| 1. |
- Béguin, Andreas, et al.
(författare)
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The opposing effects of climate change and socio-economic development on the global distribution of malaria
- 2011
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Ingår i: Global Environmental Change. - : Elsevier. - 0959-3780 .- 1872-9495. ; 21:4, s. 1209-1214
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Tidskriftsartikel (refereegranskat)abstract
- The current global geographic distribution of malaria results from a complex interaction between climatic and non-climatic factors. Over the past century, socio-economic development and public health measures have contributed to a marked contraction in the distribution of malaria. Previous assessments of the potential impact of global changes on malaria have not quantified the effects of non-climate factors. In this paper, we describe an empirical model of the past, present and future-potential geographic distribution of malaria which incorporates both the effects of climate change and of socio-economic development. A logistic regression model using temperature, precipitation and gross domestic product per capita (GDPpc) identifies the recent global geographic distribution of malaria with high accuracy (sensitivity 85% and specificity 95%). Empirically, climate factors have a substantial effect on malaria transmission in countries where GDPpc is currently less than US$20,000. Using projections of future climate, GDPpc and population consistent with the IPCC A1B scenario, we estimate the potential future population living in areas where malaria can be transmitted in 2030 and 2050. In 2050, the projected population at risk is approximately 5.2 billion when considering climatic effects only, 1.95 billion when considering the combined effects of GDP and climate, and 1.74 billion when considering GDP effects only. Under the A1B scenario, we project that climate change has much weaker effects on malaria than GDPpc increase. This outcome is, however, dependent on optimistic estimates of continued socioeconomic development. Even then, climate change has important effects on the projected distribution of malaria, leading to an increase of over 200 million in the projected population at risk.
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| 2. |
- Blomstedt, Yulia, et al.
(författare)
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Measuring self-reported health in low-income countries : piloting three instruments in semi-rural Burkina Faso
- 2012
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Ingår i: Global Health Action. - Järfälla : Co-Action Publishing. - 1654-9716 .- 1654-9880. ; 5, s. 8488-
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Tidskriftsartikel (refereegranskat)abstract
- Background: National surveys in low-income countries increasingly rely on self-reported measures of health. The ease, speed, and economy of collecting self-reports of health make such collection attractive for rapid appraisals. However, the interpretation of these measures is complicated since different cultures understand and respond to the same question in different ways. Objective: The aim of this pilot study was to develop a culturally sensitive tool to study the self-reported health (SRH) of the local adult population in Burkina Faso. Design: The study was carried out in the 2009 rainy season. The sample included 27 men and 25 women aged 18 or older who live in semi-urban Nouna, Burkina Faso. Three culturally adapted instruments were tested: a SRH question, a wooden visual analogue scale (VAS), and a drawn VAS. Respondents were asked to explain their answers to each instrument. The narratives were analyzed with the content analysis technique, and the prevalence of poor SRH was estimated from the quantitative data by stratification for respondent background variables (sex, age, literacy, education, marital status, ethnicity, chronic diseases). The correlation between the instruments was tested with Spearman's correlation test. Results: The SRH question showed a 38.5% prevalence of poor SRH and 44.2% prevalence with both VAS. The correlation between the VAS was 0.89, whereas the correlation between the VAS and the SRH question was 0.60-0.64. Nevertheless, the question used as the basis of each instrument was culturally sensitive and clear to all respondents. Analysis of the narratives shows that respondents clearly differentiated between the various health statuses. Conclusion: In this pilot, we developed and tested a new version of the SRH question that may be more culturally sensitive than its non-adapted equivalents. Additional insight into this population's understanding and reporting of health was also obtained. A larger sample is needed to further study the validity and reliability of the SRH question and the VAS and understand which instrument is best suited to study SRH in the low-income setting of semi-rural Burkina Faso.
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| 3. |
- Bunker, Aditi, et al.
