Cognitive therapy for depression in tuberculosis treatment: protocol for multicentre pragmatic parallel arm randomised control trial with an internal pilot.

INTRODUCTION AND OBJECTIVES: There is an unmet need to develop high-quality evidence addressing tuberculosis (TB)-related mental health comorbidity, particularly in the context of lower-middle-income countries. This study aims to examine the effectiveness and cost-effectiveness of cognitive behavioural therapy (CBT) versus enhanced treatment as usual (ETAU) in improving depressive symptoms in people with TB and comorbid depression, enhancing adherence with anti-TB treatment (ATT) and its implementation in the real-world setting of Pakistan. METHODS: We will conduct a pragmatic parallel arm randomised control trial with an internal pilot. A brief psychological intervention based on CBT has been developed using a combination of qualitative and ethnographic studies. The inbuilt pilot trial will have a sample size of 80, while we plan to recruit 560 (280 per arm) participants in the definitive trial. Participants who started on ATT within 1 month of diagnosis for pulmonary and extrapulmonary TB or multidrug resistant TB (MDR-TB) and meeting the criteria for depression on Patient Health Questionnaire-9 (PHQ-9) will be randomised with 1:1 allocation to receive six sessions of CBT (delivered by TB healthcare workers) or ETAU. Data on the feasibility outcomes of the pilot will be considered to proceed with the definitive trial. Participants will be assessed (by a blinded assessor) for the following main trial primary outcomes: (1) severity of depression using PHQ-9 scale (interviewer-administered questionnaire) at baseline, weeks 8, 24 and 32 postrandomisation and (2) ATT at baseline and week 24 at the end of ATT therapy. ETHICS AND DISSEMINATION: Ethical approval has been obtained from Keele University Research Ethics Committee (ref: 2023-0599-792), Khyber Medical University Ethical Review Board (ref: DIR/KMU-EB/CT/000990) and National Bioethics Committee Pakistan (ref: No.4-87/NBC-998/23/587). The results of this study will be reported in peer-reviewed journals and academic conferences and disseminated to stakeholders and policymakers. TRIAL REGISTRATION NUMBER: ISRCTN10761003.

Assessment of variability in PM2.5 and its impact on human health in a West African country.

PM2.5 has become a global challenge threatening human health, climate, and the environment. PM2.5 is ranked as the most common cause of premature mortality and morbidity. Therefore, the current study endeavors to probe the spatiodynamic characteristics of PM2.5 in the Republic of Niger and its impacts on human health from 1998 to 2019. Based on remotely sensed satellite datasets, the study found that the concentration of PM2.5 continued to rise in Niger from 68.85 µg/m3 in 1998 to 70.47 µg/m3 in 2019. During the study period, the annual average PM2.5 concentration is far above the WHO guidelines and the interim target-1 (35 µg/m3). The overall annual growth rate of PM2.5 concentration in Niger is 0.02 µg/m3/year. The health risk (HR) due to PM2.5 exposure is also escalated in Niger, particularly, in Southern Niger. The extent of the extremely high-risk areas corresponding to 1 × 104-9.4 × 105 µg.persons/m3 is increased from 0.9% (2000) to 2.8% (2019). Niamey, southern Dakoro, Mayahi, Tessaoua, Mirriah, Magaria, Matameye, Aguié, Madarounfa, Groumdji, Madaoua, Bouza, Keita, eastern Tahoua, eastern Illéla, Bkomnni, southern Dogon-Doutchi, Gaya, eastern Boboye, central Kollo, and western Tillabéry are experienced high HR due to long-term exposure to PM2.5. These findings indicate that PM2.5 causes a serious health risk across Niger. There is an immediate need to carry out its regional control. Therefore, policymakers and the Nigerien government should make conscious efforts to identify the priority target areas with radically innovative appropriate mitigation interventions.

Long term spatiotemporal trends and health risk assessment of remotely sensed PM2.5 concentrations in Nigeria.

