| 1. |
- Adams, Nicholas, et al.
(författare)
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El Niño Southern Oscillation, monsoon anomaly, and childhood diarrheal disease morbidity in Nepal
- 2022
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Ingår i: PNAS Nexus. - : Oxford University Press (OUP). - 2752-6542. ; 1:2
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Tidskriftsartikel (refereegranskat)abstract
- Climate change is adversely impacting the burden of diarrheal diseases. Despite significant reduction in global prevalence, diarrheal disease remains a leading cause of morbidity and mortality among young children in low- and middle-income countries. Previous studies have shown that diarrheal disease is associated with meteorological conditions but the role of large-scale climate phenomena such as El Niño-Southern Oscillation (ENSO) and monsoon anomaly is less understood. We obtained 13 years (2002–2014) of diarrheal disease data from Nepal and investigated how the disease rate is associated with phases of ENSO (El Niño, La Niña, vs. ENSO neutral) monsoon rainfall anomaly (below normal, above normal, vs. normal), and changes in timing of monsoon onset, and withdrawal (early, late, vs. normal). Monsoon season was associated with a 21% increase in diarrheal disease rates (Incident Rate Ratios [IRR]: 1.21; 95% CI: 1.16–1.27). El Niño was associated with an 8% reduction in risk while the La Niña was associated with a 32% increase in under-5 diarrheal disease rates. Likewise, higher-than-normal monsoon rainfall was associated with increased rates of diarrheal disease, with considerably higher rates observed in the mountain region (IRR 1.51, 95% CI: 1.19–1.92). Our findings suggest that under-5 diarrheal disease burden in Nepal is significantly influenced by ENSO and changes in seasonal monsoon dynamics. Since both ENSO phases and monsoon can be predicted with considerably longer lead time compared to weather, our findings will pave the way for the development of more effective early warning systems for climate sensitive infectious diseases.
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| 2. |
- An, Dong, et al.
(författare)
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Extreme precipitation patterns in the Asia-Pacific region and its correlation with El Niño-Southern Oscillation (ENSO)
- 2023
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Ingår i: Scientific Reports. - 2045-2322. ; 13
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Tidskriftsartikel (refereegranskat)abstract
- In the Asia-Pacific region (APR), extreme precipitation is one of the most critical climate stressors, affecting 60% of the population and adding pressure to governance, economic, environmental, and public health challenges. In this study, we analyzed extreme precipitation spatiotemporal trends in APR using 11 different indices and revealed the dominant factors governing precipitation amount by attributing its variability to precipitation frequency and intensity. We further investigated how these extreme precipitation indices are influenced by El Niño-Southern Oscillation (ENSO) at a seasonal scale. The analysis covered 465 ERA5 (the fifth-generation atmospheric reanalysis of the European Center for Medium-Range Weather Forecasts) study locations over eight countries and regions during 1990-2019. Results revealed a general decrease indicated by the extreme precipitation indices (e.g., the annual total amount of wet-day precipitation, average intensity of wet-day precipitation), particularly in central-eastern China, Bangladesh, eastern India, Peninsular Malaysia and Indonesia. We observed that the seasonal variability of the amount of wet-day precipitation in most locations in China and India are dominated by precipitation intensity in June-August (JJA), and by precipitation frequency in December-February (DJF). Locations in Malaysia and Indonesia are mostly dominated by precipitation intensity in March-May (MAM) and DJF. During ENSO positive phase, significant negative anomalies in seasonal precipitation indices (amount of wet-day precipitation, number of wet days and intensity of wet-day precipitation) were observed in Indonesia, while opposite results were observed for ENSO negative phase. These findings revealing patterns and drivers for extreme precipitation in APR may inform climate change adaptation and disaster risk reduction strategies in the study region.
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| 3. |
- Andhikaputra, Gerry, et al.
