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Disentangling associations between vegetation greenness and dengue in a Latin American city: Findings and challenges.

ABSTRACT: Being a Re-Emerging Infectious Disease, dengue causes 390 million cases globally and is prevalent in many urban areas in South America. Understanding the fine-scale relationships between dengue incidence and environmental and socioeconomic factors can guide improved disease prevention strategies. This ecological study examines the association between dengue incidence and satellite-based vegetation greenness in 3826 census tracts nested in 474 neighborhoods in Belo Horizonte, Brazil, during the 2010 dengue epidemic. To reduce potential bias in the estimated dengue-greenness association, we adjusted for socioeconomic vulnerability, population density, building height and density, land cover composition, elevation, weather patterns, and neighborhood random effects. We found that vegetation greenness was negatively associated with dengue incidence in a univariate model, and this association attenuated after controlling for additional covariates. The dengue-greenness association was modified by socioeconomic vulnerability: while a positive association was observed in the least vulnerable census tracts, the association was negative in the most vulnerable areas. Using greenness as a proxy for vegetation quality, our results show the potential of vegetation management in reducing dengue incidence, particularly in socioeconomically vulnerable areas. We also discuss the role of water infrastructure, sanitation services, and tree cover in lowering dengue risk.

SUBMITTER: Cunha MDCM

PROVIDER: S-EPMC8519391 | biostudies-literature | 2021 Dec

REPOSITORIES: biostudies-literature

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Disentangling associations between vegetation greenness and dengue in a Latin American city: Findings and challenges.

Cunha Maria da Consolação Magalhães MDCM Ju Yang Y Morais Maria Helena Franco MHF Dronova Iryna I Ribeiro Sérvio Pontes SP Bruhn Fábio Raphael Pascoti FRP Lima Larissa Lopes LL Sales Denise Marques DM Schultes Olivia Lang OL Rodriguez Daniel A DA Caiaffa Waleska Teixeira WT

Landscape and urban planning 20211201

Being a Re-Emerging Infectious Disease, dengue causes 390 million cases globally and is prevalent in many urban areas in South America. Understanding the fine-scale relationships between dengue incidence and environmental and socioeconomic factors can guide improved disease prevention strategies. This ecological study examines the association between dengue incidence and satellite-based vegetation greenness in 3826 census tracts nested in 474 neighborhoods in Belo Horizonte, Brazil, during the 2 ...[more]

PMID: 34675450

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Project description:INTRODUCTION:Dengue is an escalating public health concern in Latin American Countries with a dramatic increase of cases reported during the past decade. The objectives of this study were to identify and provide insights into current management and attitudes toward dengue and to understand attitudes to vaccination and current behaviors to prevent dengue in Mexico and Colombia. METHODS:This was a community-based, cross-sectional, descriptive study conducted in urban and rural areas in endemic and non-endemic regions. The interviews were conducted face-to-face using a structured questionnaire containing 58 questions. A quota sampling approach was used to obtain a nationally representative sample of the adult population. All data were weighted to correct for differences between the samples surveyed in each country relative to their general population. RESULTS:A total of 1978 participants completed the survey. Two percent and 10% of participants in Mexico and Colombia, respectively, had experienced dengue fever, with just under one-third of adults and almost two-thirds of their children hospitalized as a result of the illness. Awareness of dengue was similar in Colombia (76%) and Mexico (68%), with awareness higher in endemic regions than in non-endemic regions. Colombia had a higher proportion of participants (84%) who considered dengue to be a common disease in their country, compared with Mexico (56%). In Mexico and Colombia, 55% and 54% in endemic areas, and 28% and 46% in non-endemic areas believed that everyone was at risk of contracting dengue. In both countries, the most common action undertaken by participants to prevent dengue infection was removal of standing water. At least 70% of participants believe their government could do more to prevent dengue in their country. CONCLUSIONS:Dengue was identified as a severe and common disease in Mexico and Colombia. Most participants recognized the need to reduce the risk of dengue infection by removal of standing water. Awareness was similar in Colombia and Mexico.

Project description:BackgroundStudies have shown that more than 50% of the antibiotics used in hospitals are unnecessary or inappropriate and, that antimicrobial resistance may cost up to 20 billion USD in excess medical costs each year. On the other hand, Antimicrobial Stewardship Programs (ASP) significantly reduce inappropriate antimicrobial use, emergence of antimicrobial resistance, healthcare associated infections, and costs in hospital settings.ObjectiveTo evaluate the development of ASP and antibiotic savings in 7 Latin American hospitals using standardized quantitative indicators in all the participating health care institutions.MethodsAn interventional study was conducted, where pre- and post- evaluations were performed using a standardized score tool adapted from the Joint Commission International accreditation standards and, the Colombian Institute of Technical Standards and Certification. We evaluated ASP from 7 Latin American hospitals between 2019 and 2020. A pre-intervention evaluation was done in each hospital to quantify the degree of development of the ASP (ASP Development score). Based on these results, tailored on-site training was implemented in each hospital, followed by a post-intervention evaluation to quantify improvement of ASP-development indicators. In addition, monetary savings in antimicrobials derived from the ASP intervention were estimated.ResultsIn the pre-intervention evaluation, the average ASP development score for the 7 institutions was 65.8% (40-94.3%). The items with the lowest development score were those related to monitoring and communicating the ASP progress and success. For the post-intervention evaluation, 2 institutions couldn't participate due to the pressure imposed by the COVID-19 pandemic. For the remaining 5/7 hospitals, the average ASP development score was 82.3% with an increase of 12.0% when compared to the pre-intervention measurement of the same institutions (average pre-intervention score 70.3% (48.2%-94.3%) The items with a significant increase were key performance indicators, AMS education and training of the prescribers. Three of the seven (3/7) hospitals reported antibiotic monetary savings associated to the ASP intervention.ConclusionsThe use of the tool described shown to be useful to evaluate specific areas of ASP-development that were lacking and tailor interventions for the participating hospitals, consequently, it helped improve ASP-development in the institutions that underwent pre- intervention and post-intervention analysis. In addition, the strategies showed monetary savings on antimicrobial costs when measured.

