The influence of 14 predictor variables on active trachoma risk and disease severity in children was investigated using mixed effects logistic regression. Young age, unclean face and low household expenses were risk factors for active disease. Older age and unclean face were risk factors for Trachomatous inflammation, intense (TI), the more severe form of active disease. Interviews and focus groups revealed that lack of food, water and money were of greatest concern to the communities surveyed. The results of the qualitative and quantitative analyses converged, supporting continued implementation of the facial cleanliness (‘F’) and environmental improvement (‘E’) components of the WHO’s SAFE strategy.RésuméA l’aide de régression logistique à effets mixtes, ce papier analyse l’importance de quatorze facteurs prédictifs liés aux risques du « trachome actif » chez les enfants. Le jeune âge, le défaut d’hygiène faciale et le faible niveau de dépenses des ménages ont été les facteurs à risque du « trachome actif ». Dans le cas de l’inflammation Trachomateuse-Intense (TI), la forme la plus sévère de la maladie, l’âge avancé et le défaut d’hygiène faciale ont été les principaux facteurs aggravant du trachome cécitant. Des entrevues et discussions de groupes, il en est ressorti que les défauts d’alimentation, d’eau et de revenu ont été les aspects les plus préoccupants pour les communautés étudiées. Les résultats des analyses qualitatives et quantitatives aboutissent à des conclusions similaires. Ils plaident pour une mise en œuvre continue du nettoyage du visage (N) et le changement de l’environnement (CE), deux interventions de la stratégie « CHANCE » développée par l’Organisme mondiale de la Santé.
Tag: public health
Understanding Factors that Shape Exposure to Zoonotic and Food-Borne Diseases Across Wild Meat Trade Chains
The rise of zoonotic disease-related public health crises has sparked calls for policy action, including calls to close wildlife markets. Yet, these calls often reflect limited understanding of where, precisely, exposure to risk occurs along wildlife and wild meat trade chains. They also threaten to negatively impact food security and livelihoods. From a public health perspective, it is important to understand the practices that shape food safety all along the trade chain, resulting in meat that is either safe to eat or managed as a potential vector of pathogens. This article uses ethnographic methods to examine the steps that lead a wild animal from the forest to the plate of an urban consumer in Yangambi and Kisangani in the Democratic Republic of Congo (DRC). Focusing on hunters, village-level consumers, transporters, market traders and urban consumers, we highlight specific practices that expose different actors involved in the trade chain to wild meat related health risks, including exposure to food borne illnesses from contaminated meat and zoonotic pathogens through direct contact with wild animals, and the local practices in place to reduce the same. We discuss interventions that could help prevent and mitigate zoonotic and food borne disease risks associated with wild meat trade chains.
A scoping review on the health effects of smoke haze from vegetation and peatland fires in Southeast Asia: Issues with study approaches and interpretation
Smoke haze due to vegetation and peatland fires in Southeast Asia is a serious public health concern. Several approaches have been applied in previous studies; however, the concepts and interpretations of these approaches are poorly understood. In this scoping review, we addressed issues related to the application of epidemiology (EPI), health burden estimation (HBE), and health risk assessment (HRA) approaches, and discussed the interpretation of findings, and current research gaps. Most studies reported an air quality index exceeding the ‘unhealthy’ level, especially during smoke haze periods. Although smoke haze is a regional issue in Southeast Asia, studies on its related health effects have only been reported from several countries in the region. Each approach revealed increased health effects in a distinct manner: EPI studies reported excess mortality and morbidity during smoke haze compared to non-smoke haze periods; HBE studies estimated approximately 100,000 deaths attributable to smoke haze in the entire Southeast Asia considering all-cause mortality and all age groups, which ranged from 1,064–260,000 for specified mortality cause, age group, study area, and study period; HRA studies quantified potential lifetime cancer and non-cancer risks due to exposure to smoke-related chemicals. Currently, there is a lack of interconnection between these three approaches. The EPI approach requires extensive effort to investigate lifetime health effects, whereas the HRA approach needs to clarify the assumptions in exposure assessments to estimate lifetime health risks. The HBE approach allows the presentation of health impact in different scenarios, however, the risk functions used are derived from EPI studies from other regions. Two recent studies applied a combination of the EPI and HBE approaches to address uncertainty issues due to the selection of risk functions. In conclusion, all approaches revealed potential health risks due to smoke haze. Nonetheless, future studies should consider comparable exposure assessments to allow the integration of the three approaches.