Pub Date : 2024-12-01DOI: 10.1016/S2542-5196(24)00238-9
Alexander R Kaye MSc , Uri Obolski PhD , Lantao Sun PhD , William S Hart DPhil , Prof James W Hurrell PhD , Prof Michael J Tildesley PhD , Robin N Thompson PhD
Background
Aedes aegypti spread pathogens affecting humans, including dengue, Zika, and yellow fever viruses. Anthropogenic climate change is altering the spatial distribution of Ae aegypti and therefore the locations at risk of vector-borne disease. In addition to climate change, natural climate variability, resulting from internal atmospheric processes and interactions between climate system components (eg, atmosphere–land and atmosphere–ocean interactions), determines climate outcomes. However, the role of natural climate variability in modifying the effects of anthropogenic climate change on future environmental suitability for Ae aegypti has not been assessed fully. In this study, we aim to assess uncertainty arising from natural climate variability in projections of Ae aegypti suitability up to the year 2100.
Methods
In this mathematical modelling study, we developed an ecological model in which Ae aegypti population dynamics depend on climate variables (temperature and rainfall). We used 100 projections of future climate from the Community Earth System Model, a comprehensive climate model that simulates natural climate variability as well as anthropogenic climate change, in combination with our ecological model to generate a range of equally plausible scenarios describing the global distribution of suitable conditions for Ae aegypti up to 2100. Each of these scenarios corresponds to a single climate projection, allowing us to explore the difference in Ae aegypti suitability between the most-suitable and the least-suitable projections.
Findings
Our key finding was that natural climate variability generates substantial variation in future projections of environmental suitability for Ae aegypti. Even for projections generated under the same Shared Socioeconomic Pathway (SSP) scenario (SSP3–7.0), in 2100 climatic conditions in London might be suitable for Ae aegypti for 0–5 months of the year, depending on natural climate variability.
Interpretation
Natural climate variability affects environmental suitability for important disease vectors. Some regions could experience vector-borne disease outbreaks earlier than expected under climate change alone.
Funding
Engineering and Physical Sciences Research Council and Wellcome Trust.
背景：埃及伊蚊传播影响人类的病原体，包括登革热、寨卡病毒和黄热病病毒。人为的气候变化正在改变埃及伊蚊的空间分布，因此也改变了媒介传播疾病风险的地点。除气候变化外，由大气内部过程和气候系统组分之间的相互作用（如大气-陆地和大气-海洋相互作用）引起的自然气候变率也决定着气候结果。然而，自然气候变率在改变人为气候变化对埃及伊蚊未来环境适宜性的影响中的作用尚未得到充分评估。在这项研究中，我们的目标是评估由自然气候变化引起的埃及伊蚊适应性预测到2100年的不确定性。方法：在数学建模研究中，我们建立了一个埃及伊蚊种群动态依赖于气候变量（温度和降雨量）的生态模型。我们使用了来自社区地球系统模型（Community Earth System Model）的100个未来气候预测，这是一个模拟自然气候变化和人为气候变化的综合气候模型，结合我们的生态模型，生成了一系列同样可信的情景，描述了到2100年埃及伊蚊的全球适宜条件分布。这些情景中的每一个都对应于一个单一的气候预测，使我们能够探索埃及伊蚊在最适合和最不适合的预测之间的适应性差异。研究结果：我们的主要发现是，自然气候变率对埃及伊蚊未来的环境适应性预测产生了实质性的变化。即使在相同的共享社会经济路径（SSP）情景（SSP3-7.0）下生成的预测，2100年伦敦的气候条件可能在一年中0-5个月适合埃及伊蚊，这取决于自然气候的变化。解释：自然气候变率影响重要病媒的环境适宜性。仅在气候变化的情况下，一些地区可能比预期更早爆发病媒传播疾病。资助：工程与物理科学研究委员会和威康信托基金。
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Pub Date : 2024-12-01DOI: 10.1016/S2542-5196(24)00281-X
Benjamin Talbot PhD , Robert A Fletcher MSc , Prof Bruce Neal PhD , Megumi Oshima PhD , Fiona Adshead MSc , Keith Moore MSc , Forbes McGain PhD , Scott McAlister PhD , Katherine A Barraclough PhD , Prof John Knight MBBS , Brendon L Neuen PhD , Clare Arnott PhD
