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Banu B, Khan MMH, Ali L, Barnighausen T, Sauerborn R, Souares A. Pattern and predictors of non-adherence to diabetes self-management recommendations among patients in peripheral district of Bangladesh. Trop Med Int Health 2024; 29:233-242. [PMID: 38221661 DOI: 10.1111/tmi.13966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2024]
Abstract
OBJECTIVES This study was designed to determine the extent of non-adherence to the different dimensions of diabetes self-management and to identify the factors influencing non-adherence among peripheral patients in Bangladesh. METHODS A cross-sectional study was conducted among 990 adult diabetic patients residing in Thakurgaon district, Bangladesh. Data were collected through face-to-face interviews including socio-demographic information, disease and therapeutic, health services, knowledge and adherence to self-management components. RESULTS The proportion of non-adherence to drug prescription was 66.7%, dietary regimen (68.9%), physical exercise (58.0%), follow-up visit/blood glucose test (88.2%), stopping tobacco (50.6%), and regular foot care (93.9%). Significant predictors for non-adherence to drug were poorest socio-economic status (OR = 2.47), absence of diabetic complications (OR = 1.43), using non-clinical therapy (OR = 5.61), and moderate level of knowledge (OR = 1.87). Non-adherence to dietary recommendations was higher for women (OR = 1.72), poorest socio-economic status (OR = 3.17), and poor technical knowledge (OR = 4.68). Non-adherence to physical exercise was lower for women (OR = 0.62), combined family (OR = 0.63), middle socio-economic status (OR = 0.54), and moderate knowledge on physical exercise (OR = 0.55). Non-adherence to follow-up visits/blood glucose test was higher among patients who did not have diabetic complications (OR = 1.81) and with own transport (OR = 2.57), and respondents from high-income group (OR = 0.23) were less likely to be non-adherent. Non-adherence to stopping tobacco was higher for older individuals (OR = 1.86); but lower for women (OR = 0.48), individuals with higher education level (OR = 0.17) and patients sick for a longer time (OR = 0.52). Non-adherence to foot care was higher for patients who needed longer time to go to hospital (OR = 4.07) and had poor basic knowledge on diabetes (OR = 17.80). CONCLUSION An alarmingly high proportion of diabetic patients did not adhere to diabetes self-management. Major predictors for non-adherence were related to patient's demographic characteristics and their experience with disease, treatment and health care services.
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Affiliation(s)
- Bilkis Banu
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg, Germany
- Department of Public Health, Northern University Bangladesh, Dhaka, Bangladesh
| | | | - Liaquat Ali
- Pothikrit Institute of Health Studies, Dhaka, Bangladesh
| | - Till Barnighausen
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg, Germany
| | - Rainer Sauerborn
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg, Germany
| | - Aurélia Souares
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg, Germany
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Corvetto JF, Federspiel A, Sewe MO, Müller T, Bunker A, Sauerborn R. Impact of heat on mental health emergency visits: a time series study from all public emergency centres, in Curitiba, Brazil. BMJ Open 2023; 13:e079049. [PMID: 38135317 DOI: 10.1136/bmjopen-2023-079049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2023] Open
Abstract
OBJECTIVES Quantify the risk of mental health (MH)-related emergency department visits (EDVs) due to heat, in the city of Curitiba, Brazil. DESIGN Daily time series analysis, using quasi-Poisson combined with distributed lag non-linear model on EDV for MH disorders, from 2017 to 2021. SETTING All nine emergency centres from the public health system, in Curitiba. PARTICIPANTS 101 452 EDVs for MH disorders and suicide attempts over 5 years, from patients residing inside the territory of Curitiba. MAIN OUTCOME MEASURE Relative risk of EDV (RREDV) due to extreme mean temperature (24.5°C, 99th percentile) relative to the median (18.02°C), controlling for long-term trends, air pollution and humidity, and measuring effects delayed up to 10 days. RESULTS Extreme heat was associated with higher single-lag EDV risk of RREDV 1.03(95% CI 1.01 to 1.05-single-lag 2), and cumulatively of RREDV 1.15 (95% CI 1.05 to 1.26-lag-cumulative 0-6). Strong risk was observed for patients with suicide attempts (RREDV 1.85, 95% CI 1.08 to 3.16) and neurotic disorders (RREDV 1.18, 95% CI 1.06 to 1.31). As to demographic subgroups, females (RREDV 1.20, 95% CI 1.08 to 1.34) and patients aged 18-64 (RREDV 1.18, 95% CI 1.07 to 1.30) were significantly endangered. Extreme heat resulted in lower risks of EDV for patients with organic disorders (RREDV 0.60, 95% CI 0.40 to 0.89), personality disorders (RREDV 0.48, 95% CI 0.26 to 0.91) and MH in general in the elderly ≥65 (RREDV 0.77, 95% CI 0.60 to 0.98). We found no significant RREDV among males and patients aged 0-17. CONCLUSION The risk of MH-related EDV due to heat is elevated for the entire study population, but very differentiated by subgroups. This opens avenue for adaptation policies in healthcare: such as monitoring populations at risk and establishing an early warning systems to prevent exacerbation of MH episodes and to reduce suicide attempts. Further studies are welcome, why the reported risk differences occur and what, if any, role healthcare seeking barriers might play.
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Affiliation(s)
| | - Andrea Federspiel
- Private Psychiatric Hospital, Meiringen, Switzerland
- Support Center for Advanced Neuroimaging, Institute for Diagnostic and Interventional Neuroradiology Inselspital, University of Bern, Bern, Switzerland
| | - Maquins Odhiambo Sewe
- Heidelberg Institute of Global Health, Universität Heidelberg, Heidelberg, Germany
- Department of Public Health and Clinical Medicine, Sustainable health section, Umeå University, Umeå, Sweden
| | - Thomas Müller
- Private Psychiatric Hospital, Meiringen, Switzerland
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Aditi Bunker
- Heidelberg Institute of Global Health, Universität Heidelberg, Heidelberg, Germany
| | - Rainer Sauerborn
- Heidelberg Institute of Global Health, Universität Heidelberg, Heidelberg, Germany
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Müller C, Ouédraogo WA, Schwarz M, Barteit S, Sauerborn R. The effects of climate change-induced flooding on harvest failure in Burkina Faso: case study. Front Public Health 2023; 11:1166913. [PMID: 37614457 PMCID: PMC10442567 DOI: 10.3389/fpubh.2023.1166913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 07/24/2023] [Indexed: 08/25/2023] Open
Abstract
Background Climate change leads to more frequent and severe extreme weather events including floods, heatwaves, heavy rainfalls, and droughts. In contrast to the majority of research on weather extremes in sub-Saharan Africa, which focus primarily on how a lack of rainfall causes droughts, this paper aims to elucidate the effect of flooding on harvest failure in rural Burkina Faso. Methods We conducted a case study in north-western Nouna, Burkina Faso, between August and December 2021 covering a study population of n = 180 participants. The study comprised four components: (i) interviews with farmers (n = 180) on whether any of their fields had been inundated and if so, on harvest loss on these fields; (ii) determining the feasibility of using Sentinel-2 satellite images to validate study participants reports of floods; (iii) characterizing short-term weather including frequency and duration, of extreme rainfall events within the study area, as well as comparing cumulative rainfall (long-term) over the past 50 years; and (v), estimating both the food energy and economic loss of harvest failure due to flooding. Results 49% of interviewed farmers (n = 88) reported that floods had damaged at least one of their fields. Some fields (n = 13, 7%) had no harvest due to flooding, while some farmers (n = 14, 8%) had lost part of their harvest. Images from the Sentinel-2-Satellite indicated that reported and remotely observed flooding were consistent. According to time series of data from the local weather station, there has been an increase irregular rainfall distribution and at the same time of cumulative annual rainfall in Nouna. Furthermore, a first illustrative calculation allowed us to estimate the amount of energy lost when one hectare of a common crop is flooded. Conclusion This case study demonstrated that flood-related harvest failures leading to crop losses in sub-Saharan Africa, exemplified by Burkina Faso, are likely to be substantial. This study serves as a proof-of-principle for flooding effects on food security. This could provide more detail for agricultural adaptation and mitigation strategies. Inundation-vulnerable fields need alternative and novel management practices, which may only be effectively implemented if agricultural institutions and national policy-making bodies receive evidence of flooding e.g., from remote sensing.
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Affiliation(s)
- Charlotte Müller
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
- Faculty of Health Science and Medicine, University of Lucerne, Lucerne, Switzerland
| | | | | | - Sandra Barteit
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
| | - Rainer Sauerborn
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
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Belesova K, Gasparrini A, Wilkinson P, Sié A, Sauerborn R. Child Survival and Annual Crop Yield Reductions in Rural Burkina Faso: Critical Windows of Vulnerability Around Early-Life Development. Am J Epidemiol 2023; 192:1116-1127. [PMID: 37116074 PMCID: PMC10326605 DOI: 10.1093/aje/kwad068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 10/02/2022] [Accepted: 03/21/2023] [Indexed: 04/30/2023] Open
Abstract
Populations that are reliant on subsistence farming are particularly vulnerable to climatic effects on crop yields. However, empirical evidence on the role of the timing of exposure to crop yield deficits in early-life development is limited. We examined the relationship between child survival and annual crop yield reductions at different stages of early-life development in a subsistence farming population in Burkina Faso. Using shared frailty Cox proportional hazards models adjusting for confounders, we analyzed 57,288 children under 5 years of age followed by the Nouna Health and Demographic Surveillance System (1994-2016) in relation to provincial food-crop yield levels experienced in 5 nonoverlapping time windows (12 months before conception, gestation, birth-age 5.9 months, ages 6.0 months-1.9 years, and ages 2.0-4.9 years) and their aggregates (birth-1.9 years, first 1,000 days from conception, and birth-4.9 years). Of the nonoverlapping windows, point estimates were largest for child survival related to food-crop yields for the time window of 6.0 months-1.9 years: The adjusted mortality hazard ratio was 1.10 (95% confidence interval: 1.03, 1.19) for a 90th-to-10th percentile yield reduction. These findings suggest that child survival in this setting is particularly vulnerable to cereal-crop yield reductions during the period of nonexclusive breastfeeding.
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Affiliation(s)
- Kristine Belesova
- Correspondence to Dr. Kristine Belesova, Department of Department of Primary Care and Public Health, Faculty of Medicine, Imperial College London, Reynolds Building, St. Dunstan's Road, London W6 8RP, United Kingdom (e-mail: )
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Barteit S, Sié A, Zabré P, Traoré I, Ouédraogo WA, Boudo V, Munga S, Khagayi S, Obor D, Muok E, Franke J, Schwarz M, Blass K, Su TT, Bärnighausen T, Sankoh O, Sauerborn R. Widening the lens of population-based health research to climate change impacts and adaptation: the climate change and health evaluation and response system (CHEERS). Front Public Health 2023; 11:1153559. [PMID: 37304117 PMCID: PMC10248881 DOI: 10.3389/fpubh.2023.1153559] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 05/05/2023] [Indexed: 06/13/2023] Open
Abstract
Background Climate change significantly impacts health in low-and middle-income countries (LMICs), exacerbating vulnerabilities. Comprehensive data for evidence-based research and decision-making is crucial but scarce. Health and Demographic Surveillance Sites (HDSSs) in Africa and Asia provide a robust infrastructure with longitudinal population cohort data, yet they lack climate-health specific data. Acquiring this information is essential for understanding the burden of climate-sensitive diseases on populations and guiding targeted policies and interventions in LMICs to enhance mitigation and adaptation capacities. Objective The objective of this research is to develop and implement the Change and Health Evaluation and Response System (CHEERS) as a methodological framework, designed to facilitate the generation and ongoing monitoring of climate change and health-related data within existing Health and Demographic Surveillance Sites (HDSSs) and comparable research infrastructures. Methods CHEERS uses a multi-tiered approach to assess health and environmental exposures at the individual, household, and community levels, utilizing digital tools such as wearable devices, indoor temperature and humidity measurements, remotely sensed satellite data, and 3D-printed weather stations. The CHEERS framework utilizes a graph database to efficiently manage and analyze diverse data types, leveraging graph algorithms to understand the complex interplay between health and environmental exposures. Results The Nouna CHEERS site, established in 2022, has yielded significant preliminary findings. By using remotely-sensed data, the site has been able to predict crop yield at a household level in Nouna and explore the relationships between yield, socioeconomic factors, and health outcomes. The feasibility and acceptability of wearable technology have been confirmed in rural Burkina Faso for obtaining individual-level data, despite the presence of technical challenges. The use of wearables to study the impact of extreme weather on health has shown significant effects of heat exposure on sleep and daily activity, highlighting the urgent need for interventions to mitigate adverse health consequences. Conclusion Implementing the CHEERS in research infrastructures can advance climate change and health research, as large and longitudinal datasets have been scarce for LMICs. This data can inform health priorities, guide resource allocation to address climate change and health exposures, and protect vulnerable communities in LMICs from these exposures.
