent. Via regression modeling, we tested the association between household sanitation and each imputed latrine use variable. RESULTS The optimal model presented strong evidence of two latent classes (entropy = 0.86): consistent users (78%) and inconsistent users (22%), predicted by 5 of our 16 psychosocial variables. There was no evidence of an association between the probability of latrine use, predicted from the LCA, and household access to basic sanitation (OR = 1.1, 95% CI = 0.6-2.1). This suggests that home access to a sanitation facility may not ensure the use of the facility for every family member at all times. CONCLUSION Effective implementation and evaluation of sanitation programs requires accurate measurement of latrine use. Psychosocial variables, such as norms, perceptions, and attitudes may provide robust proxy-measures. Future longitudinal studies will help to strengthen the use of these surrogate measures, as many of these factors may be subject to secular trends. Additionally, subgroup analyses will elucidate how our proxy indicators of latrine defecation vary by individual-level characteristics.
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Affiliation(s)
- V. K. Lopez
- Department of Epidemiology, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109 USA
| | - B. T. West
- Institute for Social Research, University of Michigan, Ann Arbor, MI USA
| | - P. J. Clarke
- Department of Epidemiology, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109 USA
- Institute for Social Research, University of Michigan, Ann Arbor, MI USA
| | - E. Quentin
- Instituto Nacional de Investigación en Salud Pública, Centro de Investigación EpiSIG, Quito, Ecuador
| | - J. N. S. Eisenberg
- Department of Epidemiology, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109 USA
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Smith SM, Montero L, Paez M, Ortega E, Hall E, Bohnert K, Sanchez X, Puebla E, Endara P, Cevallos W, Trueba G, Levy K. Locals get travellers' diarrhoea too: risk factors for diarrhoeal illness and pathogenic Escherichia coli infection across an urban-rural gradient in Ecuador. Trop Med Int Health 2018; 24:205-219. [PMID: 30444557 DOI: 10.1111/tmi.13183] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVES Diarrhoea is a common and well-studied cause of illness afflicting international travellers. However, traveller's diarrhoea can also result from travel between high and low disease transmission regions within a country, which is the focus of this study. METHODS We recruited participants for a case-control study of diarrhoea at four sites along an urban-rural gradient in Northern Ecuador: Quito, Esmeraldas, Borbón and rural communities outside of Borbón. At each of these sites, approximately 100 subjects with diarrhoea (cases) were recruited from Ministry of Health clinics and were age-matched with subjects visiting the same clinics for other complaints (controls). RESULTS Travellers to urban destinations had higher risk of diarrhoea and diarrhoeagenic Escherichia coli (DEC) infections. Travel to Quito was associated with diarrhoea (aOR = 2.01, 95% CI = 1.10-3.68) and travel to Guayaquil (another urban centre in Ecuador) was associated with Diffuse Adherent E. coli infection (OR = 2.09, 95% CI = 1.01-4.33). Compared to those not travelling, urban origins were also associated with greater risk of diarrhoea in Esmeraldas (aOR = 2.28, 95% CI = 1.20-4.41), and with higher risk of diarrhoeagenic E. coli infections in Quito (aOR = 2.61, 95% CI = 1.16-5.86), with >50% of travel from Quito and Esmeraldas specified to another urban destination. CONCLUSIONS This study suggests that individuals travelling from lower-transmission regions (rural areas) to higher transmission regions (urban centres) within a single country are at a greater risk of acquiring a diarrhoea-related illness. Investments to improve water, sanitation and hygiene conditions in urban areas could have impacts on outlying rural areas within a given country.
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Affiliation(s)
- Shanon M Smith
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Lorena Montero
- Instituto de Microbiología, Universidad San Francisco de Quito, Quito, Ecuador
| | - Maritza Paez
- Instituto de Microbiología, Universidad San Francisco de Quito, Quito, Ecuador
| | - Estefania Ortega
- Instituto de Microbiología, Universidad San Francisco de Quito, Quito, Ecuador
| | - Eric Hall
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Kate Bohnert
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Xavier Sanchez
- Centro de Biomedicina, Universidad Central del Ecuador, Quito, Ecuador
| | - Edison Puebla
- Centro de Biomedicina, Universidad Central del Ecuador, Quito, Ecuador
| | - Pablo Endara
- Instituto de Microbiología, Universidad San Francisco de Quito, Quito, Ecuador
| | - William Cevallos
- Centro de Biomedicina, Universidad Central del Ecuador, Quito, Ecuador
| | - Gabriel Trueba