<div><h3>Background</h3><div>The health-care sector is responsible for 5·2% of global emissions, however, little data exist regarding the environmental impact of disease management strategies. SGLT2 inhibitors are now widely used to reduce the risk of hospital admission and kidney failure in people with type 2 diabetes and chronic kidney disease. This study aimed to estimate the impact of SGLT2 inhibitors on greenhouse gas emissions using data from the CREDENCE trial.</div></div><div><h3>Methods</h3><div>For this modelling analysis, we used data from the randomised, double-blind, placebo-controlled, CREDENCE trial, which compared the effect of canagliflozin versus placebo on kidney and cardiovascular outcomes in patients with type 2 diabetes and albuminuric chronic kidney disease. For this secondary analysis, we included all participants randomly assigned to canagliflozin or placebo at baseline in the CREDENCE trial. Data on greenhouse gas emissions resulting from hospital inpatient days, maintenance dialysis therapy, and SGLT2 inhibitor tablet production were derived from published reports and used to model greenhouse gas emissions from total number of hospital inpatient days, total number of days of maintenance dialysis therapy, and from SGLT2 inhibitor treatment over the course of the CREDENCE trial. We compared greenhouse gas emission estimates for participants in the canagliflozin group and placebo group of the CREDENCE trial. We used bootstrapping analyses to calculate uncertainty estimates and permutation tests to generate p values for the difference in number of days on dialysis and inpatient bed days between treatment groups.</div></div><div><h3>Findings</h3><div>4401 participants who were randomly assigned to the canagliflozin (n=2202) or placebo group (n=2199) were included in the secondary analyses. During a median follow-up of 2·62 years (IQR 0·02 to 4·53), SGLT2 inhibitor production for 2202 participants resulted in greenhouse gas emissions of 63 tonnes of CO<sub>2</sub> equivalent (CO<sub>2</sub>e; 95% CI 62 to 64). The total number of inpatient bed days was 17 002 days in the placebo group versus 13 672 days in the canagliflozin group; the 3330 fewer inpatient days (95% CI 1037 to 5686; p=0·042) with SGLT2 inhibitor treatment equated to a reduction of approximately 126 tonnes of CO<sub>2</sub>e (95% CI 39 to 216). Participants in the placebo group required 24 877 days of maintenance dialysis compared with 16 605 days in the treatment group; 8272 fewer days of dialysis ( –168 to 16 755; p=0·16), equated to a reduction of 161 tonnes of CO<sub>2</sub>e (–3 to 327). Overall, mean greenhouse gas emissions per-participant-year were reduced from 196 kg of CO<sub>2</sub>e per-participant-year to 157 kg of CO<sub>2</sub>e per-participant-year.</div></div><div><h3>Interpretation</h3><div>The addition of an SGLT2 inhibitor to routine therapy for people with type 2 diabetes and chronic kidney disease has the potential to reduce greenhouse gas
背景：卫生保健部门的排放量占全球排放量的5.2%，然而，关于疾病管理战略对环境影响的数据很少。SGLT2抑制剂现在被广泛用于降低2型糖尿病和慢性肾脏疾病患者住院和肾衰竭的风险。本研究旨在利用CREDENCE试验的数据估计SGLT2抑制剂对温室气体排放的影响。方法：在建模分析中，我们使用了随机、双盲、安慰剂对照、CREDENCE试验的数据，该试验比较了卡格列净与安慰剂对2型糖尿病和蛋白尿慢性肾病患者肾脏和心血管结局的影响。在这一次要分析中，我们纳入了在CREDENCE试验基线时随机分配到卡格列净或安慰剂组的所有参与者。住院天数、维持性透析治疗和SGLT2抑制剂片剂生产导致的温室气体排放数据来自已发表的报告，并用于模拟CREDENCE试验过程中住院总天数、维持性透析治疗总天数和SGLT2抑制剂治疗产生的温室气体排放。我们比较了CREDENCE试验中卡格列净组和安慰剂组受试者的温室气体排放估计值。我们使用自举分析来计算不确定性估计值，并使用排列检验来生成治疗组之间透析天数和住院天数差异的p值。研究结果：4401名随机分配到canagliflozin组（n=2202）或安慰剂组（n=2199）的参与者被纳入二次分析。在中位随访2.62年（IQR 0.02至4.53）期间，2202名参与者的SGLT2抑制剂生产导致温室气体排放量为63吨二氧化碳当量(CO2e；95% CI 62 ~ 64)。安慰剂组的总住院天数为17 002天，而卡格列净组为13 672天；住院天数减少3330天(95%可信区间1037 - 5686；p= 0.042)， SGLT2抑制剂处理相当于减少约126吨二氧化碳当量（95% CI 39至216）。安慰剂组的参与者需要24877天的维持性透析，而治疗组为16605天；透析天数减少8272天(-168天至16755天；p= 0.16)，相当于减少了161吨二氧化碳当量（-3至327吨）。总体而言，每参与者年平均温室气体排放量从每参与者年196公斤二氧化碳当量减少到157公斤二氧化碳当量。结论：在2型糖尿病和慢性肾脏疾病患者的常规治疗中添加SGLT2抑制剂有可能通过预防住院和透析需求来减少温室气体排放。资金:没有。
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Pub Date : 2024-12-01DOI: 10.1016/S2542-5196(24)00277-8
Nicole Redvers ND , Felix Lockhart , John B Zoe , Rassi Nashalik , Denise McDonald , Gladys Norwegian , Jamie Hartmann-Boyce DPhil , Sarah Tonkin-Crine PhD