(författare)
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Effects of Air Temperature on Climate-Sensitive Mortality and Morbidity Outcomes in the Elderly; a Systematic Review and Meta-analysis of Epidemiological Evidence
- 2016
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Ingår i: EBioMedicine. - : Elsevier BV. - 2352-3964. ; 6, s. 258-268
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Forskningsöversikt (refereegranskat)abstract
- Introduction: Climate change and rapid population ageing are significant public health challenges. Understanding which health problems are affected by temperature is important for preventing heat and cold-related deaths and illnesses, particularly in the elderly. Here we present a systematic review and meta-analysis on the effects of ambient hot and cold temperature (excluding heat/cold wave only studies) on elderly (65+ years) mortality and morbidity.Methods: Time-series or case-crossover studies comprising cause-specific cases of elderly mortality (n = 3,933,398) or morbidity (n = 12,157,782) were pooled to obtain a percent change (%) in risk for temperature exposure on cause-specific disease outcomes using a random-effects meta-analysis. Results: A 1 degrees C temperature rise increased cardiovascular (3.44%, 95% CI 3.10-3.78), respiratory (3.60%, 3.18-4.02), and cerebrovascular (1.40%, 0.06-2.75) mortality. A 1 degrees C temperature reduction increased respiratory (2.90%, 1.84-3.97) and cardiovascular (1.66%, 1.19-2.14) mortality. The greatest risk was associated with cold-induced pneumonia (6.89%, 20-12.99) and respiratory morbidity (4.93% 1.54-8.44). A 1 degrees C temperature rise increased cardiovascular, respiratory, diabetes mellitus, genitourinary, infectious disease and heat-related morbidity.Discussion: Elevated risks for the elderly were prominent for temperature-induced cerebrovascular, cardiovascular, diabetes, genitourinary, infectious disease, heat-related, and respiratory outcomes. These risks will likely increase with climate change and global ageing.
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| 4. |
- Bunker, Aditi, et al.
(författare)
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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
- 2017
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Ingår i: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 7:11
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Tidskriftsartikel (refereegranskat)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 degrees C (50th percentile) to 41.4 degrees C (90th percentile) resulted in 4.44 (95% CI 0.24 to 12.28) excess daily NCDYLL for all ages, rising to 7.39 (95% CI 0.32 to 24.62) at extreme temperature (42.8 degrees 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 degrees C compared with 36.4 degrees 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 degrees C vs 36.4 degrees 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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| 5. |
- Corvetto, Julia Feriato, et al.
(författare)
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Impact of heat on mental health emergency visits : a time series study from all public emergency centres, in Curitiba, Brazil
- 2023
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Ingår i: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 13:12
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Tidskriftsartikel (refereegranskat)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 (RR EDV) 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 RR EDV 1.03(95% CI 1.01 to 1.05 - single-lag 2), and cumulatively of RR EDV 1.15 (95% CI 1.05 to 1.26 - lag-cumulative 0-6). Strong risk was observed for patients with suicide attempts (RR EDV 1.85, 95% CI 1.08 to 3.16) and neurotic disorders (RR EDV 1.18, 95% CI 1.06 to 1.31). As to demographic subgroups, females (RR EDV 1.20, 95% CI 1.08 to 1.34) and patients aged 18-64 (RR EDV 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 (RR EDV 0.60, 95% CI 0.40 to 0.89), personality disorders (RR EDV 0.48, 95% CI 0.26 to 0.91) and MH in general in the elderly ≥65 (RR EDV 0.77, 95% CI 0.60 to 0.98). We found no significant RR EDV 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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| 6. |
- Corvetto, Julia F., et al.