- Instituto de Microbiología, Universidad San Francisco de Quito, Quito, Ecuador
| | - Karen Levy
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
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Calvopina M, Romero-Alvarez D, Diaz F, Cevallos W, Sugiyama H. A comparison of Kato-Katz technique to three other methods for diagnosis of Amphimerus spp. liver fluke infection and the prevalence of infection in Chachi Amerindians of Ecuador. PLoS One 2018; 13:e0203811. [PMID: 30286114 PMCID: PMC6171820 DOI: 10.1371/journal.pone.0203811] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 08/28/2018] [Indexed: 01/05/2023] Open
Abstract
Background Recently, a high prevalence of infection by the liver fluke Amphimerus spp. has been documented in the Chachi Amerindians of Ecuador. For diagnosis, no studies exist that compare the sensitivity of different coproparasitological detection techniques. The present study compares the Kato-Katz technique with three other coproparasitological methods for detecting eggs of Amphimerus in stools, as well as determines the prevalence of infection in Chachi residents in a Tropical rain forest area in the northwest coast of Ecuador. Methodology/Results A total of 105 samples, utilizing the Kato-Katz technique (KK), the spontaneous sedimentation technique in tube (SSTT), the formalin-ether concentration technique (FEC), and direct smear microscopy (DM), were examined. Combining the four methods (fixed “gold” standard), 38 samples were positive with a prevalence of infection of 36.2%. The sensitivities of individual methods were 71%, 58%, 50% and 3% for KK, SSTT, FEC, and DM respectively. Our results indicated that KK alone had the best performance, detecting 27 (71%) of the 38 positive samples. The combination of KK and SSTT detected amphimeriasis in 36 (95%) samples, and KK and FEC in 31 (82%) samples. Conclusions DM showed the lowest sensitivity, which raises concern for its value, because it is the standard technique for stool examination for detection of parasites in both public and private laboratories in Ecuador. SSTT alone detected eggs in 22 samples (58%) and would be recommended for field studies because of its simplicity. Performing two techniques on a single sample enhances the detection of Amphimerus infection. Its sensitivity is relative to a fixed “gold” standard, determined as the combined results of the four techniques performed. This study confirms the high prevalence of human infection by Amphimerus in the indigenous Chachi group where the first human cases were described.
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Affiliation(s)
- Manuel Calvopina
- OneHealth Group, Carrera de Medicina, Facultad de Ciencias de la Salud, Universidad De Las Américas (UDLA), Quito, Ecuador
- * E-mail: ,
| | - Daniel Romero-Alvarez
- Department of Ecology and Evolutionary Biology – Biodiversity Institute, University of Kansas, Lawrence, Kansas, United States of America
| | - Fernanda Diaz
- Carrera de Medicina, Universidad Central del Ecuador, Quito, Ecuador
| | - William Cevallos
- Carrera de Medicina, Universidad Central del Ecuador, Quito, Ecuador
| | - Hiromu Sugiyama
- Department of Parasitology, National Institute of Infectious Diseases, Tokyo, Japan
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Guo X, Stedtfeld RD, Hedman H, Eisenberg JNS, Trueba G, Yin D, Tiedje JM, Zhang L. Antibiotic Resistome Associated with Small-Scale Poultry Production in Rural Ecuador. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2018; 52:8165-8172. [PMID: 29944836 DOI: 10.1021/acs.est.8b01667] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Small-scale poultry farming is common in rural communities across the developing world. To examine the extent to which small-scale poultry farming serves as a reservoir for resistance determinants, the resistome of fecal samples was compared between production chickens that received antibiotics and free-ranging household chickens that received no antibiotics from a rural village in northern Ecuador. A qPCR array was used to quantify antibiotic resistance genes (ARGs) and mobile genetic elements (MGEs) using 248 primer pairs; and the microbiome structure was analyzed via 16S rRNA gene sequencing. A large number of ARGs (148) and MGEs (29) were detected. The ARG richness in production chickens was significantly higher than that of household chickens with an average of 15 more genes detected ( p < 0.01). Moreover, ARGs and MGEs were much more abundant in production chickens than in household chickens (up to a 157-fold difference). Production chicken samples had significantly lower taxonomic diversity and were more abundant in Gammaproteobacteria, Betaproteobacteria, and Flavobacteria. The high abundance and diversity of ARGs and MGEs found in small-scale poultry farming was comparable to the levels previously found in large scale animal production, suggesting that these chickens could act as a local reservoir for spreading ARGs into rural communities.