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Affiliation(s)
- Sandra Barteit
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
| | - Ali Sié
- Centre de Recherche en Santé de Nouna, Nouna, Burkina Faso
| | - Pascal Zabré
- Centre de Recherche en Santé de Nouna, Nouna, Burkina Faso
| | - I Traoré
- Centre de Recherche en Santé de Nouna, Nouna, Burkina Faso
| | | | - Valentin Boudo
- Centre de Recherche en Santé de Nouna, Nouna, Burkina Faso
| | | | | | - David Obor
- Kenya Medical Research Institute, Kisumu, Kenya
| | - Erick Muok
- Kenya Medical Research Institute, Kisumu, Kenya
| | | | | | - Klaus Blass
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
| | - Tin Tin Su
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
- South East Asia Community Observatory (SEACO) and Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University, Bandar Sunway, Malaysia
| | - Till Bärnighausen
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
- Africa Health Research Institute (AHRI), KwaZulu-Natal, South Africa
- Harvard Center for Population and Development Studies, Cambridge, MA, United States
| | - Osman Sankoh
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
- Statistics Sierra Leone, Freetown, Sierra Leone
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Rainer Sauerborn
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
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Rybol L, Nieder J, Amelung D, Hachad H, Sauerborn R, Depoux A, Herrmann A. Integrating climate change and health topics into the medical curriculum - a quantitative needs assessment of medical students at Heidelberg University in Germany. GMS J Med Educ 2023; 40:Doc36. [PMID: 37377571 PMCID: PMC10291352 DOI: 10.3205/zma001618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 12/23/2022] [Accepted: 03/02/2023] [Indexed: 06/29/2023]
Abstract
Objectives Climate change (CC) is of major importance for physicians as they are directly confronted with changing disease patterns, work in a greenhouse gas intensive sector and can be potential advocates for healthy people on a healthy planet. Methods We assessed third to fifth year medical students' needs to support the integration of CC topics into medical curricula. A questionnaire with 54 single choice-based items was newly designed with the following sections: role perception, knowledge test, learning needs, preference of educational strategies and demographic characteristics. It was administered online to students at Heidelberg medical faculty. Data sets were used for descriptive statistics and regression modelling. Results 72.4% of students (N=170, 56.2% female, 76% aged 20-24 years) (strongly) agreed that physicians carry a responsibility to address CC in their work setting while only 4.7% (strongly) agreed that their current medical training had given them enough skills to do so. Knowledge was high in the area of CC, health impacts of CC, vulnerabilities and adaptation (70.1% correct answers). Knowledge gaps were greatest for health co-benefits and climate-friendly healthcare (55.5% and 16.7% of correct answers, respectively). 79.4% wanted to see CC and health included in the medical curriculum with a preference for integration into existing mandatory courses. A multilinear regression model with factors age, gender, semester, aspired work setting, political leaning, role perception and knowledge explained 45.9% of variance for learning needs. Conclusion The presented results encourage the integration of CC and health topics including health co-benefits and climate-friendly healthcare, as well as respective professional role development into existing mandatory courses of the medical curriculum.
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Affiliation(s)
- Leonie Rybol
- University Hospital Heidelberg, Heidelberg Institute of Global Health, Heidelberg, Germany
| | - Jessica Nieder
- University Hospital Heidelberg, Heidelberg Institute of Global Health, Heidelberg, Germany
| | | | | | - Rainer Sauerborn
- University Hospital Heidelberg, Heidelberg Institute of Global Health, Heidelberg, Germany
| | - Anneliese Depoux
- University of Paris Cité, Centre Virchow-Villermé, Paris, France
| | - Alina Herrmann
- University Hospital Heidelberg, Heidelberg Institute of Global Health, Heidelberg, Germany
- University Hospital Cologne, Medical Faculty Cologne University, Institute for General Medicine, Cologne, Germany
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Quitmann C, Sauerborn R, Danquah I, Herrmann A. 'Climate change mitigation is a hot topic, but not when it comes to hospitals': a qualitative study on hospital stakeholders' perception and sense of responsibility for greenhouse gas emissions. J Med Ethics 2023; 49:204-210. [PMID: 35459742 PMCID: PMC9985738 DOI: 10.1136/medethics-2021-107971] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 04/11/2022] [Indexed: 05/19/2023]
Abstract
OBJECTIVE Physical and mental well-being are threatened by climate change. Since hospitals in high-income countries contribute significantly to climate change through their greenhouse gas (GHG) emissions, the medical ethics imperative of 'do no harm' imposes a responsibility on hospitals to decarbonise. We investigated hospital stakeholders' perceptions of hospitals' GHG emissions sources and the sense of responsibility for reducing GHG emissions in a hospital. METHODS We conducted 29 semistructured qualitative expert interviews at one of Germany's largest hospitals, Heidelberg University Hospital. Five patients, 12 clinical and 12 administrative employees on different levels were selected using purposive maximum variation sampling. Interviews were transcribed verbatim and analysed using the framework approach. RESULTS Concerning GHG emissions, hospital stakeholders perceived energy and waste as most relevant emission sources followed by mobility. Climate change mitigation in general was considered as important. However, in their role as patients or employees, hospital stakeholders felt less responsible for climate change mitigation. They saw providing best possible medical care to be the top priority in hospitals and were often concerned that patients' health could be jeopardised by climate change mitigation measures. CONCLUSION Perceptions of most important emission sources did not coincide with those in literature, highlighting the need to inform stakeholders, for instance, about pharmaceuticals as important emission source. A frequently perceived conflict between reducing emissions and providing high-quality medical care could be eased, if reducing emissions would not only be justified as a contribution to mitigation, but also as a contribution to preventing ill health-a basic principle of medical ethics.
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Affiliation(s)
- Claudia Quitmann
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, 69120 Heidelberg, Germany
| | - Rainer Sauerborn
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, 69120 Heidelberg, Germany
| | - Ina Danquah
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, 69120 Heidelberg, Germany
| | - Alina Herrmann
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, 69120 Heidelberg, Germany
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Nyawanda BO, Beloconi A, Khagayi S, Bigogo G, Obor D, Otieno NA, Lange S, Franke J, Sauerborn R, Utzinger J, Kariuki S, Munga S, Vounatsou P. The relative effect of climate variability on malaria incidence after scale-up of interventions in western Kenya: A time-series analysis of monthly incidence data from 2008 to 2019. Parasite Epidemiol Control 2023; 21:e00297. [PMID: 37021322 PMCID: PMC10068258 DOI: 10.1016/j.parepi.2023.e00297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 03/07/2023] [Accepted: 03/12/2023] [Indexed: 03/17/2023] Open
Abstract
Background Despite considerable progress made over the past 20 years in reducing the global burden of malaria, the disease remains a major public health problem and there is concern that climate change might expand suitable areas for transmission. This study investigated the relative effect of climate variability on malaria incidence after scale-up of interventions in western Kenya. Methods Bayesian negative binomial models were fitted to monthly malaria incidence data, extracted from records of patients with febrile illnesses visiting the Lwak Mission Hospital between 2008 and 2019. Data pertaining to bed net use and socio-economic status (SES) were obtained from household surveys. Climatic proxy variables obtained from remote sensing were included as covariates in the models. Bayesian variable selection was used to determine the elapsing time between climate suitability and malaria incidence. Results Malaria incidence increased by 50% from 2008 to 2010, then declined by 73% until 2015. There was a resurgence of cases after 2016, despite high bed net use. Increase in daytime land surface temperature was associated with a decline in malaria incidence (incidence rate ratio [IRR] = 0.70, 95% Bayesian credible interval [BCI]: 0.59-0.82), while rainfall was associated with increased incidence (IRR = 1.27, 95% BCI: 1.10-1.44). Bed net use was associated with a decline in malaria incidence in children aged 6-59 months (IRR = 0.78, 95% BCI: 0.70-0.87) but not in older age groups, whereas SES was not associated with malaria incidence in this population. Conclusions Variability in climatic factors showed a stronger effect on malaria incidence than bed net use. Bed net use was, however, associated with a reduction in malaria incidence, especially among children aged 6-59 months after adjusting for climate effects. To sustain the downward trend in malaria incidence, this study recommends continued distribution and use of bed nets and consideration of climate-based malaria early warning systems when planning for future control interventions.
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Corvetto JF, Helou AY, Dambach P, Müller T, Sauerborn R. A Systematic Literature Review of the Impact of Climate Change on the Global Demand for Psychiatric Services. Int J Environ Res Public Health 2023; 20:1190. [PMID: 36673946 PMCID: PMC9858749 DOI: 10.3390/ijerph20021190] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 01/03/2023] [Accepted: 01/05/2023] [Indexed: 06/17/2023]
Abstract
Climate Change (CC) imposes important global health risks, including on mental health (MH). They are related mostly to psychological suffering caused by climate-related events and to the heat-vulnerability caused by psychiatric disorders. This growing burden may press MH services worldwide, increasing demand on public and private systems in low-, middle-, and high-income countries. According to PRISMA, two independent reviewers searched four databases for papers published before May 2022 that associated climate-related events with healthcare demand for psychiatric conditions. Of the 7432 papers retrieved, we included 105. Only 29 were carried out in low- and middle-income countries. Twelve related the admission numbers to (i) extreme events, while 93 to (ii) meteorological factors-mostly heat. Emergency visits and hospitalizations were significantly higher during hot periods for MH disorders, especially until lag 5-7. Extreme events also caused more consultations. Suicide (completed or attempted), substance misuse, schizophrenia, mood, organic and neurotic disorders, and mortality were strongly affected by CC. This high healthcare demand is evidence of the burden patients may undergo. In addition, public and private services may face a shortage of financial and human resources. Finally, the increased use of healthcare facilities, in turn, intensifies greenhouse gas emissions, representing a self-enforcing cycle for CC. Further research is needed to better clarify how extreme events affect MH services and, in addition, if services in low- and middle-income countries are more intensely demanded by CC, as compared to richer countries.
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Affiliation(s)
- Julia Feriato Corvetto
- Heidelberg Institute of Global Health (HIGH), Heidelberg University Hospital, Heidelberg University, 69120 Heidelberg, Germany
| | - Ammir Yacoub Helou
- Department of Anatomy, Institute of Biomedical Sciences, University of São Paulo, São Paulo 05508-900, Brazil
| | - Peter Dambach
- Heidelberg Institute of Global Health (HIGH), Heidelberg University Hospital, Heidelberg University, 69120 Heidelberg, Germany
| | - Thomas Müller
- Private Clinic Meiringen, 3860 Meiringen, Switzerland
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, 3000 Bern, Switzerland
| | - Rainer Sauerborn
- Heidelberg Institute of Global Health (HIGH), Heidelberg University Hospital, Heidelberg University, 69120 Heidelberg, Germany
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Lilier K, Selim SA, Raihan ST, Islam R, Das J, Danquah I, Sauerborn R, Bärnighausen K. Coping strategies and barriers to coping in climate- vulnerable Bangladesh: a qualitative study. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac131.160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
With the mental wellbeing of billions of people at risk due to climate change, more research is required to better understand mental health and psychological implications of climate vulnerability. This research contributes to understanding how people in climate vulnerable populations psychologically cope with stress with crucial implications for adaptation efforts. We conducted n = 60 qualitative in-depth interviews with men and women in Bhola, Bangladesh to elicit the lived experiences of a climate vulnerable population. We analysed data following the tenets of Grounded Theory. Through our inductive analysis, we found coping strategies where participants highlighted what they did when encountering stress, such as ‘Resignation’ or ‘Help Seeking'. Barriers to coping were, among others, limited ‘Efficacy', ‘Time’ or ‘Stigma'. We categorized coping strategies with barriers as high-barrier coping strategies and, those without reported barriers, as low- barrier coping strategies. High-barriers restricted participants - especially women - in their coping efforts and led them to using low-barrier coping strategies. Some low-barrier coping strategies can be interpreted as maladaptive if used frequently, as they are unhealthy and draw upon resources needed to adapt for the future. Maladaptive coping strategies can thus impede long-term adaptation by reducing motivation and the ability and willingness to act. To enable adaptive coping, we recommend lifting the barriers to coping through community-led interventions where community workers create platforms for sharing problems and knowledge, such as group support meetings. Sharing and discussing could strengthen efficacy and open new opportunities for functional, adaptive coping. As the negative impacts of climate change will be felt globally with more intensity and frequency, enabling adaptive coping and removing barriers to coping in frontline communities will be essential to supporting physical and mental wellbeing.
Key messages
• Barriers to adaptive coping strategies can lead people to using maladaptive low-barrier coping strategies, which draw upon resources needed for long-term adaptation.
• Enabling adaptive coping by lifting barriers to coping in climate vulnerable populations is crucial to strengthen adaptation efforts.
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Affiliation(s)
- K Lilier
- Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University , Heidelberg, Germany
| | - SA Selim
- Centre for Sustainable Development, University of Liberal Arts , Dhaka, Bangladesh
| | - ST Raihan
- Centre for Sustainable Development, University of Liberal Arts , Dhaka, Bangladesh
| | - R Islam
- Centre for Sustainable Development, University of Liberal Arts , Dhaka, Bangladesh
| | - J Das
- Centre for Sustainable Development, University of Liberal Arts , Dhaka, Bangladesh
| | - I Danquah
- Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University , Heidelberg, Germany
| | - R Sauerborn
- Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University , Heidelberg, Germany
| | - K Bärnighausen
- Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University , Heidelberg, Germany
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11
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Rybol L, Amelung D, Nieder J, Hachad H, Depoux A, Sauerborn R, Herrmann A. Medical studentś needs for an integration of climate change into the medical curriculum. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac130.068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The impacts of climate change (CC) on health comprise increased human morbidity and mortality. Consequently, physicians need to be systematically trained to address CC in their professional life. Due to lacking research on educational needs of medical students, we developed a survey instrument to assess studentś attitudinal and knowledge-based needs for the integration of CC into medical curricula and their readiness to learn.
Methods
Our survey was administered online to 788 students at the Medical Faculty of Heidelberg University between 06/2021 and 02/2022. Data analyses included descriptive statistics, reliability analyses as well as regression modeling with regard to readiness to learn.
Results
214 students participated in the survey, 170 fully completed datasets were included in the analysis. A majority of students (72.35%) (strongly) agreed that doctors carry a responsibility to address CC in their work setting, while only 4.71% (strongly) agreed, that their current medical training had imparted them with enough skill to do so. Students showed both considerable knowledge and interest in the area of CC, its health impacts, vulnerabilities and clinical adaptation (70.09% correct answers). Knowledge gaps were identified in the areas of health co-benefits and sustainable healthcare (55.53% and 16.71% of correct answers). 79.42% of students want to learn about CC through the integration into existing mandatory courses.
Conclusions
Results encourage the integration of CC topics with a focus on knowledge and professional role development into existing mandatory courses of the medical curriculum. Specifically, they also pinpoint health impacts and adaptation as greatest areas of interest for students and at health co-benefits and sustainable healthcare as areas with least prior knowledge.