(författare)
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Private vs. public emergency visits for mental health due to heat : an indirect socioeconomic assessment of heat vulnerability and healthcare access, in Curitiba, Brazil
- 2024
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Ingår i: Science of the Total Environment. - : Elsevier. - 0048-9697 .- 1879-1026. ; 934
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Tidskriftsartikel (refereegranskat)abstract
- Few studies have explored the influence of socioeconomic status (SES) on the heat vulnerability of mental health (MH) patients. As individual socioeconomic data was unavailable, we aimed to fill this gap by using the healthcare system type as a proxy for SES. Brazilian national statistics indicate that public patients have lower SES than private. Therefore, we compared the risk of emergency department visits (EDVs) for MH between patients from both healthcare types. EDVs for MH disorders from all nine public (101,452 visits) and one large private facility (154,954) in Curitiba were assessed (2017–2021). Daily mean temperature was gathered and weighed from 3 stations. Distributed-lag non-linear model with quasi-Poisson (maximum 10-lags) was used to assess the risk. We stratified by private and public, age, and gender under moderate and extreme heat. Additionally, we calculated the attributable fraction (AF), which translates individual risks into population-representative burdens – especially useful for public policies. Random-effects meta-regression pooled the risk estimates between healthcare systems. Public patients showed significant risks immediately as temperatures started to increase. Their cumulative relative risk (RR) of MH-EDV was 7.5 % higher than the private patients (Q-Test 26.2 %) under moderate heat, suggesting their particular heat vulnerability. Differently, private patients showed significant risks only under extreme heat, when their RR became 4.3 % higher than public (Q-Test 6.2 %). These findings suggest that private patients have a relatively greater adaptation capacity to heat. However, when faced with extreme heat, their current adaptation means were potentially insufficient, so they needed and could access healthcare freely, unlike their public counterparts. MH patients would benefit from measures to reduce heat vulnerability and access barriers, increasing equity between the healthcare systems in Brazil. AF of EDVs due to extreme heat was 0.33 % (95%CI 0.16;0.50) for the total sample (859 EDVs). This corroborates that such broad population-level policies are urgently needed as climate change progresses.
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| 7. |
- Dambach, Peter, et al.
(författare)
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Using high spatial resolution remote sensing for risk mapping of malaria occurrence in the Nouna district, Burkina Faso
- 2009
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Ingår i: Global Health Action. - : Co-action publishing. - 1654-9716 .- 1654-9880. ; 2, s. 149-155
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Malaria control measures such as early diagnosis and treatment, intermittent treatment of pregnant women, impregnated bed nets, indoor spraying and larval control measures are difficult to target specifically because of imprecise estimates of risk at a small-scale level. Ways of estimating local risks for malaria are therefore important.Methods: A high-resolution satellite view from the SPOT 5 satellite during 2008 was used to generate a land cover classification in the malaria endemic lowland of North-Western Burkina Faso. For the area of a complete satellite view of 60 x 60 km, a supervised land cover classification was carried out. Ten classes were built and correlated to land cover types known for acting as Anopheles mosquito breeding sites.Results: According to known correlations of Anopheles larvae presence and surface water-related land cover, cultivated areas in the riverine vicinity of Kossi River were shown to be one of the most favourable sites for Anopheles production. Similar conditions prevail in the South of the study region, where clayey soils and higher precipitations benefit the occurrence of surface water. Besides pools, which are often directly detectable, rice fields and occasionally flooded crops represent most appropriate habitats. On the other hand, forests, elevated regions on porous soils, grasslands and the dryer, sandy soils in the north-western part turned out to deliver fewer mosquito breeding opportunities.Conclusions: Potential high and low risks for malaria at the village level can be differentiated from satellite data. While much remains to be done in terms of establishing correlations between remotely sensed risks and malaria disease patterns, this is a potentially useful approach which could lead to more focused disease control programmes.
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| 8. |
- Dambach, Peter, et al.