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Affiliation(s)
- Xueping Guo
- State Key Laboratory of Pollution Control and Resources Reuse, College of Environmental Science and Engineering , Tongji University , Shanghai 200092 , China
- Department of Plant, Soil and Microbial Sciences , Michigan State University , East Lansing , Michigan 48824 , United States
- Center for Microbial Ecology , East Lansing , Michigan 48824 , United States
| | - Robert D Stedtfeld
- Department of Civil and Environmental Engineering , Michigan State University , East Lansing , Michigan 48824 , United States
| | - Hayden Hedman
- School for Environment and Sustainability , University of Michigan , Ann Arbor , Michigan 48109 , United States
| | - Joseph N S Eisenberg
- Department of Epidemiology , University of Michigan , Ann Arbor , Michigan 48109 , United States
| | - Gabriel Trueba
- Institute of Microbiology, Colegio de Ciencias Biológicas y Ambientales , Universidad San Francisco de Quito , Quito 170157 , Ecuador
| | - Daqiang Yin
- State Key Laboratory of Pollution Control and Resources Reuse, College of Environmental Science and Engineering , Tongji University , Shanghai 200092 , China
| | - James M Tiedje
- Department of Plant, Soil and Microbial Sciences , Michigan State University , East Lansing , Michigan 48824 , United States
- Center for Microbial Ecology , East Lansing , Michigan 48824 , United States
- Department of Microbiology and Molecular Genetics , Michigan State University , East Lansing , Michigan 48824 , United States
| | - Lixin Zhang
- Department of Microbiology and Molecular Genetics , Michigan State University , East Lansing , Michigan 48824 , United States
- Department of Epidemiology and Biostatistics , Michigan State University , East Lansing , Michigan 48824 , United States
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Alamgir M, Campbell MJ, Sloan S, Goosem M, Clements GR, Mahmoud MI, Laurance WF. Economic, Socio-Political and Environmental Risks of Road Development in the Tropics. Curr Biol 2018; 27:R1130-R1140. [PMID: 29065299 DOI: 10.1016/j.cub.2017.08.067] [Citation(s) in RCA: 111] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
It is projected that 25 million km of new paved roads will be developed globally by 2050 - enough to encircle the planet more than 600 times. Roughly 90% of new roads will be built in developing nations, frequently in tropical and subtropical regions with high biodiversity and environmental values. Many developing nations are borrowing from international lenders or negotiating access to their natural resources in order to expand their transportation infrastructure. Given the unprecedented pace and extent of these initiatives, it is vital to thoroughly assess the potential consequences of large-scale road and highway projects. In appropriate contexts and locales, new roads can promote sizeable economic and social benefits. If poorly planned or implemented, however, new roads can provoke serious cost overruns, corruption and environmental impacts, while generating sparse economic benefits and intense social and political conflict. Using examples from developing nations, we identify risks that can hinder road projects in wet and dry tropical environments. Such risks, we assert, are often inadequately considered by project proponents, evaluators and the general public, creating a systematic tendency to overestimate project benefits while understating project risks. A more precautionary approach is needed to reduce risks while maximizing benefits of new road projects in the tropics.
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Affiliation(s)
- Mohammed Alamgir
- Centre for Tropical Environmental and Sustainability Science, and College of Science and Engineering, James Cook University, Cairns, Queensland, 4878, Australia
| | - Mason J Campbell
- Centre for Tropical Environmental and Sustainability Science, and College of Science and Engineering, James Cook University, Cairns, Queensland, 4878, Australia
| | - Sean Sloan
- Centre for Tropical Environmental and Sustainability Science, and College of Science and Engineering, James Cook University, Cairns, Queensland, 4878, Australia
| | - Miriam Goosem
- Centre for Tropical Environmental and Sustainability Science, and College of Science and Engineering, James Cook University, Cairns, Queensland, 4878, Australia
| | - Gopalasamy Reuben Clements
- Centre for Tropical Environmental and Sustainability Science, and College of Science and Engineering, James Cook University, Cairns, Queensland, 4878, Australia
| | - Mahmoud I Mahmoud
- Centre for Tropical Environmental and Sustainability Science, and College of Science and Engineering, James Cook University, Cairns, Queensland, 4878, Australia
| | - William F Laurance
- Centre for Tropical Environmental and Sustainability Science, and College of Science and Engineering, James Cook University, Cairns, Queensland, 4878, Australia.
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Determinants of Short-term Movement in a Developing Region and Implications for Disease Transmission. Epidemiology 2018; 29:117-125. [PMID: 28901976 DOI: 10.1097/ede.0000000000000751] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Human mobility is important for infectious disease spread. However, little is known about how travel varies by demographic groups and how this heterogeneity influences infectious disease risk. METHODS We analyzed 10 years of survey data from 15 communities in a remote but rapidly changing region in rural Ecuador where road development in the past 15-20 years has dramatically changed travel. We identify determinants of travel and incorporate them into an infection transmission model. RESULTS Individuals living in communities more remote at baseline had lower travel rates compared with less remote villages (adjusted odds ratio [OR] = 0.51; 95% confidence interval [CI] = 0.38, 0.67). Our model predicts that less remote villages are, therefore, at increased disease risk. Though road building and travel increased for all communities, this risk differential remained over 10 years of observation. Our transmission model also suggests that travelers and nontravelers have different roles in disease transmission. Adults travel more than children (adjusted OR = 1.73; 95% CI = 1.30, 2.31) and therefore disseminate infection from population centers to rural communities. Children are more likely than adults to be infected locally (attributable fraction = 0.24 and 0.09, respectively) and were indirectly affected by adult travel patterns. CONCLUSIONS These results reinforce the importance of large population centers for regional transmission and show that children and adults may play different roles in disease spread. Changing transportation infrastructure and subsequent economic and social transitions are occurring worldwide, potentially causing increased regional risk of disease.
