Wednesday, January 17, 2024

 

Chronic inflammation and poverty are a ‘double whammy’ for mortality risk


Peer-Reviewed Publication

UNIVERSITY OF FLORIDA




A new study led by a University of Florida College of Public Health and Health Professions researcher finds that people with chronic inflammation living in poverty have more than double the risk of dying from heart disease and nearly triple the risk of dying from cancer within the next 15 years. The findings are based on data representing 95 million Americans ages 40 and over.

While chronic inflammation and poverty are each known to increase mortality risk, when combined, the two factors appear to have a synergistic effect, producing a greater increase in risk than if the individual effects of the two factors were merely added together, the study authors say. Their findings appear in the journal Frontiers in Medicine.

“There is a lot of existing evidence that chronic inflammation can lead to disease,” said lead author Arch Mainous III, Ph.D., a professor in the department of health services research, management and policy in the UF College of Public Health and Health Professions. “We became interested in the potential interplay of chronic inflammation with poverty, which tends to increase inflammation in its own right through factors such as chronic stress. We found that poverty and high levels of inflammation act synergistically, giving people with both factors basically a double whammy. It makes them far more likely to die and in a relatively short period of time, just 15 years.”

Acute inflammation is part of the body’s healthy short-term immune response to fighting infection, toxins or other foreign substances that may enter the body. Chronic inflammation, however, lasts for months or years and has been shown to increase the risk for developing conditions such as cancer, heart disease, Type 2 diabetes and kidney disease. Another new study led by Mainous indicates that 34.6% of U.S. adults have systemic inflammation.

Chronic inflammation can be caused by a host of lifestyle, physiological and environmental factors, such as poor diet, stress, lack of physical activity, smoking, aging, obesity, autoimmune disorders and exposure to toxins in the environment.

The findings from the UF study highlight the need for routine chronic inflammation screenings in vulnerable populations to limit what are, in many cases, preventable deaths, said Mainous, also the vice chair for research in the UF College of Medicine’s department of community health and family medicine. Currently, there are no clinical guidelines for chronic inflammation screening.

“Investigators have been studying chronic inflammation for 25 years and we have a lot of data on its role in the disease pathway and mortality,” Mainous said. “We know it’s a problem, but we don’t do anything about it. We need to translate the basic science on chronic inflammation to the doctor’s office through the creation of screening guidelines so physicians can identify chronic inflammation in their patients and work to treat the underlying causes.”

For the UF study, researchers evaluated data from the National Health and Nutrition

Examination Survey, a nationally representative survey conducted by the National Center for Health Statistics that combines survey questions with laboratory testing. The team analyzed data collected from adults ages 40 and older whose household income fell below the U.S. poverty line and whose lab tests showed elevated levels of C-reactive protein, an indicator of chronic inflammation. Records were linked to the National Death Index to track mortality over a 15-year period.

Those individuals living with both chronic inflammation and poverty had a 127% increased risk for dying from heart disease and a 196% increased risk for dying from cancer. People living with chronic inflammation or poverty, but not both factors, had about a 50% increase in mortality risk over the same period.

“It is time to move beyond documenting the health problems that inflammation can cause to trying to fix these problems,” Mainous said.

In addition to Mainous, the UF study team included members of the department of community health and family medicine at the College of Medicine: Frank A. Orlando, M.D., a clinical associate professor; Lu Yin, Ph.D., a data management analyst; Velyn L. Wu, M.D., an assistant clinical professor; and Aaron A. Saguil, M.D., a professor and of the department chair; as well as Pooja Sharma, a doctoral student in health services research at the College of Public Health and Health Professions.

A new study led by a University of Florida College of Public Health and Health Professions researcher finds that people with chronic inflammation living in poverty have more than double the risk of dying from heart disease and nearly triple the risk of dying from cancer within the next 15 years. The findings are based on data representing 95 million Americans ages 40 and over.