(författare)
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Utilization of combined remote sensing techniques to detect environmental variables influencing malaria vector densities in rural West Africa
- 2012
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Ingår i: International Journal of Health Geographics. - London : BioMed Central (BMC). - 1476-072X. ; 11, s. 8-
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: The use of remote sensing has found its way into the field of epidemiology within the last decades. With the increased sensor resolution of recent and future satellites new possibilities emerge for high resolution risk modeling and risk mapping. Methods: A SPOT 5 satellite image, taken during the rainy season 2009 was used for calculating indices by combining the image's spectral bands. Besides the widely used Normalized Difference Vegetation Index (NDVI) other indices were tested for significant correlation against field observations. Multiple steps, including the detection of surface water, its breeding appropriateness for Anopheles and modeling of vector imagines abundance, were performed. Data collection on larvae, adult vectors and geographic parameters in the field, was amended by using remote sensing techniques to gather data on altitude (Digital Elevation Model = DEM), precipitation (Tropical Rainfall Measurement Mission = TRMM), land surface temperatures (LST). Results: The DEM derived altitude as well as indices calculations combining the satellite's spectral bands (NDTI = Normalized Difference Turbidity Index, NDWI Mac Feeters = Normalized Difference Water Index) turned out to be reliable indicators for surface water in the local geographic setting. While Anopheles larvae abundance in habitats is driven by multiple, interconnected factors - amongst which the NDVI - and precipitation events, the presence of vector imagines was found to be correlated negatively to remotely sensed LST and positively to the cumulated amount of rainfall in the preceding 15 days and to the Normalized Difference Pond Index (NDPI) within the 500 m buffer zone around capture points. Conclusions: Remotely sensed geographical and meteorological factors, including precipitations, temperature, as well as vegetation, humidity and land cover indicators could be used as explanatory variables for surface water presence, larval development and imagines densities. This modeling approach based on remotely sensed information is potentially useful for counter measures that are putting on at the environmental side, namely vector larvae control via larviciding and water body reforming.
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| 9. |
- Diboulo, Eric, et al.
(författare)
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Weather and mortality : a 10 year retrospective analysis of the Nouna Health and Demographic Surveillance System, Burkina Faso
- 2012
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Ingår i: Global Health Action. - : Informa UK Limited. - 1654-9716 .- 1654-9880. ; 5, s. 19078-
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Tidskriftsartikel (refereegranskat)abstract
- Background: A growing body of evidence points to the emission of greenhouse gases from human activity as a key factor in climate change. This in turn affects human health and wellbeing through consequential changes in weather extremes. At present, little is known about the effects of weather on the health of sub-Saharan African populations, as well as the related anticipated effects of climate change partly due to scarcity of good quality data. We aimed to study the association between weather patterns and daily mortality in the Nouna Health and Demographic Surveillance System (HDSS) area during 1999-2009. Methods: Meteorological data were obtained from a nearby weather station in the Nouna HDSS area and linked to mortality data on a daily basis. Time series Poisson regression models were established to estimate the association between the lags of weather and daily population-level mortality, adjusting for time trends. The analyses were stratified by age and sex to study differential population susceptibility. Results: We found profound associations between higher temperature and daily mortality in the Nouna HDSS, Burkina Faso. The short-term direct heat effect was particularly strong on the under-five child mortality rate. We also found independent coherent effects and strong associations between rainfall events and daily mortality, particularly in elderly populations. Conclusion: Mortality patterns in the Nouna HDSS appear to be closely related to weather conditions. Further investigation on cause-specific mortality, as well as on vulnerability and susceptibility is required. Studies on local adaptation and mitigation measures to avoid health impacts from weather and climate change is also needed to reduce negative effects from weather and climate change on population health in rural areas of the sub-Saharan Africa.
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| 10. |
- Dubouis, Ghislain, et al.