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38
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Chen SM, Adam SI. Adaptive fuzzy interpolation based on ranking values of interval type-2 polygonal fuzzy sets. Inf Sci (N Y) 2018. [DOI: 10.1016/j.ins.2018.01.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Asad H, Carpenter DO. Effects of climate change on the spread of zika virus: a public health threat. REVIEWS ON ENVIRONMENTAL HEALTH 2018; 33:31-42. [PMID: 29500926 DOI: 10.1515/reveh-2017-0042] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 11/09/2017] [Indexed: 05/18/2023]
Abstract
Zika is a vector-borne viral disease transmitted to humans primarily by Aedes aegypti mosquitoes. The increased climate instability has contributed to the emergence of infections carried by mosquitoes like dengue, chikungunya and zika. While infection with the zika virus is not new, the recent epidemic of microcephaly in Brazil and other countries in South America resulting from the infection of pregnant women with the zika virus raise a number of serious public health concerns. These include the question of how climate change affects the range of zika vectors, what can we do to shorten the length of mosquito season, how and why the symptoms of zika infection have changed and what can be done to reduce the burden of human disease from this infection? Another important question that needs to be answered is what are the factors that caused the zika virus to leave the non-human primates and/or other mammals and invade the human population?
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Affiliation(s)
- Hina Asad
- Institute for Health and the Environment, University at Albany, Rensselaer, NY, USA
| | - David O Carpenter
- Institute for Health and the Environment, University at Albany, Rensselaer, NY, USA
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Kraay ANM, Brouwer AF, Lin N, Collender PA, Remais JV, Eisenberg JNS. Modeling environmentally mediated rotavirus transmission: The role of temperature and hydrologic factors. Proc Natl Acad Sci U S A 2018; 115:E2782-E2790. [PMID: 29496960 PMCID: PMC5866583 DOI: 10.1073/pnas.1719579115] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Rotavirus is considered a directly transmitted disease due to its high infectivity. Environmental pathways have, therefore, largely been ignored. Rotavirus, however, persists in water sources, and both its surface water concentrations and infection incidence vary with temperature. Here, we examine the potential for waterborne rotavirus transmission. We use a mechanistic model that incorporates both direct and waterborne transmission pathways, coupled with a hydrological model, and we simulate rotavirus transmission between two communities with interconnected water sources. To parameterize temperature dependency, we estimated temperature-dependent decay rates in water through a meta-analysis. Our meta-analysis suggests that rotavirus decay rates are positively associated with temperature (n = 39, P [Formula: see text] 0.001). This association is stronger at higher temperatures (over 20 °C), consistent with tropical climate conditions. Our model analysis demonstrates that water could disseminate rotavirus between the two communities for all modeled temperatures. While direct transmission was important for disease amplification within communities, waterborne transmission could also amplify transmission. In standing-water systems, the modeled increase in decay led to decreased disease, with every 1 °C increase in temperature leading to up to a 2.4% decrease in incidence. These effect sizes are consistent with prior meta-analyses, suggesting that environmental transmission through water sources may partially explain the observed associations between temperature and rotavirus incidence. Waterborne rotavirus transmission is likely most important in cooler seasons and in communities that use slow-moving or stagnant water sources. Even when indirect transmission through water cannot sustain outbreaks, it can seed outbreaks that are maintained by high direct transmission rates.
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Affiliation(s)
- Alicia N M Kraay
- Department of Epidemiology, University of Michigan, Ann Arbor, MI 48104
| | - Andrew F Brouwer
- Department of Environmental Health Sciences, University of California, Berkeley, CA 94720
| | - Nan Lin
- Department of Environmental Health Sciences, University of California, Berkeley, CA 94720
| | - Philip A Collender
- Department of Environmental Health Sciences, University of California, Berkeley, CA 94720
| | - Justin V Remais
- Department of Environmental Health Sciences, University of California, Berkeley, CA 94720
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Moser KA, Zhang L, Spicknall I, Braykov NP, Levy K, Marrs CF, Foxman B, Trueba G, Cevallos W, Goldstick J, Trostle J, Eisenberg JNS. The Role of Mobile Genetic Elements in the Spread of Antimicrobial-Resistant Escherichia coli From Chickens to Humans in Small-Scale Production Poultry Operations in Rural Ecuador. Am J Epidemiol 2018; 187:558-567. [PMID: 29506196 DOI: 10.1093/aje/kwx286] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2016] [Accepted: 07/25/2017] [Indexed: 11/15/2022] Open
Abstract
Small-scale production poultry operations are increasingly common worldwide. To investigate how these operations influence antimicrobial resistance and mobile genetic elements (MGEs), Escherichia coli isolates were sampled from small-scale production birds (raised in confined spaces with antibiotics in feed), household birds (no movement constraints; fed on scraps), and humans associated with these birds in rural Ecuador (2010-2012). Isolates were screened for genes associated with MGEs as well as phenotypic resistance to 12 antibiotics. Isolates from small-scale production birds had significantly elevated odds of resistance to 7 antibiotics and presence of MGE genes compared with household birds (adjusted odds ratio (OR) range = 2.2-87.9). Isolates from humans associated with small-scale production birds had elevated odds of carrying an integron (adjusted OR = 2.0; 95% confidence interval (CI): 1.06, 3.83) compared with humans associated with household birds, as well as resistance to sulfisoxazole (adjusted OR = 1.9; 95% CI: 1.01, 3.60) and trimethoprim/sulfamethoxazole (adjusted OR = 2.1; 95% CI: 1.13, 3.95). Stratifying by the presence of MGEs revealed antibiotic groups that are explained by biological links to MGEs; in particular, resistance to sulfisoxazole, trimethoprim/sulfamethoxazole, or tetracycline was highest among birds and humans when MGE exposures were present. Small-scale production poultry operations might select for isolates carrying MGEs, contributing to elevated levels of resistance in this setting.
