Search Results (25)

Climate change is significantly altering the distribution, seasonality, and transmission dynamics of vector-borne diseases, posing an increasing public health concern, particularly in regions previously considered at low risk. Key climatic variables, including temperature, precipitation, and humidity, strongly influence vector survival, reproduction, and pathogen transmission capacity. This review provides an overview of current evidence on the relationship between climate change, vector ecology, and vector-borne disease epidemiology in Europe, based on evidence extracted from peer-reviewed literature published between 2010 and 2024 and retrieved from PubMed, Scopus, and Web of Science. Particular attention is given to vector-borne diseases with current or potential relevance to Europe. This includes infections that are already endemic, such as leishmaniasis and tick-borne encephalitis, as well as diseases currently imported, such as malaria, dengue, chikungunya, Zika, yellow fever, and Chagas disease, that may pose a future risk of local transmission due to climate-driven changes in vector distribution and abundance. The analysis highlights potential health and economic impacts, and discusses implications for public health preparedness, environmental sanitation, surveillance, and vector control strategies. Strengthening adaptive and mitigation policies, alongside targeted research efforts, is essential to enhance resilience of health systems against climate-driven epidemic risks. Full article

Background/Objectives: Malaria remains a major global health burden, particularly in sub-Saharan Africa, where the recent invasion and urban expansion of Anopheles stephensi are increasing transmission risk in densely populated areas. Conventional vector control strategies, including widespread insecticide application, are progressively losing efficacy due to the rapid spread of resistance. These limitations have accelerated the development of genetic control approaches aimed at either suppressing vector populations or replacing them with genetically modified mosquitoes incapable of transmitting pathogens, with the shared objective of reducing disease transmission. For population suppression strategies, an essential component is a conditional regulatory system that enables precise control of toxic or otherwise deleterious effector proteins. The most widely used platform, the tetracycline-dependent (Tet) system, modulates gene expression in response to tetracycline. However, this system can exhibit leaky expression and variable regulation, which may compromise its reliability and limit its application in certain contexts. The dihydrofolate reductase (DHFR) destabilization domain (DD) system, developed in Drosophila, offers an alternative strategy for post-translational control of protein stability. In this system, proteins fused to a destabilization domain are rapidly degraded unless stabilized by the small molecule trimethoprim (TMP), enabling tight and reversible control. In Drosophila and prior reports, this system has been associated with relatively low fitness costs, although such effects have not been systematically evaluated in mosquitoes. Before adapting this system for mosquito genetic control, it is therefore essential to assess the impact of TMP exposure on key life-history traits. Methods: Here, we assessed the effects of varying TMP concentrations on mosquito development, survival, and reproductive output. Results: Our results demonstrate that low concentrations of TMP exposure had no detectable effects on immature development, adult survival, or reproductive output under the conditions tested, supporting the implementation of the DHFR-DD system in mosquitoes. Importantly, these effects were dose-dependent, with moderate to high TMP concentrations producing measurable impacts on mosquito fitness. Conclusions: These findings provide a foundational step toward the development of more precise and reliable conditional expression systems for genetic vector control, advancing innovative strategies to mitigate malaria transmission in high-risk regions. Full article