(författare)
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It starts at home? Climate policies targeting household consumption and behavioral decisions are key to low-carbon futures
- 2019
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Ingår i: Energy Research & Social Science. - : Elsevier. - 2214-6296 .- 2214-6326. ; 52, s. 144-158
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Tidskriftsartikel (refereegranskat)abstract
- Through their consumption behavior, households are responsible for 72% of global greenhouse gas emissions. Thus, they are key actors in reaching the 1.5°C goal under the Paris Agreement. However, the possible contribution and position of households in climate policies is neither well understood, nor do households receive sufficiently high priority in current climate policy strategies. This paper investigates how behavioral change can achieve a substantial reduction in greenhouse gas emissions in European high-income countries. It uses theoretical thinking and some core results from the HOPE research project, which investigated household preferences for reducing emissions in four European cities in France, Germany, Norway and Sweden. The paper makes five major points: First, car and plane mobility, meat and dairy consumption, as well as heating are the most dominant components of household footprints. Second, household living situations (demographics, size of home) greatly influence the household potential to reduce their footprint, even more than country or city location. Third, household decisions can be sequential and temporally dynamic, shifting through different phases such as childhood, adulthood, and illness. Fourth, short term voluntary efforts will not be sufficient by themselves to achieve the drastic reductions needed to achieve the 1.5°C goal; instead, households need a regulatory framework supporting their behavioral changes. Fifth, there is a mismatch between the roles and responsibilities conveyed by current climate policies and household perceptions of responsibility. We then conclude with further recommendations for research and policy.
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| 11. |
- Evengård, Birgitta, 1952-, et al.
(författare)
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Climate change influences infectious diseases both in the Arctic and the tropics : joining the dots
- 2009
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Ingår i: Global Health Action. - : Informa UK Limited. - 1654-9716 .- 1654-9880. ; 2
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Tidskriftsartikel (refereegranskat)abstract
- Climate change is incontestably a phenomenon of global causes and impacts. However, as much as the contribution of different regions and countries to climate change differs, as much differ the impacts. This paper examines the current and potential impact of climate change on infectious diseases in regions that could not be more different: the Arctic and the tropics (The Arctic is the area north of the Arctic Circle (66.6°N), while the tropics lie between the Tropic of Cancer (23.4°N) and the Tropic of Capricorn (23.4°S)). Despite obvious differences in environmental and socio-economic contexts, there are commonalities between these areas, both in the mechanisms through which climate change influences disease transmission and in the adaptation responses health systems can and should mount. We hope that the lessons in this comparison can be distilled both by policy makers and researchers in both regions. The purpose of this article is ‘to join the dots’ and thus stimulate discussion. Inevitably, the different dots (issues) themselves cannot be elaborated on in detail here. For this, we refer the interested reader to a wide-ranging list of references.
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| 12. |
- Herrmann, Alina, et al.
(författare)
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Household preferences for reducing greenhouse gas emissions in four European high-income countries : Does health information matter? A mixed-methods study protocol
- 2017
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 18
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Tidskriftsartikel (refereegranskat)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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| 13. |
- Herrmann, Alina, et al.
(författare)
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The Role of Health in Households' Balancing Act for Lifestyles Compatible with the Paris Agreement : Qualitative Results from Mannheim, Germany
- 2020
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 17:4
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Tidskriftsartikel (refereegranskat)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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| 14. |
- Hii, Yien Ling, 1962-
(författare)
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Climate and dengue fever : early warning based on temperature and rainfall
- 2013
