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Sanz-Mas M, Ubalde-López M, Borràs S, Brugueras S, Continente X, Daher C, Marí-Dell'Olmo M, López MJ. Adapting Schools to Climate Change with Green, Blue, and Grey Measures in Barcelona: Study Protocol of a Mixed-Method Evaluation. J Urban Health 2024; 101:141-154. [PMID: 38236429 PMCID: PMC10897086 DOI: 10.1007/s11524-023-00814-y] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/07/2023] [Indexed: 01/19/2024]
Abstract
Under the framework of the Urban Innovative Actions program of the European Commission, in 2020, 11 primary schools in Barcelona were transformed into climate shelters by implementing green, blue, and grey measures. Schoolyards were also opened to the local community to be used during non-school periods. Here we present the study protocol of a mixed-method approach to evaluate the effectiveness of the interventions in terms of improving environmental quality and health for users. We evaluated school level through the following: (1) quantitative pre-post quasi-experimental study, and (2) qualitative evaluation. The quantitative study included measures of (a) environmental variables (collected via low-cost and non-low-cost sensors), (b) students' health and well-being (collected via health questionnaires, attention levels test, and systematic observations), and (c) teachers' health and well-being (collected via thermal comfort measurements and health questionnaires). The qualitative methods evaluated the perceptions about the effects of the interventions among students (using Photovoice) and teachers (through focus groups). The impact of the interventions was assessed at community level during summer non-school periods through a spontaneous ethnographic approach. Data collection started in August 2019 and ended in July 2022. The evaluation provides the opportunity to identify those solutions that worked and those that need to be improved for future experiences, as well as improve the evaluation methodology and replication for these kinds of interventions.
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Affiliation(s)
- Marta Sanz-Mas
- Agència de Salut Pública de Barcelona (ASPB), Pl. Lesseps 1, 08023, Barcelona, Spain
- Departament de Ciències Experimentals i de La Salut (DCEXS), Universitat Pompeu Fabra, Doctor Aiguader 88, 08003, Barcelona, Spain
| | - Mònica Ubalde-López
- Departament de Ciències Experimentals i de La Salut (DCEXS), Universitat Pompeu Fabra, Doctor Aiguader 88, 08003, Barcelona, Spain
- ISGlobal, Barcelona Institute for Global Health, Doctor Aiguader 88, 08003, Barcelona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos 3-5, Pabellón 11, Planta 0, 28029, Madrid, Spain
| | - Sílvia Borràs
- ISGlobal, Barcelona Institute for Global Health, Doctor Aiguader 88, 08003, Barcelona, Spain
| | - Sílvia Brugueras
- Agència de Salut Pública de Barcelona (ASPB), Pl. Lesseps 1, 08023, Barcelona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos 3-5, Pabellón 11, Planta 0, 28029, Madrid, Spain
| | - Xavier Continente
- Agència de Salut Pública de Barcelona (ASPB), Pl. Lesseps 1, 08023, Barcelona, Spain.
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos 3-5, Pabellón 11, Planta 0, 28029, Madrid, Spain.
- Institut de Recerca Sant Pau (IR SANT PAU), Sant Quintí 77-79, 08041, Barcelona, Spain.
