Ecoepidemiology,short history and control of Chagas disease in the endemic countries and the new challenge for non-endemic countries

Chagas disease is maintained in nature through the interchange of three cycles: the wild, peridomestic and domestic cycles. The wild cycle, which is enzootic, has existed for millions of years maintained between triatomines and wild mammals. Human infection was only detected in mummies from 4,000-9,000 years ago, before the discovery of the disease by Carlos Chagas in 1909. With the beginning of deforestation in the Americas, two-three centuries ago for the expansion of agriculture and livestock rearing, wild mammals, which had been the food source for triatomines, were removed and new food sources started to appear in peridomestic areas: chicken coops, corrals and pigsties. Some accidental human cases could also have occurred prior to the triatomines in peridomestic areas. Thus, triatomines progressively penetrated households and formed the domestic cycle of Chagas disease. A new epidemiological, economic and social problem has been created through the globalisation of Chagas disease, due to legal and illegal migration of individuals infected by Trypanosoma cruzi or presenting Chagas disease in its varied clinical forms, from endemic countries in Latin America to non-endemic countries in North America, Europe, Asia and Oceania, particularly to the United States of America and Spain. The main objective of the present paper was to present a general view of the interchanges between the wild, peridomestic and domestic cycles of the disease, the development of T. cruzi among triatomine, their domiciliation and control initiatives, the characteristics of the disease in countries in the Americas and the problem of migration to non-endemic countries.     

Reproductive research in non-human primates at Institute of Primate Research in Nairobi, Kenya (WHO Collaborating Center): a platform for the development of clinical infertility services?

³ Correspondence address. Tel: +32-16-34-36-24; Fax: +32-16-34-36-07; E-mail: thomas.dhooghe{at}uz.kuleuven.ac.be The Institute of Primate Research (IPR; www.ipr.or.ke) is aWHO collaborating center for research in reproductive biology,infectious diseases and ecology/conservation. It includes afully equipped surgical complex, >5000 square feet of laboratoryspace, a quarantaine facility, library, conference room, administrativeoffices, etc. More than 500 primates can be housed at IPR, mainlybaboons. Reproductive research at IPR is applied to endometriosis,assisted reproduction, prevention of heterosexual transmissionof HIV and includes the investigation of immunocontraceptivesand placental retroviruses. Reproductive research capacitiesof IPR include: videolaparoscopic surgical equipment, surgicalexperience, endometrial biopsies and uterine flushes, ovarianstimulation, laparoscopic oocyte aspiration, hormonal analysesin baboon blood and urine, sperm assessment, in vitro cultureand reproductive immunological investigations. During the lastyears, simultaneously with the development of baboon IVF, therehave been contacts with several Kenyan gynecologists at thelevel of KEMRI (Kenya Medical Research Institute), KOGS (KenyanObstetrical and Gynecological Society), Kenyatta National Hospitaland Aga Khan Hospital in Nairobi to develop clinical infertilityservices including low-budget high-quality IVF in Nairobi. Thelogic behind this initiative is that the Kenyans trained innon-human primate embryology, and IVF would be natural partnersto develop human IVF in Kenya.     

Is affordable and cost-effective assisted reproductive technology in low-income countries possible? What should we know to answer the question?

¹ Correspondence address. E-mail: j.d.f.habbema{at}erasmusmc.nl Decision making on infertility treatment in low-income countries(LIC) assumes answers to quite a few questions: how should theinfertility problem be defined? How often does infertility occur?What is the burden-of-disease of infertility? What is the incomein LIC, and what can be spend on health care? How cheap shouldIVF be in order to be accessible to a considerable part of thepopulation? With what alternative health interventions shouldinfertility treatment be compared? How cost-effective shouldIVF be in order to compete with those other interventions? Thesequestions will be discussed. The emphasis is on the situationin Sub-Saharan Africa (SSA). It is concluded that a place forART in a health care package is not straightforward. Many ofthe questions are not or only partially answered. Moreover,cheap and effective ART has yet to be developed and tested.From the limited evidence available for each of the questions,it could be calculated that an IVF cycle should cost between50 and 75 dollar in order to be a candidate for the inclusionin a health package in SSA. This estimate can easily changeconsiderably when in the future the calculations will be basedon thorough research. Thus, a targeted research programme foranswering the open questions, especially on quality-of-lifeimplications of infertility in different societies, is the preferredoption for facilitating the future evaluation of ART in LIC.     

Assisted reproductive technologies: how to minimize the risks and complications in developing countries?