Background: The Democratic Republic of the Congo accounts for approximately 12–13% of the global malaria burden. While international guidelines oppose the use of Artemisia annua infusions due to risks of sub-therapeutic dosing and resistance selection, the plant remains widely used in resource-limited regions. This study evaluates the clinical acceptability and perceptions of healthcare providers regarding the integration of Artemisia annua tea into formal malaria control in the Maniema province. Methods: A cross-sectional survey was conducted among 337 healthcare professionals in the Kalima health district using the KoboCollect digital platform. Multivariate logistic regression was employed to identify the primary socio-professional determinants of clinical acceptability. Results: The overall clinical acceptability of Artemisia annua integration was 81.0%, with 82.8% of providers perceiving the preparation as effective. Rural residency was the strongest predictor of adherence (AOR = 6.847; p = 0.003), reflecting a pragmatic response to frequent ACT stockouts and high treatment costs. Despite high acceptability, 49.0% of providers identified the lack of clinical evidence as a major barrier, and 91.4% demanded formal training on standardized dosage and biological mechanisms. Conclusions: A significant “policy–practice gap” exists between international guidelines and field realities in the DRC. Healthcare providers demonstrate high readiness for integration but emphasize the absolute necessity of galenic standardization to mitigate resistance risks. To address these concerns, a complementary genomic investigation is currently underway in the same study area, comparing PfKelch13 mutation prevalence among Artemisia tea users versus ACT-treated patients. This molecular surveillance will provide essential evidence to define safety parameters for future phytopharmaceutical integration. Full article

Medical drone delivery (MDD), defined as the use of uncrewed aerial vehicles to transport medical products, is an emerging technological innovation responding to persistent health supply chain challenges in rural and low-resource settings. Within sub-Saharan Africa, MDD systems have demonstrated large-scale success in improving key health outcomes, health supply chain efficiency, and reductions in medical product stockouts and wastage. However, the existing evidence base on the effectiveness of this technology is dominated by quantitative, performance-based evaluations, with limited emphasis on the community-driven mechanisms that shape such outcomes. Drawing on original qualitative research, this article presents a qualitative secondary analysis (QSA) of interview data collected as part of a larger case study on MDD in Madagascar. The QSA, guided by socio-technical systems theory, analyzes a subset of 18 interviews with 23 community-level stakeholders to understand how MDD affects healthcare services in remote regions of the country. Participants reported that MDD led to downstream healthcare improvements in vaccination coverage and malaria-related health outcomes. These improvements were enabled through four interconnected socio-technical mechanisms: (1) improved medical product availability through the mitigation of geographic and transportation barriers, (2) stabilization of vaccine and cold chain transportation, (3) building trust and healthcare-seeking behaviours through predictable service delivery, and (4) reduced physical, mental, and financial burdens experienced by healthcare workers. A final, cross-cutting theme emphasized was the criticality of MDD program continuity, with participants noting that operation disruptions or withdrawals risked reversing benefits and breaking communities’ trust in the health system. By centering lived realities, perceptions, and social processes, this article bridges the gap between predominantly quantitative evidence on MDD systems and the experiences of the communities they are intended to serve. Full article

Malaria in pregnancy remains a major driver of poor maternal and neonatal health outcomes in sub-Saharan Africa. For decades, intermittent preventive treatment in pregnancy (IPTp), with sulphadoxine-pyrimethamine (SP), has mitigated malaria-associated health risks, but concerns have been raised regarding accumulated Plasmodium falciparum dihydrofolate reductase (dhfr) and dihydropteroate synthase (dhps) mutations on the efficacy of SP. Western Kenya, including Busia County, is a high malaria transmission setting where molecular surveillance of dhfr and dhps mutations remains limited. This study assessed the prevalence and haplotype structure of dhfr and dhps mutations in P. falciparum isolates from Busia County, Kenya. A total of 66 samples of P. falciparum isolates collected from patients attending Matayos Sub-County Hospital between November 2024 and January 2025 were analysed. PCR amplification and Sanger sequencing targeted dhfr codons C50R, N51I, C59R, S108N/T, I164L, and dhps codons I431V, S436A/F, A437G, K540E, A581G, and A613S/T to determine mutation frequencies, haplotypes, and combined dhps and dhfr haplotype profiles. High frequencies of dhfr and dhps mutations were observed across the parasite isolates. The most common dhfr substitutions included N51I (85.2%) and C59R (75.4%), while S108N (32.8%) and S108T (19.7%) were detected at lower frequencies. Dhfr haplotypes identified included N51I + C59R, N51I + C59R + S108N, and a N51I + C59R + S108T + I164L variant. The I164L mutation was detected at a frequency of 18.0% and was observed exclusively on a non-canonical S108T background (19.7%). Dhps haplotypes were dominated by A437G (92.3%), K540E (40%) alone, and the A437G + K540E double mutant. Combined dhfr and dhps haplotype analyses revealed circulation of classical dhfr triple-mutant (N51I + C59R + S108N) backgrounds with dhps A437G. Quintuple haplotypes (dhfr N51I + C59R + S108T + I164L with dhps A437G) and rare complex haplotypes incorporating both I164L and K540E or I164L and S436F were also detected. These findings indicate the persistence and circulation of both canonical and non-canonical dhfr and dhps haplotypes in P. falciparum isolates from Busia County. This study highlights the need for continuous molecular and phenotypic surveillance to clarify the functional and epidemiological significance of parasites carrying S108T and I164L mutations, and to inform IPT policy. Full article