Key messages
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Affiliation(s)
- L Rybol
- Medical Faculty, Heidelberg Institute of Global Health , Heidelberg, Germany
| | - D Amelung
- Medical Faculty, Heidelberg Institute of Global Health , Heidelberg, Germany
| | - J Nieder
- Medical Faculty, Heidelberg Institute of Global Health , Heidelberg, Germany
| | - H Hachad
- Medical Faculty, Sorbonne University , Paris, France
| | - A Depoux
- Centre Virchow-Villermé of Public Health, University of Paris Cité , Paris, France
| | - R Sauerborn
- Medical Faculty, Heidelberg Institute of Global Health , Heidelberg, Germany
| | - A Herrmann
- Medical Faculty, Heidelberg Institute of Global Health , Heidelberg, Germany
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12
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Huhn S, Matzke I, Koch M, Gunga HC, Maggioni MA, Sié A, Boudo V, Ouedraogo WA, Compaoré G, Bunker A, Sauerborn R, Bärnighausen T, Barteit S. Using wearable devices to generate real-world, individual-level data in rural, low-resource contexts in Burkina Faso, Africa: A case study. Front Public Health 2022; 10:972177. [PMID: 36249225 PMCID: PMC9561896 DOI: 10.3389/fpubh.2022.972177] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 08/30/2022] [Indexed: 01/25/2023] Open
Abstract
Background Wearable devices may generate valuable data for global health research for low- and middle-income countries (LMICs). However, wearable studies in LMICs are scarce. This study aims to investigate the use of consumer-grade wearables to generate individual-level data in vulnerable populations in LMICs, focusing on the acceptability (quality of the devices being accepted or even liked) and feasibility (the state of being workable, realizable, and practical, including aspects of data completeness and plausibility). Methods We utilized a mixed-methods approach within the health and demographic surveillance system (HDSS) to conduct a case study in Nouna, Burkina Faso (BF). All HDSS residents older than 6 years were eligible. N = 150 participants were randomly selected from the HDSS database to wear a wristband tracker (Withings Pulse HR) and n = 69 also a thermometer patch (Tucky thermometer) for 3 weeks. Every 4 days, a trained field worker conducted an acceptability questionnaire with participants, which included questions for the field workers as well. Descriptive and qualitative thematic analyses were used to analyze the responses of study participants and field workers. Results In total, n = 148 participants were included (and n = 9 field workers). Participant's acceptability ranged from 94 to 100% throughout the questionnaire. In 95% of the cases (n = 140), participants reported no challenges with the wearable. Most participants were not affected by the wearable in their daily activities (n = 122, 83%) and even enjoyed wearing them (n = 30, 20%). Some were concerned about damage to the wearables (n = 7, 5%). Total data coverage (i.e., the proportion of the whole 3-week study duration covered by data) was 43% for accelerometer (activity), 3% for heart rate, and 4% for body shell temperature. Field workers reported technical issues like faulty synchronization (n = 6, 1%). On average, participants slept 7 h (SD 3.2 h) and walked 8,000 steps per day (SD 5573.6 steps). Acceptability and data completeness were comparable across sex, age, and study arms. Conclusion Wearable devices were well-accepted and were able to produce continuous measurements, highlighting the potential for wearables to generate large datasets in LMICs. Challenges constituted data missingness mainly of technical nature. To our knowledge, this is the first study to use consumer-focused wearables to generate objective datasets in rural BF.
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Affiliation(s)
- Sophie Huhn
- Faculty of Medicine and University Hospital, Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany,*Correspondence: Sophie Huhn
| | - Ina Matzke
- Faculty of Medicine and University Hospital, Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany
| | - Mara Koch
- Faculty of Medicine and University Hospital, Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany
| | - Hanns-Christian Gunga
- Charité – Universitätsmedizin Berlin, Institute of Physiology, Center for Space Medicine and Extreme Environments Berlin, Berlin, Germany
| | - Martina Anna Maggioni
- Charité – Universitätsmedizin Berlin, Institute of Physiology, Center for Space Medicine and Extreme Environments Berlin, Berlin, Germany,Department of Biomedical Sciences for Health, Università Degli Studi di Milano, Milano, Italy
| | - Ali Sié
- Centre de Recherche en Santé, Nouna, Burkina Faso
| | | | | | | | - Aditi Bunker
- Faculty of Medicine and University Hospital, Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany
| | - Rainer Sauerborn
- Faculty of Medicine and University Hospital, Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany
| | - Till Bärnighausen
- Faculty of Medicine and University Hospital, Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany,Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, United States,Africa Health Research Institute (AHRI), KwaZulu-Natal, South Africa
| | - Sandra Barteit
- Faculty of Medicine and University Hospital, Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany
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13
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Nieder J, Nayna Schwerdtle P, Sauerborn R, Barteit S. Massive Open Online Courses for Health Worker Education in Low- and Middle-Income Countries: A Scoping Review. Front Public Health 2022; 10:891987. [PMID: 35903395 PMCID: PMC9315291 DOI: 10.3389/fpubh.2022.891987] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 06/01/2022] [Indexed: 12/02/2022] Open
Abstract
Background Massive Open Online Courses (MOOCs) have the potential to improve access to quality education for health care workers (HCWs) globally. Although studies have reported on the use of MOOCs in low- and middle-income countries (LMICs), our understanding of the scope of their utilization or access barriers and facilitators for this cohort is limited. We conducted a scoping review to map published peer-reviewed literature on MOOCs for HCW education in LMICs. We systematically searched four academic databases (Scopus, Web of Science, PubMed, ERIC) and Google Scholar, and undertook a two-stage screening process. The analysis included studies that reported on MOOCs relevant to HCWs' education accessed by HCWs based in LMICs. Results The search identified 1,317 studies with 39 studies included in the analysis, representing 40 MOOCs accessed in over 90 LMICs. We found that MOOCs covered a wide range of HCWs' including nurses, midwives, physicians, dentists, psychologists, and other workers from the broader health care sector, mainly at a post-graduate level. Dominant topics covered by the MOOCs included infectious diseases and epidemic response, treatment and prevention of non-communicable diseases, communication techniques and patient interaction, as well as research practice. Time contribution and internet connection were recognized barriers to MOOC completion, whilst deadlines, email reminders, graphical design of the MOOC, and blended learning modes facilitated uptake and completion. MOOCs were predominantly taught in English (20%), French (12.5%), Spanish (7.5%) and Portuguese (7.5%). Overall, evaluation outcomes were positive and focused on completion rate, learner gain, and student satisfaction. Conclusion We conclude that MOOCs can be an adequate tool to support HCWs' education in LMICs and may be particularly suited for supporting knowledge and understanding. Heterogeneous reporting of MOOC characteristics and lack of cohort-specific reporting limits our ability to evaluate MOOCs at a broader scale; we make suggestions on how standardized reporting may offset this problem. Further research should focus on the impact of learning through MOOCs, as well as on the work of HCWs and the apparent lack of courses covering the key causes of diseases in LMICs. This will result in increased understanding of the extent to which MOOCs can be utilized in this context.
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Affiliation(s)
- Jessica Nieder
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
- *Correspondence: Jessica Nieder
| | - Patricia Nayna Schwerdtle
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
- Nursing and Midwifery, Faculty of Medicine, Nursing and Health Science, Monash University, Clayton, VIC, Australia
| | - Rainer Sauerborn
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
| | - Sandra Barteit
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
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14
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Huhn S, Axt M, Gunga HC, Maggioni MA, Munga S, Obor D, Sié A, Boudo V, Bunker A, Sauerborn R, Bärnighausen T, Barteit S. The Impact of Wearable Technologies in Health Research: Scoping Review. JMIR Mhealth Uhealth 2022; 10:e34384. [PMID: 35076409 PMCID: PMC8826148 DOI: 10.2196/34384] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 11/23/2021] [Accepted: 12/17/2021] [Indexed: 12/23/2022] Open
Abstract
Background Wearable devices hold great promise, particularly for data generation for cutting-edge health research, and their demand has risen substantially in recent years. However, there is a shortage of aggregated insights into how wearables have been used in health research. Objective In this review, we aim to broadly overview and categorize the current research conducted with affordable wearable devices for health research. Methods We performed a scoping review to understand the use of affordable, consumer-grade wearables for health research from a population health perspective using the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) framework. A total of 7499 articles were found in 4 medical databases (PubMed, Ovid, Web of Science, and CINAHL). Studies were eligible if they used noninvasive wearables: worn on the wrist, arm, hip, and chest; measured vital signs; and analyzed the collected data quantitatively. We excluded studies that did not use wearables for outcome assessment and prototype studies, devices that cost >€500 (US $570), or obtrusive smart clothing. Results We included 179 studies using 189 wearable devices covering 10,835,733 participants. Most studies were observational (128/179, 71.5%), conducted in 2020 (56/179, 31.3%) and in North America (94/179, 52.5%), and 93% (10,104,217/10,835,733) of the participants were part of global health studies. The most popular wearables were fitness trackers (86/189, 45.5%) and accelerometer wearables, which primarily measure movement (49/189, 25.9%). Typical measurements included steps (95/179, 53.1%), heart rate (HR; 55/179, 30.7%), and sleep duration (51/179, 28.5%). Other devices measured blood pressure (3/179, 1.7%), skin temperature (3/179, 1.7%), oximetry (3/179, 1.7%), or respiratory rate (2/179, 1.1%). The wearables were mostly worn on the wrist (138/189, 73%) and cost <€200 (US $228; 120/189, 63.5%). The aims and approaches of all 179 studies revealed six prominent uses for wearables, comprising correlations—wearable and other physiological data (40/179, 22.3%), method evaluations (with subgroups; 40/179, 22.3%), population-based research (31/179, 17.3%), experimental outcome assessment (30/179, 16.8%), prognostic forecasting (28/179, 15.6%), and explorative analysis of big data sets (10/179, 5.6%). The most frequent strengths of affordable wearables were validation, accuracy, and clinical certification (104/179, 58.1%). Conclusions Wearables showed an increasingly diverse field of application such as COVID-19 prediction, fertility tracking, heat-related illness, drug effects, and psychological interventions; they also included underrepresented populations, such as individuals with rare diseases. There is a lack of research on wearable devices in low-resource contexts. Fueled by the COVID-19 pandemic, we see a shift toward more large-sized, web-based studies where wearables increased insights into the developing pandemic, including forecasting models and the effects of the pandemic. Some studies have indicated that big data extracted from wearables may potentially transform the understanding of population health dynamics and the ability to forecast health trends.
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Affiliation(s)
- Sophie Huhn
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany
| | - Miriam Axt
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany
| | - Hanns-Christian Gunga
- Charité - Universitätsmedizin Berlin, Institute of Physiology, Center for Space Medicine and Extreme Environment, Berlin, Germany
| | - Martina Anna Maggioni
- Charité - Universitätsmedizin Berlin, Institute of Physiology, Center for Space Medicine and Extreme Environment, Berlin, Germany.,Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milano, Italy
| | | | - David Obor
- Kenya Medical Research Institute, Kisumu, Kenya
| | - Ali Sié
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany.,Centre de Recherche en Santé Nouna, Nouna, Burkina Faso
| | | | - Aditi Bunker
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany
| | - Rainer Sauerborn
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany
| | - Till Bärnighausen
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany.,Harvard Center for Population and Development Studies, Cambridge, MA, United States.,Africa Health Research Institute, KwaZulu-Natal, South Africa
| | - Sandra Barteit
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany
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15
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Mank I, Belesova K, Bliefernicht J, Traoré I, Wilkinson P, Danquah I, Sauerborn R. The Impact of Rainfall Variability on Diets and Undernutrition of Young Children in Rural Burkina Faso. Front Public Health 2021; 9:693281. [PMID: 34616704 PMCID: PMC8489680 DOI: 10.3389/fpubh.2021.693281] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Accepted: 08/24/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Climate change and consequent increases in rainfall variability may have negative consequences for the food production of subsistence farmers in West Africa with adverse impacts on nutrition and health. We explored the pathway from rainfall through diet up to child undernutrition for rural Burkina Faso. Methods: The study used data of a dynamic cohort with 1,439 children aged 7-60 months from the Nouna Health and Demographic Surveillance Site (HDSS) for 2017 to 2019. We assessed data on diets, height, weight, household characteristics, and daily precipitation (from 1981 to 2019). Principal component analysis was used to identify distinct child dietary patterns (Dietary Pattern Scores, DPS). These were related to 15 rainfall indicators by area to obtain a precipitation variability score (PVS) through reduced rank regression (RRR). Associations between the PVS and anthropometric measures, height-for-age (HAZ), and weight-for-height (WHZ), were examined using multi-level regression analysis. Results: Stunting (HAZ < -2) and wasting (WHZ < -2) were seen in 24 and 6% of the children. Three main dietary patterns were identified (market-based, vegetable-based, and legume-based diets) and showed mixed evidence for associations with child undernutrition. The RRR-derived PVS explained 14% of the total variance in these DPS. The PVS was characterized by more consecutive dry days during the rainy season, higher cumulative rainfall in July and more extremely wet days. A 1-point increase in the PVS was associated with a reduction of 0.029 (95% CI: -0.06, 0.00, p < 0.05) in HAZ in the unadjusted, and an increase by 0.032 (95% CI: 0.01, 0.06, p < 0.05) in WHZ in the fully adjusted model. Conclusion: Rainfall variability was associated with dietary patterns in young children of a rural population of Burkina Faso. Increased rainfall variability was associated with an increase in chronic undernutrition, but not in acute undernutrition among young children.
