Meteorologic influences on Plasmodium falciparum malaria in the Highland Tea Estates of Kericho,Western Kenya

Recent epidemics of Plasmodium falciparum malaria have been observed in high-altitude areas of East Africa. Increased malaria incidence in these areas of unstable malaria transmission has been attributed to a variety of changes including global warming. To determine whether the reemergence of malaria in western Kenya could be attributed to changes in meteorologic conditions, we tested for trends in a continuous 30-year monthly malaria incidence dataset (1966-1995) obtained from complete hospital registers at a Kenyan tea plantation. Contemporary monthly meteorologic data (1966-1995) that originated from the tea estate meteorologic station and from global climatology records were also tested for trends. We found that total hospital admissions (malaria and nonmalaria) remained unchanged while malaria admissions increased significantly during the period. We also found that all meteorologic variables showed no trends for significance, even when combined into a monthly suitability index for malaria transmission. We conclude that climate changes have not caused the highland malaria resurgence in western Kenya.     

气候变化对媒介生物性传染病的影响

近百年来,地球气候经历着前所未有的变化。其对媒介生物传染病的潜在影响也对人类健康造成了巨大的威胁。笔者收集整理了现有相关文献,概述了全球范围内气候变化和气象因素对媒介生物数量和地理分布、病原体生长发育和主要媒介生物性传染病传播的影响。通过分析总结发现,在全球范围内及我国部分地区温度、湿度、降水和风速等气候因子的变异和变化对主要媒介传染病的发生、传播和暴发有着显著的影响。尽管如此,由于气候变化和媒传疾病分布及传播机制改变的关系非常复杂。另外,部分研究结果仍存在空间不一致性,因此需要未来更多的相关研究为适应策略的制定提供有力的科学依据。     

Climate change, crop yields, and undernutrition: development of a model to quantify the impact of climate scenarios on child undernutrition

Background: Global climate change is anticipated to reduce future cereal yields and threaten food security, thus potentially increasing the risk of undernutrition. The causation of undernutrition is complex, and there is a need to develop models that better quantify the potential impacts of climate change on population health.Objectives: We developed a model for estimating future undernutrition that accounts for food and nonfood (socioeconomic) causes and can be linked to available regional scenario data. We estimated child stunting attributable to climate change in five regions in South Asia and sub-Saharan Africa (SSA) in 2050.Methods: We used current national food availability and undernutrition data to parameterize and validate a global model, using a process-driven approach based on estimations of the physiological relationship between a lack of food and stunting. We estimated stunting in 2050 using published modeled national calorie availability under two climate scenarios and a reference scenario (no climate change).Results: We estimated that climate change will lead to a relative increase in moderate stunting of 1–29% in 2050 compared with a future without climate change. Climate change will have a greater impact on rates of severe stunting, which we estimated will increase by 23% (central SSA) to 62% (South Asia).Conclusions: Climate change is likely to impair future efforts to reduce child malnutrition in South Asia and SSA, even when economic growth is taken into account. Our model suggests that to reduce and prevent future undernutrition, it is necessary to both increase food access and improve socioeconomic conditions, as well as reduce greenhouse gas emissions.     

The impact of climate variability and change on cryptosporidiosis and giardiasis rates in New Zealand

Aim: To investigate the spatial relationship between climate variability and cryptosporidiosis and giardiasis notifications in New Zealand between 1997 and 2006.     

Methodological problems and amendments to demonstrate effects of temperature on the epidemiology of malaria. A new perspective on the highland epidemics in Madagascar, 1972-1989

There is a growing consensus that changes in climate will have major consequences for human health through a reduction in the availability of food and an increasing frequency of natural disasters. However, the contribution of higher temperatures to vector-borne diseases, particularly malaria, remains controversial despite the known biological dependence of both vector and pathogen on climate. Misconceptions and inappropriate use of variables and methods have contributed to the controversy. At present there appears to be more support for non-climatic explanations to account for the resurgence of malaria in the African highlands, e.g. the deterioration of malaria control and the development of drug resistance. An attempt is made here to show that dismissing temperature as a driving force in the case of malaria is premature. Using a de-trended time-series of malaria incidence in Madagascar between 1972 and 1989 indicated that a minimum temperature during 2 months at the start of the transmission season can account for most of the variability between years (r² = 0.66). These months correspond with the months when the human-vector (Anopheles gambiae sensu lato) contact is greatest. The relationship between El Niño Southern Oscillation (ENSO) and temperature (r = 0.79), and ENSO and malaria (r = 0.64), suggests that there might be an increased epidemic risk during post-Niño years in the Madagascar highlands and therefore warrants increased vigilance and extended control efforts in the first half of 2003. This review suggests that the rejection of climate-disease associations in studies so far published may not have used biologically relevant climate parameters. It highlights the importance of identifying more relevant parameters during critical periods of the transmission season in order to aid epidemic forecasting and to assess the potential impact of global warming.     

