Friday, February 21, 2025

Measuring poverty better to strengthen tuberculosis research

Boston University School of Medicine

(Boston—Tuberculosis (TB) has long been recognized as a disease of poverty, yet most TB research does not measure poverty in a meaningful way. A new review in the journal BMC Global and Public Health examines existing methods for assessing socioeconomic status in TB studies and highlights their shortcomings. The authors call for better, standardized poverty metrics to improve research and policy.

Led by researchers from Boston University Chobanian & Avedisian School of Medicine, Brown University and Oxford University, the review explores different ways poverty has been measured in TB studies—including income-based measures, wealth indices and multidimensional poverty indices (MPIs). The authors found that many commonly used tools fail to capture key aspects of deprivation relevant to TB risk and treatment, such as food insecurity, overcrowded housing and access to healthcare.

“Poverty isn’t just background context—it’s central to understanding who develops TB and who struggles with treatment,” says corresponding author Pranay Sinha, MD, assistant professor of medicine at Boston University. “Yet, many TB studies rely on outdated or oversimplified measures of socioeconomic status, limiting what we can learn and how we respond.”

As part of the review, the researchers also assessed how frequently observational TB studies accounted for poverty and found that of the 100 most recently published observational TB studies, nearly 70% did not include any measure of socioeconomic status. According to the authors, this lack of measurement can lead to misinterpretations of TB risk factors and policies that fail to reach the most vulnerable.

“If we don’t measure deprivation well, we can’t address it effectively,” said co-first author Chelsie Cintron, MPH, a third-year doctoral student at Brown University and a senior research study coordinator at Boston Medical Center. “We found that most TB research does not include even basic socioeconomic data. That’s a missed opportunity because poverty affects every stage of the TB journey—from exposure to treatment outcomes.”

The researchers argue that adopting tools like the global multidimensional poverty index – which has been refined and applied in various contexts by co-senior author Jakob Dirksen MSc, MPP, a research and policy officer at Oxford Poverty and Human Development Initiative – could lead to more targeted interventions and stronger policy recommendations."

This research was supported by the National Institutes of Health, the Warren Alpert Foundation, the Burroughs Wellcome Fund/American Society for Tropical Medicine and Hygiene, and the Government of India’s Department of Biotechnology and Indian Council of Medical Research.

Journal

BMC Global and Public Health

Method of Research

Systematic review

Subject of Research

People

Article Publication Date

21-Feb-2025

PFAS: Found 180 times more ‘forever chemicals’ in birds

New technology allows for much more precise measurements of these chemicals in organisms.

Norwegian University of Science and Technology

image:
New methods show that birds absorb more PFAS toxins than previously demonstrated.
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Credit: Photo: Louis Westgeest, NTNU

Researchers studying birds and the food they eat are now finding much larger volumes of the toxic PFAS chemicals than before. The substances either never break down or degrade very slowly, which is why they are called ‘forever chemicals’.

PFAS (per- and polyfluoroalkyl substances) are a large group of synthetic environmental toxins, and you are most likely full of them too. Forever chemicals do not break down; instead, they accumulate in the natural environment and inside your body.

“PFAS have received a lot of attention in recent years. This is because they are so widely used in industry, at the same time as these substances can also be harmful to many different organisms,” said postdoctoral fellow Junjie Zhang, who was recently affiliated with the Norwegian University of Science and Technology (NTNU).

He is the lead author of an article that addresses new findings regarding the toxins. PFAS contain fluorine, and they have received particular attention in Norway because they are used in ski wax, Teflon and fire retardants.

Possible and confirmed harmful effects include various forms of cancer, liver damage, cholesterol disorders, reduced fertility, hormone disorders, developmental disorders in children, and a weakened immune system.

Finding more PFAS than before

Ideally, you do not want these substances in your body, but in practice, it is virtually impossible for humans and many other living organisms to avoid them.

Recent research and a new method for detecting PFAS bring both bad and good news. The bad news is that we are finding PFAS in places we have not previously found them. The good news is that this means we have become better at detecting these substances.

“The biggest increase is in the livers of wading birds. We found up to 180 times more PFAS than previously,” said Zhang.

Some of the increase may be due to a new analysis method.

“This suggests that previous methods have not been good enough at detecting certain types of PFAS,” said Zhang.

He was affiliated with the Department of Chemistry at NTNU during the study and collaborated with Professor Veerle Jaspers at the Department of Biology on a project funded by the Research Council of Norway (COAST IMPACT). He is now a postdoctoral fellow at the University of Copenhagen.

Investigating migratory birds and their food

The international research group analyzed samples from migratory birds and the shellfish they eat.

“The East Asian–Australasian Flyway is an important route for millions of migratory birds, including wading birds,” said Jaspers.

As the name suggests, this migration route extends between Siberia and East Asia and large parts of Australia.

However, the populations of many bird species along this migration route are rapidly declining. The researchers wanted to find out whether exposure to environmental toxins could be a contributing factor.

The researchers took samples from 25 wading birds. In addition, they collected samples from 30 shellfish found in areas of China where migratory birds often stop to feed. This is because it is common for birds – and humans for that matter – to ingest PFAS through food and water.

Easier to detect substances

The researchers took both liver and blood samples from the birds. They used a new method to analyze the samples, called the Total Oxidizable Precursor (TOP) assay, developed by co-author Lara Cioni. This method makes it easier to detect certain types of PFAS.

A lot of research has been done on one group of PFAS called PFAAs (perfluoroalkyl acids), but little is known about the substances that can be converted into PFAAs. PFAAs are formed when other substances break down, and it is these substances that are more easily detected using TOP.

“The TOP results show a significant increase in several types of harmful substances in all of the samples,” said Zhang.

Some of the findings suggest that many forever chemicals originate from sources we are not yet aware of, which is not particularly good news.

According to the researchers, the findings highlight how important it is to conduct more research on the substances that PFAS come from.

“We need to find out more about the sources, but also about the effects PFAS have on wading birds, other animals and humans,” said Jaspers.

Reference: Junjie Zhang, Lara Cioni, Veerle L.B. Jaspers, Alexandros G. Asimakopoulos, He-Bo Peng, Tobias A. Ross, Marcel Klaassen, Dorte Herzke. Shellfish and shorebirds from the East-Asian Australian Flyway as bioindicators for unknown per- and polyfluoroalkyl substances using the total oxidizable precursor assay, Journal of Hazardous Materials, Volume 487, 2025, 137189, ISSN 0304-3894. https://doi.org/10.1016/j.jhazmat.2025.137189

Ruddy turnstones ingest PFAS both through food and water.

Credit

Photo: Louis Westgeest, NTNU.