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- ItemMaternal mycotoxin exposure and adverse pregnancy outcomes: a systematic review(Berlin ; Heidelberg : Springer, 2020) Kyei, Nicholas N.A.; Boakye, Daniel; Gabrysch, SabineMycotoxin exposure from food occurs globally but is more common in hot humid environments, especially in low-income settings, and might affect pregnancy outcomes. This study aimed to synthesize the evidence from epidemiological studies on the relationship between maternal or fetal exposure to different mycotoxins and the occurrence of adverse pregnancy outcomes. Multiple databases were systematically searched up to December 2018 to identify studies that assessed the association between mycotoxin exposure in pregnant women or fetuses and at least one pregnancy outcome. Studies were appraised and results were synthesized using standard methods for conducting systematic reviews. This review identified and included 17 relevant studies. There is some evidence to suggest that exposure to various Aspergillus mycotoxins (e.g., aflatoxin) during pregnancy may impair intrauterine fetal growth and promote neonatal jaundice. Findings were inconclusive concerning the influence of aflatoxin exposure on perinatal death and preterm birth. Only two studies assessed effects of maternal exposure to Fusarium mycotoxins (e.g., fumonisin) on adverse pregnancy outcomes. These studies found that maternal fumonisin exposure may be associated with hypertensive emergencies in pregnancy and with neural tube defects. Studies using grain farming and weather conditions as a proxy measure for mycotoxin exposure found that such exposure was associated with an increased risk of preterm birth and late-term miscarriage. In conclusion, there is already some evidence to suggest that exposure to mycotoxins during pregnancy may have detrimental effects on pregnancy outcomes. However, given the limited number of studies, especially on effects of Fusarium mycotoxins, more studies are needed for a more comprehensive understanding of the effects of different mycotoxins on maternal and fetal health and to guide public health policies and interventions. © 2020, The Author(s).
- ItemAwareness, Experience, and Knowledge of Farming Households in Rural Bangladesh Regarding Mold Contamination of Food Crops: A Cross-Sectional Study(Basel : MDPI AG, 2021) Kyei, Nicholas N. A.; Waid, Jillian L; Ali, Nurshad; Gabrysch, SabineAside from specific environmental conditions, poor agricultural practices contribute to mold and thus the mycotoxin contamination of crops. This study investigated Bangladeshi farming households’ (i) awareness of and experience with mold contamination of food crops; (ii) knowledge and awareness of the timing, causes, and consequences of mold and mycotoxin contamination; and (iii) knowledge of the recommended agricultural practices for controlling and preventing mold contamination of food crops. A survey was conducted with 1280 households in rural areas of Habiganj district, Bangladesh. Basic descriptive statistics were calculated, and mixed-effects linear regression analyses were performed to examine associations between household characteristics and overall knowledge scores. The awareness of mold contamination of food crops was very high (99%; 95% CI: 98–100%) and a shared experience among households (85%; 95% CI: 80–88%). Yet, the majority (80%; 95% CI: 76–84%) demonstrated a low level of knowledge of the timing, causes, and preventive practices regarding mold contamination of crops. Knowledge scores were similar over demographic groups and better for households with more arable land. The findings suggest a generally insufficient knowledge of the conditions that favor mold contamination and the measures for preventing mold contamination of food crops. These findings underline the need for tailored interventions to promote good agricultural practices and reduce mold contamination of food crops.
- ItemCorona and the climate: A comparison of two emergencies(Cambridge : Cambridge Univ. Press, 2020) Vinke, Kira; Gabrysch, Sabine; Paoletti, Emanuela; Rockström, Johan; Schellnhuber, Hans JoachimSocial media summary Lessons from the corona crisis can help manage the even more daunting challenge of anthropogenic global warming. © The Author(s), 2020.
- ItemIntroducing urine-enriched biochar-based fertilizer for vegetable production: acceptability and results from rural Bangladesh([S.l.] : Proquest, 2021) Sutradhar, Ipsita; Jackson-deGraffenried, Meredith; Akter, Sayema; McMahon, Shannon A.; Waid, Jillian L.; Schmidt, Hans-Peter; Wendt, Amanda S.; Gabrysch, SabineImproved agricultural practices that increase yields and preserve soils are critical to addressing food insecurity and undernutrition among smallholder farmer families. Urine-enriched biochar has been shown to be an accessible and effective fertilization option in various subtropical countries; however, it is new to Bangladesh. To better understand attitudes and experiences preparing and using urine-enriched biochar fertilizer, mixed-methods research was undertaken among smallholder farmers in northeastern Bangladesh in 2016/2017. In-depth interviews were conducted with 25 respondents who had compared the production of crops grown with biochar-based fertilizer to usual practice. In addition, in areas where trainings on biochar-based fertilization had been offered, 845 farmers were asked about their experience through a quantitative survey. Interview results indicated that cow urine-enriched biochar was favored over human urine because cow urine was perceived as clean and socially acceptable, whereas human urine was considered impure and disgusting. Respondents praised biochar-based fertilizer because it increased yields, cost little, was convenient to prepare with readily available natural materials, produced tastier crops, and allowed families to share their larger yields which in turn enhanced social and financial capital. Comparative field trials indicated a 60% yield benefit in both cabbage and kohlrabi crops. Challenges included uneven access to ingredients, with some respondents having difficulty procuring cow urine and biomass feedstock. The low social, health, and financial risk of adoption and the perceived benefits motivated farmers to produce and apply biochar-based fertilizer in their gardens, demonstrating strong potential for scale-up of this technology in Bangladesh.
