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1.
Nature ; 598(7880): 315-320, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34526720

RESUMO

Despite contributing to healthy diets for billions of people, aquatic foods are often undervalued as a nutritional solution because their diversity is often reduced to the protein and energy value of a single food type ('seafood' or 'fish')1-4. Here we create a cohesive model that unites terrestrial foods with nearly 3,000 taxa of aquatic foods to understand the future impact of aquatic foods on human nutrition. We project two plausible futures to 2030: a baseline scenario with moderate growth in aquatic animal-source food (AASF) production, and a high-production scenario with a 15-million-tonne increased supply of AASFs over the business-as-usual scenario in 2030, driven largely by investment and innovation in aquaculture production. By comparing changes in AASF consumption between the scenarios, we elucidate geographic and demographic vulnerabilities and estimate health impacts from diet-related causes. Globally, we find that a high-production scenario will decrease AASF prices by 26% and increase their consumption, thereby reducing the consumption of red and processed meats that can lead to diet-related non-communicable diseases5,6 while also preventing approximately 166 million cases of inadequate micronutrient intake. This finding provides a broad evidentiary basis for policy makers and development stakeholders to capitalize on the potential of aquatic foods to reduce food and nutrition insecurity and tackle malnutrition in all its forms.


Assuntos
Abastecimento de Alimentos , Internacionalidade , Alimentos Marinhos/classificação , Animais , Dieta Saudável , Feminino , Peixes , Saúde , Humanos , Masculino , Valor Nutritivo , Carne Vermelha , Alimentos Marinhos/análise , Populações Vulneráveis
2.
Proc Natl Acad Sci U S A ; 121(30): e2403691121, 2024 Jul 23.
Artigo em Inglês | MEDLINE | ID: mdl-39018198

RESUMO

The global biodiversity that underpins wild food systems-including fisheries-is rapidly declining. Yet, we often have only a limited understanding of how households use and benefit from biodiversity in the ecosystems surrounding them. Explicating these relationships is critical to forestall and mitigate the effects of biodiversity declines on food and nutrition security. Here, we quantify how biodiversity filters from ecosystems to household harvest, consumption, and sale, and how ecological traits and household characteristics shape these relationships. We used a unique, integrated ecological (40 sites, quarterly data collection) and household survey (n = 414, every 2 mo data collection) dataset collected over 3 y in rice field fisheries surrounding Cambodia's Tonlé Sap, one of Earth's most productive and diverse freshwater systems. While ecosystem biodiversity was positively associated with household catch, consumption, and sold biodiversity, households consumed an average of 43% of the species present in the ecosystem and sold only 9%. Larger, less nutritious, and more common species were disproportionally represented in portfolios of commercially traded species, while consumed species mirrored catches. The relationship between ecosystem and consumed biodiversity was remarkably consistent across variation in household fishing effort, demographics, and distance to nearest markets. Poorer households also consumed more species, underscoring how wild food systems may most benefit the vulnerable. Our findings amplify concerns about the impacts of biodiversity loss on our global food systems and highlight that utilization of biodiversity for consumption may far exceed what is commercially traded.


Assuntos
Biodiversidade , Características da Família , Pesqueiros , Peixes , Animais , Camboja , Humanos , Ecossistema , Conservação dos Recursos Naturais , Abastecimento de Alimentos , Comércio
3.
Ecol Lett ; 26(11): 1887-1897, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37671723

RESUMO

Species, through their traits, influence how ecosystems simultaneously sustain multiple functions. However, it is unclear how trait diversity sustains the multiple contributions biodiversity makes to people. Freshwater fisheries nourish hundreds of millions of people globally, but overharvesting and river fragmentation are increasingly affecting catches. We analyse how loss of nutritional trait diversity in consumed fish portfolios affects the simultaneous provisioning of six essential dietary nutrients using household data from the Amazon and Tonlé Sap, two of Earth's most productive and diverse freshwater fisheries. We find that fish portfolios with high trait diversity meet higher thresholds of required daily intakes for a greater variety of nutrients with less fish biomass. This beneficial biodiversity effect is driven by low redundancy in species nutrient content profiles. Our findings imply that sustaining the dietary contributions fish make to people given declining biodiversity could require more biomass and ultimately exacerbate fishing pressure in already-stressed ecosystems.