While chronic inflammation and poverty are each known to increase mortality risk, when combined, the two factors appear to have a synergistic effect, producing a greater increase in risk than if the individual effects of the two factors were merely added together, the study authors say. Their findings appear in the journal Frontiers in Medicine.

“There is a lot of existing evidence that chronic inflammation can lead to disease,” said lead author Arch Mainous III, Ph.D., a professor in the department of health services research, management and policy in the UF College of Public Health and Health Professions. “We became interested in the potential interplay of chronic inflammation with poverty, which tends to increase inflammation in its own right through factors such as chronic stress. We found that poverty and high levels of inflammation act synergistically, giving people with both factors basically a double whammy. It makes them far more likely to die and in a relatively short period of time, just 15 years.”

Acute inflammation is part of the body’s healthy short-term immune response to fighting infection, toxins or other foreign substances that may enter the body. Chronic inflammation, however, lasts for months or years and has been shown to increase the risk for developing conditions such as cancer, heart disease, Type 2 diabetes and kidney disease. Another new study led by Mainous indicates that 34.6% of U.S. adults have systemic inflammation.

Chronic inflammation can be caused by a host of lifestyle, physiological and environmental factors, such as poor diet, stress, lack of physical activity, smoking, aging, obesity, autoimmune disorders and exposure to toxins in the environment.

The findings from the UF study highlight the need for routine chronic inflammation screenings in vulnerable populations to limit what are, in many cases, preventable deaths, said Mainous, also the vice chair for research in the UF College of Medicine’s department of community health and family medicine. Currently, there are no clinical guidelines for chronic inflammation screening.

“Investigators have been studying chronic inflammation for 25 years and we have a lot of data on its role in the disease pathway and mortality,” Mainous said. “We know it’s a problem, but we don’t do anything about it. We need to translate the basic science on chronic inflammation to the doctor’s office through the creation of screening guidelines so physicians can identify chronic inflammation in their patients and work to treat the underlying causes.”

For the UF study, researchers evaluated data from the National Health and Nutrition

Examination Survey, a nationally representative survey conducted by the National Center for Health Statistics that combines survey questions with laboratory testing. The team analyzed data collected from adults ages 40 and older whose household income fell below the U.S. poverty line and whose lab tests showed elevated levels of C-reactive protein, an indicator of chronic inflammation. Records were linked to the National Death Index to track mortality over a 15-year period.

Those individuals living with both chronic inflammation and poverty had a 127% increased risk for dying from heart disease and a 196% increased risk for dying from cancer. People living with chronic inflammation or poverty, but not both factors, had about a 50% increase in mortality risk over the same period.

“It is time to move beyond documenting the health problems that inflammation can cause to trying to fix these problems,” Mainous said.

In addition to Mainous, the UF study team included members of the department of community health and family medicine at the College of Medicine: Frank A. Orlando, M.D., a clinical associate professor; Lu Yin, Ph.D., a data management analyst; Velyn L. Wu, M.D., an assistant clinical professor; and Aaron A. Saguil, M.D., a professor and of the department chair; as well as Pooja Sharma, a doctoral student in health services research at the College of Public Health and Health Professions.

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SUBJECT OF RESEARCH

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Living in poverty with chronic inflammation significantly increases heart disease and cancer mortality risk, study finds


Combined effect of poverty and inflammation on mortality is worse than expected from separate effects


Peer-Reviewed Publication

FRONTIERS





In the US, approximately 37.9 million people, or 11.4% of the population, lived below the poverty line in 2022. It has been well demonstrated that poverty negatively affects physical and mental health. For example, people living in poverty run a greater risk of mental illness, heart disease, hypertension, and stroke, and have a higher mortality and lower life expectancy. The mechanisms by which poverty impacts on health outcomes are manifold: for example, people experiencing poverty have reduced access to healthy food, clean water, safe housing, education, and healthcare.