¹ Correspondence address. E-mail: petra.desutter{at}ugent.be In 2% of assisted reproductive techniques (ART) cycles complicationsoccur. Some are preventable, some are not. In this paper, wewill discuss risks and complications of the standard ‘Western’approach in ART today and point to some measures to be takenwhen implementing ART in developing countries, where resourcesand access to medical care may be limited. Ovarian hyperstimulationsyndrome (OHSS, and its thrombo-embolic complications) is responsiblefor the majority of cycle-related complications, followed bybleeding and infection at oocyte retrieval. ART pregnanciesare complicated by first-trimester bleeding more often thanspontaneous pregnancies, they are more often ectopic, but themajor complication is the very high incidence of multiple pregnancies,when more than one embryo is transferred. OHSS can be preventedby screening patients at risk and by using mild or no stimulation.Simple measures can minimize the risks of bleeding or infection.Obviously single embryo transfer is the only way to avoid multiplepregnancies, which have a highly increased risk for severe maternaland neonatal morbidity and mortality (mainly due to prematurity).Special attention should be given to pre-existing pathologies.Risk minimization of ART in developing countries is not onlymandatory from an economical but also an ethical point of view.     

Estimating Body Fat from Anthropometry and Isotopic Dilution: A Four‐Country Comparison

Objective: The goal was to assess the ability of BMI to predict body fat (BF) among youths in four countries and identify the degree to which additional anthropometric measures improve this prediction. BMI is widely recommended as an indicator of overweight. However, whether BMI adequately estimates BF and has the same meaning in different ethnic groups and youths has been questioned. Research Methods and Procedures: Data come from 456 Filipino, Chinese, Russian, and black South African youths, 6 to 16 years old. Percentage BF and fat mass index (FMI) were estimated by the deuterium dilution method. Skinfold thicknesses (triceps, subscapular, and suprailiac) and weight and height measures were collected. Percentage BF was regressed first on BMI and age and then with the addition of the skinfold measures. Linear models were run separately by country and sex. The models were repeated with FMI as the outcome. Results: The R² values from the percentage BF models ranged from 0.13 to 0.69 in the first models to 0.38 to 0.81 in the full models. The values were lowest among Russian males ≥ 13 years and Russian females ≥ 13 years of age in the reduced and full models, respectively, and were highest among Chinese females. Using FMI as the outcome did not meaningfully change the results. Discussion: The ability of BMI to adequately predict BF and the additional predictivity of anthropometric measures varied widely across the samples, making its uniform use as a proxy for BF in youths from different countries questionable.     

西方高温热浪研究述评

高温热浪不仅给自然生态系统造成不可逆转的冲击,也对人类经济社会与健康产生巨大的负面影响。西方学者历来重视高温热浪相关研究,并产生了丰硕的成果。首先梳理了西方高温热浪研究的脉络,即从指标测度上明析其内涵;从对比模拟角度分析其产生的机理;从空间格局上总结其分布与规律;从复合系统层面探讨其影响;从流行病学角度解析其对健康的危害。其次,指出了趋势判断、机理解析、影响评估、脆弱性评估、风险感知、适应分析等未来关注的矛盾与焦点。在此基础上,提出了西方高温热浪研究对中国的启示,包括:拓展典型区域的实证研究;关注脆弱群体与欠发达地区;重视健康尤其是心理健康的影响;注重研究领域拓展;尝试多学科视角融合等。     

乡村生态景观生物多样性研究热点和趋势——基于文献计量研究

乡村生态景观生物多样性是全球生物多样性的重要组成部分,是乡村景观构建、评价和乡村宜居发展的重要保障。以Web of Science中1990-2020年522篇相关文献为研究对象,运用文献计量工具CiteSpace绘制文献共被引和关键词共现网络知识图谱,重点考察转折点、高突现及高被引文献,理清乡村生态景观生物多样性研究的发展脉络、热点与趋势。研究发现:(1)乡村生态景观生物多样性研究的发展可分3阶段,即萌芽期(1993-2002年),该期为乡村生态景观生物多样性研究指引了方向,提出了城市化对乡村生物多样性的影响;蓄势期(2003-2010年),该期以Hansen在2005年发表的探究生物多样性对景观变化的响应机制文章为节点,重点研究如何可持续地进行乡村生态景观生物多样性的恢复与保护;发展期(2011-2020年),突现性文献为2014年Beilin发表的文章,研究重点转向社会生态系统,即从生态、经济和社会多维度出发研究乡村生态景观生物多样性;(2)乡村生态景观生物多样性研究主线变化从大量的案例研究,到城市化对乡村生态景观生物多样性影响的理论归纳,再到将理论用于实践并持续保护乡村生态景观生物多样性;(3)乡村生态景观生物多样性研究热点变化从城市化对乡村生态景观生物多样性的影响,到乡村可持续发展,再到保证人类可持续生计。未来应加强以下工作:(1)研究和建立适用于不同乡村生态景观建设的规划体系;(2)研究和创新乡村生态景观生态系统多样性的维护技术;(3)研究和构建乡村生态景观生物多样性的监控预警机制。最终的研究目标均指向如何将乡村生态景观生物多样性更好地服务于人类社会。     