| | - Carolyn Daher
- Departament de Ciències Experimentals i de La Salut (DCEXS), Universitat Pompeu Fabra, Doctor Aiguader 88, 08003, Barcelona, Spain
- ISGlobal, Barcelona Institute for Global Health, Doctor Aiguader 88, 08003, Barcelona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos 3-5, Pabellón 11, Planta 0, 28029, Madrid, Spain
| | - Marc Marí-Dell'Olmo
- Agència de Salut Pública de Barcelona (ASPB), Pl. Lesseps 1, 08023, Barcelona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos 3-5, Pabellón 11, Planta 0, 28029, Madrid, Spain
- Institut de Recerca Sant Pau (IR SANT PAU), Sant Quintí 77-79, 08041, Barcelona, Spain
| | - María José López
- Agència de Salut Pública de Barcelona (ASPB), Pl. Lesseps 1, 08023, Barcelona, Spain
- Departament de Ciències Experimentals i de La Salut (DCEXS), Universitat Pompeu Fabra, Doctor Aiguader 88, 08003, Barcelona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos 3-5, Pabellón 11, Planta 0, 28029, Madrid, Spain
- Institut de Recerca Sant Pau (IR SANT PAU), Sant Quintí 77-79, 08041, Barcelona, Spain
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Ferraguti M, Martínez-de la Puente J, Brugueras S, Millet JP, Rius C, Valsecchi A, Figuerola J, Montalvo T. Spatial distribution and temporal dynamics of invasive and native mosquitoes in a large Mediterranean city. Sci Total Environ 2023; 896:165322. [PMID: 37414178 DOI: 10.1016/j.scitotenv.2023.165322] [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] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 06/16/2023] [Accepted: 07/02/2023] [Indexed: 07/08/2023]
Abstract
Mosquitoes, including invasive species like the Asian tiger mosquito Aedes albopictus, alongside native species Culex pipiens s.l., pose a significant nuisance to humans and serve as vectors for mosquito-borne diseases in urban areas. Understanding the impact of water infrastructure characteristics, climatic conditions, and management strategies on mosquito occurrence and effectiveness of control measures to assess their implications on mosquito occurrence is crucial for effective vector control. In this study, we examined data collected during the local vector control program in Barcelona, Spain, focusing on 234,225 visits to 31,334 different sewers, as well as 1817 visits to 152 fountains between 2015 and 2019. We investigated both the colonization and recolonization processes of mosquito larvae within these water infrastructures. Our findings revealed higher larval presence in sandbox-sewers compared to siphonic or direct sewers, and the presence of vegetation and the use of naturalized water positively influenced larval occurrence in fountains. The application of larvicidal treatment significantly reduced larvae presence; however, recolonization rates were negatively affected by the time elapsed since treatment. Climatic conditions played a critical role in the colonization and recolonization of sewers and urban fountains, with mosquito occurrence exhibiting non-linear patterns and, generally, increasing at intermediate temperatures and accumulated rainfall levels. This study emphasizes the importance of considering sewers and fountains characteristics and climatic conditions when implementing vector control programs to optimize resources and effectively reduce mosquito populations.
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Affiliation(s)
- M Ferraguti
- Department of Wetland Ecology, Doñana Biological Station (EBD-CSIC), Avda. Américo Vespucio 26, E-41092, Seville, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.
| | - J Martínez-de la Puente
- Department of Parasitology, University of Granada (UGR), Granada, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - S Brugueras
- Agència de Salut Pública de Barcelona (ASPB), Barcelona, Spain
| | - J P Millet
- Agència de Salut Pública de Barcelona (ASPB), Barcelona, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - C Rius
- Agència de Salut Pública de Barcelona (ASPB), Barcelona, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - A Valsecchi
- Agència de Salut Pública de Barcelona (ASPB), Barcelona, Spain
| | - J Figuerola
- Department of Wetland Ecology, Doñana Biological Station (EBD-CSIC), Avda. Américo Vespucio 26, E-41092, Seville, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - T Montalvo
- Agència de Salut Pública de Barcelona (ASPB), Barcelona, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
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Prats-Uribe A, Brugueras S, Comet D, Álamo-Junquera D, Ortega Gutiérrez LL, Orcau À, Caylà JA, Millet JP. Evidences supporting the inclusion of immigrants in the universal healthcare coverage. Eur J Public Health 2021; 30:785-787. [PMID: 32044956 DOI: 10.1093/eurpub/ckaa020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
In 2012, the Spanish government enforced a healthcare exclusion policy against undocumented immigrants. The newly elected government has recently derogated this policy. To analyze how this decree could have affected population health, we looked at primary health patients who would have been excluded and compared with a matched sample of non-excluded patients. Potentially excluded patients had decreased odds of: depression, chronic obstructive pulmonary disease, dyslipidaemia, heart failure and hypertension while diabetes mellitus rates were similar to non-excluded. Infectious diseases were more frequent in potentially excluded population (HIV, tuberculosis and syphilis). The exclusion of patients impedes the control of infectious diseases at a community level.