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Affiliation(s)
- Kara A Moser
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan
| | - Lixin Zhang
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, Michigan
- Department of Microbiology and Molecular Genetics, Michigan State University, East Lansing, Michigan
| | - Ian Spicknall
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan
| | - Nikolay P Braykov
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Karen Levy
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Carl F Marrs
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan
| | - Betsy Foxman
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan
| | - Gabriel Trueba
- Instituto de Microbiología, Universidad San Francisco de Quito, Quito, Ecuador
| | - William Cevallos
- Centro de Biomedicina, Universidad Central del Ecuador, Quito, Ecuador
| | - Jason Goldstick
- Department of Emergency Medicine, University of Michigan, Ann Arbor, Michigan
- Injury Research Center, University of Michigan, Ann Arbor, Michigan
| | - James Trostle
- Department of Anthropology, Trinity College, Hartford, Connecticut
| | - Joseph N S Eisenberg
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan
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Lopez VK, Dombecki C, Trostle J, Mogrovejo P, Castro Morillo N, Cevallos W, Goldstick J, Jones AD, Eisenberg JNS. Trends of child undernutrition in rural Ecuadorian communities with differential access to roads, 2004-2013. MATERNAL AND CHILD NUTRITION 2018; 14:e12588. [PMID: 29411943 DOI: 10.1111/mcn.12588] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Revised: 12/04/2017] [Accepted: 12/11/2017] [Indexed: 11/28/2022]
Abstract
Road access can influence protective and risk factors associated with nutrition by affecting various social and biological processes. In northern coastal Ecuador, the construction of new roads created a remoteness gradient among villages, providing a unique opportunity to examine the impact of roads on child nutritional outcomes 10 years after the road was built. Anthropometric and haemoglobin measurements were collected from 2,350 children <5 years in Esmeraldas, Ecuador, from 2004 to 2013 across 28 villages with differing road access. Logistic generalized estimating equation models assessed the longitudinal association between village remoteness and prevalence of stunting, wasting, underweight, overweight, obesity, and anaemia. We examined the influence of socio-economic characteristics on the pathway between remoteness and nutrition by comparing model results with and without household-level socio-economic covariates. Remoteness was associated with stunting (OR = 0.43, 95% CI [0.30, 0.63]) and anaemia (OR = 0.56, 95% CI [0.44, 0.70]). Over time, the prevalence of stunting was generally decreasing but remained higher in villages closer to the road compared to those farther away. Obesity increased (0.5% to 3%) over time; wasting was high (6%) but stable during the study period. Wealth and education partially explained the better nutritional outcomes in remote vs. road villages more than a decade after some communities gained road access. Establishing the extent to which these patterns persist requires additional years of observation.
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Affiliation(s)
- Velma K Lopez
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Carolyn Dombecki
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - James Trostle
- Department of Anthropology, Trinity College, Hartford, Connecticut, USA
| | - Patricia Mogrovejo
- Facultad de Ciencias de la Salud Eugenio Espejo, Universidad Tecnológica Equinoccial, Quito, Ecuador
| | - Nancy Castro Morillo
- Carrera de Nutrición y Dietética, Universidad de San Francisco de Quito, Quito, Ecuador
| | - William Cevallos
- Instituto de Biomedicina, Universidad Central del Ecuador, Quito, Ecuador
| | - Jason Goldstick
- Emergency Medicine, University of Michigan Health Systems, Ann Arbor, Michigan, USA
| | - Andrew D Jones
- Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Joseph N S Eisenberg
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
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Arthur RF, Gurley ES, Salje H, Bloomfield LSP, Jones JH. Contact structure, mobility, environmental impact and behaviour: the importance of social forces to infectious disease dynamics and disease ecology. Philos Trans R Soc Lond B Biol Sci 2017; 372:rstb.2016.0454. [PMID: 28289265 DOI: 10.1098/rstb.2016.0454] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/22/2016] [Indexed: 11/12/2022] Open
Abstract
Human factors, including contact structure, movement, impact on the environment and patterns of behaviour, can have significant influence on the emergence of novel infectious diseases and the transmission and amplification of established ones. As anthropogenic climate change alters natural systems and global economic forces drive land-use and land-cover change, it becomes increasingly important to understand both the ecological and social factors that impact infectious disease outcomes for human populations. While the field of disease ecology explicitly studies the ecological aspects of infectious disease transmission, the effects of the social context on zoonotic pathogen spillover and subsequent human-to-human transmission are comparatively neglected in the literature. The social sciences encompass a variety of disciplines and frameworks for understanding infectious diseases; however, here we focus on four primary areas of social systems that quantitatively and qualitatively contribute to infectious diseases as social-ecological systems. These areas are social mixing and structure, space and mobility, geography and environmental impact, and behaviour and behaviour change. Incorporation of these social factors requires empirical studies for parametrization, phenomena characterization and integrated theoretical modelling of social-ecological interactions. The social-ecological system that dictates infectious disease dynamics is a complex system rich in interacting variables with dynamically significant heterogeneous properties. Future discussions about infectious disease spillover and transmission in human populations need to address the social context that affects particular disease systems by identifying and measuring qualitatively important drivers.This article is part of the themed issue 'Opening the black box: re-examining the ecology and evolution of parasite transmission'.