Now, researchers have shown for the first time that the effects of poverty may combine in a synergistic manner with another risk factor, chronic inflammation, to reduce health and life expectancy even further. They found that health outcomes for Americans living in poverty and with chronic inflammation are significantly worse than expected from their separate health effects. The results are published in Frontiers in Medicine.

“Here we show that clinicians need to consider the effect of inflammation on people’s health and longevity, especially on those experiencing poverty,” said lead author Dr Arch Mainous, a professor at the University of Florida.

Inflammation is a natural physiological reaction to infections or injuries, essential for healing. But chronic inflammation – caused by exposure to environmental toxins, certain diets, autoimmune disorders such as arthritis, or other chronic diseases like Alzheimer’s – is a known risk factor for disease and mortality, just like poverty.

NHANES

Mainous and colleagues analyzed data from adults aged 40 and older, enrolled between 1999 and 2002 in the National Health and Nutrition Examination Survey (NHANES), and followed them until 31 December 2019. The NHANES, conducted since 1971 by the National Center for Health Statistics, tracks the health and nutritional status of US adults and children. The NHANES allows for estimates of the US population represented by the cohort, and this study represented nearly 95 million adults. The authors combined NHANES data with records from the National Death Index, to calculate mortality rates over a period of 15 years after enrollment.

Among other demographics, NHANES records the household income. The authors divided this by the official poverty threshold to calculate the ‘poverty index ratio’, a standard measure of poverty.

Chronic inflammation

Whether participants suffered from severe inflammation was deduced from their plasma concentration of high sensitivity C-reactive protein (hs-CRP), produced by the liver in response to the secretion of interleukins by immune and fat cells. The concentration of hs-CRP, included among NHANES data, is a readily available, informative, and well-studied measure of inflammation: for example, elevated concentrations are known to increase the risk of cardiovascular disease and all-cause mortality.

Typically, a concentration of greater than 0.3 mg/dl hs-CRP is taken to indicate chronic systemic inflammation, but Mainous et al. also considered the more stringent threshold of 1.0 mg/dl in a separate analysis.

The authors classified participants in four groups: with or without chronic inflammation, and living below the poverty line or not. By comparing the 15-year mortality rate between these, they could thus study the effects of poverty and inflammation separately and jointly.

Synergistic effect

“We found that participants with either inflammation or poverty alone each had about a 50% increased risk in all-cause mortality. In contrast, individuals with both inflammation and poverty had a 127% increased heart disease mortality risk and a 196% increased cancer mortality risk,” said Dr Frank A. Orlando, an associate professor at the University of Florida and the study’s second author.

“If the effects of inflammation and poverty on mortality were additive, you’d expect a 100% increase in mortality for people where both apply. But since the observed 127% and 196% increases are much greater than 100%, we conclude that the combined effect of inflammation and poverty on mortality is synergistic.”

Routine screening for both risk factors?

A wide variety of treatments for systemic inflammation exists, ranging from diet and exercise to nonsteroidal anti-inflammatory drugs (NSAIDs) and steroids. The present results suggest that clinicians might consider screening socially disadvantaged people – already a medically vulnerable group – for chronic inflammation, and if necessary treat them with such anti-inflammatory drugs. However, steroids and NSAIDS aren’t without risks when taken long-term. More research will thus be needed before patients are routinely prescribed them in clinical practice to decrease systemic inflammation.

“It’s important for guidelines panels to take up this issue to help clinicians integrate inflammation screening into their standard of care, particularly for patients who may have factors that place them at risk for chronic inflammation, including living in poverty. It is time to move beyond documenting the health problems that inflammation can cause, to trying to fix these problems,” concluded Mainous.