Indigenous Peoples and their knowledge systems are increasingly being looked to for solutions regarding climate change, including within clinical health-care settings. Indigenous Elders specifically are noted knowledge keepers within their communities and are often looked to with great respect for their Land-based knowledges as they pertain to planetary health approaches. We sought to explore the views of health-systems change informed by planetary health within the circumpolar north from the perspective of Indigenous Elders. We held a sharing circle, in which Elders identified four interconnected themes following a cyclical pattern that were also depicted with relational systems mapping, including the past and how we got here, where we are now, where we need to go in the future, and our reflections. Our findings showed that any concepts related to planetary health that are discussed within health systems cannot be disconnected from the context around them. Overall, health systems were stated to be currently devoid of any environmental context or consideration.
{"title":"Indigenous Elders' voices on health-systems change informed by planetary health: a qualitative and relational systems mapping inquiry","authors":"Nicole Redvers ND , Felix Lockhart , John B Zoe , Rassi Nashalik , Denise McDonald , Gladys Norwegian , Jamie Hartmann-Boyce DPhil , Sarah Tonkin-Crine PhD","doi":"10.1016/S2542-5196(24)00277-8","DOIUrl":"10.1016/S2542-5196(24)00277-8","url":null,"abstract":"<div><div>Indigenous Peoples and their knowledge systems are increasingly being looked to for solutions regarding climate change, including within clinical health-care settings. Indigenous Elders specifically are noted knowledge keepers within their communities and are often looked to with great respect for their Land-based knowledges as they pertain to planetary health approaches. We sought to explore the views of health-systems change informed by planetary health within the circumpolar north from the perspective of Indigenous Elders. We held a sharing circle, in which Elders identified four interconnected themes following a cyclical pattern that were also depicted with relational systems mapping, including the past and how we got here, where we are now, where we need to go in the future, and our reflections. Our findings showed that any concepts related to planetary health that are discussed within health systems cannot be disconnected from the context around them. Overall, health systems were stated to be currently devoid of any environmental context or consideration.</div></div>","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":"8 12","pages":"Pages e1106-e1117"},"PeriodicalIF":24.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01DOI: 10.1016/S2542-5196(24)00270-5
Kim Robin van Daalen PhD , Laura Jung MD , Sara Dada MSc , Razan Othman MBBS , Alanna Barrios-Ruiz MD , Grace Zurielle Malolos MD , Kai-Ti Wu MSc , Ana Garza-Salas MD , Salma El-Gamal MSc , Tarek Ezzine BMSc , Parnian Khorsand MPH , Arthur Wyns MSc , Blanca Paniello-Castillo MMSc , Sophie Gepp MD , Maisoon Chowdhury MPH , Ander Santamarta Zamorano MPH , Jess Beagley MSc , Clare Oliver-Williams PhD , Ramit Debnath PhD , Ronita Bardhan PhD , Prof Rachel Lowe PhD
Focusing specifically on the gender–climate–health nexus, this Personal View builds on existing feminist works and analyses to discuss why intersectional approaches to climate policy and inclusive representation in climate decision making are crucial for achieving just and equitable solutions to address the impacts of climate change on human health and societies. This Personal View highlights how women, girls, and gender-diverse people often face disproportionate climate-related health impacts, particularly those who experience compounding and overlapping vulnerabilities due to current and former systems of oppression. We summarise the insufficient meaningful inclusion of gender, health, and their intersection in international climate governance. Despite the tendency to conflate gender equality with number-based representation, climate governance under the UNFCCC (1995–2023) remains dominated by men, with several countries projected to take over a decade to achieve gender parity in their Party delegations. Advancing gender-responsiveness in climate policy and implementation and promoting equitable participation in climate governance will not only improve the inclusivity and effectiveness of national strategies, but will also build more resilient, equitable, and healthier societies.