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Affiliation(s)
- Albert Prats-Uribe
- Epidemiology Service, Public Health Agency of Barcelona (ASPB), Barcelona, Spain.,Preventive Medicine and Public Health Training Unit, PSMar-ASPB, Barcelona, Spain.,Centre for Statistics in Medicine, Botnar Research Centre, NDORMS, University of Oxford, Oxford, UK
| | - Sílvia Brugueras
- Epidemiology Service, Public Health Agency of Barcelona (ASPB), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Epidemiologia y Salud Pública (CIBERESP), Barcelona, Spain.,Departament de Pediatria, d'Obstetrícia i Ginecologia i de Medicina Preventiva, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Dolors Comet
- Departament de Salut, Subdirecció General d'Avaluacions Mèdiques, Direcció General d'ordenació i Regulació Sanitària del, Barcelona, Spain
| | | | | | - Àngels Orcau
- Epidemiology Service, Public Health Agency of Barcelona (ASPB), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Epidemiologia y Salud Pública (CIBERESP), Barcelona, Spain
| | - Joan A Caylà
- Foundation of Tuberculosis Research Unit of Barcelona (fuiTB), Barcelona, Spain
| | - Joan-Pau Millet
- Epidemiology Service, Public Health Agency of Barcelona (ASPB), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Epidemiologia y Salud Pública (CIBERESP), Barcelona, Spain
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Brugueras S, Molina VI, Casas X, González YD, Forcada N, Romero D, Rodés A, Altet MN, Maldonado J, Martin-Sánchez M, Caylà JA, Orcau À, Rius C, Millet JP. Tuberculosis recurrences and predictive factors in a vulnerable population in Catalonia. PLoS One 2020; 15:e0227291. [PMID: 31940383 PMCID: PMC6961944 DOI: 10.1371/journal.pone.0227291] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 12/16/2019] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Patients with a history of tuberculosis (TB) have a high probability of recurrence because long-term cure is not always maintained in successfully treated patients. The aim of this study was to identify the probability of TB recurrence and its predictive factors in a cohort of socially vulnerable patients who completed treatment in the TB referral center in Catalonia, which acts as the center for patients with social and health problems. METHODS This retrospective open cohort study included all patients diagnosed with TB who were admitted and successfully treated in Serveis Clínics between 2000 and 2016 and who remained disease-free for a minimum of 1 year after treatment completion. We calculated the incidence density of TB recurrences per person-years of follow-up. We also estimated the cumulative incidence of TB recurrence at 1, 2, 5, and 10 years of follow-up. Bivariate analysis was conducted using Kaplan-Meier curves. Multivariate analysis was conducted using Cox regression. Hazard ratios (HR) were calculated with their 95% confidence intervals (95%CI). RESULTS There were 839 patients and 24 recurrences (2.9%), representing 0.49 per 100 person-years. The probability of a recurrence was 0.63% at 1 year of follow-up, 1.35% at 2 years, and 3.69% at 5 years. The multivariate analysis showed that the predictive factors of recurrence were age older than 34 years (aHR = 3.90; CI = 1.06-14.34 at age 35-45 years and aHR = 3.88; CI = 1.02-14.80 at age >45 years) and resistance to at least one anti-TB drug (aHR = 2.91; CI = 1.11-7.65). CONCLUSIONS Attention should be paid to socially vulnerable persons older than 34 years with a previous episode of resistant TB. Surveillance resources should be directed toward adequately treated patients who nevertheless have a high risk of recurrence.