 

Who defends bullying victims? A study analyzes adolescents' behavior in this regard


Peer-Reviewed Publication

UNIVERSITY OF CÓRDOBA

Researchers who carried out the study 

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RESEARCHERS WHO CARRIED OUT THE STUDY

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CREDIT: UNIVERSITY OF CÓRDOBA





The LAECOVI research team at the University of Cordoba studied the behavior of those defending adolescent victims of bullying and its relationship to thesestudents' social and regulatory adjustment and perceptions of popularity among peers

Bullying is defined as a set of aggressive and immoral behaviors repeated over time and in which an imbalance of power is created between aggressors and their victims. Many of these situations of bullying occur in the presence of other schoolchildren, who adopt different roles, either enabling the aggressor, defending the victim, or simply keeping out of it.

In these cases defense behaviors can be decisive in reducing the consequences of or preventing those immoral dynamics generated within groups. Until now how these defense behaviors can change over time, and their connection to elements that shape the social dynamics of the classroom, had not been explored. With this dual objective, researchers in the Department of Psychology at the University of Córdoba Eva Romera, Ana Bravo and Rosario Ortega,members of the "Coexistence and Violence Prevention Studies Lab" (LAECOVI), in collaboration with Christian Berger, a researcher at the Pontificia Universidad Católica de Chile, carried out a longitudinal study with 3,303 adolescents in which they identify how defense behaviors change over time and their association with degrees of adjustment to norms, peer groups, and structures of popularity within them.

Striving to dispel the idea that being a defender of bullying victims, or not, is a static role, "we explored different trajectories that would help us understand defense behaviors: those who always defend victims, those who never do, and, above all, why they begin to defend them, or why they stop doing so", explained Professor Eva Romera. Her results confirm that these trends of change highlight the importance of discarding the classic idea that defense is a static role over time.

After four waves of data collection through questionnaires completed by the students over two academic years, and multigroup analysis using a complex methodology combining the analysis of personal relationships with growth curves, "we found four trajectories to describe the defense: one that remained stable at high levels of defense, another that drops, another that increases, and another group that remains at a low level of defense all along the trajectory," explained researcher Ana Bravo. According to Romera, "the results of the study are encouraging. Most adolescents (84%) defend victims of bullying in a sustained way over time. There is also a percentage of schoolchildren who had not defended victims, but began to do so (5%) over time."

Defending victims: a personality that is socially and normatively adjusted and self-perceived as popular

"The results of the study show that social networks have inherent restorative power. The defense group is strong and stable," said Professor Rosario Ortega.

To understand what occurs and to encourage the promotion of defensive behaviors, the UCO study analyzed the associationsbetween the different victim defense trajectories in relation to three other variables involved in  management of relationships with peers: normative adjustment,  social adjustment and students' self-perceived popularity.

Normative adjustment entails ethical and responsible behavior. "If you're normatively adjusted, it's because you respect others," says Romera. Social adjustment involves being integrated into the group. And, finally, self-perceived popularity refers to the adolescent's own perception of his social position and influence within the group.

"We observed that the first group (stable in highly defensive behavior) was also stable in terms of these three social dynamics, perceiving themselves as normatively, socially and popularly adjusted," continued Bravo. "Those who stopped defending victims, in turn, showed a tendency to not adjust to social norms; and those who began to defend victimsstarted to feel more integrated into the group and in a position of influence, which allowed them to do something to change the situations of bullying suffered by  their peers."

Thus, "to increase this defense it is necessary for the adolescent to feel that their context is cohesive, that they are part of a group that must be cared for and protected, and that also features a certain leadership and legitimacy," adds Romera.

"We find that these results, in addition to opening up new research questions, are very encouraging, as they allow us to continue supporting educational proposals based on the ethics of care, which we are working on through different projects at schools, such as the CuidaMe (TakeCareOfMe) program," concluded Ortega.

In short, this work demonstrates that defense behavior is linked to socio-moral balance and the relevance of that ethical principle of care, which can curb bullying. This opens up lines of research that will seek to identify, for example, the causality of those defense behaviors. What motivates adolescents to defend these victims?