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Dengue is a viral infectious disease that is transmitted by mosquitoes. The disease causes a significant health burden in tropical countries, and has been a public health burden in Singapore for several decades. Severe complications such as hemorrhage can develop and lead to fatal outcomes. Before tetravalent vaccine and drugs are available, vector control is the key component to control dengue transmission. Vector control activities need to be guided by surveillance of outbreak and implement timely action to suppress dengue transmission and limit the risk of further spread. This study aims to explore the feasibility of developing a dengue early warning system using temperature and rainfall as main predictors. The objectives were to 1) analyze the relationship between dengue cases and weather predictors, 2) identify the optimal lead time required for a dengue early warning, 3) develop forecasting models, and 4) translate forecasts to dengue risk indices.Methods: Poisson multivariate regression models were established to analyze relative risks of dengue corresponding to each unit change of weekly mean temperature and cumulative rainfall at lag of 1-20 weeks. Duration of vector control for localized outbreaks was analyzed to identify the time required by local authority to respond to an early warning. Then, dengue forecasting models were developed using Poisson multivariate regression. Autoregression, trend, and seasonality were considered in the models to account for risk factors other than temperature and rainfall. Model selection and validation were performed using various statistical methods. Forecast precision was analyzed using cross-validation, Receiver Operating Characteristics curve, and root mean square errors. Finally, forecasts were translated into stratified dengue risk indices in time series formats.Results: Findings showed weekly mean temperature and cumulative rainfall preceded higher relative risk of dengue by 9-16 weeks and that a forecast with at least 3 months would provide sufficient time for mitigation in Singapore. Results showed possibility of predicting dengue cases 1-16 weeks using temperature and rainfall; whereas, consideration of autoregression and trend further enhance forecast precision. Sensitivity analysis showed the forecasting models could detect outbreak and non-outbreak at above 90% with less than 20% false positive. Forecasts were translated into stratified dengue risk indices using color codes and indices ranging from 1-10 in calendar or time sequence formats. Simplified risk indices interpreted forecast according to annual alert and outbreak thresholds; thus, provided uniform interpretation.Significance: A prediction model was developed that forecasted a prognosis of dengue up to 16 weeks in advance with sufficient accuracy. Such a prognosis can be used as an early warning to enhance evidence-based decision making and effective use of public health resources as well as improved effectiveness of dengue surveillance and control. Simple and clear dengue risk indices improve communications to stakeholders.
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| 15. |
- Hii, Yien Ling, 1962-, et al.
(författare)
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Climate variability and increase in intensity and magnitude of dengue incidence in Singapore
- 2009
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Ingår i: Global Health Action. - : CoAction Publishing. - 1654-9716 .- 1654-9880. ; 2, s. 124-132
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Dengue is currently a major public health burden in Asia Pacific Region. This study aims to establish an association between dengue incidence, mean temperature and precipitation, and further discuss how weather predictors influence the increase in intensity and magnitude of dengue in Singapore during the period 2000-2007.MATERIALS AND METHODS: Weekly dengue incidence data, daily mean temperature and precipitation and the midyear population data in Singapore during 2000-2007 were retrieved and analysed. We employed a time series Poisson regression model including time factors such as time trends, lagged terms of weather predictors, considered autocorrelation, and accounted for changes in population size by offsetting.RESULTS: The weekly mean temperature and cumulative precipitation were statistically significant related to the increases of dengue incidence in Singapore. Our findings showed that dengue incidence increased linearly at time lag of 5-16 and 5-20 weeks succeeding elevated temperature and precipitation, respectively. However, negative association occurred at lag week 17-20 with low weekly mean temperature as well as lag week 1-4 and 17-20 with low cumulative precipitation.DISCUSSION: As Singapore experienced higher weekly mean temperature and cumulative precipitation in the years 2004-2007, our results signified hazardous impacts of climate factors on the increase in intensity and magnitude of dengue cases. The ongoing global climate change might potentially increase the burden of dengue fever infection in near future.
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| 16. |
- Ingole, Vijendra, 1984-
(författare)
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Too Hot! : an Epidemiological Investigation of Weather-Related Mortality in Rural India
- 2016
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- BackgroundMost environmental epidemiological studies are conducted in high income settings. The association between ambient temperature and mortality has been studied worldwide, especially in developed countries. However, more research on the topic is necessary, particularly in India, given the limited evidence on the relationship between temperature and health in this country. The average global temperature is increasing, and it is estimated that it will go up further. The factors affecting vulnerability to heat-related mortality are not well studied. Therefore, identifying high-risk population subgroups is of particular importance given the rising temperature in India.ObjectivesThis research aimed to investigate the association of daily mean temperature and rainfall with daily deaths (Paper I), examine the relationship of hot and cold days with