This scoping review aimed to identify and synthesise spatially relevant environmental, demographic, and socio-economic factors associated with vector-borne diseases (VBDs) in Pacific Island Countries and Territories (PICTs), a region particularly vulnerable due to its ecological and climate diversity. A systematic search of PubMed, Scopus, and Web of Science was conducted in March 2025 with no time restrictions, yielding 3008 records. After applying the inclusion criteria, 21 studies were selected for analysis. Environmental factors such as temperature, precipitation, and land cover were consistently associated with increased burden of malaria, dengue, and lymphatic filariasis, while associations with elevation and flooding were mixed or inconclusive. Demographic factors, including population density and household composition, were found to be associated with disease occurrence, although the direction and the strength of these associations varied. Three studies reported a negative association between population density and disease outcomes, including lymphatic filariasis in American Samoa and dengue in New Caledonia. Spatial socioeconomic factors such as low income, unemployment, and limited education were positively correlated with disease burden, particularly lymphatic filariasis and dengue. These findings underscore the importance of spatial determinants in shaping VBD transmission across PICTs and highlight the utility of spatial risk mapping to inform geographically targeted vector control strategies. Notably, infrastructure, health care access, and intra-island mobility remain underexplored in the literature, representing critical gaps for future research. Strengthening surveillance through spatially informed public health planning is essential to mitigate disease burden in this climate-sensitive and geographically dispersed region. Full article

Polycyclic aromatic hydrocarbons (PAHs) are persistent organic pollutants with significant ecological and public health implications, particularly in urban wetlands exposed to chronic anthropogenic stress. This study evaluates the occurrence, spatial distribution, seasonal variability, and ecological risk of three low molecular weight PAHs—naphthalene (NAP), phenanthrene (PHEN), and anthracene (ANT)—in surface waters of Caño La Malaria, the main freshwater source of Cucharillas Marsh, Puerto Rico’s largest urban wetland. Surface water samples were collected at four locations during both wet- and dry-season campaigns. Samples were extracted and quantified by GC-MS. NAP was the dominant compound, Σ3PAHs concentrations ranging from 7.4 to 2198.8 ng/L, with higher wet-season levels (mean = 745.79 ng/L) than dry-season levels (mean = 186.71 ng/L); most wet-season samples fell within the mild-to-moderate contamination category. Compositional shifts indicated increased levels of PHEN and ANT during the wet season. No significant spatial differences were found (p = 0.753), and high correlations between sites (r = 0.96) suggest uniform input sources. Diagnostic ratios, inter-species correlations, and principal component analysis (PCA) consistently indicated a predominant pyrogenic origin, with robust PHEN–ANT correlation (r = 0.824) confirming shared combustion-related sources. PCA revealed a clear separation between dry- and wet-season samples, with the latter showing greater variability and stronger associations with NAP and ANT. Ecological risk assessment using hazard quotients (HQ_water) indicated negligible acute toxicity risk across all sites and seasons (<0.01); the highest HQ_water (0.0095), observed upstream during the wet season, remained within this range. However, benchmark exceedances by PHEN and ANT suggest potential chronic risks not captured by the acute ERA framework. These findings support integrated watershed management practices to mitigate PAH pollution and strengthen long-term ecological health in tropical urban wetlands. Full article