(författare)
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The impact of temperature and precipitation on all-infectious-, bacterial-, and viral-diarrheal disease in Taiwan
- 2023
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Ingår i: Science of the Total Environment. - : Elsevier BV. - 1879-1026 .- 0048-9697. ; 862
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The ongoing climate change will elevate the incidence of diarrheal in 2030-2050 in Asia, including Taiwan. This study investigated associations between meteorological factors (temperature, precipitation) and burden of age-cause-specific diarrheal diseases in six regions of Taiwan using 13 years of (2004-2016) population-based data.METHODS: Weekly cause-specific diarrheal and meteorological data were obtained from 2004 to 2016. We used distributed lag non-linear model to assess age (under five, all age) and cause-specific (viral, bacterial) diarrheal disease burden associated with extreme high (99th percentile) and low (5th percentile) of climate variables up to lag 8 weeks in six regions of Taiwan. Random-effects meta-analysis was used to pool these region-specific estimates.RESULTS: Extreme low temperature (15.30 °C) was associated with risks of all-infectious and viral diarrhea, with the highest risk for all-infectious diarrheal found at lag 8 weeks among all age [Relative Risk (RR): 1.44; 95 % Confidence Interval (95 % CI): 1.24-1.67]. The highest risk of viral diarrheal infection was observed at lag 2 weeks regardless the age. Extreme high temperature (30.18 °C) was associated with risk of bacterial diarrheal among all age (RR: 1.07; 95 % CI: 1.02-1.13) at lag 8 weeks. Likewise, extreme high precipitation (290 mm) was associated with all infectious diarrheal, with the highest risk observed for bacterial diarrheal among population under five years (RR: 2.77; 95 % CI: 1.60-4.79) at lag 8 weeks. Extreme low precipitation (0 mm) was associated with viral diarrheal in all age at lag 1 week (RR: 1.08; 95 % CI: 1.01-1.15)].CONCLUSION: In Taiwan, extreme low temperature is associated with an increased burden of viral diarrheal, while extreme high temperature and precipitation elevated burden of bacterial diarrheal. This distinction in cause-specific and climate-hazard specific diarrheal disease burden underscore the importance of incorporating differences in public health preparedness measures designed to enhance community resilience against climate change.
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| 4. |
- Eggeling, Jakob, et al.
(författare)
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Spatiotemporal link between El Niño Southern Oscillation (ENSO), extreme heat, and thermal stress in the Asia-Pacific region
- 2024
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Ingår i: Scientific Reports. - 2045-2322. ; 14:1
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Tidskriftsartikel (refereegranskat)abstract
- Climate change is closely monitored and numerous studies reports increasing air temperature and weather extremes across the globe. As a direct consequence of the increase of global temperature, the increased heat stress is becoming a global threat to public health. While most climate change and epidemiological studies focus on air temperature to explain the increasing risks, heat strain can be predicted using comprehensive indices such as Universal Thermal Climate Index (UTCI). The Asia-Pacific region is prone to thermal stress and the high population densities in the region impose high health risk. This study evaluated the air temperature and UTCI trends between 1990 and 2019 and found significant increasing trends for air temperature for the whole region while the increases of UTCI are not as pronounced and mainly found in the northern part of the region. These results indicate that even though air temperature is increasing, the risks of heat stress when assessed using UTCI may be alleviated by other factors. The associations between El Niño Southern Oscillation (ENSO) and heat stress was evaluated on a seasonal level and the strongest regional responses were found during December-January (DJF) and March-May (MAM).
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| 5. |
- Forouzanfar, Mohammad H, et al.
(författare)
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Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries, 1990-2013 : a systematic analysis for the Global Burden of Disease Study 2013.
- 2015
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Ingår i: The Lancet. - 0140-6736 .- 1474-547X. ; 386:10010, s. 2287-2323
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The Global Burden of Disease, Injuries, and Risk Factor study 2013 (GBD 2013) is the first of a series of annual updates of the GBD. Risk factor quantification, particularly of modifiable risk factors, can help to identify emerging threats to population health and opportunities for prevention. The GBD 2013 provides a timely opportunity to update the comparative risk assessment with new data for exposure, relative risks, and evidence on the appropriate counterfactual risk distribution.METHODS: Attributable deaths, years of life lost, years lived with disability, and disability-adjusted life-years (DALYs) have been estimated for 79 risks or clusters of risks using the GBD 2010 methods. Risk-outcome pairs meeting explicit evidence criteria were assessed for 188 countries for the period 1990-2013 by age and sex using three inputs: risk exposure, relative risks, and the theoretical minimum risk exposure level (TMREL). Risks are organised into a hierarchy with blocks of behavioural, environmental and occupational, and metabolic risks at the first level of the hierarchy. The next level in the hierarchy includes nine clusters of related risks and two individual risks, with more detail provided at levels 3 and 4 of the hierarchy. Compared with GBD 2010, six new risk factors have been added: handwashing practices, occupational exposure to trichloroethylene, childhood wasting, childhood stunting, unsafe sex, and low glomerular filtration rate. For most risks, data for exposure were synthesised with a Bayesian meta-regression method, DisMod-MR 2.0, or spatial-temporal Gaussian process regression. Relative risks were based on meta-regressions of published cohort and intervention studies. Attributable burden for clusters of risks and all risks combined took into account evidence on the mediation of some risks such as high body-mass index (BMI) through other risks such as high systolic blood pressure and high cholesterol.FINDINGS: All risks combined account for 57·2% (95% uncertainty interval [UI] 55·8-58·5) of deaths and 41·6% (40·1-43·0) of DALYs. Risks quantified account for 87·9% (86·5-89·3) of cardiovascular disease DALYs, ranging to a low of 0% for neonatal disorders and neglected tropical diseases and malaria. In terms of global DALYs in 2013, six risks or clusters of risks each caused more than 5% of DALYs: dietary risks accounting for 11·3 million deaths and 241·4 million DALYs, high systolic blood pressure for 10·4 million deaths and 208·1 million DALYs, child and maternal malnutrition for 1·7 million deaths and 176·9 million DALYs, tobacco smoke for 6·1 million deaths and 143·5 million DALYs, air pollution for 5·5 million deaths and 141·5 million DALYs, and high BMI for 4·4 million deaths and 134·0 million DALYs. Risk factor patterns vary across regions and countries and with time. In sub-Saharan Africa, the leading risk factors are child and maternal malnutrition, unsafe sex, and unsafe water, sanitation, and handwashing. In women, in nearly all countries in the Americas, north Africa, and the Middle East, and in many other high-income countries, high BMI is the leading risk factor, with high systolic blood pressure as the leading risk in most of Central and Eastern Europe and south and east Asia. For men, high systolic blood pressure or tobacco use are the leading risks in nearly all high-income countries, in north Africa and the Middle East, Europe, and Asia. For men and women, unsafe sex is the leading risk in a corridor from Kenya to South Africa.INTERPRETATION: Behavioural, environmental and occupational, and metabolic risks can explain half of global mortality and more than one-third of global DALYs providing many opportunities for prevention. Of the larger risks, the attributable burden of high BMI has increased in the past 23 years. In view of the prominence of behavioural risk factors, behavioural and social science research on interventions for these risks should be strengthened. Many prevention and primary care policy options are available now to act on key risks.FUNDING: Bill & Melinda Gates Foundation.