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Affiliation(s)
- Isabel Mank
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
| | - Kristine Belesova
- Department of Public Health, Environments and Society and Centre on Climate Change and Planetary Health, London School of Hygiene and Tropical Medicine (LSHTM), London, United Kingdom
| | - Jan Bliefernicht
- Institute of Geography, Faculty of Applied Computer Science, University of Augsburg, Augsburg, Germany
| | - Issouf Traoré
- Centre de Recherche en Santé de Nouna (CRSN), Institut National de Santé Publique, Nouna, Burkina Faso.,Institut Universitaire de Formations Initiale et Continue (IUFIC), Université Thomas Sankara (UTS), Ouagadougou, Burkina Faso
| | - Paul Wilkinson
- Department of Public Health, Environments and Society and Centre on Climate Change and Planetary Health, London School of Hygiene and Tropical Medicine (LSHTM), London, United Kingdom
| | - Ina Danquah
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
| | - Rainer Sauerborn
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
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16
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Barteit S, Boudo V, Ouedraogo A, Zabré P, Ouremi L, Sié A, Munga S, Obor D, Kwaro D, Huhn S, Bunker A, Sauerborn R, Gunga HC, Maggioni MA, Bärnighausen T. Feasibility, acceptability and validation of wearable devices for climate change and health research in the low-resource contexts of Burkina Faso and Kenya: Study protocol. PLoS One 2021; 16:e0257170. [PMID: 34591893 PMCID: PMC8483291 DOI: 10.1371/journal.pone.0257170] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 08/23/2021] [Indexed: 12/15/2022] Open
Abstract
As the epidemiological transition progresses throughout sub-Saharan Africa, life lived with diseases is an increasingly important part of a population's burden of disease. The burden of disease of climate-sensitive health outcomes is projected to increase considerably within the next decades. Objectively measured, reliable population health data is still limited and is primarily based on perceived illness from recall. Technological advances like non-invasive, consumer-grade wearable devices may play a vital role in alleviating this data gap and in obtaining insights on the disease burden in vulnerable populations, such as heat stress on human cardiovascular response. The overall goal of this study is to investigate whether consumer-grade wearable devices are an acceptable, feasible and valid means to generate data on the individual level in low-resource contexts. Three hundred individuals are recruited from the two study locations in the Nouna health and demographic surveillance system (HDSS), Burkina Faso, and the Siaya HDSS, Kenya. Participants complete a structured questionnaire that comprises question items on acceptability and feasibility under the supervision of trained data collectors. Validity will be evaluated by comparing consumer-grade wearable devices to research-grade devices. Furthermore, we will collect demographic data as well as the data generated by wearable devices. This study will provide insights into the usage of consumer-grade wearable devices to measure individual vital signs in low-resource contexts, such as Burkina Faso and Kenya. Vital signs comprising activity (steps), sleep (duration, quality) and heart rate (hr) are important measures to gain insights on individual behavior and activity patterns in low-resource contexts. These vital signs may be associated with weather variables-as we gather them from weather stations that we have setup as part of this study to cover the whole Nouna and Siaya HDSSs-in order to explore changes in behavior and other variables, such as activity, sleep, hr, during extreme weather events like heat stress exposure. Furthermore, wearable data could be linked to health outcomes and weather events. As a result, consumer-grade wearables may serve as a supporting technology for generating reliable measurements in low-resource contexts and investigating key links between weather occurrences and health outcomes. Thus, wearable devices may provide insights to better inform mitigation and adaptation interventions in these low-resource settings that are direly faced by climate change-induced changes, such as extreme weather events.
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Affiliation(s)
- Sandra Barteit
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany
- * E-mail:
| | | | | | - Pascal Zabré
- Centre de Recherche en Santé, Nouna, Burkina Faso
| | | | - Ali Sié
- Centre de Recherche en Santé, Nouna, Burkina Faso
| | | | - David Obor
- Kenya Medical Research Institute, Kisumu, Kenya
| | | | - Sophie Huhn
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany
| | - Aditi Bunker
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany
| | - Rainer Sauerborn
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany
| | - Hanns-Christian Gunga
- Institute of Physiology, Center for Space Medicine and extreme Environment Berlin, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Martina A. Maggioni
- Institute of Physiology, Center for Space Medicine and extreme Environment Berlin, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- Department of Biomedical Sciences for health, Università degli Studi di Milano, Milan, Italy
| | - Till Bärnighausen
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany
- Department of Global Health and Population, Harvard T.MLP. Chan School of Public Health, Boston, Massachusetts, United States of America
- Africa Health Research Institute (AHRI), Durban, KwaZulu-Natal, South Africa
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17
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Clauss A, Sie A, Zabre P, Schmoll J, Sauerborn R, Listl S. Population-Based Prevalence of Oral Conditions as a Basis for Planning Community-Based Interventions: An Epidemiological Study From Rural Burkina Faso. Front Public Health 2021; 9:697498. [PMID: 34277555 PMCID: PMC8280293 DOI: 10.3389/fpubh.2021.697498] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 05/28/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives: The purpose of the present study was to: (i) provide timely data on dental caries and periodontal conditions in rural Burkina Faso; (ii) identify the oral health practices carried out in this population, and (iii) to prioritize evidence-based interventions at the community level. Methods: Leaning on WHO recommendations for oral health epidemiological studies, clinical examinations and questionnaire-based surveys were conducted in two different age groups (adolescents: 15-19 years old; adults: 35-44 years old) in the health district of Nouna, Burkina Faso. Caries and tooth status were assessed according to the DMFT Index. The periodontal status was assessed by a modified Community Periodontal Index on all teeth present and measuring the level of attachment-loss of six index teeth. Questionnaire items specifically included utilization of oral health care and oral health behaviors. Results: The prevalence of untreated caries was 38% in adolescents and 73% in adults. In terms of periodontal health, 21% of adolescents and 61% of adults had an attachment loss ≥4 mm. Ninety seven percent of adolescents had not attended a dentist in the previous year and 78% of adults had never seen a dentist in their life. About one third of adolescents and adults cleaned their teeth less often than once per day with equal proportions of toothbrushes and traditional chewing sticks made of tree branches. Fluoride toothpaste was used by <10% of study participants. Almost half of the examined people reported to drink a sugar-sweetened beverage at least once a day. Conclusions: Dental caries and periodontitis are highly prevalent in rural Burkina Faso. These findings highlight the key relevance of epidemiological data for identifying people's oral health needs as basis for developing, testing, and implementing oral health interventions and programs. Special emphasis should be put on the design and evaluation of community-based interventions.
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Affiliation(s)
- Alexandra Clauss
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg, Germany
| | - Ali Sie
- Institut National de Santé Publique, Ouagadougou, Burkina Faso
| | - Pascal Zabre
- Institut National de Santé Publique, Ouagadougou, Burkina Faso
| | - Jörg Schmoll
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg, Germany
| | - Rainer Sauerborn
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg, Germany
| | - Stefan Listl
- Radboud Institute for Health Sciences, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands.,Section for Translational Health Economics, Heidelberg University Hospital, Department of Conservative Dentistry, Heidelberg, Germany
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18
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Dambach P, Bärnighausen T, Yadouleton A, Dambach M, Traoré I, Korir P, Ouedraogo S, Nikiema M, Sauerborn R, Becker N, Louis VR. Is biological larviciding against malaria a starting point for integrated multi-disease control? Observations from a cluster randomized trial in rural Burkina Faso. PLoS One 2021; 16:e0253597. [PMID: 34143831 PMCID: PMC8213177 DOI: 10.1371/journal.pone.0253597] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 06/08/2021] [Indexed: 11/29/2022] Open
Abstract
Objectives To evaluate the impact of anti-malaria biological larviciding with Bacillus thuringiensis israelensis on non-primary target mosquito species in a rural African setting. Methods A total of 127 villages were distributed in three study arms, each with different larviciding options in public spaces: i) no treatment, ii) full or iii) guided intervention. Geographically close villages were grouped in clusters to avoid contamination between treated and untreated villages. Adult mosquitoes were captured in light traps inside and outside houses during the rainy seasons of a baseline and an intervention year. After enumeration, a negative binomial regression was used to determine the reductions achieved in the different mosquito species through larviciding. Results Malaria larviciding interventions showed only limited or no impact against Culex mosquitoes; by contrast, reductions of up to 34% were achieved against Aedes when all detected breeding sites were treated. Culex mosquitoes were captured in high abundance in semi-urban settings while more Aedes were found in rural villages. Conclusions Future malaria larviciding programs should consider expanding onto the breeding habitats of other disease vectors, such as Aedes and Culex and evaluate their potential impact. Since the major cost components of such interventions are labor and transport, other disease vectors could be targeted at little additional cost.
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Affiliation(s)
- Peter Dambach
- Institute for Global Health, University Hospital Heidelberg, Heidelberg, Germany
- * E-mail:
| | - Till Bärnighausen
- Institute for Global Health, University Hospital Heidelberg, Heidelberg, Germany
| | - Anges Yadouleton
- Centre de Recherche Entomologique de Cotonou (CREC), Cotonou, Benin
| | - Martin Dambach
- Institute of Zoology, University of Cologne, Cologne, Germany
| | - Issouf Traoré
- Centre de Recherche en Santé de Nouna, Nouna, Burkina Faso
| | - Patricia Korir
- Institute of Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Bonn, Germany
| | | | | | - Rainer Sauerborn
- Institute for Global Health, University Hospital Heidelberg, Heidelberg, Germany
| | - Norbert Becker
- German Mosquito Control Association (KABS), Speyer, Germany
| | - Valérie R. Louis
- Institute for Global Health, University Hospital Heidelberg, Heidelberg, Germany
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19
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Dambach P, Winkler V, Bärnighausen T, Traoré I, Ouedraogo S, Sié A, Sauerborn R, Becker N, Louis VR. Biological larviciding against malaria vector mosquitoes with Bacillus thuringiensis israelensis (Bti) - Long term observations and assessment of repeatability during an additional intervention year of a large-scale field trial in rural Burkina Faso. Glob Health Action 2021; 13:1829828. [PMID: 33028158 PMCID: PMC7580761 DOI: 10.1080/16549716.2020.1829828] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
The first line of malaria vector control to date mainly relies on the use of long-lasting insecticidal nets (LLINs) and indoor residual spraying (IRS). For integrated vector management, targeting the vector larvae with biological larvicides such as Bacillus thuringiensis israelensis (Bti) can be an effective additional mainstay. This study presents data from the second intervention year of a large-scale trial on biological larviciding with Bti that was carried out in 127 rural villages and a semi-urban town in Burkina Faso. Here we present the reductions in malaria mosquitoes that were achieved by continuing the initial interventions for an additional year, important to assess sustainability and repeatability of the results from the first intervention year. Larviciding was performed applying two different larviciding choices ((a) treatment of all environmental breeding sites, and (b) selective treatment of those that were most productive for Anopheles larvae indicated by remote sensing based risk maps). Adult Anopheles spp. mosquito abundance was reduced by 77.4% (full treatment) and 63.5% (guided treatment) compared to the baseline year. The results showed that malaria vector abundance can be dramatically reduced using biological larviciding and that this effect can be achieved and maintained over several consecutive transmission seasons.
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Affiliation(s)
- Peter Dambach
- Institute of Global Health, University Hospital Heidelberg , Heidelberg, Germany
| | - Volker Winkler
- Institute of Global Health, University Hospital Heidelberg , Heidelberg, Germany
| | - Till Bärnighausen
- Institute of Global Health, University Hospital Heidelberg , Heidelberg, Germany
| | - Issouf Traoré
- Centre de Recherche en Santé de Nouna , Nouna, Burkina Faso
| | | | - Ali Sié
- Centre de Recherche en Santé de Nouna , Nouna, Burkina Faso
| | - Rainer Sauerborn
- Institute of Global Health, University Hospital Heidelberg , Heidelberg, Germany
| | - Norbert Becker
- German Mosquito Control Association (KABS) , Speyer, Germany
| | - Valérie R Louis
- Institute of Global Health, University Hospital Heidelberg , Heidelberg, Germany
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20
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Dambach P, Traoré I, Sawadogo H, Zabré P, Shukla S, Sauerborn R, Becker N, Phalkey R. Community acceptance of environmental larviciding against malaria with Bacillus thuringiensis israelensis in rural Burkina Faso - A knowledge, attitudes and practices study. Glob Health Action 2021; 14:1988279. [PMID: 34927578 PMCID: PMC8725727 DOI: 10.1080/16549716.2021.1988279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background Malaria control is based on early treatment of cases and on vector control. The current measures for malaria vector control in Africa are mainly based on long-lasting insecticidal nets (LLINs) and to a much smaller extent on indoor residual spraying (IRS). While bed net use is widely distributed and its role is intensively researched, Bti-based larviciding is a relatively novel tool in Africa. In this study, we analyze the perception and acceptability of Bti-based larval source management under different larviciding scenarios that were performed in a health district in Burkina Faso. Objective To research people’s perception and acceptance regarding biological larviciding interventions against malaria in their communities. Methods A cross-sectional study was undertaken using a total of 634 administered questionnaires. Data were collected in a total of 36 rural villages and in seven town quarters of the semi-urban town of Nouna. Results Respondents had basic to good knowledge regarding malaria transmission and how to protect oneself against it. More than 90% reported sleeping under a bed net, while other measures such as mosquito coils and insecticides were only used by a minority. The majority of community members reported high perceived reductions in mosquito abundance and the number of malaria episodes. There was a high willingness to contribute financially to larviciding interventions among interviewees. Conclusions This study showed that biological larviciding interventions are welcomed by the population that they are regarded as an effective and safe means to reduce mosquito abundance and malaria transmission. A routine implementation would, despite low intervention costs, require community ownership and contribution.
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Affiliation(s)
- Peter Dambach
- Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany
| | - Issouf Traoré
- Centre De Recherche En Santé De Nouna, Nouna, Burkina Faso.,Institut De Formations Initiale Et Continue, Université Thomas Sankara, Ouagadougou, Burkina Faso
| | | | - Pascal Zabré
- Centre De Recherche En Santé De Nouna, Nouna, Burkina Faso
| | - Sharvari Shukla
- Symbiosis Statistical Institute, Symbiosis International (Deemed University)
| | - Rainer Sauerborn
- Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany
| | - Norbert Becker
- German Mosquito Control Association (KABS), Speyer, Germany.,Centre for Organismal Studies, University of Heidelberg, Heidelberg, Germany
| | - Revati Phalkey
- Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany.,Epidemiology and Public Health Division, University of Nottingham, Nottingham, UK.,Climate Change and Health Group, Public Health England, Chilton, UK
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21
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Nayna Schwerdtle P, Stockemer J, Bowen KJ, Sauerborn R, McMichael C, Danquah I. A Meta-Synthesis of Policy Recommendations Regarding Human Mobility in the Context of Climate Change. Int J Environ Res Public Health 2020; 17:E9342. [PMID: 33327439 PMCID: PMC7764877 DOI: 10.3390/ijerph17249342] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 12/04/2020] [Accepted: 12/10/2020] [Indexed: 02/06/2023]
Abstract
Changing mobility patterns combined with changes in the climate present challenges and opportunities for global health, requiring effective, relevant, and humane policy responses. This study used data from a systematic literature review that examined the intersection between climate change, migration, and health. The study aimed to synthesize policy recommendations in the peer-reviewed literature, regarding this type of environmental migration with respect to health, to strengthen the evidence-base. Systematic searches were conducted in four academic databases (PubMed, Ovid Medline, Global Health and Scopus) and Google Scholar for empirical studies published between 1990-2020 that used any study design to investigate migration and health in the context of climate change. Studies underwent a two-stage protocol-based screening process and eligible studies were appraised for quality using a standardized mixed-methods tool. From the initial 2425 hits, 68 articles were appraised for quality and included in the synthesis. Among the policy recommendations, six themes were discernible: (1) avoid the universal promotion of migration as an adaptive response to climate risk; (2) preserve cultural and social ties of mobile populations; (3) enable the participation of migrants in decision-making in sites of relocation and resettlement; (4) strengthen health systems and reduce barriers for migrant access to health care; (5) support and promote optimization of social determinants of migrant health; (6) integrate health into loss and damage assessments related to climate change, and consider immobile and trapped populations. The results call for transformative policies that support the health and wellbeing of people engaging in or affected by mobility responses, including those whose migration decisions and experiences are influenced by climate change, and to establish and develop inclusive migrant healthcare.