The West Nile Virus outbreak in Israel (2000) from a new perspective: the regional impact of climate change

The West Nile Virus (WNV) outbreak in Israel in 2000 appeared after medical and climatic warning signs. Re-analysis of the epidemic from a new viewpoint, the regional impact of global warming, especially the worsening in the summers' heat conditions, is presented. The disease appeared averagely at a lag of 3-9 weeks (strongest correlation = lag of 7 weeks). The minimum temperature was found as the most important climatic factor that encourages the disease earlier appearance. Extreme heat is more significant than high air humidity for increasing WNV cases. An early extreme rise in the summer temperature could be a good indicator of increased vector populations. While 93.5% of cases were in the metropolitan areas, the disease was not reported in the sub-arid regions. The outbreak development was comparable to the cases from Romania (1996) and NYC (1999). Each of those epidemics appeared after a long heatwave.     

Impacts of climate change on public health in India: future research directions

Background

Climate change and associated increases in climate variability will likely further exacerbate global health disparities. More research is needed, particularly in developing countries, to accurately predict the anticipated impacts and inform effective interventions.

Objectives

Building on the information presented at the 2009 Joint Indo–U.S. Workshop on Climate Change and Health in Goa, India, we reviewed relevant literature and data, addressed gaps in knowledge, and identified priorities and strategies for future research in India.

Discussion

The scope of the problem in India is enormous, based on the potential for climate change and variability to exacerbate endemic malaria, dengue, yellow fever, cholera, and chikungunya, as well as chronic diseases, particularly among the millions of people who already experience poor sanitation, pollution, malnutrition, and a shortage of drinking water. Ongoing efforts to study these risks were discussed but remain scant. A universal theme of the recommendations developed was the importance of improving the surveillance, monitoring, and integration of meteorological, environmental, geospatial, and health data while working in parallel to implement adaptation strategies.

Conclusions

It will be critical for India to invest in improvements in information infrastructure that are innovative and that promote interdisciplinary collaborations while embarking on adaptation strategies. This will require unprecedented levels of collaboration across diverse institutions in India and abroad. The data can be used in research on the likely impacts of climate change on health that reflect India’s diverse climates and populations. Local human and technical capacities for risk communication and promoting adaptive behavior must also be enhanced.     

Vulnerability of Quebec drinking-water treatment plants to cyanotoxins in a climate change context

Cyanobacteria are a growing concern in the province of Quebec due to recent highly publicised bloom episodes. The health risk associated with the consumption of drinking water coming from contaminated sources was unknown. A study was undertaken to evaluate treatment plants' capacity to treat cyanotoxins below the maximum recommended concentrations of 1.5 μg/L microcystin-LR (MC-LR) and the provisional concentration of 3.7 μg/L anatoxin-a, respectively. The results showed that close to 80% of the water treatment plants are presently able to treat the maximum historical concentration measured in Quebec (5.35 μg/L MC-LR equ.). An increase, due to climate change or other factors, would not represent a serious threat because chlorine, the most popular disinfectant, is effective in treating MC-LR under standard disinfection conditions. The highest concentration of anatoxin-a (2.3 μg/L) measured in natural water thus far in source water is below the current guideline for treated waters. However, higher concentrations of anatoxin-a would represent a significant challenge for the water industry as chlorine is not an efficient treatment option. The use of ozone, potassium permanganate or powder activated carbon would have to be considered.     

Measuring the burden of disease due to climate change and developing a forecast model in South Korea

Objectives

Climate change influences human health in various ways, and quantitative assessments of the effect of climate change on health at national level are becoming essential for environmental health management.

Study design

This study quantified the burden of disease attributable to climate change in Korea using disability-adjusted life years (DALY), and projected how this would change over time.