Climate change is increasingly recognized as a major driver of emerging infectious diseases, particularly vector-borne diseases (VBDs), which are expanding in range and intensity worldwide. Europe, traditionally considered low-risk for many arboviral infections, is now experiencing autochthonous transmission of pathogens such as dengue, chikungunya, Zika virus, West Nile virus, malaria, and leishmaniasis. Rising temperatures, altered precipitation patterns, and milder winters have facilitated the establishment and spread of competent vectors, including Aedes, Anopheles, Phlebotomus, and Culex species, in previously non-endemic areas. These climatic shifts not only impact vector survival and distribution but also influence vector competence and pathogen development, ultimately increasing transmission potential. This narrative review explores the complex relationship between climate change and VBDs, with a particular focus on pediatric populations. It highlights how children may experience distinct clinical manifestations and complications, and how current data on pediatric burden remain limited for several emerging infections. Through an analysis of existing literature and reported outbreaks in Europe, this review underscores the urgent need for enhanced surveillance, integrated vector control strategies, and climate-adapted public health policies. Finally, it outlines research priorities to better anticipate and mitigate future disease emergence in the context of global warming. Understanding and addressing this evolving risk is essential to safeguard public health and to protect vulnerable populations, particularly children, in a rapidly changing climate. Full article

Climate change has magnified health disparities across the Southern African Development Community (SADC) region by destabilizing the critical natural systems, which include water security, food production, and disease ecology. The IPCC (2007) underscores the disproportionate impact on low-income populations characterized by limited adaptive capacity, exacerbating existing vulnerabilities. Rising temperatures, erratic precipitation patterns, and increased frequency of extreme weather events ranging from prolonged droughts to catastrophic floods have created favourable conditions for the spread of waterborne diseases such as cholera, dysentery, and typhoid, as well as the expansion of vector-borne diseases zone also characterized by warmer and wetter conditions where diseases like malaria thrives. This study employed a comparative analysis of climate and health data across Malawi, Zimbabwe, Mozambique, and South Africa examining the interplay between climatic shifts and disease patterns. Through reviews of national surveillance reports, adaptation policies, and outbreak records, the analysis reveals the existence of critical gaps in preparedness and response. Zimbabwe’s Matabeleland region experienced a doubling of diarrheal diseases in 2019 due to drought-driven water shortages, forcing communities to rely on unsafe alternatives. Mozambique faced a similar crisis following Cyclone Idai in 2019, where floodwaters precipitated a threefold surge in cholera cases, predominantly affecting children under five. In Malawi, Cyclone Ana’s catastrophic flooding in 2022 contaminated water sources, leading to a devastating cholera outbreak that claimed over 1200 lives. Meanwhile, in South Africa, inadequate sanitation in KwaZulu-Natal’s informal settlements amplified cholera transmission during the 2023 rainy season. Malaria incidence has also risen in these regions, with warmer temperatures extending the geographic range of Anopheles mosquitoes and lengthening the transmission seasons. The findings underscore an urgent need for integrated, multisectoral interventions. Strengthening disease surveillance systems to incorporate climate data could enhance early warning capabilities, while national adaptation plans must prioritize health resilience by bridging gaps between water, agriculture, and infrastructure policies. Community-level interventions, such as water purification programs and targeted vector control, are essential to reduce outbreaks in high-risk areas. Beyond these findings, there is a critical need to invest in longitudinal research so as to elucidate the causal pathways between climate change and disease burden, particularly for understudied linkages like malaria expansion and urbanization. Without coordinated action, climate-related health inequalities will continue to widen, leaving marginalized populations increasingly vulnerable to preventable diseases. The SADC region must adopt evidence-based, equity-centred strategies to mitigate these growing threats and safeguard public health in a warming world. Full article