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Affiliation(s)
- Patricia Nayna Schwerdtle
- Heidelberg Institute of Global Health, Universitaetsklinikum Heidelberg, 69120 Heidelberg, Germany; (J.S.); (R.S.); (I.D.)
- Nursing & Midwifery, Faculty of Medicine, Nursing & Health Science, Monash University, Clayton, VIC 3800, Australia
| | - Julia Stockemer
- Heidelberg Institute of Global Health, Universitaetsklinikum Heidelberg, 69120 Heidelberg, Germany; (J.S.); (R.S.); (I.D.)
| | - Kathryn J. Bowen
- Fenner School of Environment and Society, and Research School of Population Health, Australian National University, Canberra, ACT 2601, Australia;
- Institute for Advanced Sustainability Studies, 14467 Potsdam, Germany
- Melbourne School of Population and Global Health, University of Melbourne, Parkville, VIC 3010, Australia
| | - Rainer Sauerborn
- Heidelberg Institute of Global Health, Universitaetsklinikum Heidelberg, 69120 Heidelberg, Germany; (J.S.); (R.S.); (I.D.)
| | - Celia McMichael
- School of Geography, University of Melbourne, Parkville, VIC 3010, Australia;
| | - Ina Danquah
- Heidelberg Institute of Global Health, Universitaetsklinikum Heidelberg, 69120 Heidelberg, Germany; (J.S.); (R.S.); (I.D.)
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22
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Mank I, Vandormael A, Traoré I, Ouédraogo WA, Sauerborn R, Danquah I. Dietary habits associated with growth development of children aged < 5 years in the Nouna Health and Demographic Surveillance System, Burkina Faso. Nutr J 2020; 19:81. [PMID: 32772913 PMCID: PMC7416397 DOI: 10.1186/s12937-020-00591-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 07/21/2020] [Indexed: 02/06/2023] Open
Abstract
Background Knowing which dietary habits are associated with child growth could lead to better long-term health outcomes and improve the design of food-based interventions. We aimed to identify dietary habits that are associated with the growth development of children aged < 5 years living in rural Burkina Faso. Methods This study used cross-sectional baseline data from 514 children (8–59 months) within the Nouna Health and Demographic Surveillance System (HDSS) in 2018. Household socio-demographics and child dietary habits, height and weight were assessed. We constructed scores for dietary diversity (DDS) and food variety (FVS), and extracted exploratory dietary pattern scores (DPS) using principal component analysis (PCA). Child growth was measured using height-for-age (HAZ) and weight-for-height z-scores (WHZ). We used multiple-adjusted linear regressions considering for socio-economic factors to quantify associations. Results In this study population (median 36 ± 14 months old), stunting (HAZ < − 2) was seen in 26% and wasting (WHZ < − 2) in 7%. The DDS (median 7 ± 2 food groups) was positively associated with WHZ, while the FVS (median 13 ± 8 food items) was inversely associated with HAZ. We identified 4 dietary patterns: leaves-based, beans and poultry-based, maize and fish-based, and millet and meat-based diets. Only the maize and fish-based diet showed a statistically significant and here positive trend for associations with WHZ. Conclusion Growth development of children aged < 5 years continues to be a health problem in the Nouna HDSS. A higher dietary diversity and food variety and dietary patterns characterized by maize and fish and beans and poultry intake appear to be beneficial for growth of young children in this area.
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Affiliation(s)
- Isabel Mank
- Heidelberg Institute of Global Health (HIGH), Medical Faculty, Heidelberg University, Heidelberg, Germany.
| | - Alain Vandormael
- Heidelberg Institute of Global Health (HIGH), Medical Faculty, Heidelberg University, Heidelberg, Germany
| | - Issouf Traoré
- Centre de Recherche en Santé de Nouna (CRSN), Institut National de Santé Publique (INSP), Nouna, Burkina Faso.,Institut Universitaire de Formations Initiale et Continue (IUFIC), Université Ouaga II (UO2), Ouagadougou, Burkina Faso
| | | | - Rainer Sauerborn
- Heidelberg Institute of Global Health (HIGH), Medical Faculty, Heidelberg University, Heidelberg, Germany
| | - Ina Danquah
- Heidelberg Institute of Global Health (HIGH), Medical Faculty, Heidelberg University, Heidelberg, Germany
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23
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Yasmin F, Nahar N, Banu B, Ali L, Sauerborn R, Souares A. The influence of mobile phone-based health reminders on patient adherence to medications and healthy lifestyle recommendations for effective management of diabetes type 2: a randomized control trial in Dhaka, Bangladesh. BMC Health Serv Res 2020; 20:520. [PMID: 32513164 PMCID: PMC7282058 DOI: 10.1186/s12913-020-05387-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 06/01/2020] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND In 2017, 80% of 425 million adults with diabetes worldwide were living in low and middle-income countries. Diabetes affected 6.9 million adults in Bangladesh and accounted for 3% of the country's total mortality. Proper management of diabetes is the key to positive health outcomes. This study investigated how mobile phone-based health intervention could increase patient adherence and thereby improve the disease outcomes for diabetes type 2 in Bangladesh. METHODS A mobile phone-based health project (including mobile phone reminders and 24/7 call center) was implemented in Dhaka District, Bangladesh from January to December 2014. A randomized control trial was carried out, recruiting randomly in intervention and control groups among the patients receiving treatment for type 2 diabetes at the Bangladesh Institute of Health Sciences Hospital, Dhaka, Bangladesh. A total of 320 patients from both groups at baseline and 273 at endline were interviewed. RESULTS A significant improvement in patient adherence to diet, physical exercise, the cessation of use of tobacco and betel nut, and blood glycaemic control was found in the intervention group, whereas no such significant improvement was found in the control group. Cost and other co-morbidities were found to be the main reasons for non-adherence. CONCLUSION A mobile-health intervention should be considered as an additional option for non-communicable disease programs.
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Affiliation(s)
- Farzana Yasmin
- Heidelberg Institute of Global Health (HIGH), Heidelberg University Hospital, Heidelberg, Germany.
- Friede Springer Endowed Professorship for Global Child Health, Faculty of Health/Department of Human Medicine, University of Witten/Herdecke, Alfred-Herrhausen-Str. 50, 58448, Witten, Germany.
| | | | - Bilkis Banu
- Heidelberg Institute of Global Health (HIGH), Heidelberg University Hospital, Heidelberg, Germany
| | - Liaquat Ali
- Pothikrit Institute of Health Studies, Dhaka, Bangladesh
| | - Rainer Sauerborn
- Heidelberg Institute of Global Health (HIGH), Heidelberg University Hospital, Heidelberg, Germany
| | - Aurélia Souares
- Heidelberg Institute of Global Health (HIGH), Heidelberg University Hospital, Heidelberg, Germany
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24
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Herrmann A, Sauerborn R, Nilsson M. The Role of Health in Households' Balancing Act for Lifestyles Compatible with the Paris Agreement-Qualitative Results from Mannheim, Germany. Int J Environ Res Public Health 2020; 17:E1297. [PMID: 32085458 PMCID: PMC7068404 DOI: 10.3390/ijerph17041297] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 02/07/2020] [Accepted: 02/09/2020] [Indexed: 12/16/2022]
Abstract
Household lifestyles are the main drivers of climate change. Climate change mitigation measures directed to households often have substantial health co-benefits. The European mixed-methods study HOPE (HOuseholds' Preferences for reducing greenhouse gas emissions in four European high-income countries) investigates households' preferences for reducing greenhouse gas emissions and particularly researches the role of information on health co-benefits in households' decision making. The results presented in this study are derived from 18 qualitative interviews, conducted with a subsample of households from Mannheim, Germany. The in-depth interviews were transcribed verbatim, analyzed with a qualitative content analysis, supported by NVivo software. They showed that, in order to reduce their greenhouse gas emission in a way compatible with the 1.5 °C goal, households have to undertake a difficult balancing act, considering factors from the individual sphere, such as health co-benefits, as well as from the public sphere, such as (climate) policies. Shared responsibility and equity are important aspects of households. In conclusion, health is an important factor in households' decision making. However, information policies about health co-benefits need to go along with structural policy measures, in order to support households effectively in the implementation of healthy and climate-friendly lifestyles, especially in sectors where behavior change is difficult, like the mobility sector.
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Affiliation(s)
- Alina Herrmann
- Heidelberg Institute of Global Health (HIGH), Heidelberg University Hospital, 69120 Heidelberg, Germany;
| | - Rainer Sauerborn
- Heidelberg Institute of Global Health (HIGH), Heidelberg University Hospital, 69120 Heidelberg, Germany;
| | - Maria Nilsson
- Department of Epidemiology and Global Health, Umeå University, 90187 Umeå, Sweden;
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25
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Yasmin F, Ali L, Banu B, Rasul FB, Sauerborn R, Souares A. Understanding patients' experience living with diabetes type 2 and effective disease management: a qualitative study following a mobile health intervention in Bangladesh. BMC Health Serv Res 2020; 20:29. [PMID: 31918704 PMCID: PMC6953219 DOI: 10.1186/s12913-019-4811-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 12/04/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In 2017, 425 million adults worldwide had diabetes; 80% were living in low and middle-income countries. Bangladesh had 6.9 million adults with diabetes; death from diabetes comprised 3% of the country's total mortality. This study looked at different factors (personal, familial, social, and financial) affecting both the life of patients with diabetes type 2 and the management of the disease. It also explored patient's perception of the mobile health intervention in the context of disease management and helped to explain the findings obtained from the quantitative part of this study. METHOD The study was a mixed-method, sequential explanatory design. A mobile health project (interactive voice call and call center) was implemented in Dhaka district, Bangladesh from January to December, 2014. Patients received treatment at the outpatient department of Bangladesh Institute of Health Science Hospital, Dhaka, Bangladesh, were included in intervention and control groups of the main study following a Randomized Control Trial. Among them, a total of 18 patients (9 + 9) were selected purposefully for the qualitative study, which was conducted in July, 2015. The sample was selected purposefully considering the age, sex, socio-economic status and proximity of living due to the political instability of the country during the data collection period. The interviews were transcribed and analyzed applying investigator triangulation. RESULTS Most patients stated that diabetes has affected their lives. In general, both groups´ evaluation of mobile health services were good and both regarded the recommendations for medication, diet, physical exercise, and other lifestyle behaviors (use of tobacco and betel nuts) as helpful. The cost of overall treatment (medications, physician consultations, laboratory investigations), the lack of availability of safe public places for physical exercise and unfavorable weather conditions (heat, rainfall) were mentioned as barriers to the overall management of the disease. CONCLUSION A patient-centered mobile health intervention supported by a collaborative patient-provider relationship, a strong family support system, available public spaces for exercise and the introduction of a functional public health insurance system could be beneficial for the better management of diabetes.
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Affiliation(s)
- F Yasmin
- Heidelberg Institute of Global Health, Heidelberg University Hospital, 69120, Heidelberg, Germany.
- Faculty of Health/Department of Human Medicine, University Witten/Herdecke, 58448, Witten, Germany.
| | - L Ali
- Bangladesh University of Health Sciences (BUHS), Mirpur-1, Dhaka, 1216, Bangladesh
| | - B Banu
- Heidelberg Institute of Global Health, Heidelberg University Hospital, 69120, Heidelberg, Germany
| | - F B Rasul
- Heidelberg Institute of Global Health, Heidelberg University Hospital, 69120, Heidelberg, Germany
- BRAC James P. Grant School of Public Health, BRAC University, Mohakhali, Dhaka, 1212, Bangladesh
| | - R Sauerborn
- Heidelberg Institute of Global Health, Heidelberg University Hospital, 69120, Heidelberg, Germany
| | - A Souares
- Heidelberg Institute of Global Health, Heidelberg University Hospital, 69120, Heidelberg, Germany
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26
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Belesova K, Gornott C, Milner J, Sié A, Sauerborn R, Wilkinson P. Mortality impact of low annual crop yields in a subsistence farming population of Burkina Faso under the current and a 1.5°C warmer climate in 2100. Sci Total Environ 2019; 691:538-548. [PMID: 31325854 DOI: 10.1016/j.scitotenv.2019.07.027] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Revised: 05/31/2019] [Accepted: 07/02/2019] [Indexed: 06/10/2023]
Abstract
In subsistence farming populations of sub-Saharan Africa reliant on rainfed agriculture, years of low crop yields result in poorer child nutrition and survival. Estimates of such impacts are critical for their reduction and prevention. We developed a model to quantify such health impacts, and the degree to which they are attributable to weather variations, for a subsistence farming population in the Nouna district of Burkina Faso (89,000 people in 2010). The method combines data from a new weather-crop yield model with empirical epidemiological risk functions. We quantify the child mortality impacts for 1984-2012 using observed weather data and estimate potential future burdens in 2050 and 2100 using daily weather data generated by global climate models parameterized to simulate global warming of 1.5°C above pre-industrial levels. For 1984-2012, crop yields below 90% of the period average were estimated to result in the total of 109.8 deaths per 10,000 children <5years, or around 7122.0years of life lost, 72% of which are attributable to unfavourable weather conditions in the crop growing season. If all non-weather factors are assumed to remain unchanged, the mortality burden related to low crop yields would increase about twofold under 1.5°C global warming by 2100. These results emphasize the importance and value of developing strategies to protect against the effects of low crop yields and specifically the adverse impact of unfavourable weather conditions in such settings under the current and future climate.