Methods

Diseases related to climate change in Korea were selected, and meteorological data for each risk factor of climate change were collected. Mortality was calculated, and a database of incidence and prevalence was established. After measuring the burden of each disease, the total burden of disease related to climate change was assessed by multiplying population-attributable fractions. Finally, an estimation model for the burden of disease was built based on Korean climate data.

Results

The total burden of disease related to climate change in Korea was 6.85 DALY/1000 population in 2008. Cerebrovascular diseases induced by heat waves accounted for 72.1% of the total burden of disease (hypertensive disease 1.82 DALY/1000 population, ischaemic heart disease 1.56 DALY/1000 population, cerebrovascular disease 1.56 DALY/1000 population). According to the estimation model, the total burden of disease will be 11.48 DALY/1000 population in 2100, which is twice the total burden of disease in 2008.

Conclusions

This study quantified the burden of disease caused by climate change in Korea, and provides valuable information for determining the priorities of environmental health policy in East Asian countries with similar climates.     

Modelling the impact of future socio-economic and climate change scenarios on river microbial water quality

Microbial surface water quality is important, as it is related to health risk when the population is exposed through drinking, recreation or consumption of irrigated vegetables. The microbial surface water quality is expected to change with socio-economic development and climate change. This study explores the combined impacts of future socio-economic and climate change scenarios on microbial water quality using a coupled hydrodynamic and water quality model (MIKE21FM-ECOLab). The model was applied to simulate the baseline (2014–2015) and future (2040s and 2090s) faecal indicator bacteria (FIB: E. coli and enterococci) concentrations in the Betna river in Bangladesh. The scenarios comprise changes in socio-economic variables (e.g. population, urbanization, land use, sanitation and sewage treatment) and climate variables (temperature, precipitation and sea-level rise). Scenarios have been developed building on the most recent Shared Socio-economic Pathways: SSP1 and SSP3 and Representative Concentration Pathways: RCP4.5 and RCP8.5 in a matrix. An uncontrolled future results in a deterioration of the microbial water quality (+75% by the 2090s) due to socio-economic changes, such as higher population growth, and changes in rainfall patterns. However, microbial water quality improves under a sustainable scenario with improved sewage treatment (-98% by the 2090s). Contaminant loads were more influenced by changes in socio-economic factors than by climatic change. To our knowledge, this is the first study that combines climate change and socio-economic development scenarios to simulate the future microbial water quality of a river. This approach can also be used to assess future consequences for health risks.     

Obesity and climate change mitigation in Australia: overview and analysis of policies with co‐benefits

Objective: To provide an overview of the shared structural causes of obesity and climate change, and analyse policies that could be implemented in Australia to both equitably reduce obesity rates and contribute to mitigating climate change. Methods: Informed by the political economy of health theoretical framework, a review was conducted of the literature on the shared causes of, and solutions to, obesity and climate change. Policies with potential co‐benefits for climate change and obesity were then analysed based upon their feasibility and capacity to reduce greenhouse gas emissions and equitably reduce obesity rates in Australia. Results: Policies with potential co‐benefits fit within three broad categories: those to replace car use with low‐emissions, active modes of transport; those to improve diets and reduce emissions from the food system; and macro‐level economic policies to reduce the over‐consumption of food and fossil fuel energy. Conclusion: Given the complex causes of both problems, it is argued that a full spectrum of complementary strategies across different sectors should be utilised. Implications: Such an approach would have significant public health, social and environmental benefits.     

Soil and human health: Understanding agricultural and socio-environmental risk and resilience in the age of climate change

Prolonged monocropping of commodity crops, such as peanuts (Arachis hypogea L.) in West Africa, typically strips nutrients from soils and may exacerbate vulnerability to insects and diseases. In this paper, we focus on aflatoxins, toxic chemicals produced by certain molds growing on moist crops, as one risk of growing importance for its negative impacts on human health, crop yields, and agricultural livelihoods and ecosystems. We link the increased prevalence of this deadly fungus to the long history of peanut monoculture, exacerbated by market liberalization and China's increased investment and export demand for peanuts, climate change, food insecurity, as well as disregard for and displacement of traditional agricultural knowledge. We use a political ecology approach to place the public health threat from aflatoxin in the context of both historical pressures for cash-crop production of peanuts and contemporary soil degradation, food insecurity, climate change precarity and changes within social and economic systems of agriculture in Senegal.     