This work is part of a research project under the National R&D& I Plan (PID2020-113911RB-I00), which aims to explore the moral, motivational and group factors that influence decision-making in situations of bullying and cyberbullying.

Reference

Bravo A, Berger C, Ortega-Ruiz R, Romera EM. Trajectories of defending behaviors: Longitudinal association with normative and social adjustment and self-perceived popularity. J Sch Psychol. 2023 Dec;101:101252. doi: 10.1016/j.jsp.2023.101252

 

KAIST research team develops anti-icing film that only requires sunlight

Peer-Reviewed Publication

THE KOREA ADVANCED INSTITUTE OF SCIENCE AND TECHNOLOGY (KAIST)

Image 01 

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FIGURE 1. CONCEPTUAL IMAGE TO DISPLAY HYDRODYNAMIC MECHANISMS FOR THE FORMATION OF A HOMOGENEOUS QUADRANT CELLULOSE NANOCRYSTAL(CNC) MATRIX.

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CREDIT: KAIST FLUID & INTERFACE LABORATORY

A KAIST research team has developed an anti-icing and de-icing film coating technology that can apply the photothermal effect of gold nanoparticles to industrial sites without the need for heating wires, periodic spray or oil coating of anti-freeze substances, and substrate design alterations.
The group led by Professor Hyoungsoo Kim from the Department of Mechanical Engineering (Fluid & Interface Laboratory) and Professor Dong Ki Yoon from the Department of Chemistry (Soft Material Assembly Group) revealed on January 3 to have together developed an original technique that can uniformly pattern gold nanorod (GNR) particles in quadrants through simple evaporation, and have used this to develop an anti-icing and de-icing surface.
Many scientists in recent years have tried to control substrate surfaces through various coating techniques, and those involving the patterning of functional nanomaterials have gained special attention. In particular, GNR is considered a promising candidate nanomaterial for its biocompatibility, chemical stability, relatively simple synthesis, and its stable and unique property of surface plasmon resonance. To maximize the performance of GNR, it is important to achieve a high uniformity during film deposition, and a high level of rod alignment. However, achieving both criteria has thus far been a difficult challenge.
To solve this, the joint research team utilized cellulose nanocrystal (CNC), a next-generation functional nanomaterial that can easily be extracted from nature. By co-assembling GNR on CNC quadrant templates, the team could uniformly dry the film and successfully obtain a GNR film with a uniform alignment in a ring-shape. Compared to existing coffee-ring films, the highly uniform and aligned GNR film developed through this research showed enhanced plasmonic photothermal properties, and the team showed that it could carry out anti-icing and de-icing functions by simply irradiating light in the visible wavelength range.
Professor Hyoungsoo Kim said, “This technique can be applied to plastic, as well as flexible surfaces. By using it on exterior materials and films, it can generate its own heat energy, which would greatly save energy through voluntary thermal energy harvesting across various applications including cars, aircrafts, and windows in residential or commercial spaces, where frosting becomes a serious issue in the winter.” Professor Dong Ki Yoon added, “This research is significant in that we can now freely pattern the CNC-GNR composite, which was previously difficult to create into films, over a large area. We can utilize this as an anti-icing material, and if we were to take advantage of the plasmonic properties of gold, we can also use it like stained-glass to decorate glass surfaces.”
This research was conducted by Ph.D. candidate Jeongsu Pyeon from the Department of Mechanical Engineering, and his co-first author Dr. Soon Mo Park (a KAIST graduate, currently a post-doctoral associate at Cornell University), and was pushed in the online volume of Nature Communication on December 8, 2023 under the title “Plasmonic Metasurfaces of Cellulose Nanocrystal Matrices with Quadrants of Aligned Gold Nanorods for Photothermal Anti-Icing. Recognized for its achievement, the research was also selected as an editor’s highlight for the journals Materials Science and Chemistry, and Inorganic and Physical Chemistry.
This research was supported by the Individual Basic Mid-Sized Research Fund from the National Research Foundation of Korea and the Center for Multiscale Chiral Architectures.