Assuntos
Ecossistema , Pesqueiros , Humanos , Animais , Biomassa , Biodiversidade , Água Doce , Nutrientes , Peixes
4.
J Hum Nutr Diet ; 36(6): 2201-2218, 2023 12.
Artigo em Inglês | MEDLINE | ID: mdl-37792904

RESUMO

BACKGROUND: Economic reforms and trade liberalisation in Vietnam have transformed the food environment, influencing dietary patterns and malnutrition status. The present study focuses on the relationship between food environments (proximity and density of food outlets) and malnutrition (underweight, overweight, obesity) through diet quality in adult populations across urban, periurban and rural areas of Vietnam. METHODS: We evaluated food environment by geospatial mapping of food outlets through a transect walk across the "food ecosystem" from rural to urban areas. Diet quality was assessed using the Diet Quality Index - Vietnamese (DQI-V) comprising Variety, Adequacy, Moderation and Balance components. Malnutrition status was determined using body mass index. We performed a mediation analysis utilising mixed effect models to control for neighbourhood clustering effects. Confounders included age, education, income and nutrition knowledge score. RESULTS: Analysis of data from 595 adult participants (mean ± SD age: 31.2 ± 6.4 years; 50% female) found that longer distance to the nearest food outlet was associated with higher overall DQI-V (ß = 2.0; 95% confidence interval = 0.2-3.8; p = 0.036) and the Moderation component (ß = 2.6; 95% confidence interval = 1.2-4.0; p = 0.001). Outlet density shows a negative association with the odds of underweight among women (odds ratio = 0.62; 95% confidence interval = 0.37-0.96). However, we did not observe statistically significant relationships between diet quality and malnutrition. Education and nutrition knowledge scores were positively associated with diet diversity, while income was negatively associated with diet moderation. CONCLUSIONS: The findings of the present study have important implications for nutrition and dietetics practice in Vietnam and globally. It emphasises the need to consider various dimensions of sustainable diets, including economic, health and socio-cultural/political factors. Longer distances to food outlets are associated with higher diet quality, whereas lower food outlet density increases the odds of underweight among women. This poses challenges in balancing modernisation and its adverse effects on sustainable food systems. Socio-economic status consistently correlated with diet quality and malnutrition, necessitating further research to promote healthy diets across socio-economic strata.


Assuntos
Desnutrição , Magreza , Feminino , Adulto , Humanos , Adulto Jovem , Masculino , Magreza/epidemiologia , Magreza/etiologia , Vietnã/epidemiologia , Ecossistema , Dieta/efeitos adversos , Desnutrição/epidemiologia , Desnutrição/etiologia
5.
Public Health Nutr ; 24(3): 476-486, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33308365

RESUMO

OBJECTIVE: Our understanding of the nutrient contribution of fish and other aquatic species to human diets relies on nutrient composition data for a limited number of species. Yet particularly for nutritionally vulnerable aquatic food consumers, consumption includes a wide diversity of species whose nutrient composition data are disparate, poorly compiled or unknown. DESIGN: To address the gap in understanding fish and other aquatic species' nutrient composition data, we reviewed the literature with an emphasis on species of fish that are under-represented in global databases. We reviewed 164 articles containing 1370 entries of all available nutrient composition data (e.g. macronutrients, micronutrients and fatty acids) and heavy metals (e.g. Pb and Hg) for 515 species, including both inland and marine species of fish, as well as other aquatic species (e.g. crustaceans, molluscs, etc.) when those species were returned by our searches. RESULTS: We highlight aquatic species that are particularly high in nutrients of global importance, including Fe, Zn, Ca, vitamin A and docosahexaenoic acid (DHA), and demonstrate that, in many cases, a serving can fill critical nutrient needs for pregnant and lactating women and young children. CONCLUSIONS: By collating the available nutrient composition data on species of fish and other aquatic species, we provide a resource for fisheries and nutrition researchers, experts and practitioners to better understand these critical species and include them in fishery management as well as food-based programmes and policies.