Integrating evidence-based treatments for common mental disorders in routine primary care: feasibility and acceptability of the MANAS intervention in Goa,India

Common mental disorders, such as depression and anxiety, pose a major public health burden in developing countries. Although these disorders are thought to be best managed in primary care settings, there is a dearth of evidence about how this can be achieved in low resource settings. The MANAS project is an attempt to integrate an evidence based package of treatments into routine public and private primary care settings in Goa, India. Before initiating the trial, we carried out extensive preparatory work, over a period of 15 months, to examine the feasibility and acceptability of the planned intervention. This paper describes the systematic development and evaluation of the intervention through this preparatory phase. The preparatory stage, which was implemented in three phases, utilized quantitative and qualitative methods to inform our understanding of the potential problems and possible solutions in implementing the trial and led to critical modifications of the original intervention plan. Investing in systematic formative work prior to conducting expensive trials of the effectiveness of complex interventions is a useful exercise which potentially improves the likelihood of a positive result of such trials.     

Who does all the research in conservation biology?

Much of the worlds biodiversity is located within countries with developing economies. We therefore examine how well developing nations and their scientists are represented in three international conservation biology journals (Conservation Biology, Biological Conservation, Biodiversity and Conservation). We found: (1) that 28% of studies were from lower income countries and only 15% of all papers had primary authors from these nations. Of papers from lower income countries, although 80% had at least one local author, only 47% had primary authors from the country where the study was conducted. (2) Lower income countries had more research with a strong applied focus compared to research from high-income countries. (3) In lower income countries research was often funded by international sources but the primary authors of these studies were from affluent nations. (4) The three journals differed in how well they represented lower income nations and their scientists, reflecting their editorial policies for including research from lower income nations. The main reason for the large discrepancy in a countrys output of conservation research is due to the difference in a nations ability to invest in science. However, a brief survey of authors suggests that there is a large amount of information available in lower income and non-English speaking countries that is not easily accessible to the international conservation community. Journals may therefore need to consider altering their policies if we are to improve the representation of research by scientists in lower income nations.     

Ozone pollution will compromise efforts to increase global wheat production

Introduction of high‐performing crop cultivars and crop/soil water management practices that increase the stomatal uptake of carbon dioxide and photosynthesis will be instrumental in realizing the United Nations Sustainable Development Goal (SDG) of achieving food security. To date, however, global assessments of how to increase crop yield have failed to consider the negative effects of tropospheric ozone, a gaseous pollutant that enters the leaf stomatal pores of plants along with carbon dioxide, and is increasing in concentration globally, particularly in rapidly developing countries. Earlier studies have simply estimated that the largest effects are in the areas with the highest ozone concentrations. Using a modelling method that accounts for the effects of soil moisture deficit and meteorological factors on the stomatal uptake of ozone, we show for the first time that ozone impacts on wheat yield are particularly large in humid rain‐fed and irrigated areas of major wheat‐producing countries (e.g. United States, France, India, China and Russia). Averaged over 2010–2012, we estimate that ozone reduces wheat yields by a mean 9.9% in the northern hemisphere and 6.2% in the southern hemisphere, corresponding to some 85 Tg (million tonnes) of lost grain. Total production losses in developing countries receiving Official Development Assistance are 50% higher than those in developed countries, potentially reducing the possibility of achieving UN SDG2. Crucially, our analysis shows that ozone could reduce the potential yield benefits of increasing irrigation usage in response to climate change because added irrigation increases the uptake and subsequent negative effects of the pollutant. We show that mitigation of air pollution in a changing climate could play a vital role in achieving the above‐mentioned UN SDG, while also contributing to other SDGs related to human health and well‐being, ecosystems and climate change.