total and cause-specific mortality (Paper II), assess the effects of heat and cold on daily mortality among different socio-demographic groups (Paper III) and estimate the effect of maximum temperature on years of life lost (Paper IV).MethodsThe Vadu Health and Demographic Surveillance System (HDSS) monitors daily deaths, births, in-out migration and other demographic trends in 22 villages from two administrative blocks in the rural Pune district of Maharashtra state, in western India. Daily deaths from Vadu HDSS and daily weather data (temperature and rainfall) from the Indian Meteorological Department were collected from 2003 through 2013. Verbal autopsy data were used to define causes of death and classified into four groups: non-infectious diseases, infectious diseases, external causes and unspecified causes of death. Socio-demographic groups were based on education, occupation, house type and land ownership. In all papers, time series regression models were applied as the basic approach; additionally, in Paper III, a case-crossover design and, in Paper IV, a distributed lag non-linear model (DLNM) were used.ResultsThere was a significant association between daily temperature and mortality. Younger age groups (0-4 years) reported higher risk of mortality due to high and low temperature and heavy rainfall. In the working age group (20-59 years), mortality was significantly associated only with high temperature. Mortality due to non-infectious diseases was higher on hot days (>39°C), while mortality from infectious diseases and from external causes were not associated with hot or cold days. A higher heat-related total mortality was observed among men than in women. Mortality among residents with low education and those whose occupation was farming was associated with high temperature. We found a significant impact of high temperature on years of life lost, which confirms our results from the previous research (Papers I-III).ConclusionThe study findings broadened our knowledge of the health impacts of environmental exposure by providing evidence on the risks related to ambient temperature in a rural population in India. More specifically, the study identified vulnerable population groups (working age groups, those of low education and farmers) in relation to high temperature. The adverse effect of heat on population is preventable if local human and technical capacities for risk communication and promoting adaptive behavior are built. Furthermore, it is necessary to increase residents’ awareness and prevention measures to tackle this public health challenge in rural populations.
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| 19. |
- Parmar, Divya, et al.
(författare)
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Does community-based health insurance protect household assets? Evidence from rural Africa
- 2012
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Ingår i: Health Services Research. - : Wiley. - 0017-9124 .- 1475-6773. ; 47:2, s. 819-839
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To evaluate whether community-based health insurance (CBHI) protects household assets in rural Burkina Faso, Africa. DATA SOURCES: Data were used from a household panel survey that collected primary data from randomly selected households, covering 41 villages and one town, during 2004-2007(n = 890). STUDY DESIGN: The study area was divided into 33 clusters and CBHI was randomly offered to these clusters during 2004-2006. We applied different strategies to control for selection bias-ordinary least squares with covariates, two-stage least squares with instrumental variable, and fixed-effects models. DATA COLLECTION: Household members were interviewed in their local language every year, and information was collected on demographic and socio-economic indicators including ownership of assets, and on self-reported morbidity. PRINCIPAL FINDINGS: Fixed-effects and ordinary least squares models showed that CBHI protected household assets during 2004-2007. The two-stage least squares with instrumental variable model showed that CBHI increased household assets during 2004-2005. CONCLUSIONS: In this study, we found that CBHI has the potential to not only protect household assets but also increase household assets. However, similar studies from developing countries that evaluate the impact of health insurance on household economic indicators are needed to benchmark these results with other settings.
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- Pokhrel, Subhash, et al.
(författare)
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Illness reporting and demand for medical care in rural Burkina Faso
- 2010
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Ingår i: Social Science and Medicine. - : Elsevier BV. - 0277-9536 .- 1873-5347. ; 70:11, s. 1693-1700
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Tidskriftsartikel (refereegranskat)abstract
- The issue of illness reporting in modelling demand for health care in low- and middle-income countries can be handled according to either of two conceptually-different constructs: (a) considering illness reporting behaviour as endogenous to demand; or (b) considering demand itself as the outcome of a sample selection phenomenon. In this paper, we take the second viewpoint and estimate the demand for medical care with an estimator that uses Heckman-type. Empirical estimates based on household survey data from rural Burkina Faso suggest that there are some implications of illness reporting behaviour for modelling the demand for medical care.
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| 21. |
- Robyn, Paul Jacob, et al.