Assuntos
Peixes , Valor Nutritivo , Alimentos Marinhos/análise , Animais , Criança , Pré-Escolar , Feminino , Pesqueiros , Humanos , Lactação , Micronutrientes , Estado Nutricional , Gravidez
6.
Fish Res ; 237: 105856, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-36540269

RESUMO

Small-scale fisheries underpin the aquatic food supply, and are facing acute challenges in the wake of the COVID-19 pandemic. The study aimed to examine how small-scale fishing households, including fishers and fish traders, are responding to COVID-19 and associated movement restrictions around Lake Victoria, Kenya. We conducted phone interviews with 88 households in three riparian communities around Lake Victoria to examine shifts in fish consumption, fishing activities, price changes, and coping strategies. We found that households are consuming less fish, perceiving high fish prices, and coping by more often selling than eating fish. Most fishers and traders reported spending less time fishing and trading, and concern about being infected with COVID-19 was high. Our findings suggest movement restrictions and COVID-19 concern, along with high lake levels in the region, may limit fishing activities and fish access. Controlling COVID-19 and supporting opportunities for fishers and traders to safely return to their livelihood activities will be paramount to the recovery of small-scale fishing communities today. Our findings can also support planning to mitigate the impacts of future crises on small-scale fishing communities.

7.
Proc Natl Acad Sci U S A ; 114(16): 4171-4176, 2017 04 18.
Artigo em Inglês | MEDLINE | ID: mdl-28377522

RESUMO

Understanding feedbacks between human and environmental health is critical for the millions who cope with recurrent illness and rely directly on natural resources for sustenance. Although studies have examined how environmental degradation exacerbates infectious disease, the effects of human health on our use of the environment remains unexplored. Human illness is often tacitly assumed to reduce human impacts on the environment. By this logic, ill people reduce the time and effort that they put into extractive livelihoods and, thereby, their impact on natural resources. We followed 303 households living on Lake Victoria, Kenya over four time points to examine how illness influenced fishing. Using fixed effect conditional logit models to control for individual-level and time-invariant factors, we analyzed the effect of illness on fishing effort and methods. Illness among individuals who listed fishing as their primary occupation affected their participation in fishing. However, among active fishers, we found limited evidence that illness reduced fishing effort. Instead, ill fishers shifted their fishing methods. When ill, fishers were more likely to use methods that were illegal, destructive, and concentrated in inshore areas but required less travel and energy. Ill fishers were also less likely to fish using legal methods that are physically demanding, require travel to deep waters, and are considered more sustainable. By altering the physical capacity and outlook of fishers, human illness shifted their effort, their engagement with natural resources, and the sustainability of their actions. These findings show a previously unexplored pathway through which poor human health may negatively impact the environment.


Assuntos
Conservação dos Recursos Naturais/economia , Estado Terminal , Pesqueiros/economia , Pesqueiros/estatística & dados numéricos , Fatores Socioeconômicos , África Oriental , Animais , Ecossistema , Meio Ambiente , Humanos , Recursos Naturais
8.
Matern Child Nutr ; 15(3): e12782, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-30676696

RESUMO

Food insecurity and poor infant and young child feeding (IYCF) practices contribute to undernutrition. The Kanyakla Nutrition Program was developed in rural Kenya to provide knowledge alongside social support for recommended IYCF practices. Utilizing a social network approach, the Kanyakla Nutrition Program trained community health workers (CHWs) to engage mothers, fathers, and grandparents in nutrition education and discussions about strategies to provide instrumental, emotional, and information support within their community. The 12-week programme included six sessions and was implemented on Mfangano Island, Kenya, in 2014-2015. We analysed intervention effects on (a) nutrition knowledge among community members or CHWs and (2) IYCF practices among children 1-3 years. Nutrition knowledge was assessed using a postintervention comparison among intervention (community, n = 43; CHW, n = 22) and comparison groups (community, n = 149; CHW, n = 64). We used a quasi-experimental design and difference-in-difference to assess IYCF indicators using dietary recall data from an ongoing cohort study among intervention participants (n = 48) with individuals living on Mfangano Island where the intervention was not implemented (n = 178) before the intervention, within 1 month postintervention, and 6 months postintervention. Findings showed no effect of the intervention on IYCF indicators (e.g., dietary diversity and meal frequency), and less than 15% of children met minimum acceptable diet criteria at any time point. However, knowledge and confidence among community members and CHWs were significantly higher 2 years postintervention. Thus, a social network approach had an enduring effect on nutrition knowledge, but no effects on improved IYCF practices.