{"title":"Bridging the gender, climate, and health gap: the road to COP29","authors":"Kim Robin van Daalen PhD , Laura Jung MD , Sara Dada MSc , Razan Othman MBBS , Alanna Barrios-Ruiz MD , Grace Zurielle Malolos MD , Kai-Ti Wu MSc , Ana Garza-Salas MD , Salma El-Gamal MSc , Tarek Ezzine BMSc , Parnian Khorsand MPH , Arthur Wyns MSc , Blanca Paniello-Castillo MMSc , Sophie Gepp MD , Maisoon Chowdhury MPH , Ander Santamarta Zamorano MPH , Jess Beagley MSc , Clare Oliver-Williams PhD , Ramit Debnath PhD , Ronita Bardhan PhD , Prof Rachel Lowe PhD","doi":"10.1016/S2542-5196(24)00270-5","DOIUrl":"10.1016/S2542-5196(24)00270-5","url":null,"abstract":"<div><div>Focusing specifically on the gender–climate–health nexus, this Personal View builds on existing feminist works and analyses to discuss why intersectional approaches to climate policy and inclusive representation in climate decision making are crucial for achieving just and equitable solutions to address the impacts of climate change on human health and societies. This Personal View highlights how women, girls, and gender-diverse people often face disproportionate climate-related health impacts, particularly those who experience compounding and overlapping vulnerabilities due to current and former systems of oppression. We summarise the insufficient meaningful inclusion of gender, health, and their intersection in international climate governance. Despite the tendency to conflate gender equality with number-based representation, climate governance under the UNFCCC (1995–2023) remains dominated by men, with several countries projected to take over a decade to achieve gender parity in their Party delegations. Advancing gender-responsiveness in climate policy and implementation and promoting equitable participation in climate governance will not only improve the inclusivity and effectiveness of national strategies, but will also build more resilient, equitable, and healthier societies.</div></div>","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":"8 12","pages":"Pages e1088-e1105"},"PeriodicalIF":24.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11634786/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01DOI: 10.1016/S2542-5196(24)00273-0
Bianca van Bavel PhD , Prof Lea Berrang-Ford PhD , Kelly Moon MSc , Fredrick Gudda PhD , Alexander J Thornton MSc , Rufus F S Robinson MSc , Prof Rebecca King PhD
Climate change and antimicrobial resistance (AMR) present crucial challenges for the health and wellbeing of people, animals, plants, and ecosystems worldwide, yet the two are largely treated as separate and unrelated challenges. The aim of this systematic scoping Review is to understand the nature of the growing evidence base linking AMR and climate change and to identify knowledge gaps and areas for further research. We conducted a systematic search of the peer-reviewed literature in Scopus, Web of Science, and PubMed on 27 June, 2022. Our search strategy identified and screened 1687 unique results. Data were extracted and analysed from 574 records meeting our inclusion criteria. 222 (39%) of these reviewed articles discussed harmful synergies in which both climate change and AMR exist independently and can interact synergistically, resulting in negative outcomes. Just over a quarter (n=163; 28%) of the literature contained general or broad references to AMR and climate change, whereas a fifth (n=111; 19%) of articles referred to climate change influencing the emergence and evolution of AMR. 12% of articles (n=70) presented positive synergies between approaches aimed at addressing climate change and interventions targeting the management and control of AMR. The remaining literature focused on the