PM2.5 is an important indicator reflecting air quality variations. Currently, environmental pollution related issues have become more severe that significantly threaten human health. The current study is an attempt to analyze the spatio-dynamic characteristics of PM2.5 in Nigeria based on the directional distribution and trend clustering analysis from 2001 to 2019. The results indicated that PM2.5 concentration increased in most of the Nigerian states, particularly in mid-northern and southern states. The lowest PM2.5 concentration in Nigeria is even beyond the interim target-1 (35 µg/m3) of the WHO. During the study period, the average PM2.5 concentration increased at a growth rate of 0.2 µg/m3/yr from 69 µg/m3 to 81 µg/m3. The growth rate varied from region to region. Kano, Jigawa, Katsina, Bauchi, Yobe, and Zamfara experienced the fastest growth rate of 0.9 µg/m3/yr with 77.9 µg/m3 mean concentration. The median center of the national average PM2.5 moved toward the north indicating the highest PM2.5 concentration in northern states. The Saharan desert dust is the dominant source of PM2.5 in northern areas. Moreover, agricultural practices and deforestation activities along with low rainfall increase desertification and air pollution in these regions. Health risks increased in most of the mid-northern and southern states. The extent of ultra-high health risk (UHR) areas corresponding to the 8×104-7.3×106 µg⋅person/m3 increased from 1.5% to 2.8%. Mainly Kano, Lagos, Oyo, Edo, Osun, Ekiti, southeastern Kwara, Kogi, Enugu, Anambra, Northeastern Imo, Abia, River, Delta, northeastern Bayelsa, Akwa Ibom, Ebonyi, Abuja, Northern Kaduna, Katsina, Jigawa, central Sokoto, northeastern Zamfara, central Borno, central Adamawa, and northwestern Plateau are under UHR areas.

Defining the role of renewable energy, economic growth, globalization, energy consumption, and population growth on PM2.5 concentration: evidence from South Asian countries.

Rapid industrialization and economic development in South Asia (SA) caused serious air pollution-related issues. Air pollutants, particularly fine particulate matter (PM2.5), have negative effects on health, instigating widespread concern. The current study is an attempt to analyze the impact of non-renewable energy (NRE), globalization (GLO), GDP, renewable energy (RE), and population (POP) on PM2.5 concentration in SA from 1998 to 2020. In doing so, this study incorporated advanced and robust econometric techniques, i.e., Pesaran (Economet Rev 34(6-10), 1089-1117, 2015), to check the cross-sectional dependency, and the unit root presence checked through Cross-sectional Im, Pesaran, and Shin (CIPS) and Cross-sectionally Augmented Dickey-Fuller (CADF) unit root tests. Moreover, the long and short-run association among the selected variables was analyzed through Westerlund and Edgerton (Econ Lett 97(3), 185-190, 2007), cointegration test, and cross-sectional augmented ARDL (CS-ARDL). The empirical results indicate that the panel was cross-sectionally correlated, stationary at the first difference, and co-integrated in the long run. Moreover, the CS-ARDL model indicates a positive association between GDP and PM2.5 concentration. Similarly, NRE and POP contribute significantly to increasing the PM2.5 concentration in SA. However, RE and GLO play an important role to decrease the PM2.5 concentration in SA.

Economic policy uncertainty and CO2 emissions: a comparative analysis of developed and developing nations.

Energy consumption is essential for economic growth; however, its consumption also increases CO2 emissions, which contributes to climate change and environmental degradation. However, both environmental sustainability and sustainable development can be achieved by clean energy (CE) consumption since it consists of noncarbohydrates energy sources that seldom or do not cause CO2 emissions. Therefore, the current study considers economic policy uncertainty (EPU) to study the impacts of CE on CO2 emissions that control economic growth (GDP) and urbanization in both developed and developing nations. The findings from ARDL show that EPU significantly increases CO2 emissions in both the long and short run for both developing and developed nations. While CE and urbanization contribute to improving environmental quality. Economic growth increases CO2 emissions. The results could have a few significant practical impacts on economic policies across which policymakers could try to reduce policy uncertainty by participating in and organizing international treaties and summits. Additionally, international organizations could organize programs to reduce EPU. The role of political stability can be effective in reducing EPU in these countries. Moreover, these nations should introduce environmentally friendly innovation and clean energy technologies and give tax releases on the import and use of CE products while increasing R&D budgets.

Spatial and temporal variations in PM2.5 and associated health risk assessment in Saudi Arabia using remote sensing.