The impact of heat waves on mortality in seven major cities in Korea

Background: Understanding the health impacts of heat waves is important, especially given anticipated increases in the frequency, duration, and intensity of heat waves due to climate change.Objectives: We examined mortality from heat waves in seven major Korean cities for 2000 through 2007 and investigated effect modification by individual characteristics and heat wave characteristics (intensity, duration, and timing in season).Methods: Heat waves were defined as ≥ 2 consecutive days with daily mean temperature at or above the 98th percentile for the warm season in each city. We compared mortality during heat-wave days and non-heat-wave days using city-specific generalized linear models. We used Bayesian hierarchical models to estimate overall effects within and across all cities. In addition, we estimated effects of heat wave characteristics and effects according to cause of death and examined effect modification by individual characteristics for Seoul.Results: Overall, total mortality increased 4.1% [95% confidence interval (CI): –6.1%, 15.4%] during heat waves compared with non-heat-wave days, with an 8.4% increase (95% CI: 0.1%, 17.3%) estimated for Seoul. Estimated mortality was higher for heat waves that were more intense, longer, or earlier in summer, although effects were not statistically significant. Estimated risks were higher for women versus men, older versus younger residents, those with no education versus some education, and deaths that occurred out of hospitals in Seoul, although differences among strata of individual characteristics were not statistically significant.Conclusions: Our findings support evidence of mortality impacts from heat waves and have implications for efforts to reduce the public health burden of heat waves.     

气候变化对媒介传播传染病影响的区域分析及应对措施

过去几十年间,随着气候变化,一系列媒介传播传染病(VBI)的流行病学特征在全球各地均出现了不同程度的改变。VBI对自然环境包括气候的依赖程度很大,了解气候变化对VBI的影响,对进一步预防VBI的流行非常重要。本文对气候变化与VBI二者的关系进行了概述,综述了气候变化对各大洲VBI发病模式的改变,并就此阐述了应对方法,力求全面了解气候变化对VBI的影响。     

公共财政职能转变对卫生发展的机遇和挑战

我国政府公共财政职能正在逐步实行三大转变,即宏观上合理配置资源的职能,收入再分配职能和稳定社会的职能,卫生发展必须抓住机遇,利用卫生事业在政府实现上述三大职能中的特殊作用,以争取更大的政府投入。     

2017年成都市PM2.5浓度与循环系统疾病急救人次的关系

目的 研究2017年成都市空气污染物PM2.5对循环系统急救人次的急性影响。方法 收集成都市2017年1月1日-12月31日 PM2.5每日24小时浓度均值、每日循环系统疾病急救人次数、每日平均气温和平均相对湿度,采用广义相加时间序列模型,分析空气污染物PM2.5浓度与循环系统疾病急救人次的关系。结果 最强效应期为累积滞后0~2日,大气中PM2.5 浓度每升高10μg/m³,居民因循环系统疾病急救风险增加0.99%(95%CI:0.46%~1.52%),PM2.5 浓度与居民因循环系统疾病急救风险的暴露反应关系曲线呈上升趋势,随着PM2.5 浓度升高,上升加速度趋于平缓。结论 空气PM2.5污染,可能增加居民因循环系统疾病急救的风险。     

农村居民慢性病危险因素SOC模型干预效果评价

目的应用SOC模型探索科学、有效的人群行为干预方法,评估其慢性病危险因素干预效果。方法选取干预组与对照组各500人,按SOC模型对其健康行为的接受程度划分为5个阶段,对干预组不同阶段人群进行有针对性的健康干预,在干预末期评估2组行为改变及血压及生化指标改变。结果干预后干预社区前后及与对照社区比较,干预社区农民对健康生活方式的认知程度明显改善;吸烟率、饮酒率分别由33.6%、50.2%下降到21.3%、33.6%(P<0.05);平均每天锻炼时间、膳食结构明显改善;干预社区农民BM I收缩压、舒张压、血中总胆固醇分别由(24.07±4.16)、(124.90±20.66)、(81.47±13.53)mm Hg(1 mm Hg=0.133 kPa)和(5.43±1.12)mmol/L下降到(23.69±3.15)、(122.89±15.36)、(79.37±9.39)mm Hg和(4.87±0.82)mmol/L(P<0.05)。结论 SOC模型对农民进行慢性病危险因素干预效果明显。