shared drivers of AMR and climate change, the trade-offs between climate actions that have unanticipated negative outcomes for AMR (or vice versa), and, finally, the pathways through which AMR can negatively influence climate change. Our findings indicate multiple intersections through which climate change and AMR can and do connect. Research in this area is still nascent, disciplinarily isolated, and only beginning to converge, with few documents primarily focused on the equal intersection of both topics. Greater empirical and evidence-based attention is needed to investigate knowledge gaps related to specific climate change hazards and antimicrobial resistant fungi, helminths, protists, and viruses.
气候变化和抗菌药物耐药性（AMR）对全球人类、动物、植物和生态系统的健康和福祉构成了严峻的挑战，但这两者在很大程度上被视为相互独立、互不相关的挑战。本系统性范围界定综述旨在了解将 AMR 与气候变化联系起来的不断增长的证据基础的性质，并确定知识差距和有待进一步研究的领域。我们于 2022 年 6 月 27 日在 Scopus、Web of Science 和 PubMed 上对同行评审文献进行了系统检索。我们的搜索策略识别并筛选了 1687 项独特的结果。我们从符合纳入标准的 574 条记录中提取并分析了数据。在这些综述文章中，有 222 篇（39%）讨论了有害的协同作用，其中气候变化和急性呼吸道感染既独立存在，又能协同作用，从而导致负面结果。略高于四分之一（n=163；28%）的文献一般性地或广泛地提到了AMR和气候变化，而五分之一（n=111；19%）的文章提到气候变化影响了AMR的出现和演变。12% 的文章（n=70）介绍了旨在应对气候变化的方法与针对管理和控制 AMR 的干预措施之间的积极协同作用。其余的文献则重点关注AMR和气候变化的共同驱动因素、对AMR产生意想不到的负面结果（或反之亦然）的气候行动之间的权衡，以及AMR可能对气候变化产生负面影响的途径。我们的研究结果表明，气候变化与 AMR 之间存在多种交叉联系。这一领域的研究仍处于起步阶段，在学科上是孤立的，而且刚刚开始融合，很少有文献主要关注这两个主题的平等交叉。需要更多地关注实证和循证研究，以调查与特定气候变化危害和抗微生物真菌、蠕虫、原生动物和病毒相关的知识差距。
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Pub Date : 2024-12-01DOI: 10.1016/S2542-5196(24)00284-5
Cecilia Sorensen MD , Danielly Magalhães PhD , Nicola Hamacher MPH , James K Sullivan MD , Hannah N W Weinstein BA , Ana-Catarina Pinho-Gomes DPhil , Dorothy Biberman MPH , Holly Donaldson MPH , Ingrid Gómez-Duarte PhD , John Middleton FFPH , Laura Magaña PhD , Manuel Urbina MPH , Prof Margaret Kaseje PhD , Nora Cascante-Flores PhD , Prof Rajendra Surenthirakumaran MD , Prof Rebecca Ivers PhD , Rocío Sáenz MPH , Tara Tai-Wen Chen MPH , Wendy Lopez BHS , Marina Romanello PhD , Ying Zhang PhD
<div><h3>Background</h3><div>Public health professionals are crucial in implementing health-promoting climate change adaptation and mitigation measures, yet climate education is inconsistently integrated into public health curricula worldwide. We aimed to assess the proportion of institutions that provided public health degrees with climate and health education, the annual number of students trained in climate and health, and the extent to which students had climate and health knowledge during 2023–24.</div></div><div><h3>Methods</h3><div>From Nov 1, 2023, to March 15, 2024, our online survey quantified climate and health education in public health schools that provide degrees across all WHO regions. The survey was available in English, Spanish, and Portuguese and distributed to Global Consortium on Climate and Health Education member institutions and organisations and the Global Network for Academic Public Health; institutions in 138 countries were invited to participate. We collected data on optional and mandatory training, enrolment in versus actual education on climate topics, degree programmes offering climate education, year of curriculum implementation, and the extent of training across eight competency domains. Instructions stated that the survey should be completed by school staff who designed, taught, or were familiar with climate or planetary health content and curricula within their institution. Two follow-up reminder emails were sent to institutions that had not completed the survey on Jan 13, 2024, and Feb 15, 2024. We also measured the presence of climate education among randomly selected non-responding institutions through internet searches for evidence of a class or a concentration from June 1 to July 25, 2024.</div></div><div><h3>Findings</h3><div>The survey was sent to 1251 public health institutions across 138 countries; we received responses from 279 (22%) of 1251 institutions in 81 (59%) of 138 countries. Most institutions that we invited were in the WHO region of the Americas (n=776), the African region (n=177), and the European region (n=155). 