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Affiliation(s)
- Ronan F Arthur
- Emmett Interdisciplinary Program in Environment and Resources, Stanford University, Stanford, CA 94305, USA
| | - Emily S Gurley
- Department of Epidemiology, Johns Hopkins University, Baltimore, MD 21205, USA.,International Centre for Diarrhoeal Diseases Research, Bangladesh (ICDDR, B), Dhaka, Bangladesh
| | - Henrik Salje
- Department of Epidemiology, Johns Hopkins University, Baltimore, MD 21205, USA.,Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, Paris, France
| | - Laura S P Bloomfield
- Emmett Interdisciplinary Program in Environment and Resources, Stanford University, Stanford, CA 94305, USA.,Stanford University School of Medicine, Stanford, CA 94305, USA
| | - James H Jones
- Department of Earth Systems Science, Johns Hopkins University, Baltimore, MD 21205, USA.,Department of Life Sciences, Imperial College London, London, UK
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Transformation-Based Fuzzy Rule Interpolation Using Interval Type-2 Fuzzy Sets. ALGORITHMS 2017. [DOI: 10.3390/a10030091] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Racial inequality in the annual risk of Tuberculosis infection in the United States, 1910-1933. Epidemiol Infect 2017; 145:1797-1804. [PMID: 28436340 DOI: 10.1017/s0950268817000802] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Tuberculosis (TB) mortality rates in the USA fell rapidly from 1910 to 1933. However, during this period, racial disparities in TB mortality in the nation's expanding cities grew. Because of long delays between infection and disease, TB mortality is a poor indicator of short-term changes in transmission. We estimated the annual risk of TB infection (ARTI) in 11 large US cities to understand whether rising inequality in mortality reflected rising inequality in ARTI using city-level TB mortality data compiled by the US Department of Commerce from 1910 to 1933. We estimated ARTI for African-Americans and whites using pediatric extrapulmonary TB mortality data for African-Americans and whites in our panel of cities. We also estimated age-adjusted pulmonary TB mortality rates for these cities. We find that the ratio of ARTI for African-Americans vs. whites increased from 2·1 (95% CI = 1·7, 2·4) in 1910 to 4·2 (95% CI = 3·4, 5·2) in 1933. This change mirrored the increasing inequality in age-adjusted pulmonary TB mortality during this period. These findings may reflect the combined effects of migration, inequality in access to care, increasing population density, and racial residential segregation in northern cities during this period.
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Boithias L, Choisy M, Souliyaseng N, Jourdren M, Quet F, Buisson Y, Thammahacksa C, Silvera N, Latsachack K, Sengtaheuanghoung O, Pierret A, Rochelle-Newall E, Becerra S, Ribolzi O. Hydrological Regime and Water Shortage as Drivers of the Seasonal Incidence of Diarrheal Diseases in a Tropical Montane Environment. PLoS Negl Trop Dis 2016; 10:e0005195. [PMID: 27935960 PMCID: PMC5147807 DOI: 10.1371/journal.pntd.0005195] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Accepted: 11/17/2016] [Indexed: 12/02/2022] Open
Abstract
Background The global burden of diarrhea is a leading cause of morbidity and mortality worldwide. In montane areas of South-East Asia such as northern Laos, recent changes in land use have induced increased runoff, soil erosion and in-stream suspended sediment loads, and potential pathogen dissemination. To our knowledge, few studies have related diarrhea incidences to catchment scale hydrological factors such as river discharge, and loads of suspended sediment and of Fecal Indicator Bacteria (FIB) such as Escherichia coli, together with sociological factors such as hygiene practices. We hypothesized that climate factors combined with human behavior control diarrhea incidence, either because higher rainfall, leading to higher stream discharges, suspended sediment loads and FIB counts, are associated with higher numbers of reported diarrhea cases during the rainy season, or because water shortage leads to the use of less safe water sources during the dry season. Using E. coli as a FIB, the objectives of this study were thus (1) to characterize the epidemiological dynamics of diarrhea in Northern Laos, and (2) to identify which hydro-meteorological and sociological risk factors were associated with diarrhea epidemics. Methods Considering two unconnected river catchments of 22 and 7,448 km2, respectively, we conducted a retrospective time series analysis of meteorological variables (rainfall, air temperature), hydrological variables (discharge, suspended sediments, FIB counts, water temperature), and the number of diarrheal disease cases reported at 6 health centers located in the 5 southern districts of the Luang Prabang Province, Lao PDR. We also examined the socio-demographic factors potentially affecting vulnerability to the effect of the climate factors, such as drinking water sources, hygiene habits, and recreational water exposure. Results Using thus a mixed methods approach, we found E. coli to be present all year long (100–1,000 Most Probable Number or MPN 100 mL-1) indicating that fecal contamination is ubiquitous and constant. We found that populations switch their water supply from wells to surface water during drought periods, the latter of which appear to be at higher risk of bacterial contamination than municipal water fountains. We thus found that water shortage in the Luang Prabang area triggers diarrhea peaks during the dry and hot season and that rainfall and aquifer refill ends the epidemic during the wet season. The temporal trends of reported daily diarrhea cases were generally bimodal with hospital admissions peaking in February-March and later in May-July. Annual incidence rates were higher in more densely populated areas and mostly concerned the 0–4 age group and male patients. Conclusions We found that anthropogenic