Assuntos
Cuidadores/educação , Educação em Saúde/métodos , Conhecimentos, Atitudes e Prática em Saúde , Fenômenos Fisiológicos da Nutrição do Lactente , Apoio Social , Adulto , Pré-Escolar , Estudos de Coortes , Agentes Comunitários de Saúde , Pai/educação , Feminino , Humanos , Lactente , Quênia , Masculino , Mães/educação , Estado Nutricional , Avaliação de Programas e Projetos de Saúde , População Rural
9.
Public Health Nutr ; 21(4): 777-784, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-29173215

RESUMO

OBJECTIVE: Long-chain PUFA (LCPUFA) found in breast milk are derived from dietary sources and critical for optimal infant development. We examined associations between fish consumption and concentrations of LCPUFA and essential n-3 and n-6 fatty acids in breast milk among mothers living around Lake Victoria. DESIGN: We used cross-sectional analyses of associations between recent fish consumption and breast-milk fatty acid concentrations. SETTING: The study was conducted around Lake Victoria on Mfangano Island, Kenya, where multiple fish species are key dietary components and also are widely exported. SUBJECTS: Breast-feeding mothers (n 60) provided breast-milk samples, anthropometric measurements and questionnaire responses. RESULTS: In the previous 3 d, 97 % of women consumed a mean of 178 (sd 111) g fish (~2 servings/3 d). Mean breast-milk concentrations included DHA (0·75 % of total fatty acids), EPA (0·16 %), α-linolenic acid (ALA; 0·54 %), arachidonic acid (AA; 0·44 %) and linoleic acid (LA; 12·7 %). Breast-milk DHA concentrations exceeded the global average of 0·32 % in fifty-nine of sixty samples. We found native cichlids (Cichlidae) and dagaa (Rastrineobola argentea) contributed high levels of DHA, EPA and AA to local diets. We also found evidence for associations between fish species consumed and breast-milk LCPUFA concentrations when controlling for intake of other fish species, maternal body mass, maternal age, child age and exclusive breast-feeding. CONCLUSIONS: The fatty acid composition of breast milk was influenced by the fish species consumed. Ensuring access to diverse fish and particularly inexpensive, locally available species, may be important for diet quality as well as infant growth and development.


Assuntos
Dieta , Ácidos Graxos Insaturados/metabolismo , Comportamento Alimentar , Peixes , Fenômenos Fisiológicos da Nutrição Materna , Leite Humano/metabolismo , Alimentos Marinhos , Adulto , Animais , Ácido Araquidônico/metabolismo , Aleitamento Materno , Estudos Transversais , Ácidos Graxos Ômega-3/metabolismo , Feminino , Peixes/classificação , Humanos , Lactente , Quênia , Ácido Linoleico/metabolismo , Glândulas Mamárias Humanas/metabolismo , Mães , Especificidade da Espécie , Adulto Jovem
10.
Matern Child Nutr ; 14(2): e12543, 2018 04.
Artigo em Inglês | MEDLINE | ID: mdl-29063732

RESUMO

This study examines the association between 3 dimensions of food insecurity (timing, intensity, and duration) and 3 domains of child development (gross motor, communication, and personal social). Longitudinal data from 303 households (n = 309 children) visited 9 times over 2 years were collected. Children in households experiencing severe food insecurity 3 months prior (timing) had significantly lower gross motor (ß -0.14; 95% CI [0.27, -0.0033]; p = .045), communication (ß -0.16; 95% CI [-0.30, -0.023]; p = .023), and personal social (ß -0.20; 95% CI [-0.33, -0.073]; p = .002) Z-scores, using lagged longitudinal linear models controlling for current food insecurity; these results were attenuated in full models, which included maternal education, household asset index, and child anthropometry. Children in households that experienced greater aggregate food insecurity over the past 2 years (intensity) had significantly lower gross motor (ß -0.047; 95% CI [-0.077, -0.018]; p = .002), communication (ß -0.042; 95% CI [-0.076, -0.0073]; p = .018), and personal social (ß -0.042; 95% CI [-0.074, -0.010]; p = .010) Z-scores; these results were also attenuated in full models. Children with more time exposed to food insecurity (duration) had significantly lower gross motor (ß -0.050; 95% CI [-0.087, -0.012]; p = .010), communication (ß -0.042; 95% CI [-0.086, 0.0013]; p = .057), and personal social (ß -0.037; 95% CI [-0.077, 0.0039]; p = .076) Z-scores; these results were no longer significant in full models. Our findings suggest that acute and chronic food insecurity and child development are related, but that many associations are attenuated with the inclusion of relevant covariates.