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Affiliation(s)
- Sílvia Brugueras
- Epidemiology Service, Agència de Salut Pública de Barcelona (ASPB), Barcelona, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Departamento de Pediatría, Obstetricia y Ginecología y Medicina Preventiva, Facultad de Medicina, Universidad Autónoma de Barcelona, Barcelona, Spain
| | | | | | | | | | | | - Anna Rodés
- Agència de Salut Pública de Catalunya, Barcelona, Spain
| | | | | | - Mario Martin-Sánchez
- Preventive Medicine and Public Health Training Unit Parc de Salut Mar–Pompeu Fabra University—Public Health Agency of Barcelona (PSMar-UPF-ASPB), Barcelona, Spain
| | - Joan A. Caylà
- Foundation of the Tuberculosis Research Unit of Barcelona (fuiTB), Barcelona, Spain
| | - Àngels Orcau
- Epidemiology Service, Agència de Salut Pública de Barcelona (ASPB), Barcelona, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Foundation of the Tuberculosis Research Unit of Barcelona (fuiTB), Barcelona, Spain
| | - Cristina Rius
- Epidemiology Service, Agència de Salut Pública de Barcelona (ASPB), Barcelona, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Departamento de Pediatría, Obstetricia y Ginecología y Medicina Preventiva, Facultad de Medicina, Universidad Autónoma de Barcelona, Barcelona, Spain
| | - Joan-Pau Millet
- Epidemiology Service, Agència de Salut Pública de Barcelona (ASPB), Barcelona, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Serveis Clínics, Barcelona, Spain
- Foundation of the Tuberculosis Research Unit of Barcelona (fuiTB), Barcelona, Spain
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Brugueras S, Rius C, Millet JP, Casals M, Caylà JA. Does the economic recession influence the incidence of pertussis in a cosmopolitan European city? BMC Public Health 2019; 19:144. [PMID: 30717741 PMCID: PMC6360796 DOI: 10.1186/s12889-019-6448-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 01/17/2019] [Indexed: 11/30/2022] Open
Abstract
Background In the last few years, pertussis has re-emerged worldwide. The aim of this article is to study how the incidence of the disease has evolved in Barcelona city over a 16-year period, and determine which factors are associated with the evolution of the disease. We discuss the causes of the observed changes considering different possibilities such as vaccination coverage, vaccine effectiveness, increased surveillance or the effect of the current economic recession. Methods We performed a cross-sectional, observational, population-based descriptive study using data for the 2000–2015 period from the notifiable diseases register maintained by Barcelona Public Health Agency. We used Poisson regression to compute adjusted odds ratios (aOR) and their corresponding 95% confidence intervals (CI). Results A total of 1791 cases were registered. The incidence of the disease increased throughout the city from 2011 onwards. While children under 1 year of age had the highest-incidence and were the most at risk (aOR = 27.18, CI:23.51–31.44), we found that the age of affected children was higher in the last years. Incidence proportion (PRR) was lower among foreign-born children than native children (PRR = 0.43 CI:0.32–0.58). In the whole-cell vaccine period (2000–2004), the percentage of cases under 1 year of age who received the vaccine was lower than in 2005–2015 when the acellular vaccine was used (p = 0.01), suggesting a lower efficacy of the acellular vaccine. However, vaccination coverage in children under 6 years remained high (~ 90%), and there were no significant year-to-year variations (p = 0.757). Moreover, there did not appear to be any significant restrictions in medical care. According to the index of disposable household income (DHI), pertussis incidence increased from 2011 onwards in all neighbourhoods and remained higher in those with lower DHI. Conclusions The noteworthy increase in pertussis incidence does not seem to be due to the economic recession, but to other factors here described.
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Affiliation(s)
- Sílvia Brugueras
- Servei d'epidemiologia, Agència de Salut Pública de Barcelona, Barcelona, Spain. .,Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain. .,Departamento de Pediatría, Obstetricia y Ginecología y Medicina Preventiva, Facultad de Medicina, Universidad Autónoma de Barcelona, Barcelona, Spain.
| | - Cristina Rius
- Servei d'epidemiologia, Agència de Salut Pública de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.,Departamento de Pediatría, Obstetricia y Ginecología y Medicina Preventiva, Facultad de Medicina, Universidad Autónoma de Barcelona, Barcelona, Spain
| | - Joan-Pau Millet
- Servei d'epidemiologia, Agència de Salut Pública de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.,Tuberculosis Research Unit Foundation (fuiTB), Barcelona, Spain
| | - Martí Casals
- Sport and Physical Activity Studies Centre (CEEAF), University of Vic-Central University of Catalonia (UVic-UCC), Barcelona, Spain
| | - Joan A Caylà
- Servei d'epidemiologia, Agència de Salut Pública de Barcelona, Barcelona, Spain.,Tuberculosis Research Unit Foundation (fuiTB), Barcelona, Spain
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Brugueras S, Orcau À, Millet JP, Espinosa L, de Andrés A, Gorrindo P, Caylà JA. Tuberculosis clinical units improve contact tracing. Int J Tuberc Lung Dis 2016; 20:1572-1579. [DOI: 10.5588/ijtld.16.0147] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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