(författare)
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Econometric analysis to evaluate the effect of community-based health insurance on reducing informal self-care in Burkina Faso
- 2012
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Ingår i: Health Policy and Planning. - : Oxford University Press (OUP). - 0268-1080 .- 1460-2237. ; 27:2, s. 156-165
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE This study examines the role of community-based health insurance (CBHI) in influencing health-seeking behaviour in Burkina Faso, West Africa. Community-based health insurance was introduced in Nouna district, Burkina Faso, in 2004 with the goal to improve access to contracted providers based at primary- and secondary-level facilities. The paper specifically examines the effect of CBHI enrolment on reducing the prevalence of seeking modern and traditional methods of self-treatment as the first choice in care among the insured population. METHODS Three stages of analysis were adopted to measure this effect. First, propensity score matching was used to minimize the observed baseline differences between the insured and uninsured populations. Second, through matching the average treatment effect on the treated, the effect of insurance enrolment on health-seeking behaviour was estimated. Finally, multinomial logistic regression was applied to model demand for available health care options, including no treatment, traditional self-treatment, modern self-treatment, traditional healers and facility-based care. RESULTS For the first choice in care sought, there was no significant difference in the prevalence of self-treatment among the insured and uninsured populations, reaching over 55% for each group. When comparing the alternative option of no treatment, CBHI played no significant role in reducing the demand for self-care (either traditional or modern) or utilization of traditional healers, while it did significantly increase consumption of facility-based care. The average treatment effect on the treated was insignificant for traditional self-care, modern self-care and traditional healer, but was significant with a positive effect for use of facility care. Discussion While CBHI does have a positive impact on facility care utilization, its effect on reducing the prevalence of self-care is limited. The policy recommendations for improving the CBHI scheme's responsiveness to population health care demand should incorporate community-based initiatives that offer attractive and appropriate alternatives to self-care.
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| 23. |
- Sauerborn, Rainer, et al.
(författare)
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Climate change and natural disasters : integrating science and practice to protect health
- 2012
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Ingår i: Global Health Action. - : Informa UK Limited. - 1654-9716 .- 1654-9880. ; 5, s. 1-7
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Tidskriftsartikel (refereegranskat)abstract
- Background: Hydro-meteorological disasters are the focus of this paper. The authors examine, to which extent climate change increases their frequency and intensity. Methods: Review of IPCC-projections of climate-change related extreme weather events and related literature on health effects. Results: Projections show that climate change is likely to increase the frequency, intensity, duration, and spatial distribution of a range of extreme weather events over coming decades. Conclusions: There is a need for strengthened collaboration between climate scientists, the health researchers and policy-makers as well as the disaster community to jointly develop adaptation strategies to protect human.
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| 25. |
- Sié, Ali, et al.
(författare)
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The health and demographic surveillance system (HDSS) in Nouna, Burkina Faso, 1993-2007
- 2010
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Ingår i: Global Health Action. - : Informa UK Limited. - 1654-9716 .- 1654-9880. ; 3
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Tidskriftsartikel (refereegranskat)abstract
- The Nouna Health and Demographic Surveillance System (HDSS) is located in rural Burkina Faso and has existed since 1992. Currently, it has about 78,000 inhabitants. It is a member of the International Network for the Demographic Evaluation of Populations and Their Health in Developing Countries (INDEPTH), a global network of members who conducts longitudinal health and demographic evaluation of populations in low- and middle-income countries. The health facilities consist of one hospital and 13 basic health centres (locally known as CSPS). The Nouna HDSS has been used as a sampling frame for numerous studies in the fields of clinical research, epidemiology, health economics, and health systems research. In this paper we review some of the main findings, and we describe the effects that almost 20 years of health research activities have shown in the population in general and in terms of the perception, economic implications, and other indicators. Longitudinal data analyses show that childhood, as well as overall mortality, has significantly decreased over the observation period 1993-2007. The under-five mortality rate dropped from about 40 per 1,000 person-years in the mid-1990s to below 30 per 1,000 in 2007. Further efforts are needed to meet goal four of the Millennium Development Goals, which is to reduce the under-five mortality rate by two-thirds between 1990 and 2015.
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