Assuntos
Desenvolvimento Infantil/fisiologia , Abastecimento de Alimentos/estatística & dados numéricos , Pré-Escolar , Países em Desenvolvimento , Feminino , Humanos , Lactente , Quênia , Estudos Longitudinais , Masculino , Pobreza/estatística & dados numéricos , Fatores de Tempo
11.
Nature ; 538(7625): 371, 2016 10 20.
Artigo em Inglês | MEDLINE | ID: mdl-27762358

Assuntos
Aprendizagem , Humanos
12.
AIDS Care ; 28(11): 1386-93, 2016 11.
Artigo em Inglês | MEDLINE | ID: mdl-27145451

RESUMO

HIV treatment is life-long, yet many patients travel or migrate for their livelihoods, risking treatment interruption. We examine timely reengagement in care among patients who transferred-out or were lost-to-follow-up (LTFU) from a rural HIV facility. We conducted a cohort study among 369 adult patients on antiretroviral therapy between November 2011 and November 2013 on Mfangano Island, Kenya. Patients who transferred or were LTFU (i.e., missed a scheduled appointment by ≥90 days) were traced to determine if they reengaged or accessed care at another clinic. We report cumulative incidence and time to reengagement using Cox proportional hazards models adjusted for patient demographic and clinical characteristics. Among 369 patients at the clinic, 23(6%) requested an official transfer and 78(21%) were LTFU. Among official transfers, cumulative incidence of linkage to their destination facility was 91% at three months (95%CI (confidence intervals) 69-98%). Among LTFU, cumulative incidence of reengagement in care at the original or a new clinic was 14% at three months (95%CI 7-23%) and 60% at six months (95%CI 48-69%). In the adjusted Cox model, patients who left with an official transfer reengaged in care six times faster than those who did not (adjusted hazard ratio 6.2, 95%CI 3.4-11.0). Patients who left an island-based HIV clinic in Kenya with an official transfer letter reengaged in care faster than those who were LTFU, although many in both groups had treatment gaps long enough to risk viral rebound. Better coordination of transfers between clinics, such as assisting patients with navigating the process or improving inter-clinic communication surrounding transfers, may reduce delays in treatment during transfer and improve overall clinical outcomes.


Assuntos
Fármacos Anti-HIV/uso terapêutico , Infecções por HIV/tratamento farmacológico , Perda de Seguimento , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Transferência de Pacientes/estatística & dados numéricos , Migrantes/estatística & dados numéricos , Adulto , Instituições de Assistência Ambulatorial , Feminino , Seguimentos , Humanos , Incidência , Quênia , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais
14.
Ecol Food Nutr ; 54(4): 358-69, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25680030

RESUMO

The objective of this study was to investigate the relationship among socioeconomic status, social support, and food insecurity in a rural Kenyan island community. A cross-sectional random sample of 111 female heads of households representing 583 household members were surveyed in Mfangano Island, Kenya from August to October 2010 using adaptations of the Household Food Insecurity Access Scale and the Medical Outcomes Study Social Support Survey. In multiple linear regression models, less instrumental social support, defined as concrete direct ways people help others (B = -0.81; 95% confidence interval [CI] -1.45 to -0.17), and decreased ownership scale based on owning material assets (B = -2.93; 95% CI -4.99 to -0.86) were significantly associated with increased food insecurity, controlling for age, education, marital status, and household size. Social support interventions geared at group capacity and resilience may be crucial adjuncts to improve and maintain the long term food security and health of persons living in low-resource regions.


Assuntos
Abastecimento de Alimentos , Classe Social , Apoio Social , Adulto , Idoso , Estudos Transversais , Feminino , Humanos , Ilhas , Quênia , Pessoa de Meia-Idade , População Rural , Adulto Jovem
15.
Lancet ; 381(9877): 1561-9, 2013 May 04.
Artigo em Inglês | MEDLINE | ID: mdl-23391466

