| 1. |
- Arisco, Nicholas J, et al.
(författare)
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The effect of extreme temperature and precipitation on cause-specific deaths in rural Burkina Faso : a longitudinal study
- 2023
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Ingår i: The Lancet Planetary Health. - : Elsevier. - 2542-5196. ; 7:6, s. e478-e489
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Tidskriftsartikel (refereegranskat)abstract
- Background: Extreme weather is becoming more common due to climate change and threatens human health through climate-sensitive diseases, with very uneven effects around the globe. Low-income, rural populations in the Sahel region of west Africa are projected to be severely affected by climate change. Climate-sensitive disease burdens have been linked to weather conditions in areas of the Sahel, although comprehensive, disease-specific empirical evidence on these relationships is scarce. In this study, we aim to provide an analysis of the associations between weather conditions and cause-specific deaths over a 16-year period in Nouna, Burkina Faso.Methods: In this longitudinal study, we used de-identified, daily cause-of-death data from the Health and Demographic Surveillance System led by the Centre de Recherche en Santé de Nouna (CRSN) in the National Institute of Public Health of Burkina Faso, to assess temporal associations between daily and weekly weather conditions (maximum temperature and total precipitation) and deaths attributed to specific climate-sensitive diseases. We implemented distributed-lag zero-inflated Poisson models for 13 disease-age groups at daily and weekly time lags. We included all deaths from climate-sensitive diseases in the CRSN demographic surveillance area from Jan 1, 2000 to Dec 31, 2015 in the analysis. We report the exposure–response relationships at percentiles representative of the exposure distributions of temperature and precipitation in the study area.Findings: Of 8256 total deaths in the CRSN demographic surveillance area over the observation period, 6185 (74·9%) were caused by climate-sensitive diseases. Deaths from communicable diseases were most common. Heightened risk of death from all climate-sensitive communicable diseases, and malaria (both across all ages and in children younger than 5 years), was associated with 14-day lagged daily maximum temperatures at or above 41·1°C, the 90th percentile of daily maximum temperatures, compared with 36·4°C, the median (all communicable diseases: 41·9°C relative risk [RR] 1·38 [95% CI 1·08–1·77], 42·8°C 1·57 [1·13–2·18]; malaria all ages: 41·1°C 1·47 [1·05–2·05], 41·9°C 1·78 [1·21–2·61], 42·8°C 2·35 [1·37–4·03]; malaria younger than 5 years: 41·9°C 1·67 [1·02–2·73]). Heightened risk of death from communicable diseases was also associated with 14-day lagged total daily precipitation at or below 0·1 cm, the 49th percentile of total daily precipitation, compared with 1·4 cm, the median (all communicable diseases: 0·0 cm 1·04 [1·02–1·07], 0·1 cm 1·01 [1·006–1·02]; malaria all ages: 0·0 cm 1·04 [1·01–1·08], 0·1 cm 1·02 [1·00–1·03]; malaria younger than 5 years: 0·0 cm 1·05 [1·01–1·10], 0·1 cm 1·02 [1·00–1·04]). The only significant association with a non-communicable disease outcome was a heightened risk of death from climate-sensitive cardiovascular diseases in individuals aged 65 years and older associated with 7-day lagged daily maximum temperatures at or above 41·9°C (41·9°C 2·25 [1·06–4·81], 42·8°C 3·68 [1·46–9·25]). Over 8 cumulative weeks, we found that the risk of death from communicable diseases was heightened at all ages from temperatures at or above 41·1°C (41·1°C 1·23 [1·05–1·43], 41·9°C 1·30 [1·08–1·56], 42·8°C 1·35 [1·09–1·66]) and risk of death from malaria was heightened by precipitation at or above 45·3 cm (all ages: 45·3 cm 1·68 [1·31–2·14], 61·6 cm 1·72 [1·27–2·31], 87·7 cm 1·72 [1·16–2·55]; children younger than 5 years: 45·3 cm 1·81 [1·36–2·41], 61·6 cm 1·82 [1·29–2·56], 87·7 cm 1·93 [1·24–3·00]).Interpretation: Our results indicate a high burden of death related to extreme weather in the Sahel region of west Africa. This burden is likely to increase with climate change. Climate preparedness programmes—such as extreme weather alerts, passive cooling architecture, and rainwater drainage—should be tested and implemented to prevent deaths from climate-sensitive diseases in vulnerable communities in Burkina Faso and the wider Sahel region.
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| 2. |
- Bunker, Aditi, et al.