Air pollutants, especially ambient particulate matter (PM2.5), detrimentally impact human health and cause premature deaths. The dynamic characteristics and associated health risks of PM2.5 are analyzed based on the standard deviational ellipse (SDE) and trend analysis in Saudi Arabia (SAU) from 1998 to 2018 by utilizing recently updated satellite-derived PM2.5 concentrations (V4.GL.03). The outcomes show that the national average PM2.5 concentration increased from 28 µg/m3 to 45 µg/m3 with a growth rate of 2.3 µg/m3/year. The center of median PM2.5 concentrations moved to the southeast over the years studied due to the presence of vast sandy deserts, sand dunes, a busy port, and coastal and industrial areas in this region. The areas of SAU that experienced PM2.5 concentrations above 35 µg/m3 increased from 20% to 70%. The rapid-fast growth (RFG) class acquired from the unsupervised classification has the fastest growth rate of 2.5 µg/m3/yr, occurring in southeastern SAU, namely Ash-Sharqiyah, Ar-Riyad, and Najran. It covered ∼27% of the total area of SAU over the study period. Whereas, the slow growth (SG) class with a less than 0.2 µg/m3/yr growth rate covered 12% of the total area of SAU, distributed in northwestern regions. The extent of extremely-high risk areas corresponding to greater than 1 × 103 µg·person/m3 increased from 4% to 11%, particularly in Makkah, Central Al-Madinah, and western Asir, Jizan, mid-eastern Najran, Al-Quassim, and mid-eastern Ar-Riyad and Ash Sharqiyah.

Can Financial Institutional Deepening and Renewable Energy Consumption Lower CO2 Emissions in G-10 Countries: Fresh Evidence from Advanced Methodologies.

To tackle the challenges associated with global warming and climate change, several countries set their targets to lower carbon emissions in accordance with COP21 (Paris Conference). Even though studies highlighted the different aspects that contribute to environmental degradation, there still exists the scarcity of adequate research that emphasizes the environmental implications of financial institutional deepening, renewable energy consumption (REC), and technology innovations. Therefore, this study investigated the significance of financial institutional deepening, REC, gross domestic product (GDP), imports, exports, and technology innovations to achieve sustainability in G-10 countries, namely The Netherlands, Germany, France, Switzerland, United Kingdom, Sweden, Japan, Belgium, Canada, and Italy from 1990 to 2020. The results obtained from cross-sectionally augmented autoregressive distributed lag (CS-ARDL) and the dynamic common correlated effects mean group (DCCEMG) models reveal that financial institutional deepening and imports positively impact CO2 emissions (CO2e) both in the long and short run. A 1% increase in financial institutional deepening and import will increase CO2e by 0.5403% and 0.2942% in the short run and 0.2980% and 0.1479% in the long run levels, respectively. Contrary to this, REC, GDP, exports, and technology innovations improve environmental quality in these countries. The Dumitrescu & Hurlin causality test shows bidirectional causality between imports and CO2e, GDP and CO2e, exports and CO2e, and financial institutional deepening and CO2e, compared to unidirectional causality from technology innovations to CO2e and from REC to CO2e. Apart from this, the outcomes suggest that policymakers in G-10 countries have to consider their financial markets and firms to revise their current environmental policies.

Socio-Economic Drivers of Renewable Energy: Empirical Evidence from BRICS.

There is a need to implement efficient strategies to mitigate the challenges of climate change and income inequalities in developing countries. Several studies have been conducted to address the relationship among different econometric and environmental indicators of renewable energy (RE) but overlooked the relationship between RE and income inequalities. This study investigates the influence of the distribution of income on the RE in Brazil, Russia, China, and South Africa (BRICS) between 1988 and 2017. The econometric (economic growth and trade), environmental, and institutional parameters are also integrated into the model. The outcomes reveal that reduced inequality in income distribution increases the consumption of RE. In contrast, CO2 emissions have a positive correlation with RE. The governments should implement environmentally friendly policies and increase the consumption of renewable energy in the future with regards to reducing environmental pollution. Furthermore, findings from the study indicate a positive effect on the reduction of corruption in renewable energy. This shows that institutional quality can affect the uptake of renewable energy. The study further identified that growth in a country's economy decreases RE consumption, suggesting that these countries prefer fossil fuels to gain economic growth. The Granger causality results show that a bidirectional causality exists between income inequality and RE consumption. Bidirectional causality is observed between income distribution and CO2 emissions. The results from this study are important for policymakers to achieve sustainable development because fair income distribution and environmental quality are considered as two key factors for sustainable development. Strong institutions and control on corruption can bring sound social and economic gains. Therefore, fair distribution of income and strong institutional policies can increase RE consumption to achieve a clean environment.

Analyzing the role of meteorological parameters and CO2 emissions towards crop production: empirical evidence from South Asian countries.