  

Figure 2. Optical and thermal performance evaluation results of gold nanorod film and demonstration of plasmonic heater for anti-icing and de-icing.

CREDIT

KAIST Fluid & Interface Laboratory

 

Being rough and hairy isn't all it's cracked up to be - at least if you're a tree


Peer-Reviewed Publication

UNIVERSITY OF SURREY




If you're trying to take pollution out of the air, choose evergreen trees with smaller leaves. That's according to a new study from the University of Surrey.    

Researchers from Surrey's Global Centre for Clean Air Research (GCARE) tested ten trees beside a busy main road. They studied which caught the most particles of pollution and which best allowed the rain to wash those particles safely to the ground.   

It had been thought that leaves with rougher surfaces and minute hairs would catch more pollutants. Yet that wasn't borne out by the evidence.   

Yendle Barwise, former forester and University of Surrey researcher, said:   

“When tackling air pollution, the ideal leaves cling on to particles when it's windy – but let go of them in the rain. That means the wind blows less pollution back into the air – but rain can wash it safely to the ground. 

“Being rough and hairy isn't all it's cracked up to be. To remove more particle pollutants over time, leaves need to be washed by rainfall, and it seems that the size and shape of the leaf is much more important from this perspective." 

Many planting projects use deciduous trees, which lose their leaves in winter – even though that's when air pollution is worst in towns and cities. For that reason, scientists chose ten evergreen specimens and placed them in plant pots beside the A3 in Guildford. Some 80,000 vehicles drive past every day.   

Of those studied, Yew (taxus baccata) was the plant which removed most air pollution. The most effective leaf types were awl-shaped. They were found on Japanese cedar (camellia japonica) and Lawson's Cypress (chamaecyparis lawsoniana).   

The study also suggested that stomata – the 'pores' of the leaf – could help plants 'catch' particles. For Yew, more particles of pollution gathered on the porous underside of the leaf. That's despite the other side of the leaf being 47% rougher, and despite previous research suggesting roughness mattered more.   

Professor Prashant Kumar, founder of the University of Surrey's Global Centre for Clean Air Research, said:   

"We know that planting trees by roadsides can make a big difference to air quality. Our study shows that by choosing your trees carefully, that difference can be even bigger." 

"We've shown that smarter choice of plants can take even more pollution out of the air. We just studied the shapes and textures of the leaves themselves. Other factors, like the tree's height, leaf chemistry, or how many trees you plant, could also make a big difference. Those are well worth investigating in the future." 

The paper, which helps promote the UN Sustainability Goals 3, 11, 13 and 15, is published in the journal Science of the Total Environment. 

 

Greening our cities: Wuyishan's pioneering model for urban carbon reduction


Peer-Reviewed Publication

CHINESE SOCIETY FOR ENVIRONMENTAL SCIENCES

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GRAPHICAL ABSTRACT

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CREDIT: ENVIRONMENTAL SCIENCE AND ECOTECHNOLOGY





As global warming speeds up, meeting the goals of the Paris Agreement has become crucial. Cities, especially in countries like China, play a major role in reducing carbon emissions. However, traditional approaches to making cities carbon neutral usually miss out on considering indirect emissions that happen outside city boundaries, which are vital for a comprehensive carbon reduction strategy. This study tackles this issue by introducing an integrated framework that accounts for both the emissions produced within and consumed by a city.

In a recent study featured in Volume 20 of the journal Environmental Science and Ecotechnology, researchers introduced an innovative framework for achieving carbon neutrality in urban areas. The study, which focuses on Wuyishan, a service-oriented city in Southern China, highlights the importance of inclusive strategies that consider both internal and external greenhouse gas (GHG) emissions to effectively mitigate carbon.