Climate change threatens health and social development gains in Kenya, necessitating health policy planning for risk reduction and mitigation. To understand the state of knowledge on climate-related health impacts in Kenya, a scoping review of 25 years of environmental health research was conducted. In compliance with a pre-registered protocol, nine bibliographic databases and grey literature sources were searched for articles published from 2000 to 2024. Of 19,234 articles screened, 816 full texts were reviewed in duplicate, and a final 348 articles underwent data extraction for topic categorisation, trend analysis, and narrative summary. Most of the studies (97%, n = 336) were journal articles, with 64% published after 2014 (n = 224). The health topics centred on vector-borne diseases (45%, n = 165), primarily vector abundance (n = 111) and malaria (n = 67), while mental health (n = 12) and heat exposure (n = 9) studies were less frequent. The research was geographically concentrated on the Lake Victoria Basin, Rift Valley, and Coastal regions, with fewer studies from the northern arid and semi-arid regions. The findings show a shift from a focus on infectious diseases towards broader non-communicable outcomes, as well as regional disparities in research coverage. This review highlights the development of baseline associations between environmental exposures and health outcomes in Kenya, providing a necessary foundation for evidence-informed climate change and health policy. However, challenges in data and study designs limit some of the evidentiary value. Full article

Background: This study investigates the relationship between climate variables and malaria incidence in Ethiopia’s Gambella region, a hotspot for malaria transmission. Methods: Utilizing 30 years of satellite-derived climate data and 10 years of malaria incidence records from the Ethiopian Public Health Institute, this research analyzed trends and correlations. Climate variables, including rainfall, temperature, and relative humidity, were extracted using GPS data and global climate models from NASA. Autoregressive modeling was employed to assess the impact of these variables on malaria incidence at different time lags (lag 0, 1, and 2). Results: The analysis revealed significant upward trends in rainfall, relative humidity, and temperature over the 30-year period, coinciding with a rise in malaria cases over the past decade. Rainfall exhibited delayed effects on malaria incidence, while relative humidity demonstrated both immediate and persistent impacts. Relative humidity at lag 0 had the strongest influence (IRR = 1.002, 95% CI: 1.001–1.003), whereas temperature showed minimal effects (IRR = 1.000, 95% CI: 1.000–1.001). Conclusions: These findings underscore the critical role of climate variables in driving malaria transmission and highlight the urgent need for climate adaptation strategies, early warning systems, and strengthened health infrastructure. Leveraging climate data for predictive modeling and expanding targeted interventions, such as insecticide-treated nets (ITNs), is essential to mitigate climate-driven malaria risks and protect vulnerable communities in Gambella and similar regions Full article

The present study investigates the prevalence and diversity of Plasmodium and Trypanosoma infections in Allochrocebus solatus, a vulnerable primate species native to Gabon. Using molecular techniques like nested PCR and phylogenetic analysis, we found 34.0% infection rate for malaria parasites infection, 21.3% for Trypanosoma spp., and 12.8% co-infections. Additionally, Hepatocystis was exclusively detected among malaria parasites, while Trypanosoma brucei brucei, T. vivax, and T. congolense were identified. These results underscore the complex host–parasite interactions influenced by captivity and the ecological and immunological consequences of such infections, particularly the increased susceptibility associated with captivity-induced stress. This preliminary study highlights the need for ongoing surveillance to mitigate health risks in primates and prevent potential zoonotic spillovers, providing critical data for conservation efforts. Full article