196 (70%) of 279 responding institutions and 62 (77%) of 81 responding countries reported providing climate and health education during 2023–24. The number of responding institutions providing climate and health education was 53 (80%) of 66 in the European region, 21 (72%) of 29 in the Western Pacific region, five (71%) of seven in the South-East Asia region, 97 (68%) of 143 in the region of the Americas, 15 (63%) of 24 in the African region, and five (50%) of ten in the Eastern Mediterranean region. 298 degree-level public health programmes were identified during 2023–24, of which 171 (57%) reported that climate and health education was part of the required curriculum. Master's degree programmes provided the most climate and health education (118 [40%] of 298 degree-level programmes identified). A search of 135 additional non-responding institutions indicated that 36 (27%) likely of
{"title":"Climate and health education in public health schools worldwide during 2023–24: a survey","authors":"Cecilia Sorensen MD , Danielly Magalhães PhD , Nicola Hamacher MPH , James K Sullivan MD , Hannah N W Weinstein BA , Ana-Catarina Pinho-Gomes DPhil , Dorothy Biberman MPH , Holly Donaldson MPH , Ingrid Gómez-Duarte PhD , John Middleton FFPH , Laura Magaña PhD , Manuel Urbina MPH , Prof Margaret Kaseje PhD , Nora Cascante-Flores PhD , Prof Rajendra Surenthirakumaran MD , Prof Rebecca Ivers PhD , Rocío Sáenz MPH , Tara Tai-Wen Chen MPH , Wendy Lopez BHS , Marina Romanello PhD , Ying Zhang PhD","doi":"10.1016/S2542-5196(24)00284-5","DOIUrl":"10.1016/S2542-5196(24)00284-5","url":null,"abstract":"<div><h3>Background</h3><div>Public health professionals are crucial in implementing health-promoting climate change adaptation and mitigation measures, yet climate education is inconsistently integrated into public health curricula worldwide. We aimed to assess the proportion of institutions that provided public health degrees with climate and health education, the annual number of students trained in climate and health, and the extent to which students had climate and health knowledge during 2023–24.</div></div><div><h3>Methods</h3><div>From Nov 1, 2023, to March 15, 2024, our online survey quantified climate and health education in public health schools that provide degrees across all WHO regions. The survey was available in English, Spanish, and Portuguese and distributed to Global Consortium on Climate and Health Education member institutions and organisations and the Global Network for Academic Public Health; institutions in 138 countries were invited to participate. We collected data on optional and mandatory training, enrolment in versus actual education on climate topics, degree programmes offering climate education, year of curriculum implementation, and the extent of training across eight competency domains. Instructions stated that the survey should be completed by school staff who designed, taught, or were familiar with climate or planetary health content and curricula within their institution. Two follow-up reminder emails were sent to institutions that had not completed the survey on Jan 13, 2024, and Feb 15, 2024. We also measured the presence of climate education among randomly selected non-responding institutions through internet searches for evidence of a class or a concentration from June 1 to July 25, 2024.</div></div><div><h3>Findings</h3><div>The survey was sent to 1251 public health institutions across 138 countries; we received responses from 279 (22%) of 1251 institutions in 81 (59%) of 138 countries. Most institutions that we invited were in the WHO region of the Americas (n=776), the African region (n=177), and the European region (n=155). 