drivers, such as hygiene practices, were at least as important as environmental drivers in determining the seasonal pattern of a diarrhea epidemic. For diarrheal disease risk monitoring, discharge or groundwater level can be considered as relevant proxies. These variables should be monitored in the framework of an early warning system provided that a tradeoff is found between the size of the monitored catchment and the frequency of the measurement. Aiming to identify the most critical drivers of diarrhea epidemics in montane areas of South-East Asia, we conducted a retrospective time series analysis of diarrhea reported cases and of hydro-meteorological variables measured in two contrasted river basins in northern Laos, together with socio-behavioral practices. We found that during drought periods, the population switches its water supply from wells to surface water where we measured numbers of fecal indicator bacteria (E. coli) of 100–1,000 MPN 100 mL-1 (the World Health Organization recommendation is 0 MPN 100 mL-1 in drinking water supply sources). We found that water shortages trigger diarrhea peaks during the dry and hot seasons and that rainfall and subsequent aquifer refill ends the epidemic during the wet season. As E. coli counts in surface water are high all year long, E. coli may not be a relevant indicator of the fecal risk in this area. Conversely, stream discharge and aquifer water level appear to be relevant proxies to predict diarrheal risk. Mitigating both environmental and anthropogenic drivers of fecal bacteria dissemination in developing countries is critical in the context of global change: more intense rainfall combined to the extension of run-off prone land uses (e.g. tree plantation without understorey) may decrease both the aquifer recharge and the contaminant retention ecosystem service, and thus threaten the availability of safe water resource for the population.
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Affiliation(s)
- Laurie Boithias
- Géosciences Environnement Toulouse, Université de Toulouse, CNES, CNRS, IRD, UPS, Toulouse, France
- * E-mail:
| | - Marc Choisy
- MIVEGEC (UMR CNRS-IRD-University of Montpellier), Montpellier, France
- Oxford University Clinical Research Unit, Hanoi, Vietnam
| | - Noy Souliyaseng
- Institut de la Francophonie pour la Médecine Tropicale (IFMT), Vientiane, Lao PDR
| | | | - Fabrice Quet
- Institut de la Francophonie pour la Médecine Tropicale (IFMT), Vientiane, Lao PDR
| | - Yves Buisson
- Institut de la Francophonie pour la Médecine Tropicale (IFMT), Vientiane, Lao PDR
| | - Chanthamousone Thammahacksa
- IRD, Department of Agricultural Land Management (DALaM), Ban Nogviengkham, Xaythany District, Vientiane, Lao PDR
| | - Norbert Silvera
- IRD-iEES-Paris, Department of Agricultural Land Management (DALaM), Ban Nogviengkham, Xaythany District, Vientiane, Lao PDR
- iEES-Paris (IRD-Sorbonne Universités-UPMC-CNRS-INRA-UDD-UPEC), Université Pierre et Marie Curie (UPMC), 4 place Jussieu, Paris, France
| | - Keooudone Latsachack
- IRD, Department of Agricultural Land Management (DALaM), Ban Nogviengkham, Xaythany District, Vientiane, Lao PDR
| | - Oloth Sengtaheuanghoung
- Department of Agricultural Land Management (DALaM), Ban Nogviengkham, Xaythany District, Vientiane, Lao PDR
| | - Alain Pierret
- IRD-iEES-Paris, Department of Agricultural Land Management (DALaM), Ban Nogviengkham, Xaythany District, Vientiane, Lao PDR
- iEES-Paris (IRD-Sorbonne Universités-UPMC-CNRS-INRA-UDD-UPEC), Université Pierre et Marie Curie (UPMC), 4 place Jussieu, Paris, France
| | - Emma Rochelle-Newall
- iEES-Paris (IRD-Sorbonne Universités-UPMC-CNRS-INRA-UDD-UPEC), Université Pierre et Marie Curie (UPMC), 4 place Jussieu, Paris, France
| | - Sylvia Becerra
- Géosciences Environnement Toulouse, Université de Toulouse, CNES, CNRS, IRD, UPS, Toulouse, France
| | - Olivier Ribolzi
- Géosciences Environnement Toulouse, Université de Toulouse, CNES, CNRS, IRD, UPS, Toulouse, France
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Jenkins AP, Jupiter S, Mueller U, Jenney A, Vosaki G, Rosa V, Naucukidi A, Mulholland K, Strugnell R, Kama M, Horwitz P. Health at the Sub-catchment Scale: Typhoid and Its Environmental Determinants in Central Division, Fiji. ECOHEALTH 2016; 13:633-651. [PMID: 27557784 DOI: 10.1007/s10393-016-1152-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Revised: 07/11/2016] [Accepted: 07/22/2016] [Indexed: 06/06/2023]
Abstract
The impact of environmental change on transmission patterns of waterborne enteric diseases is a major public health concern. This study concerns the burden and spatial nature of enteric fever, attributable to Salmonella Typhi infection in the Central Division, Republic of Fiji at a sub-catchment scale over 30-months (2013-2015). Quantitative spatial analysis suggested relationships between environmental conditions of sub-catchments and incidence and recurrence of typhoid fever. Average incidence per inhabited sub-catchment for the Central Division was high at 205.9/100,000, with cases recurring in each calendar year in 26% of sub-catchments. Although the numbers of cases were highest within dense, urban coastal sub-catchments, the incidence was highest in low-density mountainous rural areas. Significant environmental determinants at this scale suggest increased risk of exposure where sediment yields increase following runoff. The study suggests that populations living on large systems that broaden into meandering mid-reaches and floodplains with alluvial deposition are at a greater risk compared to small populations living near small, erosional, high-energy headwaters and small streams unconnected to large hydrological networks. This study suggests that anthropogenic alteration of land cover and hydrology (particularly via fragmentation of riparian forest and connectivity between road and river networks) facilitates increased transmission of typhoid fever and that environmental transmission of typhoid fever is important in Fiji.