- ItemKey Food Hygiene Behaviors to Reduce Microbial Contamination of Complementary Foods in Rural Bangladesh(Northbrook, Ill. : American Soc. of Tropical Medicine and Hygiene, 2022) Müller-Hauser, Anna A.; Sobhan, Shafinaz; Huda, Tarique Md. Nurul; Waid, Jillian L.; Wendt, Amanda S.; Islam, Mohammad Aminul; Rahman, Mahbubur; Gabrysch, SabineMicrobial contamination of complementary foods puts young children at risk of developing intestinal infections and could be reduced by improved handwashing and food hygiene practices. We aimed to identify which promoted food hygiene practices are associated with reduced complementary food contamination in a rural population in Bangladesh. We collected cross-sectional data on reported and observed maternal food hygiene behaviors and measured Escherichia coli counts as an indicator of microbial contamination in complementary food samples from 342 children of women enrolled in the Food and Agricultural Approaches to Reducing Malnutrition trial in Sylhet, Bangladesh. We used multivariable logistic regression to examine associations of food hygiene behaviors with food contamination. Approximately 46%of complementary food samples had detectable levels of Escherichia coli. Handwashing with soap at critical times and fresh preparation of food before feeding were strongly associated with reduced odds of food sample contamination (odds ratio [OR]: 0.8, 95% confidence interval [CI]: 0.6-0.9 and OR: 0.3, 95% CI: 0.1-0.7, respectively); in contrast, there was no or only weak evidence that reheating of stored food, safe food storage, and cleanliness of feeding utensils reduced contamination. Reduction in food contamination could be more than halved only when several food hygiene behaviors were practiced in combination. In conclusion, single food hygiene practices showed limited potential and a combined practice of multiple food hygiene behaviors may be needed to achieve a substantial reduction of complementary food contamination.
- ItemThe Berlin principles on one health - Bridging global health and conservation(Amsterdam [u.a.] : Elsevier Science, 2020) Gruetzmacher, Kim; Karesh, William B.; Amuasi, John H.; Arshad, Adnan; Farlow, Andrew; Gabrysch, Sabine; Jetzkowitz, Jens; Lieberman, Susan; Palmer, Clare; Winkler, Andrea S.; Walzer, ChrisFor over 15-years, proponents of the One Health approach have worked to consistently interweave components that should never have been separated and now more than ever need to be re-connected: the health of humans, non-human animals, and ecosystems. We have failed to heed the warning signs. A One Health approach is paramount in directing our future health in this acutely and irrevocably changed world. COVID-19 has shown us the exorbitant cost of inaction. The time to act is now. © 2020
- ItemThe ongoing nutrition transition thwarts long-term targets for food security, public health and environmental protection([London] : Macmillan Publishers Limited, part of Springer Nature, 2020) Bodirsky, Benjamin Leon; Dietrich, Jan Philipp; Martinelli, Eleonora; Stenstad, Antonia; Pradhan, Prajal; Gabrysch, Sabine; Mishra, Abhijeet; Weindl, Isabelle; Le Mouël, Chantal; Rolinski, Susanne; Baumstark, Lavinia; Wang, Xiaoxi; Waid, Jillian L.; Lotze-Campen, Hermann; Popp, AlexanderThe nutrition transition transforms food systems globally and shapes public health and environmental change. Here we provide a global forward-looking assessment of a continued nutrition transition and its interlinked symptoms in respect to food consumption. These symptoms range from underweight and unbalanced diets to obesity, food waste and environmental pressure. We find that by 2050, 45% (39–52%) of the world population will be overweight and 16% (13–20%) obese, compared to 29% and 9% in 2010 respectively. The prevalence of underweight approximately halves but absolute numbers stagnate at 0.4–0.7 billion. Aligned, dietary composition shifts towards animal-source foods and empty calories, while the consumption of vegetables, fruits and nuts increases insufficiently. Population growth, ageing, increasing body mass and more wasteful consumption patterns are jointly pushing global food demand from 30 to 45 (43–47) Exajoules. Our comprehensive open dataset and model provides the interfaces necessary for integrated studies of global health, food systems, and environmental change. Achieving zero hunger, healthy diets, and a food demand compatible with environmental boundaries necessitates a coordinated redirection of the nutrition transition. Reducing household waste, animal-source foods, and overweight could synergistically address multiple symptoms at once, while eliminating underweight would not substantially increase food demand.