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| 6. |
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| 7. |
- Sapkota, Binaya, et al.
(författare)
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Disaster Management and Emergency Preparedness in Low- and Middle-Income Countries
- 2023
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Ingår i: Encyclopedia of Evidence in Pharmaceutical Public Health and Health Services Research in Pharmacy.. - Cham : Springer Cham. - 9783030502478
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Bokkapitel (refereegranskat)abstract
- Disaster is an event that causes significant damage, destruction, and human suffering. The imbalance between needs and available resources necessitates national or international assistance based on the severity of the damage. Disasters can be caused by nature (e.g., hurricanes, floods, tsunami, landslides, and earthquakes) or human-inflicted (e.g., bioterrorism, cyberattacks, armed conflicts, civil war, chemical, biological, nuclear, and radiological hazards). Over the last decade, 4777 natural disasters occurred worldwide, taking the lives of more than 880,000 people and causing economic losses of USD 685 billion. Since disaster effects are disproportionate, there is a need for effective pre-event, event, and post-event plans. Disaster resilience can be achieved by learning and developing skills and resources at the individual, community, and operational level to respond to and recover from disasters. The practice of community-based disaster risk reduction and the concept of build back better, and management of post-disaster complications are gaining momentum. Effective disaster management demands a multidisciplinary response team to address medical and health needs; mental/psychological health and rehabilitation; disaster management education; foods, shelter, and essential logistics; sanitation, hygiene, and nutrition during relief activities. Regular healthcare operations can suddenly be hampered due to disruptions in the chain of supply, particularly. Disasters usually hamper uninterrupted flow of medical and pharmaceutical supplies and hence necessitate a competent logistics manager. Pharmacists play a crucial role in providing pharmaceutical supplies during disasters.
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| 8. |
- Sharma, Ayushi, et al.
(författare)
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Characterizing the effects of extreme heat events on all-cause mortality : a case study in Ahmedabad city of India, 2002–2018
- 2024
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Ingår i: Urban Climate. - 2212-0955. ; 54
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Tidskriftsartikel (refereegranskat)abstract
- Recent years have seen a rise in extreme heat event (EHE)-related deaths in India. However, the impact of specific temperature thresholds on health risks remains understudied. Using Distributed Lag Non-Linear Models (DLNM), we explored the link between EHEs, defined by various temperature thresholds, and mortality risk in Ahmedabad, India, from 2002 to 2018, considering a 21-day lag. We observed a ‘J'-shaped exposure-response curve, identifying a Minimum Mortality Temperature (MMT) of 26 °C for Ahmedabad. Notably, a higher and sustained risk of all-cause mortality was associated with Tmax > 35 °C. EHEs definition of Tmax ∼ 40 °C (95th percentile) increased all-cause mortality risk by 30% (Relative Risk (RR): 1.30, 95% Confidence Interval (95% CI): 1.26–1.35), with substantially higher risk at Tmax of 45 °C (RR: 3.08, 95% CI: 2.47–3.83). Analysis of attributable fractions (AF) indicated Tmax ≥ 85th percentile contributed most to total mortalities, with an AF of 3.58% (95% CI: 3.20–3.96). Gender-stratified analysis revealed higher risk of EHE-related deaths for females. The highest mortality risk was identified on the same day of exposure and persisted longer during more intense EHEs. The activation of city's heat action plans should consider the significantly elevated mortality risk below the current threshold (∼40 °C) and the persistent risk during high-intensity EHEs.
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