Project description:Due to the massive increase of the urban population, a global target is to achieve sustainable cities that are sensitive to nature and environmentally just for urban dwellers. To accomplish this, it is important to understand the responses of native and nonnative birds, identify the environmental variables that promote native species and limit nonnative species, and understand how they vary among socioeconomic groups. Although many cities in the Global South exhibit strong social and environmental segregation, few studies have investigated the relationship between socioeconomics and biodiversity. Therefore, to help promote ecological justice and biodiversity conservation in the developing world, we investigated the influence of socioeconomic level and woody cover on bird species richness and abundance in the city of Santiago de Chile. We also investigated whether bird response changes with species provenance-it is important to understand the response of native birds separately from nonnative birds because they imply opposite management strategies (e.g., conservation vs. species control/eradication). Thus, we surveyed 120 sites located in residential areas of high, medium, and low socioeconomic levels across the city and fit generalized linear (mixed) models that described bird species richness and abundance for total, native, and nonnative birds according to socioeconomic level and woody vegetation cover. We found that both socioeconomic level and woody vegetation cover influenced the bird community, but their effects changed with bird species origin, having opposite effects on native and nonnative birds. Residential areas where wealthier people live supported greater species richness and abundance of native birds than residential areas where people of lower socioeconomic status live. In contrast, residential areas where vulnerable people live had greater bird abundance that was mainly composed of nonnative birds. Therefore, affluent neighborhoods provide more opportunities to encounter native birds and experience nature close to home than poorer neighborhoods. Due to woody cover having positive effects on native birds and a negative influence on nonnative birds, increasing tree and shrub cover will contribute to supporting more native birds in residential areas deprived of woody vegetation, which are commonly low socioeconomic areas. Additional variables that can explain bird response among residential areas of different socioeconomic levels need to be investigated to better understand the factors influencing the distribution of birds in cities and promote a more biodiverse and environmentally just city.

Project description:BackgroundRecent studies highlight the equigenic potential of greenspaces by showing narrower socioeconomic health inequalities in greener areas. However, results to date have been inconsistent and derived from high-income countries. We examined whether urban greenness modifies the associations between area-level education, as a proxy for socioeconomic status, and life expectancy and cause-specific mortality in Latin American cities.MethodsWe included 28 large cities, >137 million inhabitants, in nine Latin American countries, comprising 671 sub-city units, for 2012-2016. Socioeconomic status was assessed through a composite index of sub-city level education, and greenness was calculated using the normalized difference vegetation index. We fitted multilevel models with sub-city units nested in cities, with life expectancy or log(mortality) as the outcome.FindingsWe observed a social gradient, with higher levels of education associated with higher life expectancy and lower cause-specific mortality. There was weak evidence supporting the equigenesis hypothesis as greenness differentially modified the association between education and mortality outcomes. We observed an equigenic effect, with doubling magnitudes in the violence-related mortality reduction by education in areas with low greenness compared to medium-high greenness areas among men (16% [95% CI 12%-20%] vs 8% [95% CI 4%-11%] per 1 SD increase in area-level education). However, in contradiction to the equigenesis hypothesis, the magnitude in cardiovascular diseases (CVD) mortality reduction by education was stronger in areas with medium-high greenness compared to areas with low greenness (6% [95% CI 4%-7%] vs 1% [95% CI -1%-3%] and 5% [95% CI 3%-7%] vs 1% [95% CI -1%-3%] per 1 SD increase in area-level education, in women and men, respectively). Similarly, each 1-SD increase in greenness widened the educational inequality in life expectancy by 0.15 years and 0.20 years, in women and men, respectively. The equigenic effect was not observed in violence-related mortality among women and in mortality due to communicable diseases, maternal, neonatal and nutritional conditions (CMNN).InterpretationOur results confirm socioeconomic health inequalities in Latin American cities and show that the equigenic properties of greenspace vary by health outcome. Although mixed, our findings suggest that future greening policies should account for local social and economic conditions to ensure that greenspaces provide health benefits for all, and do not further exacerbate existing health inequalities in the region.FundingWellcome Trust (Grant, 205177/Z/16/Z).

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Disentangling associations between vegetation greenness and dengue in a Latin American city: Findings and challenges.

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Disentangling associations between vegetation greenness and dengue in a Latin American city: Findings and challenges.

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