This study presents a groundbreaking strategy for urban carbon neutrality, with Wuyishan, a service-oriented city in China, serving as a model. It introduces a thorough method for calculating and reducing GHG emissions and highlights the importance of often-overlooked out-of-boundary emissions, which make up 42% of Wuyishan's total emissions. The approach innovatively combines life cycle assessments with sector-specific analyses, covering all aspects of a city's emissions. In Wuyishan, mitigations include expanding solar power, transitioning to electric vehicles, and improving agricultural practices. The study emphasizes the need to tackle both internal and external sources of emissions to create effective carbon reduction strategies. This is especially crucial for cities in developing countries, which face unique challenges and opportunities in sustainable growth due to rapid urbanization and industrial changes. With plans to significantly boost renewable energy and electrification by 2035, Wuyishan demonstrates a strong commitment to a sustainable, low-carbon future. This research offers a valuable guide for cities worldwide to develop comprehensive and practical carbon neutrality plans.

Highlights
• We propose a framework to investigate the city-level carbon neutrality pathway.
• A full-scope GHG emission perspective is considered.
• Carbon reductions within and outside city's boundaries are equally important.
• We suggest including out-of-boundary emissions in GHG accounting.

The authors of the study highlight the significance of this integrated approach. "Our methodology provides a practical tool for cities, especially in developing countries, to develop effective carbon neutrality roadmaps that encompass the full spectrum of GHG emissions," they stated.


This framework provides a complete model for cities to develop and execute strategies for achieving carbon neutrality. It underscores the necessity of accounting for external emission sources and emphasizes the shift towards low-carbon technologies and sustainable practices across various sectors such as energy, transportation, agriculture, and waste management.

###

References

DOI

10.1016/j.ese.2023.100354

Original Source URL

https://doi.org/10.1016/j.ese.2023.100354

Funding information

The National Natural Science Foundation of China: An emission scenario - air quality model-based study on the evaluation of “Dual Attainments” of Chinese city (72074154); The Research on the optimization of synergistic regional pathways under carbon emission peak and carbon neutrality goals (72140004); The Research on pathway optimization and implementation mechanism of synergistic control of GHGs and pollution for key regions (72243008).

About Environmental Science and Ecotechnology

Environmental Science and Ecotechnology (ISSN 2666-4984) is an international, peer-reviewed, and open-access journal published by Elsevier. The journal publishes significant views and research across the full spectrum of ecology and environmental sciences, such as climate change, sustainability, biodiversity conservation, environment & health, green catalysis/processing for pollution control, and AI-driven environmental engineering. The latest impact factor of ESE is 12.6, according to the Journal Citation ReportTM 2022.


Cases of chikungunya and zika fall in Brazil, but most risk clusters exhibit an upward trend


Researchers observed spatial and temporal patterns of occurrence and co-occurrence for the two arboviral diseases in all Brazilian municipalities, alongside the influence of environmental and socio-economic factors


 NEWS RELEASE 

FUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULO





Analysis of occurrence and co-occurrence patterns shows the highest-risk clusters of chikungunya and zika in Brazil spreading from the Northeast to the Center-West and coastal areas of São Paulo state and Rio de Janeiro state in the Southeast between 2018 and 2021, and increasing again in the Northeast between 2019 and 2021. 

In Brazil overall, spatial variations in the temporal trends for chikungunya and zika decreased 13% and 40% respectively, but 85% and 57% of the clusters in question displayed a rise in numbers of cases. 

These findings are from an article published in Scientific Reports by researchers at the University of São Paulo’s School of Public Health (FSP-USP) and São Paulo state’s Center for Epidemiological Surveillance (CVE) who analyzed spatial-temporal patterns of occurrence and co-occurrence of the two arboviral diseases in all Brazilian municipalities as well as the environmental and socio-economic factors associated with them.