It is need of the hour to investigate the impacts of climate parameters on agricultural production in a developing region of South Asia. Therefore, this work attempts to explore the climatic indicators on agricultural production for selected South Asian countries over the annual data of 1961-2016. This study estimates the impacts of rainfall, temperature, rural population, land under cereal production, and CO2 emissions (ECO2) on agricultural production. For empirical analysis, we applied second-generation unit root tests. After examining the order of integration of time series, we check for the co-integration among the variables. Before the co-integration test, we check for cross-section dependence among the variables. CD and LM tests confirm the existence of cross-section dependence. Afterward, we apply the Westerlund co-integration test to confirm the strong association among the variables. Further, we applied two methods for long-run coefficients of independent variables. Dynamic ordinary least square (DOLS) and fully modified ordinary least square (FMOLS) tests were applied to cross-check the findings. Our findings show that rural population and rainfall are negatively associated with agricultural production. Moreover, temperature, land area under cereal production, and ECO2 are positively associated with agricultural production. Our findings shed light on some important policy implications for South Asian countries.

Exploring the existence of environmental Phillips curve in South Asian countries.

Considering the economic activities that trigger alarming situations for the global atmosphere and ecology, this work probes the associations of unemployment (UNE), GDP, population growth (POP), renewable (REN), non-renewable energy use (ENE), and ecological footprints (EF) for South Asian countries. The annual data of 1991-2019 is analyzed for empirical results. This is the first study that employs panel as well as country-specific estimations for South Asian countries by utilizing the Pool mean group (PMG) and autoregressive distributed lag (ARDL) methods, respectively. The study also validates the environmental Phillips curve (EPC) for selected counties. The empirical evidence in all models confirms the positive effects of GDP, ENE, and POP on environmental dilapidation whereas REN and UNE reduce environmental deprivation. The findings confirm the presence of the EPC in South Asian countries. This work presents some important policy instruments for south Asian countries to reduce environmental pollution. In the efforts to improve air quality, these countries have increased unemployment. These nations have to raise the share of renewable energy to the total energy consumption. This will sustain their economies with an increasing employment ratio. At the same time, there is a need to revise the urban policies because the increasing population is also a contributing factor towards environmental degradation.

Burden and impact of chronic cough in UK primary care: a dataset analysis.

OBJECTIVE: Chronic cough (CC) is a debilitating respiratory symptom, now increasingly recognised as a discrete disease entity. This study evaluated the burden of CC in a primary care setting. DESIGN: Cross-sectional, retrospective cohort study. SETTING: Discover dataset from North West London, which links coded data from primary and secondary care. The index date depicted CC persisting for ≥8 weeks and was taken as a surrogate for date of CC diagnosis. PARTICIPANTS: Data were extracted for individuals aged ≥18 years with a cough persisting ≥8 weeks or cough remedy prescription, between Jan 2015 and Sep 2019. MAIN OUTCOME MEASURES: Demographic characteristics, comorbidities and service utilisation cost, including investigations performed and treatments prescribed were determined. RESULTS: CC was identified in 43 453 patients from a total cohort of 2 109 430 (2%). Median (IQR) age was 64 years (41-87). Among the cohort, 31% had no recorded comorbidities, 26% had been given a diagnosis of asthma, 17% chronic obstructive pulmonary disease, 12% rhinitis and 15% reflux. Prevalence of CC was greater in women (57%) and highest in the 65-74 year age range. There was an increase in the number of all investigations performed in the 12 months before and after the index date of CC diagnosis, and in particular for primary care chest X-ray and spirometry which increased from 6535 to 12 880 and from 5791 to 8720, respectively. This was accompanied by an increase in CC-associated healthcare utilisation costs. CONCLUSION: One-third of individuals had CC in the absence of associated comorbidities, highlighting the importance of recognising CC as a condition in its own right. Overall outpatient costs increased in the year after the CC index date for all comorbidities, but varied significantly with age. Linked primary-care datasets may enable earlier detection of individuals with CC for specialist clinic referral and targeted treatment.

Identification of palliative care needs among people with dementia and its association with acute hospital care and community service use at the end-of-life: A retrospective cohort study using linked primary, community and secondary care data.