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Affiliation(s)
- Kristine Belesova
- London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK.
| | - Christoph Gornott
- Potsdam Institute for Climate Impact Research, Telegraphenberg A 62/2.01, Postfach 60 12 03, D-14412 Potsdam, Germany
| | - James Milner
- London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK
| | - Ali Sié
- Centre de Recherche en Santé de Nouna, Rue Namory Kéita, Nouna, Burkina Faso
| | - Rainer Sauerborn
- Institute of Public Health, Heidelberg University, Im Neuenheimer Feld 130.3, R. 309, 69120 Heidelberg, Germany
| | - Paul Wilkinson
- London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK
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27
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Dambach P, Baernighausen T, Traoré I, Ouedraogo S, Sié A, Sauerborn R, Becker N, Louis VR. Reduction of malaria vector mosquitoes in a large-scale intervention trial in rural Burkina Faso using Bti based larval source management. Malar J 2019; 18:311. [PMID: 31521176 PMCID: PMC6744650 DOI: 10.1186/s12936-019-2951-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 09/07/2019] [Indexed: 11/21/2022] Open
Abstract
Background Malaria remains one of the most important causes of morbidity and death in sub-Saharan Africa. Along with early diagnosis and treatment of malaria cases and intermittent preventive treatment in pregnancy (IPTp), vector control is an important tool in the reduction of new cases. Alongside the use of long-lasting insecticidal nets (LLINs) and indoor residual spraying (IRS), targeting the vector larvae with biological larvicides, such as Bacillus thuringiensis israelensis (Bti) is gaining importance as a means of reducing the number of mosquito larvae before they emerge to their adult stage. This study presents data corroborating the entomological impact of such an intervention in a rural African environment. Methods The study extended over 2 years and researched the impact of biological larviciding with Bti on malaria mosquitoes that were caught indoors and outdoors of houses using light traps. The achieved reductions in female Anopheles mosquitoes were calculated for two different larviciding choices using a regression model. Results In villages that received selective treatment of the most productive breeding sites, the number of female Anopheles spp. dropped by 61% (95% CI 54–66%) compared to the pre-intervention period. In villages in which all breeding sites were treated, the number of female Anopheles spp. was reduced by 70% (95% CI 64–74%) compared to the pre-intervention period. Conclusion It was shown that malaria vector abundance can be dramatically reduced through larviciding of breeding habitats and that, in many geographical settings, they are a viable addition to current malaria control measures.
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Affiliation(s)
- Peter Dambach
- Institute of Public Health, University Hospital Heidelberg, 69120, Heidelberg, Germany.
| | - Till Baernighausen
- Institute of Public Health, University Hospital Heidelberg, 69120, Heidelberg, Germany
| | - Issouf Traoré
- Centre de Recherche en Santé de Nouna, Nouna, Burkina Faso
| | | | - Ali Sié
- Centre de Recherche en Santé de Nouna, Nouna, Burkina Faso
| | - Rainer Sauerborn
- Institute of Public Health, University Hospital Heidelberg, 69120, Heidelberg, Germany
| | - Norbert Becker
- German Mosquito Control Association (KABS), 67346, Speyer, Germany
| | - Valérie R Louis
- Institute of Public Health, University Hospital Heidelberg, 69120, Heidelberg, Germany
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28
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Barteit S, Sié A, Yé M, Depoux A, Louis VR, Sauerborn R. Lessons learned on teaching a global audience with massive open online courses (MOOCs) on health impacts of climate change: a commentary. Global Health 2019; 15:52. [PMID: 31438984 PMCID: PMC6704632 DOI: 10.1186/s12992-019-0494-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Accepted: 07/25/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The adverse health impacts of climate change are increasing on a global level. However, knowledge about climate change and health is still unavailable to many global citizens, in particular on adaptation measures and co-benefits of health mitigation. Educational technologies, such as massive open online courses (MOOCs), may have a high potential for providing access to information about climate change links to health for a global audience. MAIN BODY We developed three MOOCs addressing the link between climate change and health to take advantage of the methodology's broad reach and accelerate knowledge dissemination on the nexus of climate change and health. The primary objective was to translate an existing face-to-face short course that only reached a few participants on climate change and health into globally accessible learning opportunities. In the following, we share and comment on our lessons learned with the three MOOCs, with a focus on global teaching in the realm of climate change and health. CONCLUSIONS Overall, the three MOOCs attracted a global audience with diverse educational backgrounds, and a large number of participants from low-income countries. Our experience highlights that MOOCs may play a part in global capacity building, potentially for other health-related topics as well, as we have found that our MOOCs have attracted participants within low-resource contexts. MOOCs may be an effective method for teaching and training global students on health topics, in this case on the complex links and dynamics between climate change and health and may further act as an enabler for equitable access to quality education.
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Affiliation(s)
- Sandra Barteit
- Heidelberg Institute of Global Health, University Hospital Heidelberg, University Heidelberg, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany.
| | - Ali Sié
- Centre de Recherche en Santé de Nouna, Nouna, Burkina Faso
| | - Maurice Yé
- Centre de Recherche en Santé de Nouna, Nouna, Burkina Faso
| | - Anneliese Depoux
- Centre Virchow-Villermé for Public Health Paris-Berlin, Université Sorbonne Paris Cité, Paris, France.,Groupe de Recherches Interdisciplinaires sur les Processus d'Information et de Communication (GRIPIC), Université Paris Sorbonne, Paris, France
| | - Valérie R Louis
- Heidelberg Institute of Global Health, University Hospital Heidelberg, University Heidelberg, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany
| | - Rainer Sauerborn
- Heidelberg Institute of Global Health, University Hospital Heidelberg, University Heidelberg, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany.,Harvard T.H. Chan School of Public Health, Boston, USA
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Schwerdtle PN, Bowen K, McMichael C, Sauerborn R. Human mobility and health in a warming world. J Travel Med 2019; 26:5280412. [PMID: 30624676 DOI: 10.1093/jtm/tay160] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 01/07/2018] [Indexed: 11/14/2022]
Affiliation(s)
- Patricia Nayna Schwerdtle
- Monash University, Melbourne, Australia.,Medecins Sans Frontieres-Australia, Sydney, Australia.,Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany
| | - Kathryn Bowen
- Institute of Advanced Sustainability Studies, Berlin, Germany.,University of Melbourne, Melbourne, Australia.,Australia National University, Canberra, Australia
| | | | - Rainer Sauerborn
- Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany
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Malik AA, Yamamoto SS, Haque A, Butt NS, Baig M, Sauerborn R. Developing and assessing a tool to measure motivation among physicians in Lahore, Pakistan. PLoS One 2018; 13:e0209546. [PMID: 30596679 PMCID: PMC6312213 DOI: 10.1371/journal.pone.0209546] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Accepted: 12/08/2018] [Indexed: 01/09/2023] Open
Abstract
Physicians' motivation plays a vital role in health systems particularly in dense and urban cities, which deal with high volumes of patients in a variety of settings. The loss of physicians due to low motivation to developed countries is also a critical aspect affecting the quality of care in many regions. Fewer studies have explored health provider and particularly physicians' motivation in developing countries, which is critical to health service delivery. In addition, limited relevant tools have been developed and tested in low and middle-income settings like Pakistan. The purpose of this study was to create and test a tool for measuring physician motivation. A tool was developed to explore physicians' motivation in the Lahore district, Pakistan. Three sections of the questionnaire, which included intrinsic, socio-cultural and organizational factors, were tested with a stratified, random sample of 360 physicians from the public and private health facilities. Factor analysis produced six factors for 'intrinsic motivation,' seven for 'organizational motivation' and three for 'socio-cultural motivation' that explained 47.7%, 52.6% and 40.6% of the total variance, respectively. Bartlett's test of sphericity and the KMO were significant. Cronbach's α and confirmatory factor analysis were found satisfactory for all three sections of questionnaires. In addition to identifying important intrinsic, socio-cultural and organizational factors study found the questionnaires reliable and valid and recommend further testing the applicability of the instrument in similar and diverse settings.
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Affiliation(s)
- Ahmad Azam Malik
- Department of Family and Community Medicine, Faculty of Medicine in Rabigh, King Abdul Aziz University, Jeddah, KSA
- Institute of Public Health, University of Heidelberg, Heidelberg, Germany
| | - Shelby Suzanne Yamamoto
- Institute of Public Health, University of Heidelberg, Heidelberg, Germany
- School of Public Health, University of Alberta, Edmonton, Canada
| | - Aminul Haque
- Institute of Public Health, University of Heidelberg, Heidelberg, Germany
- Department of Population Sciences, University of Dhaka, Dhaka, Bangladesh
| | - Nadeem Shafique Butt
- Department of Family and Community Medicine, Faculty of Medicine in Rabigh, King Abdul Aziz University, Jeddah, KSA
| | - Mukhtiar Baig
- Department of Biochemistry and Medical Education, Faculty of Medicine in Rabigh, King Abdul Aziz University, Jeddah, KSA
| | - Rainer Sauerborn
- Institute of Public Health, University of Heidelberg, Heidelberg, Germany
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31
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Passarelli S, Canavan CR, Paarlberg R, Juma C, Akyeampong E, Fekadu H, Golden CD, Gunaratna NS, Jaacks LM, Kennedy E, Madzorera I, McCann J, Nwanze K, Sauerborn R, Tang L, Webb P, Willett WC, Fawzi WW. Harnessing University Strengths in Multisectoral Collaborations for Planetary Health. Curr Dev Nutr 2018; 2:nzy063. [PMID: 30569029 PMCID: PMC6295284 DOI: 10.1093/cdn/nzy063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 06/12/2018] [Accepted: 07/19/2018] [Indexed: 11/13/2022] Open
Abstract
Although significant achievements in human health have been made globally, progress has been made possible, in part, through unconstrained use of natural resources. As the health of our planet worsens, human health is also endangered. Scholars and policymakers from diverse disciplines highlighted complex, multisectoral approaches for addressing poor dietary intake, over- and undernutrition, and chronic diseases in sub-Saharan Africa at the Agriculture, Nutrition, Health, and the Environment in Africa Conference held at Harvard University on 6-7 November 2017. A planetary health approach to addressing these challenges offers a unique opportunity to advance solutions for environmental and social factors that influence agriculture, nutrition, and overall health in the larger context of rapid population growth and transitions in food systems and livelihoods. This paper outlines 3 key avenues for universities to promote science at the intersection of public health and the environment in sub-Saharan Africa.
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Affiliation(s)
| | | | | | | | | | | | | | - Nilupa S Gunaratna
- Department of Nutrition Science and Public Health Graduate Program, Purdue University, West Lafayette, IN
| | | | - Eileen Kennedy
- Tufts University Friedman School of Nutrition Science and Policy, Boston, MA
| | | | - James McCann
- Boston University African Studies Center, Boston, MA
| | - Kanayo Nwanze
- International Fund for Agricultural Development, Roma, Italy
| | - Rainer Sauerborn
- Harvard T. H. Chan School of Public Health, Boston, MA
- Heidelberg Institute of Public Health, Heidelberg, Germany
| | - Lixia Tang
- College of Humanities and Development Studies, China Agricultural University, Haidian Qu, Beijing Shi, China
| | - Patrick Webb
- Tufts University Friedman School of Nutrition Science and Policy, Boston, MA
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32
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Fischer H, Schütte S, Depoux A, Amelung D, Sauerborn R. How Well Do COP22 Attendees Understand Graphs on Climate Change Health Impacts from the Fifth IPCC Assessment Report? Int J Environ Res Public Health 2018; 15:E875. [PMID: 29702612 PMCID: PMC5981914 DOI: 10.3390/ijerph15050875] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 04/23/2018] [Accepted: 04/25/2018] [Indexed: 11/27/2022]
Abstract
Graphs are prevalent in the reports of the Intergovernmental Panel on Climate Change (IPCC), often depicting key points and major results. However, the popularity of graphs in the IPCC reports contrasts with a neglect of empirical tests of their understandability. Here we put the understandability of three graphs taken from the Health chapter of the Fifth Assessment Report to an empirical test. We present a pilot study where we evaluate objective understanding (mean accuracy in multiple-choice questions) and subjective understanding (self-assessed confidence in accuracy) in a sample of attendees of the United Nations Climate Change Conference in Marrakesh, 2016 (COP22), and a student sample. Results show a mean objective understanding of M = 0.33 for the COP sample, and M = 0.38 for the student sample. Subjective and objective understanding were unrelated for the COP22 sample, but associated for the student sample. These results suggest that (i) understandability of the IPCC health chapter graphs is insufficient, and that (ii) particularly COP22 attendees lacked insight into which graphs they did, and which they did not understand. Implications for the construction of graphs to communicate health impacts of climate change to decision-makers are discussed.
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Affiliation(s)
- Helen Fischer
- Department of Psychology, Heidelberg University, 69117 Heidelberg, Germany.
| | | | | | - Dorothee Amelung
- Department of Psychology, Heidelberg University, 69117 Heidelberg, Germany.
| | - Rainer Sauerborn
- Institute for Public Health, University Hospital, Heidelberg 69120, Germany.