196 (70%) of 279 responding institutions and 62 (77%) of 81 responding countries reported providing climate and health education during 2023–24. The number of responding institutions providing climate and health education was 53 (80%) of 66 in the European region, 21 (72%) of 29 in the Western Pacific region, five (71%) of seven in the South-East Asia region, 97 (68%) of 143 in the region of the Americas, 15 (63%) of 24 in the African region, and five (50%) of ten in the Eastern Mediterranean region. 298 degree-level public health programmes were identified during 2023–24, of which 171 (57%) reported that climate and health education was part of the required curriculum. Master's degree programmes provided the most climate and health education (118 [40%] of 298 degree-level programmes identified). A search of 135 additional non-responding institutions indicated that 36 (27%) likely of","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":"8 12","pages":"Pages e1010-e1019"},"PeriodicalIF":24.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01DOI: 10.1016/S2542-5196(24)00272-9
Jenicca Poongavanan MSc , José Lourenço PhD , Joseph L-H Tsui MSc , Vittoria Colizza PhD , Yajna Ramphal BSc , Cheryl Baxter PhD , Prof Moritz U G Kraemer PhD , Marcel Dunaiski PhD , Prof Tulio de Oliveira PhD , Houriiyah Tegally PhD
Background
Dengue is a significant global public health concern that poses a threat in Africa. Particularly, African countries are at risk of viral introductions through air travel connectivity with areas of South America and Asia in which explosive dengue outbreaks frequently occur. Limited reporting and diagnostic capacity hinder a comprehensive assessment of continent-wide transmission dynamics and deployment of surveillance strategies in Africa. In this study, we aimed to identify African airports at high risk of receiving passengers with dengue from Asia, Latin America, and other African countries with high dengue incidence.
Methods
For this modelling study, air travel flow data were obtained from the International Air Transport Association database for 2019. Data comprised monthly passenger volumes from 14 high-incidence countries outside of Africa and 18 countries within the African continent that reported dengue outbreaks in the past 10 years to 54 African countries, encompassing all 197 commercial airports in both the source and destination regions. The risk of dengue introduction into Africa from countries of high incidence in Asia, Latin America, and within Africa was estimated based on origin–destination air travel flows and epidemic activity at origin. We produced a novel proxy for local dengue epidemic activity using a composite index of theoretical climate-driven transmission suitability and population density, which we used, in addition to travel information in a risk flow model, to estimate importation risk.
Findings
Countries in eastern Africa had a high estimated risk of dengue importation from Asia and other east African countries, whereas for west African countries, the risk of importation was higher from within the region than from countries outside of Africa. Some countries with high risk of importation had low local transmission suitability, which is likely to hamper the risk that dengue importations would lead to local transmission and establishment of a dengue outbreak. Mauritius, Uganda, Côte d'Ivoire, Senegal, and Kenya were identified as countries susceptible to dengue introductions during periods of persistent transmission suitability.
Interpretation
Our study improves data-driven allocation of surveillance resources, in regions of Africa that are at high risk of dengue introduction and establishment, including from regional circulation. Improvements in resource allocation will be crucial in detecting and managing imported cases and could improve local responses to dengue outbreaks.
Funding
Rockefeller Foundation, National Institute of Health, EDCTP3 and Horizon Europe Research and Innovation, World Bank Group, Medical Research Foundation, Wellcome Trust, Google, Oxford Martin School Pandemic Genomics programme, and John Fell Fund.
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