BACKGROUND: Hospital admissions among people dying with dementia are common. It is not known whether identification of palliative care needs could help prevent unnecessary admissions. AIM: To examine the proportion of people with dementia identified as having palliative care needs in their last year of life, and the association between identification of needs and primary, community and hospital services in the last 90 days. DESIGN: Retrospective cohort study using Discover, an administrative and clinical dataset from 365 primary care practices in London with deterministic individual-level data linkage to community and hospital records. SETTING/PARTICIPANTS: People diagnosed with dementia and registered with a general practitioner in North West London (UK) who died between 2016 and 2019. The primary outcome was multiple non-elective hospital admissions in the last 90 days of life. Secondary outcomes included contacts with primary and community care providers. We examined the association between identification of palliative care needs with outcomes. RESULTS: Among 5804 decedents with dementia, 1953 (33.6%) were identified as having palliative care needs, including 1141 (19.7%) identified before the last 90 days of life. Identification of palliative care needs before the last 90 days was associated with a lower risk of multiple hospital admissions (Relative Risk 0.70, 95% CI 0.58-0.85) and more contacts with the primary care practice, community nurses and palliative care teams in the last 90 days. CONCLUSIONS: Further investigation of the mechanisms underlying the association between identification of palliative care needs and reduced hospital admissions could help reduce reliance on acute care for this population.

The interactional role of globalization in tourism-CO2 nexus in South Asian countries.

This research analyzes the impacts of tourism and globalization on CO2 emissions in South Asian countries. The annual data was converted into quarterly data of 1995Q1-2016Q4. Unit root test with structural breaks confirmed mixed order of integration for sample countries. ARDL test results showed the existence of EKC between tourism and CO2 emissions in Sri Lanka and Nepal. Globalization lowers the negative effects of tourism on CO2 emissions in Pakistan, India, Bangladesh, and Sri Lanka. Globalization can bring innovation in cleaner technologies, which can improve air quality in South Asian countries. Moreover, this research also confirms that GDP and energy use increase CO2 emissions significantly in South Asia. Therefore, policymakers should consider utilizing renewable energy to improve air quality. Developing countries of South Asia are accelerating their economies by the use of fossil fuels; these countries need to bring renewable energy to the economic sectors for cleaner environment. Apart from the interactional role of globalization in the tourism sector, more attention should also be given to bring strict environmental regulations.

Does the modifying role of institutional quality remains homogeneous in GDP-CO2 emission nexus? New evidence from ARDL approach.

This study presents a country-specific analysis for three developing countries (Pakistan, India, and Bangladesh) to determine the interaction effect of institutional quality and economic growth along with other control variables (foreign direct investment and renewable energy) on CO2 emissions. This research uses an auto regressive distributed lag (ARDL) model for quarterly data ranging from 1996Q1 to 2016Q4. The findings show that the interaction cause of economic growth and institutional quality on CO2 emissions is not homogeneous in developing countries. In India and Bangladesh, the modifying role of institutional quality is evident to reducing CO2 emissions but in Pakistan, this interacting effect increases CO2 emissions. The findings confirm an inverted U-shaped EKC in Pakistan and Bangladesh but not significant in India. The independent role of GDP and institutional quality significantly reduces CO2 emissions in Pakistan and Bangladesh.

Supervised treatment in outpatients for schizophrenia plus (STOPS+): protocol for a cluster randomised trial of a community-based intervention to improve treatment adherence and reduce the treatment gap for schizophrenia in Pakistan.

INTRODUCTION: There is a significant treatment gap, with only a few community-based services for people with schizophrenia in low-income and middle-income countries. Poor treatment adherence in schizophrenia is associated with poorer health outcomes, suicide attempts and death. We previously reported the effectiveness of supervised treatment in outpatients for schizophrenia (STOPS) for improving treatment adherence in patients with schizophrenia. However, STOPS was evaluated in a tertiary care setting with no primary care involvement, limiting its generalisability to the wider at-risk population. We aim to evaluate the effectiveness of STOPS+ in scaling up the primary care treatment of schizophrenia to a real-world setting. METHODS AND ANALYSIS: The effectiveness of the STOPS+ intervention in improving the level of functioning and medication adherence in patients with schizophrenia in Pakistan will be evaluated using a cluster randomised controlled trial design. We aim to recruit 526 participants from 24 primary healthcare centres randomly allocated in 1:1 ratio to STOPS+ intervention and enhanced treatment as usual arms. Participants will be followed-up for 12 months postrecruitment. The sample size is estimated for two outcomes (1) the primary clinical outcome is level of functioning, measured using the Global Assessment of Functioning scale and (2) the primary process outcome is adherence to treatment regimen measured using a validated measure. An intention-to-treat approach will be used for the primary analysis. ETHICS AND DISSEMINATION: Ethical approval has been obtained from Keele University Ethical Review Panel (ref: MH-190017) and Khyber Medical University Ethical Review Board (ref: DIR-KMU-EB/ST/000648). The results of the STOPS+ trial will be reported in peer-reviewed journals and academic conferences and disseminated to local stakeholders and policymakers. TRIAL REGISTRATION NUMBER: ISRCTN93243890.

