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Climate change threatens maternal and infant health; One Health genomic analysis uncovers AMR transmission pathways

A topiary depiction of a pregnant woman and unborn child

Revised COVID-19 death tolls in Zambia challenge the ‘African Paradox’. The ‘African paradox’, an anecdote that the pandemic was less severe in Africa than in other parts of the world, emerged after health experts noted that sub-Saharan nations reported lower case numbers and fewer COVID-19 deaths than other regions. However, research in Zambia indicates that almost one-third of more than 1,000 bodies taken to a morgue in the country’s capital, Lusaka, in 2020 and 2021 tested positive for SARS-CoV-2. These findings suggest that many more people died of COVID-19 in the region than official numbers indicate. Underreported COVID-19 death tolls are likely due to a deficit of testing and strained medical systems. [Nature]

Pollution reduction is essential to prepare for future respiratory disease pandemics. Associations between air pollution and COVID-19 cases, deaths, fatality, and mortality rates observed in previous studies, led researchers to investigate how long-term exposure to different pollutant concentrations of particulate matter and nitrogen oxides affected residents in Brazil. Linear regression models were applied to air quality data gathered between 2015 and 2019 in 64 monitoring stations in the state of São Paulo and to official Brazilian government COVID-19 case and death data from 2020. Positive correlations were found between long-term exposure to nitrogen oxides in the five years before the pandemic and COVID-19 mortality rate and between nitrogen oxide and particulate matter exposure and COVID-19 fatality rates. [Environmental Monitoring and Assessment Volume]  

Combatting antifungal resistance requires a One Health Approach. Due to profound global environmental change and growing numbers of at-risk populations, human-infecting pathogenic fungi are becoming resistant to current systemic antifungal drugs. Challenges in managing drug-resistant invasive fungal diseases are related to limited access to sensitive and specific diagnostic tests, clinically calibrated antifungal susceptibility testing, and a limited range of antifungal drug classes, among others. Additionally, the breadth and diversity of the fungal kingdom provides limitless new pathogens, along with variants of familiar fungi that quickly adapt and evolve when exposed to antifungal agents. The necessity to control fungal diseases in both agricultural environments and in humans requires integrated and coordinated global responses, including greater coordination between policymakers, funding agencies and researchers, and producers and users of antifungals. [Nature]  

Climate change is a health issue. An estimated 13 million deaths a year are attributed to avoidable environmental causes. This death toll will continue to grow if overconsumption and reliance on fossil fuels doesn’t subside. Global heating is causing more frequent and extreme weather events, like heatwaves, wildfires, and storms, threatening lives, harming mental health, spreading disease, and negatively impacting livelihoods and economies. Ongoing climate change will augment the impact of air pollution, water and food insecurity, and undernutrition, with the greater impact being on the most vulnerable populations. Global responses to fairly fund mitigation and adaptation activities in high and lower-income countries are urgently needed to increase global resilience. [The Lancet Public Health]  

An educational tool to limit AMR caused by international travel. To help prevent the spread of AMR, researchers developed an evidence-based educational tool targeting both healthcare workers (HCWs) and international travelers. After building a database including AMR surveillance data for over two million isolates from 86 countries, antimicrobial bacteria prevalence of carriage from 11,679 international travelers, and 15 guidance documents published by major public health agencies, researchers elaborated a consultation scheme for HCWs which included risk factor evaluation and recommendations for screening of AMR. The tool also provides guidance for international travelers, including pre-travel practical measures to minimize the risk of transmission. [Journal of Travel Medicine]  

Maternal and infant health are threatened by climate change. Marginalized communities, already facing the highest rates of maternal and newborn morbidity and mortality, are most impacted by climate change. These populations often have inadequate housing for protection against extreme weather events, or they reside in areas vulnerable to flooding and changing environments, often causing droughts, and decreasing water supplies. Consequently, climate change will augment already high rates of maternal and newborn mortality and adverse birth outcomes, worsening existing inequities between and within countries. Governments should prepare responses now to begin the implementation of relevant policy and health service delivery measures while bolstering current endeavors to advance maternal and newborn health. [The Journal of Climate Change and Health 

Digital contact tracing has complex implications. Digital data collection through contact-tracing technologies are linked to capturing and generating knowledge that is expected to aid in addressing public health problems. While some countries and regions are implementing different social distancing recommendations, others have enacted mobile-based contact tracing and quick response (QR) barcodes. Research into access, uptake, and use that accompany these technologies reveals that these strategies can also be harmful and pose new risks and sources of exposure. Digital data collection under the preface of contact tracing brings up complex issues of human ethics, informed consent, and digital privacy; and reliance on certain technologies excludes many from lower socio-economic groups, people who do not speak the primary language of their country of residence, and people with disabilities from vital public health measures. [Nature]  

Quantitatively surveilling the health risk of antibiotic resistance genes will help manage AMR. A metagenomic analysis involving 4,573 samples from six types of habitats detected 2,561 antibiotic resistance genes (ARGs) that collectively conferred resistance to 24 classes of antibiotics. The health risk for each ARG, defined as the risk of clinical treatment complications, was evaluated using a framework integrating human accessibility, mobility, pathogenicity, and clinical availability. The findings revealed that 23.78% of the ARGs studied posed a health risk. [Nature Communications]  

A One Health approach to genomic analysis is uncovering AMR transmission pathways. In a longitudinal study in a large-scale commercial poultry farm in China, researchers collected E. coli isolates from both a farm and slaughterhouse, targeting animals, carcasses, workers, and their households and environment. Through a data processing pipeline combining omics, machine learning, gene sharing network, and mobile genetic elements analysis, researchers investigated resistance to different antimicrobials and identified a network of genes correlated to AMR phenotypes, shared among livestock, humans, farm, and slaughterhouse environments. [PLOS Computational Biology]  

Growing gender inequity should be addressed through finance. Women are disproportionately affected by the COVID-19 pandemic, climate change, and growing geopolitical instability as they leave the workforce due to increased burdens of unpaid care work. A staggering rise in gender-based violence is happening worldwide and girls are dropping out of school in higher numbers than boys.  Women’s unequal access to land and natural resources, finance, technology, knowledge, mobility, and other assets constrain their abilities to cope in contexts of climate and environmental crises. To combat these disparities, there must be a shift that prioritizes inclusive sustainability of all public and private sectors’ incentive structures, decision making, and management processes, driving finance towards gender equality. [United Nations Development Programme 

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