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Affiliation(s)
- Aaron Peter Jenkins
- Edith Cowan University, 270 Joondalup Drive, Joondalup, WA, 6027, Australia.
| | | | - Ute Mueller
- Edith Cowan University, 270 Joondalup Drive, Joondalup, WA, 6027, Australia
| | - Adam Jenney
- Fiji National University, Suva, Fiji
- Murdoch Childrens Research Institute, Parkville, Australia
| | | | | | | | - Kim Mulholland
- Murdoch Childrens Research Institute, Parkville, Australia
- London School of Hygiene and Tropical Medicine, London, England
| | | | - Mike Kama
- Fiji Ministry of Health and Medical Services, Suva, Fiji
| | - Pierre Horwitz
- Edith Cowan University, 270 Joondalup Drive, Joondalup, WA, 6027, Australia
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Urlacher SS, Liebert MA, Josh Snodgrass J, Blackwell AD, Cepon-Robins TJ, Gildner TE, Madimenos FC, Amir D, Bribiescas RG, Sugiyama LS. Heterogeneous effects of market integration on sub-adult body size and nutritional status among the Shuar of Amazonian Ecuador. Ann Hum Biol 2016; 43:316-29. [PMID: 27230632 DOI: 10.1080/03014460.2016.1192219] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND Market integration (MI)-increasing production for and consumption from a market-based economy-is drastically altering traditional ways of life and environmental conditions among indigenous Amazonian peoples. The effects of MI on the biology and health of Amazonian children and adolescents, however, remain unclear. AIM This study examines the impact of MI on sub-adult body size and nutritional status at the population, regional and household levels among the Shuar of Amazonian Ecuador. SUBJECTS AND METHODS Anthropometric data were collected between 2005-2014 from 2164 Shuar (aged 2-19 years) living in two geographic regions differing in general degree of MI. High-resolution household economic, lifestyle and dietary data were collected from a sub-sample of 631 participants. Analyses were performed to investigate relationships between body size and year of data collection, region and specific aspects of household MI. RESULTS Results from temporal and regional analyses suggest that MI has a significant and overall positive impact on Shuar body size and nutritional status. However, household-level results exhibit nuanced and heterogeneous specific effects of MI underlying these overarching relationships. CONCLUSION This study provides novel insight into the complex socio-ecological pathways linking MI, physical growth and health among the Shuar and other indigenous Amazonian populations.
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Affiliation(s)
- Samuel S Urlacher
- a Department of Human Evolutionary Biology , Harvard University , Cambridge , MA , USA
| | - Melissa A Liebert
- b Department of Anthropology , University of Oregon , Eugene , OR , USA
| | - J Josh Snodgrass
- b Department of Anthropology , University of Oregon , Eugene , OR , USA
| | - Aaron D Blackwell
- c Department of Anthropology , University of California , Santa Barbara , CA , USA ;,d Broom Center for Demography, University of California , Santa Barbara , CA , USA ;,e Center for Evolutionary Psychology, University of California , Santa Barbara , CA , USA
| | - Tara J Cepon-Robins
- f Department of Anthropology , University of Colorado , Colorado Springs , CO , USA
| | - Theresa E Gildner
- b Department of Anthropology , University of Oregon , Eugene , OR , USA
| | | | - Dorsa Amir
- h Department of Anthropology , Yale University , New Haven , CT , USA
| | | | - Lawrence S Sugiyama
- b Department of Anthropology , University of Oregon , Eugene , OR , USA ;,e Center for Evolutionary Psychology, University of California , Santa Barbara , CA , USA ;,i Institute of Cognitive and Decision Sciences, University of Oregon , Eugene , OR , USA
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