Considered neglected tropical diseases by the Pan American Health Organization (PAHO/WHO), chikungunya and zika are arboviral diseases caused by viruses of the families Togaviridae and Flaviviridae respectively, and transmitted by mosquitoes of the genus Aedes. Case numbers of both diseases have risen worldwide in the last decade and expanded geographically: chikungunya has been reported in 116 countries and zika in 92, according to the Centers for Disease Control and Prevention (CDC), the main health surveillance agency in the United States. Some 8 million people are estimated to have been infected worldwide, although the number may have reached 100 million in light of generalized underreporting of neglected tropical diseases.

The emergence and re-emergence of chikungunya and zika are facilitated by environmental factors such as urbanization, deforestation and climate change, including droughts and floods. “Identifying high-risk areas for the spread of these arboviruses is important both to control the vectors and to target public health measures correctly,” said Raquel Gardini Sanches Palasio, corresponding author of the article. She is affiliated with FSP-USP’s Department of Epidemiology, where she is a researcher in the Laboratory for Spatial Analysis in Health (LAES).

Working with her PhD thesis advisor, Francisco Chiaravalloti Neto, and other researchers at USP and CVE, Palasio analyzed more than 770,000 cases (608,388 of chikungunya and 162,992 of zika) diagnosed by laboratory test or clinical and epidemiological analysis; most were autochthonous (due to locally acquired infection). The analysis encompassed spatial, temporal and seasonal data, as well as temperature, rainfall and socio-economic factors.

The results showed that high-risk areas had higher temperatures and identified co-occurrence clusters in certain regions. “In the first few years of the period the high-risk clusters were in the Northeast. They then spread to the Center-West – zika in 2016 and chikungunya in 2018 – and to coastal areas in the Southeast – in 2018 and 2021 respectively – followed by resurgence in the Northeast,” Palasio said. 

“Spatial variations in the temporal trends for chikungunya and zika decreased 13% and 40% respectively, but numbers of cases rose in 85% and 57% of the clusters concerned. Spatial variation clusters with a growing internal trend predominated in practically all states, with annual growth of 0.85%-96.56% for chikungunya and 2.77%-53.03% for zika.

“We also found that both diseases have occurred more frequently in summer and fall in Brazil since 2015. Chikungunya is associated with low rainfall, urbanization and social inequality, while zika correlates closely with high rainfall and lack of basic sanitation.”

Both are also more frequent in urban areas with less vegetation, she said, adding that socio-economic factors appear to correlate less with zika than with chikungunya.

Next steps 

“Both diseases have the same vectors and are similar in some other ways, so theoretically they should occur in the same places. We didn’t observe perfect overlapping in space and time, however,” Palasio said.

A hypothesis raised by the researchers who conducted the study, which was funded by FAPESP, relates to socio-economic factors, environment and climate. The main source of data was the 2010 census, and next steps will include an update using fresh data from IBGE’s 2022 census.

“We also want to perform a spatial and temporal analysis using a broader dataset that takes socio-economic factors and climate [especially temperature and rainfall] into account together rather than separately,” Palasio said.

Another focus will be co-occurrence or overlapping of the two diseases. Future climate change models will be run under best-case and worst-case scenarios for greenhouse gas emissions.

About São Paulo Research Foundation (FAPESP)

The São Paulo Research Foundation (FAPESP) is a public institution with the mission of supporting scientific research in all fields of knowledge by awarding scholarships, fellowships and grants to investigators linked with higher education and research institutions in the State of São Paulo, Brazil. FAPESP is aware that the very best research can only be done by working with the best researchers internationally. Therefore, it has established partnerships with funding agencies, higher education, private companies, and research organizations in other countries known for the quality of their research and has been encouraging scientists funded by its grants to further develop their international collaboration. You can learn more about FAPESP at www.fapesp.br/en and visit FAPESP news agency at www.agencia.fapesp.br/en to keep updated with the latest scientific breakthroughs FAPESP helps achieve through its many programs, awards and research centers. You may also subscribe to FAPESP news agency at http://agencia.fapesp.br/subscribe.