- ItemDepression among women of reproductive age in rural Bangladesh is linked to food security, diets and nutrition(Cambridge ; New York, NY : Cambridge Univ. Press, 2020) Sparling, Thalia M.; Waid, Jillian L.; Wendt, Amanda S.; Gabrysch, SabineObjective: To quantify the relationship between screening positive for depression and several indicators of the food and nutrition environment in Bangladesh.Design: We used cross-sectional data from the Food and Agricultural Approaches to Reducing Malnutrition (FAARM) trial in Bangladesh to examine the association of depression in non-peripartum (NPW) and peripartum women (PW) with food and nutrition security using multivariable logistic regression and dominance analysis.Setting: Rural north-eastern Bangladesh.Participants: Women of reproductive age.Results: Of 2599 women, 40 % were pregnant or up to 1 year postpartum, while 60 % were not peripartum. Overall, 20 % of women screened positive for major depression. In the dominance analysis, indicators of food and nutrition security were among the strongest explanatory factors of depression. Food insecurity (HFIAS) and poor household food consumption (FCS) were associated with more than double the odds of depression (HFIAS: NPW OR = 2·74 and PW OR = 3·22; FCS: NPW OR = 2·38 and PW OR = 2·44). Low dietary diversity (<5 food groups) was associated with approximately double the odds of depression in NPW (OR = 1·80) and PW (OR = 1·99). Consumption of dairy, eggs, fish, vitamin A-rich and vitamin C-rich foods was associated with reduced odds of depression. Anaemia was not associated with depression. Low BMI (<18·5 kg/m2) was also associated with depression (NPW: OR = 1·40).Conclusions: Depression among women in Bangladesh was associated with many aspects of food and nutrition security, also after controlling for socio-economic factors. Further investigation into the direction of causality and interventions to improve diets and reduce depression among women in low-and middle-income countries are urgently needed. © © The Authors 2020.
- ItemImpact of unseasonable flooding on women's food security and mental health in rural Sylhet, Bangladesh: a longitudinal observational study(Amsterdam : Elsevier, 2022) Gepp, Sophie; Waid, Jillian L; Brombierstäudl, Dagmar; Kader, Abdul; Müller-Hauser, Anna A; Wendt, Amanda S; Dame, Juliane; Gabrysch, SabineBackground Climate change will lead to more frequent and intensive flooding. In April, 2017, unseasonably early flooding led to the inundation of low-lying cropland before the rice harvest in northeastern Bangladesh. We describe coping strategies and quantify short-term and medium-term effects of flooding events on food security and depressive symptoms of women. Methods This observational study is part of the cluster-randomised Food and Agricultural Approaches to Reducing Malnutrition trial (FAARM; NCT02505711). Women self-reported flooding exposure on behalf of their households when surveyed (approximately 6 months after the event). Remote sensing analysis was used to detect the extent of the flooding. We collected data on household food security at baseline, depressive symptoms 4–5 months before the flooding, and coping strategies immediately after the event. We followed up on these outcome measurements for depressive symptoms and food security for up to 2·5 years after the flooding event. We used multilevel regression adjusting for intervention allocation and pre-flooding measures to quantify the flood's effect on household food security and women's mental health. Findings The FAARM trial included 2700 young women in 96 settlements in rural Sylhet, Bangladesh. 1335 (56%) of 2405 women reported that their household being greatly affected, with many losing a large part of their rice harvest. Borrowing money with interest was the most common coping strategy, with households paying back on average 1·5 times the borrowed amount. Greatly affected households had higher odds of food insecurity, with a decreasing effect with increasing time after the flood (odds ratio: 2·4 [p<0·0001] 0·5 years after; 1·6 [p<0·0001] 2·0 years after]; and 1·3 [p=0·012] 2·5 years after). Women in such households also had 1·45 times higher odds of depression (p=0·0001) 2·5 years after the flooding event. Interpretation The 2017 flooding event negatively affected food security and the mental health of women in rural Sylhet, Bangladesh, and few affected women received formal government support. To reduce the impact of future floods, livelihood adaptations and expansion of financial protection programmes are essential measures to pursue. Funding German Federal Ministry for Education and Research (Berlin, Germany) and UK Department for International Development (London, UK).
- 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.