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- ItemSpatiotemporal variation in risk of Shigella infection in childhood: a global risk mapping and prediction model using individual participant data(Oxford : Elsevier, 2023) Badr, Hamada S.; Colston, Josh M.; Nguyen, Nhat-Lan H.; Chen, Yen Ting; Burnett, Eleanor; Ali, Syed Asad; Rayamajhi, Ajit; Satter, Syed M.; Van Trang, Nguyen; Eibach, Daniel; Krumkamp, Ralf; May, Jürgen; Adegnika, Ayola Akim; Manouana, Gédéon Prince; Kremsner, Peter Gottfried; Chilengi, Roma; Hatyoka, Luiza; Debes, Amanda K.; Ateudjieu, Jerome; Faruque, Abu S. G.; Hossain, M. Jahangir; Kanungo, Suman; Kotloff, Karen L; Mandomando, Inácio; Nisar, M. Imran; Omore, Richard; Sow, Samba O.; Zaidi, Anita K. M.; Lambrecht, Nathalie; Adu, Bright; Page, Nicola; Platts-Mills, James A.; Mavacala Freitas, Cesar; Pelkonen, Tuula; Ashorn, Per; Maleta, Kenneth; Ahmed, Tahmeed; Bessong, Pascal; Bhutta, Zulfiqar A.; Mason, Carl; Mduma, Estomih; Olortegui, Maribel P.; Peñataro Yori, Pablo; Lima, Aldo A. M.; Kang, Gagandeep; Humphrey, Jean; Ntozini, Robert; Prendergast, Andrew J.; Okada, Kazuhisa; Wongboot, Warawan; Langeland, Nina; Moyo, Sabrina J.; Gaensbauer, James; Melgar, Mario; Freeman, Matthew; Chard, Anna N.; Thongpaseuth, Vonethalom; Houpt, Eric; Zaitchik, Benjamin F.; Kosek, Margaret N.BACKGROUND: Diarrhoeal disease is a leading cause of childhood illness and death globally, and Shigella is a major aetiological contributor for which a vaccine might soon be available. The primary objective of this study was to model the spatiotemporal variation in paediatric Shigella infection and map its predicted prevalence across low-income and middle-income countries (LMICs). METHODS: Individual participant data for Shigella positivity in stool samples were sourced from multiple LMIC-based studies of children aged 59 months or younger. Covariates included household-level and participant-level factors ascertained by study investigators and environmental and hydrometeorological variables extracted from various data products at georeferenced child locations. Multivariate models were fitted and prevalence predictions obtained by syndrome and age stratum. FINDINGS: 20 studies from 23 countries (including locations in Central America and South America, sub-Saharan Africa, and south and southeast Asia) contributed 66 563 sample results. Age, symptom status, and study design contributed most to model performance followed by temperature, wind speed, relative humidity, and soil moisture. Probability of Shigella infection exceeded 20% when both precipitation and soil moisture were above average and had a 43% peak in uncomplicated diarrhoea cases at 33°C temperatures, above which it decreased. Compared with unimproved sanitation, improved sanitation decreased the odds of Shigella infection by 19% (odds ratio [OR]=0·81 [95% CI 0·76-0·86]) and open defecation decreased them by 18% (OR=0·82 [0·76-0·88]). INTERPRETATION: The distribution of Shigella is more sensitive to climatological factors, such as temperature, than previously recognised. Conditions in much of sub-Saharan Africa are particularly propitious for Shigella transmission, although hotspots also occur in South America and Central America, the Ganges-Brahmaputra Delta, and the island of New Guinea. These findings can inform prioritisation of populations for future vaccine trials and campaigns. FUNDING: NASA, National Institutes of Health-The National Institute of Allergy and Infectious Diseases, and Bill & Melinda Gates Foundation.
- ItemThe Planetary Health Academy—a virtual lecture series for transformative education in Germany(Amsterdam : Elsevier, 2023) Gepp, Sophie; Jung, Laura; Wabnitz, Katharina; Schneider, Frederick; v Gierke, Friederike; Otto, Hannah; Hartmann, Sylvia; Gemke, Theresa; Schulz, Christian; Gabrysch, Sabine; Fast, Marischa; Schwienhorst-Stich, Eva-MariaThe planetary crises require health professionals to understand the interlinkages between health and environmental changes, and how to reduce ecological harm (ie, ecological footprint) and promote positive change (ie, ecological handprint). However, health professions’ education and training are mostly lacking these aspects. In this Viewpoint, we report findings from the evaluation of the Planetary Health Academy, the first open online lecture series for transformative planetary health education in Germany. In a retrospective online survey, 458 of 3656 Planetary Health Academy participants reported on their emotions towards climate change, attitudes towards health professionals’ responsibilities, self-efficacy, and the contribution of the Planetary Health Academy to their knowledge and actions. Additionally, motivators and barriers to acting were assessed. Our findings provide insights that can inform future efforts for transformative education. Combined with network and movement building, education could act as a social tipping element toward actions to mitigate global environmental changes.