(författare)
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The effects of cool roofs on health, environmental, and economic outcomes in rural Africa : study protocol for a community-based cluster randomized controlled trial
- 2024
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Ingår i: Trials. - : BioMed Central (BMC). - 1745-6215. ; 25:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: High ambient air temperatures in Africa pose significant health and behavioral challenges in populations with limited access to cooling adaptations. The built environment can exacerbate heat exposure, making passive home cooling adaptations a potential method for protecting occupants against indoor heat exposure.Methods: We are conducting a 2-year community-based stratified cluster randomized controlled trial (cRCT) implementing sunlight-reflecting roof coatings, known as “cool roofs,” as a climate change adaptation intervention for passive indoor home cooling. Our primary research objective is to investigate the effects of cool roofs on health, indoor climate, economic, and behavioral outcomes in rural Burkina Faso. This cRCT is nested in the Nouna Health and Demographic Surveillance System (HDSS), a population-based dynamic cohort study of all people living in a geographically contiguous area covering 59 villages, 14305 households and 28610 individuals. We recruited 1200 participants, one woman and one man, each in 600 households in 25 villages in the Nouna HDSS. We stratified our sample by (i) village and (ii) two prevalent roof types in this area of Burkina Faso: mud brick and tin. We randomized the same number of people (12) and homes (6) in each stratum 1:1 to receiving vs. not receiving the cool roof. We are collecting outcome data on one primary endpoint - heart rate, (a measure of heat stress) and 22 secondary outcomes encompassing indoor climate parameters, blood pressure, body temperature, heat-related outcomes, blood glucose, sleep, cognition, mental health, health facility utilization, economic and productivity outcomes, mosquito count, life satisfaction, gender-based violence, and food consumption. We followed all participants for 2 years, conducting monthly home visits to collect objective and subjective outcomes. Approximately 12% of participants (n = 152) used smartwatches to continuously measure endpoints including heart rate, sleep and activity.Discussion: Our study demonstrates the potential of large-scale cRCTs to evaluate novel climate change adaptation interventions and provide evidence supporting investments in heat resilience in sub-Saharan Africa. By conducting this research, we will contribute to better policies and interventions to help climate-vulnerable populations ward off the detrimental effects of extreme indoor heat on health.Trial registration: German Clinical Trials Register (DRKS) DRKS00023207. Registered on April 19, 2021.
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| 3. |
- Fortuin-de Smidt, Melony C., et al.
(författare)
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Physical activity attenuates but does not eliminate coronary heart disease risk amongst adults with risk factors : EPIC-CVD case-cohort study
- 2022
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Ingår i: European Journal of Preventive Cardiology. - : Oxford University Press (OUP). - 2047-4873 .- 2047-4881. ; 29:12, s. 1618-1629
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: This study aimed to evaluate the association between physical activity and the incidence of coronary heart disease (CHD) in individuals with and without CHD risk factors.METHODS AND RESULTS: EPIC-CVD is a case-cohort study of 29 333 participants that included 13 582 incident CHD cases and a randomly selected sub-cohort nested within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Self-reported physical activity was summarized using the Cambridge physical activity index (inactive, moderately inactive, moderately active, and active). Participants were categorized into sub-groups based on the presence or the absence of the following risk factors: obesity (body mass index ≥30 kg/m2), hypercholesterolaemia (total cholesterol ≥6.2 mmol/L), history of diabetes, hypertension (self-reported or ≥140/90 mmHg), and current smoking. Prentice-weighted Cox regression was used to assess the association between physical activity and incident CHD events (non-fatal and fatal).Compared to inactive participants without the respective CHD risk factor (referent), excess CHD risk was highest in physically inactive and lowest in moderately active participants with CHD risk factors. Corresponding excess CHD risk estimates amongst those with obesity were 47% [95% confidence interval (CI) 32-64%] and 21% (95%CI 2-44%), with hypercholesterolaemia were 80% (95%CI 55-108%) and 48% (95%CI 22-81%), with hypertension were 80% (95%CI 65-96%) and 49% (95%CI 28-74%), with diabetes were 142% (95%CI 63-260%), and 100% (95%CI 32-204%), and amongst smokers were 152% (95%CI 122-186%) and 109% (95%CI 74-150%).CONCLUSIONS: In people with CHD risk factors, moderate physical activity, equivalent to 40 mins of walking per day, attenuates but does not completely offset CHD risk.
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| 4. |
- Gutberlet, Jutta, et al.