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33
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Herrmann A, Sauerborn R. General Practitioners' Perceptions of Heat Health Impacts on the Elderly in the Face of Climate Change-A Qualitative Study in Baden-Württemberg, Germany. Int J Environ Res Public Health 2018; 15:ijerph15050843. [PMID: 29695135 PMCID: PMC5981882 DOI: 10.3390/ijerph15050843] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 04/11/2018] [Accepted: 04/16/2018] [Indexed: 11/16/2022]
Abstract
Heat health impacts (HHI) on the elderly are a growing concern in the face of climate change and aging populations. General practitioners (GPs) have an important role in health care for the elderly. To inform the development of effective prevention measures, it is important to investigate GPs’ perceptions of HHI. Twenty four qualitative expert interviews were conducted with GPs and analyzed using the framework approach. GPs were generally aware of heat health impacts, focusing on cardiovascular morbidity and volume imbalances. Perceptions of mortality and for instance impacts on respiratory diseases or potentially risky drugs in heat waves partly diverged from findings in literature. GPs judged the current relevance of HHI differently depending on their attitudes towards: (i) sensitivity of the elderly, (ii) status of nursing care and (iii) heat exposure in Baden-Württemberg. Future relevance of HHI was perceived to be increasing by most GPs. The main cause identified for this was population aging, while impacts of climate change were judged as uncertain by many. GPs’ perceptions, partly diverging from literature, show that GPs’ knowledge and awareness on HHI and climate change needs to be strengthened. However, they also emphasize the need for more research on HHI in the ambulant health care setting. Furthermore, GPs perceptions suggest that strong nursing care and social networks for elderly are major elements of a climate resilient health system.
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Affiliation(s)
- Alina Herrmann
- Institute of Public Health Heidelberg, University Hospital Heidelberg, 69120 Heidelberg, Germany.
- Network Aging Research, University of Heidelberg, 69115 Heidelberg, Germany.
| | - Rainer Sauerborn
- Institute of Public Health Heidelberg, University Hospital Heidelberg, 69120 Heidelberg, Germany.
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34
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Rocklöv J, Sauerborn R, Sankoh O. Guest Editorial: Weather conditions and population level mortality in resource-poor settings - understanding the past before projecting the future. Glob Health Action 2018; 5:20010. [PMID: 28140865 PMCID: PMC3508988 DOI: 10.3402/gha.v5i0.20010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Affiliation(s)
- Joacim Rocklöv
- Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, Sweden
| | - Rainer Sauerborn
- Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, Sweden
- Institute of Public Health University of Heidelberg, Germany
| | - Osman Sankoh
- INDEPTH Network, Accra, Ghana
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
- Institute of Public Health University of Heidelberg, Germany
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35
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Belesova K, Gasparrini A, Sié A, Sauerborn R, Wilkinson P. Annual Crop-Yield Variation, Child Survival, and Nutrition Among Subsistence Farmers in Burkina Faso. Am J Epidemiol 2018. [PMID: 28641367 DOI: 10.1093/aje/kwx241] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Whether year-to-year variation in crop yields affects the nutrition, health, and survival of subsistence-farming populations is relevant to the understanding of the potential impacts of climate change. However, the empirical evidence is limited. We examined the associations of child survival with interannual variation in food crop yield and middle-upper arm circumference (MUAC) in a subsistence-farming population of rural Burkina Faso. The study was of 44,616 children aged <5 years included in the Nouna Health and Demographic Surveillance System, 1992-2012, whose survival was analyzed in relation to the food crop yield in the year of birth (which ranged from 65% to 120% of the period average) and, for a subset of 16,698 children, to MUAC, using shared-frailty Cox proportional hazards models. Survival was appreciably worse in children born in years with low yield (full-adjustment hazard ratio = 1.11 (95% confidence interval: 1.02, 1.20) for a 90th- to 10th-centile decrease in annual crop yield) and in children with small MUAC (hazard ratio = 2.72 (95% confidence interval: 2.15, 3.44) for a 90th- to 10th-centile decrease in MUAC). These results suggest an adverse impact of variations in crop yields, which could increase under climate change.
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Affiliation(s)
- Kristine Belesova
- Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Antonio Gasparrini
- Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Ali Sié
- Centre de Recherche en Santé de Nouna, Nouna, Burkina Faso
| | - Rainer Sauerborn
- Institute of Public Health, Heidelberg University, Heidelberg, Germany
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Paul Wilkinson
- Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, London, United Kingdom
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36
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Herrmann A, Fischer H, Amelung D, Litvine D, Aall C, Andersson C, Baltruszewicz M, Barbier C, Bruyère S, Bénévise F, Dubois G, Louis VR, Nilsson M, Moberg KR, Sköld B, Sauerborn R. Erratum to: Household preferences for reducing greenhouse gas emissions in four European high-income countries: Does health information matter? A mixed-methods study protocol. BMC Public Health 2017; 17:679. [PMID: 28851347 PMCID: PMC5576274 DOI: 10.1186/s12889-017-4676-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 08/11/2017] [Indexed: 11/30/2022] Open
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37
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Herrmann A, Fischer H, Amelung D, Litvine D, Aall C, Andersson C, Baltruszewicz M, Barbier C, Bruyère S, Bénévise F, Dubois G, Louis VR, Nilsson M, Moberg KR, Sköld B, Sauerborn R. Correction to: household preferences for reducing greenhouse gas emissions in four European high-income countries: does health information matter? A mixed-methods study protocol. BMC Public Health 2017; 17:846. [PMID: 29070015 PMCID: PMC5657105 DOI: 10.1186/s12889-017-4861-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Accepted: 10/16/2017] [Indexed: 11/10/2022] Open
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Bunker A, Sewe MO, Sié A, Rocklöv J, Sauerborn R. Excess burden of non-communicable disease years of life lost from heat in rural Burkina Faso: a time series analysis of the years 2000-2010. BMJ Open 2017; 7:e018068. [PMID: 29102994 PMCID: PMC5695355 DOI: 10.1136/bmjopen-2017-018068] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES Investigate the association of heat exposure on years of life lost (YLL) from non-communicable diseases (NCD) in Nouna, Burkina Faso, between 2000 and 2010. DESIGN Daily time series regression analysis using distributed lag non-linear models, assuming a quasi-Poisson distribution of YLL. SETTING Nouna Health and Demographic Surveillance System, Kossi Province, Rural Burkina Faso. PARTICIPANTS 18 367 NCD-YLL corresponding to 790 NCD deaths recorded in the Nouna Health and Demographic Surveillance Site register over 11 years. MAIN OUTCOME MEASURE Excess mean daily NCD-YLL were generated from the relative risk of maximum daily temperature on NCD-YLL, including effects delayed up to 14 days. RESULTS Daily average NCD-YLL were 4.6, 2.4 and 2.1 person-years for all ages, men and women, respectively. Moderate 4-day cumulative rise in maximum temperature from 36.4°C (50th percentile) to 41.4°C (90th percentile) resulted in 4.44 (95% CI 0.24 to 12.28) excess daily NCD-YLL for all ages, rising to 7.39 (95% CI 0.32 to 24.62) at extreme temperature (42.8°C; 99th percentile). The strongest health effects manifested on the day of heat exposure (lag 0), where 0.81 (95% CI 0.13 to 1.59) excess mean NCD-YLL occurred daily at 41.7°C compared with 36.4°C, diminishing in statistical significance after 4 days. At lag 0, daily excess mean NCD-YLL were higher for men, 0.58 (95% CI 0.11 to 1.15) compared with women, 0.15 (95% CI -0.25 to 9.63) at 41.7°C vs 36.4°C. CONCLUSION Premature death from NCD was elevated significantly with moderate and extreme heat exposure. These findings have important implications for developing adaptation and mitigation strategies to reduce ambient heat exposure and preventive measures for limiting NCD in Africa.
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Affiliation(s)
- Aditi Bunker
- Network Aging Research, Heidelberg University, Heidelberg, Germany
- Institute of Public Health, University of Heidelberg, Heidelberg, Germany
| | - Maquins Odhiambo Sewe
- Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Ali Sié
- Centre de Recherche en Santé de Nouna, Nouna, Burkina Faso
| | - Joacim Rocklöv
- Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Rainer Sauerborn
- Institute of Public Health, University of Heidelberg, Heidelberg, Germany
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39
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Gosling SN, Hondula DM, Bunker A, Ibarreta D, Liu J, Zhang X, Sauerborn R. Adaptation to Climate Change: A Comparative Analysis of Modeling Methods for Heat-Related Mortality. Environ Health Perspect 2017; 125:087008. [PMID: 28885979 PMCID: PMC5783656 DOI: 10.1289/ehp634] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Revised: 09/15/2016] [Accepted: 10/24/2016] [Indexed: 05/03/2023]
Abstract
BACKGROUND Multiple methods are employed for modeling adaptation when projecting the impact of climate change on heat-related mortality. The sensitivity of impacts to each is unknown because they have never been systematically compared. In addition, little is known about the relative sensitivity of impacts to "adaptation uncertainty" (i.e., the inclusion/exclusion of adaptation modeling) relative to using multiple climate models and emissions scenarios. OBJECTIVES This study had three aims: a) Compare the range in projected impacts that arises from using different adaptation modeling methods; b) compare the range in impacts that arises from adaptation uncertainty with ranges from using multiple climate models and emissions scenarios; c) recommend modeling method(s) to use in future impact assessments. METHODS We estimated impacts for 2070-2099 for 14 European cities, applying six different methods for modeling adaptation; we also estimated impacts with five climate models run under two emissions scenarios to explore the relative effects of climate modeling and emissions uncertainty. RESULTS The range of the difference (percent) in impacts between including and excluding adaptation, irrespective of climate modeling and emissions uncertainty, can be as low as 28% with one method and up to 103% with another (mean across 14 cities). In 13 of 14 cities, the ranges in projected impacts due to adaptation uncertainty are larger than those associated with climate modeling and emissions uncertainty. CONCLUSIONS Researchers should carefully consider how to model adaptation because it is a source of uncertainty that can be greater than the uncertainty in emissions and climate modeling. We recommend absolute threshold shifts and reductions in slope. https://doi.org/10.1289/EHP634.
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Affiliation(s)
- Simon N Gosling
- School of Geography, University of Nottingham , Nottingham, United Kingdom
| | - David M Hondula
- School of Geographical Sciences and Urban Planning, Arizona State University , Tempe, Arizona, USA
| | - Aditi Bunker
- Network Aging Research, University of Heidelberg , Heidelberg, Germany
- Institute of Public Health, University of Heidelberg , Heidelberg, Germany
| | - Dolores Ibarreta
- European Commission, Joint Research Centre (JRC), Seville, Spain
| | - Junguo Liu
- School of Environmental Science and Engineering, South University of Science and Technology of China, Shenzhen, China
| | - Xinxin Zhang
- School of Nature Conservation, Beijing Forestry University , Beijing, China
| | - Rainer Sauerborn
- Institute of Public Health, University of Heidelberg , Heidelberg, Germany
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40
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Saronga HP, Duysburgh E, Massawe S, Dalaba MA, Wangwe P, Sukums F, Leshabari M, Blank A, Sauerborn R, Loukanova S. Cost-effectiveness of an electronic clinical decision support system for improving quality of antenatal and childbirth care in rural Tanzania: an intervention study. BMC Health Serv Res 2017; 17:537. [PMID: 28784130 PMCID: PMC5547541 DOI: 10.1186/s12913-017-2457-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2015] [Accepted: 07/17/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND QUALMAT project aimed at improving quality of maternal and newborn care in selected health care facilities in three African countries. An electronic clinical decision support system was implemented to support providers comply with established standards in antenatal and childbirth care. Given that health care resources are limited and interventions differ in their potential impact on health and costs (efficiency), this study aimed at assessing cost-effectiveness of the system in Tanzania. METHODS This was a quantitative pre- and post- intervention study involving 6 health centres in rural Tanzania. Cost information was collected from health provider's perspective. Outcome information was collected through observation of the process of maternal care. Incremental cost-effectiveness ratios for antenatal and childbirth care were calculated with testing of four models where the system was compared to the conventional paper-based approach to care. One-way sensitivity analysis was conducted to determine whether changes in process quality score and cost would impact on cost-effectiveness ratios. RESULTS Economic cost of implementation was 167,318 USD, equivalent to 27,886 USD per health center and 43 USD per contact. The system improved antenatal process quality by 4.5% and childbirth care process quality by 23.3% however these improvements were not statistically significant. Base-case incremental cost-effectiveness ratios of the system were 2469 USD and 338 USD per 1% change in process quality for antenatal and childbirth care respectively. Cost-effectiveness of the system was sensitive to assumptions made on costs and outcomes. CONCLUSIONS Although the system managed to marginally improve individual process quality variables, it did not have significant improvement effect on the overall process quality of care in the short-term. A longer duration of usage of the electronic clinical decision support system and retention of staff are critical to the efficiency of the system and can reduce the invested resources. Realization of gains from the system requires effective implementation and an enabling healthcare system. TRIAL REGISTRATION Registered clinical trial at www.clinicaltrials.gov ( NCT01409824 ). Registered May 2009.
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Affiliation(s)
- Happiness Pius Saronga
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
- Institute of Public Health, University of Heidelberg, Heidelberg, Germany
| | - Els Duysburgh
- International Centre for Reproductive Health (ICRH), Ghent University, Ghent, Belgium
| | - Siriel Massawe
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Maxwell Ayindenaba Dalaba
- Navrongo Health Research Centre, Navrongo, Ghana
- Institute of Public Health, University of Heidelberg, Heidelberg, Germany
| | - Peter Wangwe
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Felix Sukums
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
- Department of Clinical Pharmacology and Pharmacoepidemiology, University of Heidelberg, Heidelberg, Germany
| | | | - Antje Blank
- Department of Clinical Pharmacology and Pharmacoepidemiology, University of Heidelberg, Heidelberg, Germany
| | - Rainer Sauerborn
- Institute of Public Health, University of Heidelberg, Heidelberg, Germany
| | - Svetla Loukanova
- Department of General Medicine and Implementation Research, University of Heidelberg, Heidelberg, Germany
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41
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Herrmann A, Fischer H, Amelung D, Litvine D, Aall C, Andersson C, Baltruszewicz M, Barbier C, Bruyère S, Bénévise F, Dubois G, Louis VR, Nilsson M, Richardsen Moberg K, Sköld B, Sauerborn R. Household preferences for reducing greenhouse gas emissions in four European high-income countries: Does health information matter? A mixed-methods study protocol. BMC Public Health 2017; 18:71. [PMID: 28764686 PMCID: PMC5540303 DOI: 10.1186/s12889-017-4604-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2017] [Accepted: 07/18/2017] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND It is now universally acknowledged that climate change constitutes a major threat to human health. At the same time, some of the measures to reduce greenhouse gas emissions, so-called climate change mitigation measures, have significant health co-benefits (e.g., walking or cycling more; eating less meat). The goal of limiting global warming to 1,5° Celsius set by the Conference of the Parties to the United Nations Framework Convention on Climate Change in Paris in 2015 can only be reached if all stakeholders, including households, take actions to mitigate climate change. Results on whether framing mitigation measures in terms of their health co-benefits increases the likelihood of their implementation are inconsistent. The present study protocol describes the transdisciplinary project HOPE (HOuseholds' Preferences for reducing greenhouse gas emissions in four European high-income countries) that investigates the role of health co-benefits in households' decision making on climate change mitigation measures in urban households in France, Germany, Norway and Sweden. METHODS HOPE employs a mixed-methods approach combining status-quo carbon footprint assessments, simulations of the reduction of households' carbon footprints, and qualitative in-depth interviews with a subgroup of households. Furthermore, a policy analysis of current household oriented climate policies is conducted. In the simulation of the reduction of households' carbon footprints, half of the households are provided with information on health co-benefits of climate change mitigation measures, the other half is not. Households' willingness to implement the measures is assessed and compared in between-group analyses of variance. DISCUSSION This is one of the first comprehensive mixed-methods approaches to investigate which mitigation measures households are most willing to implement in order to reach the 1,5° target set by the Paris Agreement, and whether health co-benefits can serve as a motivator for households to implement these measures. The comparison of the empirical data with current climate policies will provide knowledge for tailoring effective climate change mitigation and health policies.