Background: Inappropriate antibiotic use drives antimicrobial resistance and remains a global concern. Evidence suggests antibiotic use may be higher among malaria-negative patients compared to malaria-positive ones, but uncertainty persists, particularly in regions with varying malaria prevalence. This study measured antibiotic residuals in three Tanzanian regions with varying malaria epidemiology and analyzed factors influencing their presence. Methods: A cross-sectional household survey was conducted in 2015, covering a population of 6000 individuals across three regions of Tanzania. Dried blood spot samples from a subset of participants were analyzed using broad-range tandem mass spectrometry to detect residual antibiotics. Risk factors associated with antibiotic presence, including household healthcare-seeking behaviors, malaria testing, and other relevant variables, were evaluated. Results: The overall prevalence of residual antibiotics in the study population was 14.4% (438/3036; 95% CI: 11.4–15.8%). Stratified by malaria transmission intensity, antibiotic prevalence was 17.2% (95% CI: 12.9–17.2%) in Mwanza (low), 14.6% (95% CI: 10.6–15.0%) in Mbeya (moderate), and 11.2% (95% CI: 7.9–11.6%) in Mtwara (high). Trimethoprim was the most frequently detected antibiotic (6.1%), followed by sulfamethoxazole (4.4%) and penicillin V (0.001%). Conclusions: Residual antibiotic prevalence did not directly correlate with malaria endemicity but was influenced by healthcare practices, including co-prescription of antibiotics and antimalarials. The higher antibiotic use in malaria-negative cases highlights the need for improved diagnostics to reduce unnecessary use and mitigate antimicrobial resistance in malaria-endemic areas. Full article

Poor waste management in shanty towns across developing countries has significantly impacted public health, contributing to widespread outbreaks of diseases such as cholera, malaria, and typhoid due to unsanitary living conditions and contaminated environments. Limited efforts by residents and governments to implement effective waste disposal practices exacerbate these health risks, perpetuating a cycle of poor sanitation, increased disease transmission, and environmental degradation. This study investigates the impact of poor waste management on public health in informal settlements and explores strategies to mitigate these risks through improved practices and collaborative efforts. The study employed a cross-sectional research design and collected data using semi-structured questionnaires to collect data from 217 households in Tandale, Manzese, and Tandika in the Dar es Salaam region. The findings confirm that inadequate waste collection services, lack of proper disposal sites, high costs of waste management, and poor public awareness are key contributors to the accumulation of waste and the prevalence of diseases. Hypothesis testing further reveals that inadequate waste collection services significantly impact public health challenges, while public health initiatives on waste management significantly improve health outcomes and reduce disease prevalence. The study’s recommendations include increasing the frequency of waste collection, fostering community-led waste management initiatives, enhancing public education on the health risks of poor waste disposal, and providing subsidized resources such as waste bins and bags. Additionally, strengthened collaboration between local governments, NGOs, and community members is essential for mobilizing resources and implementing sustainable waste management practices. These measures are vital to reducing public health risks and creating healthier living conditions in underserved communities. Full article

This study maps the rural household vulnerability to flood-induced health risks in flood-affected Khyber Pakhtunkhwa (KPK), Pakistan, focusing on the devastating 2022 flood. Using data from 600 households in the severely impacted districts of Khyber Pakhtunkhwa province (including Charsadda and Nowshera), this research examines the influence of demographic, socioeconomic, and infrastructural factors on household vulnerability. This study assesses household vulnerability to flooding and health issues using logistic regression. The current study findings revealed that female-headed households, those with younger heads, and families with lower educational levels are particularly vulnerable. Income disparities significantly shape coping capacity, with wealthier households more likely to adopt effective risk-mitigation strategies. Proximity to functioning healthcare facilities emerged as a crucial factor in reducing vulnerability, as these households faced fewer health hazards. Conversely, households in areas where health and water infrastructure were damaged experienced higher risks of disease outbreaks, including cholera and malaria, due to water contamination and inadequate sanitation. This study highlights the urgent need for resilient infrastructure, strengthened public health systems, improved health education, and enhanced water and sanitation services to mitigate flood-induced health risks. Policymakers are urged to sustainable development practices by adopting gender-sensitive disaster management strategies, prioritizing educational initiatives, and fostering community support networks to enhance resilience to future flood events in KPK. Full article