(författare)
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Socio-environmental entrepreneurship and the provision of critical services in informal settlements
- 2016
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Ingår i: Environment & Urbanization. - : SAGE Publications. - 0956-2478 .- 1746-0301. ; 28:1, s. 205-222
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Tidskriftsartikel (refereegranskat)abstract
- This paper contributes to the understanding of processes by which small-scale entrepreneurs who provide household waste collection in informal settlements succeed in formalized co-production of such services. The paper draws on the social and solidarity economy and social and environmental entrepreneurship theoretical frameworks, which offer complementary understandings of diverse strategies to tackle everyday challenges. Two questions are addressed: How do informal waste collection initiatives get established, succeed and grow? What are the implications of this transition for the entrepreneurs themselves, the communities, the environmental governance system and the scholarship? A case study is presented, based on three waste picker entrepreneurs in Kisumu, Kenya, who have consolidated and expanded their operations in informal settlements but also extended social and environmental activities into formal settlements. The paper demonstrates how initiatives, born as community-based organizations, become successful social micro-enterprises, driven by a desire to address socioenvironmental challenges in their neighbourhoods.
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| 5. |
- Kain, Jaan-Henrik, 1960, et al.
(författare)
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Translating Policies into Informal Settlements' Critical Services: Reframing, Anchoring and Muddling Through
- 2016
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Ingår i: Public Administration and Development. - : Wiley. - 0271-2075 .- 1099-162X. ; 36:5, s. 330-346
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Tidskriftsartikel (refereegranskat)abstract
- This paper examines how policies and plans are translated into informal settlements' practice. It builds on literature on policy implementation practice and organization studies, and more particularly, it applies the concepts of reframing, anchoring and muddling through. The paper is informed by the case of Kisumu City in Kenya and its Kisumu Integrated Solid Waste Management Plan and its implementation on Kisumu's informal settlements. The plan was funded by the Swedish International Development Agency through the United Nations Human Settlement Programme and implemented from 2007 to 2009. The study is based on action research carried out by a multidisciplinary and transdisciplinary group of researchers, through focus groups, participatory workshops, collaborative action, in-depth interviews, document analysis and observations. The paper examines what original aspects of Kisumu Integrated Solid Waste Management Plan were translated, that is, which ones faded out and which ones became stabilized into and travel as ‘best practices’ to other locations. The paper shows how the generation of ‘best practices’ can be loosely coupled with the practices that policy seeks to change. It concludes, in line with previous research in the field, how successful policy implementation is based on cultural and political interpretations rather on evidence of improved practices.
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| 6. |
- Zapata, Patrik, 1967, et al.
(författare)
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Translating city development projects in informal settlements: reframing, anchoring and muddling through
- 2015
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Ingår i: 16th NAERUS Conference 20th November 2015, Dortmund, Germany.
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Konferensbidrag (refereegranskat)abstract
- Numerous programs have been launched to deal with the serious solid waste predicaments in informal settlements. However, in both policy and research, there is an increasing concern with the disparities that exist between solid waste policies and what they actually achieve in practice. Informed by the case of the city of Kisumu and its Kisumu Integrated Solid Waste Management Plan (KISWAMP), this paper examines how municipal waste management programs are translated into practice in informal settlements. It is based on action-research carried out by a multidisciplinary and transdiciplinary group of researchers, through focus groups, participatory workshops, collaborative action, in-depth interviews, document analysis and observations. City management literature and the concepts of reframing, anchoring and muddling through are used to understand the KISWAMP and its implementation. It starts by reconstructing the history of KISWAMP and how it became a project. Then, it examines what original aspects of KISWAMP were actually translated, i.e. which ones faded out and which ones became stabilized into and travel as best practices to other locations. The analysis shows how KISWAMP was translated into practice by reframing the meanings and status of waste as a profession, as a policy and as a critical service worthy to pay for among residents. KISWAMP also thrived to anchor the program into existing waste entrepreneurship practices . Municipal officers and politicians were also trained to connect the plan within the municipality, yet as many moved, KISWAMP remained weakly bounded to city budgets and decision-making processes. Trust also grew among residents being served by the new waste collection services. Yet in lower-income settlements with insufficient assets to anchor the project, distrust and resentment grew instead. Skips in the new waste transfer points soon disappeared and were not regularly evacuated. Still, the skip idea did not totally vanish as it was recovered by the new KUP program. A final aspect in the implementation of KISWAMP was the ability of waste entrepreneurs and officers to develop ways to muddle through arbitrary and loosely coupled partnership arrangements to evacuate transfer points; waste pickers’ coping strategies to compensate low paid labour;; or residents’ persistent illegal disposal of waste where the skip used to be.
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