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Affiliation(s)
- Alina Herrmann
- Institute of Public Health, Heidelberg University Hospital, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany.
| | - Helen Fischer
- Institute of Public Health, Heidelberg University Hospital, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany
- Institute of Psychology, Heidelberg University, Heidelberg, Germany
| | - Dorothee Amelung
- Institute of Public Health, Heidelberg University Hospital, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany
- Institute of Psychology, Heidelberg University, Heidelberg, Germany
| | | | | | - Camilla Andersson
- Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | | | - Carine Barbier
- Centre International de Recherche sur l'Environnement et le Developpement (CIRED), Nogent, France
| | | | | | | | - Valérie R Louis
- Institute of Public Health, Heidelberg University Hospital, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany
| | - Maria Nilsson
- Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | | | - Bore Sköld
- Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Rainer Sauerborn
- Institute of Public Health, Heidelberg University Hospital, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany
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Belesova K, Gasparrini A, Sié A, Sauerborn R, Wilkinson P. Household cereal crop harvest and children's nutritional status in rural Burkina Faso. Environ Health 2017; 16:65. [PMID: 28633653 PMCID: PMC5477741 DOI: 10.1186/s12940-017-0258-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Accepted: 05/11/2017] [Indexed: 06/10/2023]
Abstract
BACKGROUND Reduction of child undernutrition is one of the Sustainable Development Goals for 2030. Achievement of this goal may be made more difficult in some settings by climate change through adverse impact on agricultural productivity. However, there is only limited quantitative evidence on the link between household crop harvests and child nutrition. We examined this link in a largely subsistence farming population in rural Burkina Faso. METHODS Data on the middle-upper arm circumference (MUAC) of 975 children ≤5 years of age, household crop yields, and other parameters were obtained from the Nouna Health and Demographic Surveillance System. Multilevel modelling was used to assess the relationship between MUAC and the household crop harvest in the year 2009 estimated in terms of kilocalories per adult equivalent per day (kcal/ae/d). RESULTS Fourteen percent of children had a MUAC <125 mm (a value indicative of acute undernutrition). The relationship between MUAC and annual household food energy production adjusted for age, sex, month of MUAC measurement, household wealth, whether a household member had a non-agricultural occupation, garden produce, village infrastructure and market presence, suggested a decline in MUAC below around 3000 kcal/ae/d. The mean MUAC was 2.49 (95% CI 0.45, 4.52) mm less at 1000 than at 3000 kcal/ae/d. CONCLUSIONS Low per capita household crop production is associated with poorer nutritional status of children in a rural farming population in Burkina Faso. This and similar populations may thus be vulnerable to the adverse effects of weather on agricultural harvest, especially in the context of climate change.
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Affiliation(s)
- Kristine Belesova
- Department of Social and Environmental Health Research, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH UK
| | - Antonio Gasparrini
- Department of Social and Environmental Health Research, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH UK
| | - Ali Sié
- Centre de Recherche en Santé de Nouna, Rue Namory Keïta, Nouna, Kossi province, Boucle du Mouhoun region Burkina Faso
| | - Rainer Sauerborn
- Institute of Public Health, Heidelberg University, Im Neuenheimer Feld, Heidelberg, 324 69120 Germany
| | - Paul Wilkinson
- Department of Social and Environmental Health Research, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH UK
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Abstract
INTRODUCTION For 28 years, the Intergovernmental Panel on Climate Change (IPCC) has been assessing the potential risks associated with anthropogenic climate change. Although interest in climate change and health is growing, the implications arising from their interaction remain understudied. Generating a greater understanding of the health impacts of climate change could be key step in inciting some of the changes necessary to decelerate global warming. A long-term and broad overview of the existing scientific literature in the field of climate change and health is currently missing in order to ensure that all priority areas are being adequately addressed. In this paper we outline our methods to conduct a scoping review of the published peer-reviewed literature on climate change and health between 1990 and 2015. METHODS AND ANALYSIS A detailed search strategy will be used to search the PubMed and Web of Science databases. Specific inclusion and exclusion criteria will be applied in order to capture the most relevant literature in the time frame chosen. Data will be extracted, categorised and coded to allow for statistical analysis of the results. ETHICS AND DISSEMINATION No ethical approval was required for this study. A searchable database of climate change and health publications will be developed and a manuscript will be complied for publication and dissemination of the findings. We anticipate that this study will allow us to map the trends observed in publications over the 25-year time period in climate change and health research. It will also identify the research areas with the highest volume of publications as well as highlight the research trends in climate change and health.
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Affiliation(s)
- Niamh Herlihy
- Centre Virchow-Villermé for Public Health Paris-Berlin, Université Sorbonne Paris Cité, Paris, France
| | - Avner Bar-Hen
- Centre Virchow-Villermé for Public Health Paris-Berlin, Université Sorbonne Paris Cité, Paris, France
- Laboratoire MAP5, Université Paris Descartes, Paris, France
| | - Glenn Verner
- Centre Virchow-Villermé for Public Health Paris-Berlin, Université Sorbonne Paris Cité, Paris, France
- French School of Public Health, Paris-Rennes, France
| | - Helen Fischer
- Institute of Psychology, University of Heidelberg, Heidelberg, Germany
| | - Rainer Sauerborn
- Institute of Public Health, University of Heidelberg, Heidelberg, Germany
| | - Anneliese Depoux
- Centre Virchow-Villermé for Public Health Paris-Berlin, Université Sorbonne Paris Cité, Paris, France
- Groupe de Recherches Interdisciplinaires sur les Processus d'information et de Communication (EA 1498), Université Paris Sorbonne-Celsa, Paris, France
| | - Antoine Flahault
- Centre Virchow-Villermé for Public Health Paris-Berlin, Université Sorbonne Paris Cité, Paris, France
- Institute of Global Health, University of Geneva, Geneva, Switzerland
| | - Stefanie Schütte
- Centre Virchow-Villermé for Public Health Paris-Berlin, Université Sorbonne Paris Cité, Paris, France
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Sauerborn R. Why should health be a central argument in climate negotiations? Can a MOOC help to bring the message across? Public Health Rev 2016; 37:18. [PMID: 29450060 PMCID: PMC5809885 DOI: 10.1186/s40985-016-0030-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Accepted: 09/19/2016] [Indexed: 11/10/2022] Open
Abstract
There are four key messages from health for climate negotiations. Two positive ones include (i) health as a motivator for action and policy and (ii) huge health co-benefits to be included in the cost-benefit trade-offs of climate negotiations. Two warning messages: (iii) there are health-based absolute limits of adaptations and (iv) hotter average temperatures will cut work productivity of farmers and other outdoor workers as well as workers in non-air conditioned factories in poor countries. This paper will examine how massive open online courses (MOOCs) have been used in the run-up to this COP to disseminate these four messages to the audience of high-level policy-makers. This required a departure from the classic MOOC format in several ways: duration, focus on decision-making rationale, policy-relevant messages presented in big brush, leaving “traceable accounts” to evidence in two layers of resources provided: essential and “deep dive”.
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Hémono M, Puig-Malet S, Zylberman P, Bar-Hen A, Sauerborn R, Schütte S, Herlihy N, Flahault A, Depoux A. Review of published articles on climate change and health in two francophone newspapers: 1990-2015. Eur J Public Health 2016. [DOI: 10.1093/eurpub/ckw174.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Kowalski C, De Jong L, Sauerborn R, Tosun J. Climate change and health in policies. Eur J Public Health 2016. [DOI: 10.1093/eurpub/ckw174.183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Herlihy N, Bar-Hen A, Verner G, Fischer H, Sauerborn R, Depoux A, Flauhault A, Schütte S. Climate change and health: scoping review of scientific literature 1990-2015. Eur J Public Health 2016. [DOI: 10.1093/eurpub/ckw174.181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Dambach P, Traoré I, Kaiser A, Sié A, Sauerborn R, Becker N. Challenges of implementing a large scale larviciding campaign against malaria in rural Burkina Faso - lessons learned and recommendations derived from the EMIRA project. BMC Public Health 2016; 16:1023. [PMID: 27686125 PMCID: PMC5041282 DOI: 10.1186/s12889-016-3587-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Accepted: 08/25/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Recent malaria control and elimination attempts show remarkable success in several parts of sub-Saharan Africa. Vector control via larval source management represents a new and to date underrepresented approach in low income countries to further reduce malaria transmission. Although the positive impact of such campaigns on malaria incidence has been researched, there is a lack of data on which prerequisites are needed for implementing such programs on a routine basis on large scale. Our objectives are to point out important steps in implementing an anti-malaria larviciding campaign in a resource and infrastructure restraint setting and share the lessons learned from our experience during a three-year intervention study in rural Burkina Faso. METHODS We describe the approaches we followed and the challenges that have been encountered during the EMIRA project, a three-year study on the impact of environmental larviciding on vector ecology and human health. An inventory of all performed work packages and associated problems and peculiarities was assembled. RESULTS Key to the successful implementation of the larviciding program within a health district was the support and infrastructure from the local research center run by the government. This included availability of trained scientific personnel for local project management, data collection and analysis by medical personnel, entomologists and demographers and teams of fieldworkers for the larviciding intervention. A detailed a priori assessment of the environment and vector breeding site ecology was essential to calculate personnel requirements and the need for larvicide and application apparel. In our case of a three-year project, solid funding for the whole duration was an important issue, which restricted the number of possible donors. We found the acquisition of qualified field personnel in fair numbers not to be always easy and training in application techniques and basic entomologic knowledge required several weeks of theoretical and practical formation. A further crucial point was to establish an effective quality control system that ensured the timely verification of larviciding success and facilitated in time data handling. While the experiences of running a larviciding campaign may vary globally, the experiences gained and the methods used in the Nouna health district may be employed in similar settings. CONCLUSIONS Our observations highlight important components and strategies that should be taken into account when planning and running a similar larviciding program against malaria in a resource limited setting. A strong local partnership, meticulous planning with the possibility of ad-hoc adaption of project components and a reliable source of funding turned out to be crucial factors to successfully accomplish such a project.
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Affiliation(s)
- Peter Dambach
- Institute of Public Health, University of Heidelberg, Heidelberg, Germany.
| | - Issouf Traoré
- Centre de Recherche en Santé de Nouna, Nouna, Burkina Faso
| | - Achim Kaiser
- German Mosquito Control Association (KABS), Speyer, Germany
| | - Ali Sié
- Centre de Recherche en Santé de Nouna, Nouna, Burkina Faso
| | - Rainer Sauerborn
- Institute of Public Health, University of Heidelberg, Heidelberg, Germany
| | - Norbert Becker
- German Mosquito Control Association (KABS), Speyer, Germany.,Centre for Organismal Studies, University of Heidelberg, Heidelberg, Germany
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Abstract
Aims: This study aims to set priorities for anti-disease malaria vaccines by determining community preference in a hyperendemic area. Methods: A bidding game technique was used to elucidate willingness to pay in rural Burkina Faso and 2,326 adults were interviewed. Results: It is shown that there are significant differences between community preference for an anti-disease vaccine aimed at reducing pathology in pregnant women, and for a vaccine directed against childhood malaria. While the target population was willing to pay CFAfr 2101 for a vaccine against maternal malaria, its members were prepared to pay only CFAfr 1433 for a vaccine against childhood malaria. Conclusions: Whilst it is increasingly likely that anti-disease malaria vaccines will become available in the foreseeable future, lessons from the past suggest that a lack of acceptance and support from the intended recipients may lead to less than optimal compliance, and hence efficacy. For the planning of vaccine development and application strategies, it is therefore highly important to take community views into account. Here it is argued that such information could help researchers and funding agencies to set priorities for future vaccine research.
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Affiliation(s)
- Rainer Sauerborn
- Hygiene Institut, Abteilung für Tropenmedizin und öffentliches Gesundheitswesen, Germany.
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Amelung D, Fischer H, Kruse L, Sauerborn R. Defogging Climate Change Communication: How Cognitive Research Can Promote Effective Climate Communication. Front Psychol 2016; 7:1340. [PMID: 27630608 PMCID: PMC5006148 DOI: 10.3389/fpsyg.2016.01340] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Accepted: 08/22/2016] [Indexed: 11/14/2022] Open
Affiliation(s)
- Dorothee Amelung
- Department of Psychology, Heidelberg University Heidelberg, Germany
| | - Helen Fischer
- Department of Psychology, Heidelberg University Heidelberg, Germany
| | - Lenelis Kruse
- Department of Psychology, Heidelberg University Heidelberg, Germany
| | - Rainer Sauerborn
- Climate Change and Health Working Group, Institue of Public Health, Heidelberg University Heidelberg, Germany
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