Quantification and risk assessment of heavy metal build-up in soil-plant system after irrigation with untreated city wastewater in Vehari, Pakistan.

In peri-urban areas of district Vehari, farmers are using untreated city wastewater for crop irrigation owing to the scarcity of good-quality irrigation water. This practice may pose severe environmental and health issues to local inhabitants attributed to the high levels of potentially toxic metals in wastewater. The present study evaluated the potential impacts of wastewater irrigation on metals (Cd, Cr, Cu, Fe, Ni, Mn, Pb and Zn) build-up in the soil-plant continuum and associated health risks. In this study, wastewater (n = 17), soil (n = 108) and plant (n = 65) samples were collected from 15 peri-urban sites of three tehsils of district Vehari. Results showed that the mean concentration (mg/L) of Cd (0.02), Mn (0.25) and Fe (1.57) in wastewater samples was higher than their respective threshold values. Similarly, Cd, Mn and Fe concentration in soil was beyond the permissible limits of agricultural soil receiving wastewater irrigation. However, plants showed high accumulation of Pb, Cr and Fe than their respective limits depending on the vegetable/crop species. The health risk parameters showed that Pb and Cd are the major toxic chemical substances to human health, and the daily intake of crop plants can pose a potential health threat due to wastewater-irrigated crop consumption. Results highlighted the necessity of wastewater pretreatment to avoid the soil and vegetable contamination by wastewater irrigation and to reduce the associated health risks.

Health system preparedness in Pakistan for crisis management: a cross-sectional evaluation study.

BACKGROUND: The World Health Organization (WHO) has strongly advocated health systems' preparedness for effective management of crisis situations globally for more than two decades. Pakistan is known for its high vulnerability to hazards and lack of coping and adaptive capabilities. Health systems' preparedness for locales with such high-risk profile is essential, yet there is a dearth of studies addressing the status of such preparedness in the country. AIMS: This study aimed to assess the status of preparedness of health-system components for crisis management in the most disaster prone districts of Pakistan. METHODS: A purposive sample of 12 of the most disaster prone districts in two provinces of Pakistan was evaluated for preparedness using the WHO's toolkit for assessing health-system capacity for crisis management. Six core functions of the Health Systems Framework, with a total of 229 indicators, were evaluated at the district management as well as secondary and tertiary health care facilities level. Proportions of indicators prepared were calculated and preparedness was classified as Acceptable (≥ 66%), Partial (36-65%) or Inadequate (≤ 35%). RESULTS: Seventy-two percent, 95% Confidence Interval [46.0, 90.0] of indicators in these most vulnerable districts were evaluated as partially or inadequately prepared for appropriate management of crises. Even the highest scoring core function, Leadership and Governance was partially prepared with a score of 53.6% (52.4, 54.9). Process elements were found to be less prepared compared with structure components. CONCLUSIONS: Federal level strategic planning, implementation, management and follow-up aimed at ensuring health-systems' preparedness need to be reviewed and strengthened.

A comparison of satellite-based indices for hazard assessment of MSW open dumps using spatial analysis.

This study compares the suitability of different satellite-based vegetation indices (VIs) for environmental hazard assessment of municipal solid waste (MSW) open dumps. The compared VIs, as bio-indicators of vegetation health, are normalized difference vegetation index (NDVI), soil adjusted vegetation index (SAVI), and modified soil adjusted vegetation index (MSAVI) that have been subject to spatio-temporal analysis. The comparison has been made based on three criteria: one is the exponential moving average (EMA) bias, second is the ease in visually finding the distance of VI curve flattening, and third is the radius of biohazardous zone in relation to the waste heap dumped at them. NDVI has been found to work well when MSW dumps are surrounded by continuous and dense vegetation, otherwise, MSAVI is a better option due to its ability for adjusting soil signals. The hierarchy of the goodness for least EMA bias is MSAVI> SAVI> NDVI with average bias values of 101 m, 203 m, and 270 m, respectively. Estimations using NDVI have been found unable to satisfy the direct relationship between waste heap and hazardous zone size and have given a false exaggeration of 374 m for relatively smaller dump as compared to the bigger one. The same false exaggeration for SAVI and MSAVI is measured to be 86 m and -14 m, respectively. So MSAVI is the only VI that has shown the true relation of waste heap and hazardous zone size. The best visualization of distance-dependent vegetation health away from the dumps is also provided by MSAVI.