RESUMO

BACKGROUND: The proportion of heterosexual HIV transmission in sub-Saharan Africa that occurs within cohabiting partnerships, compared with that in single people or extra-couple relationships, is widely debated. We estimated the proportional contribution of different routes of transmission to new HIV infections. As plans to use antiretroviral drugs as a strategy for population-level prevention progress, understanding the importance of different transmission routes is crucial to target intervention efforts. METHODS: We built a mechanistic model of HIV transmission with data from Demographic and Health Surveys (DHS) for 2003-2011, of 27,201 cohabiting couples (men aged 15-59 years and women aged 15-49 years) from 18 sub-Saharan African countries with information about relationship duration, age at sexual debut, and HIV serostatus. We combined this model with estimates of HIV survival times and country-specific estimates of HIV prevalence and coverage of antiretroviral therapy (ART). We then estimated the proportion of recorded infections in surveyed cohabiting couples that occurred before couple formation, between couple members, and because of extra-couple intercourse. FINDINGS: In surveyed couples, we estimated that extra-couple transmission accounted for 27-61% of all HIV infections in men and 21-51% of all those in women, with ranges showing intercountry variation. We estimated that in 2011, extra-couple transmission accounted for 32-65% of new incident HIV infections in men in cohabiting couples, and 10-47% of new infections in women in such couples. Our findings suggest that transmission within couples occurs largely from men to women; however, the latter sex have a very high-risk period before couple formation. INTERPRETATION: Because of the large contribution of extra-couple transmission to new HIV infections, interventions for HIV prevention should target the general sexually active population and not only serodiscordant couples. FUNDING: US National Institutes of Health, US National Science Foundation, and J S McDonnell Foundation.


Assuntos
Infecções por HIV/epidemiologia , Infecções por HIV/transmissão , Adolescente , Adulto , África Subsaariana/epidemiologia , Características da Família , Feminino , Soropositividade para HIV/epidemiologia , Soropositividade para HIV/transmissão , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Modelos Biológicos , Adulto Jovem
16.
PLoS One ; 19(5): e0302397, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38776265

RESUMO

Drowning is an overlooked public health concern and drowning risk is dependent on environmental risk factors. The preponderance of drowning deaths occurs in low- and middle-income countries. Small-scale fishers face high occupational risk of drowning. Climate change increases the frequency and intensity of storms, thereby exacerbating fishers' risks and creating a need to examine the contribution of storms to fisher drowning deaths for the development of mitigation strategies. We examined this relationship between weather and fisher drowning deaths in Lake Victoria, which is Africa's largest lake, a site of high fishing pressure, and where climate change is predicted to increase thunderstorms. We conducted a verbal autopsy with people knowledgeable about recent fatal fisher drowning incidents to collect information about the deceased fishers and circumstances surrounding the incidents across 43 landing sites in the Kenyan shore of Lake Victoria. Semi-structured interviews with stakeholders also elucidated community perspectives on drowning risks. Fatal drownings were often attributed to bad weather (41.8%). Other risk factors, such as non-use of life jacket and navigation equipment, co-occurred with bad weather at high rates (69.5% and 67.8%, respectively) to jointly contribute to fatal drowning incidents. Such co-occurrence of risk factors indicates that actions across multiple risk factors can help mitigate the issue. Stakeholder analysis revealed a range of opportunities for improved communication of risks and action to mitigate risks across boat operators and manufacturers, as well as multiple levels of management. Across global small-scale fisheries, limited use of safety equipment and intensive fishing pressure may coincide with increases in extreme weather events, necessitating action to address current and mitigate future drowning risks to small-scale fishers.


Assuntos
Mudança Climática , Afogamento , Pesqueiros , Humanos , Afogamento/mortalidade , Afogamento/epidemiologia , Masculino , Adulto , Fatores de Risco , Feminino , Pessoa de Meia-Idade , Quênia/epidemiologia , Adulto Jovem , Lagos , Adolescente , Tempo (Meteorologia) , Idoso , Acidentes de Trabalho/mortalidade , Acidentes de Trabalho/estatística & dados numéricos
17.
J Glob Antimicrob Resist ; 36: 175-180, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38154747

RESUMO

OBJECTIVES: The contamination of fresh surface waters poses a significant burden on human health and prosperity, especially in marginalized communities with limited resources and inadequate infrastructure. Here, we performed in-depth genomic analyses of multidrug-resistant bacteria (MDR-B) isolated from Al-Oueik river water that is used for irrigation of agricultural fields in a disenfranchised area that also hosts a makeshift Syrian refugee camp. METHODS: A composite freshwater sample was filtered. Faecal coliforms were counted and extended spectrum cephalosporins and/or ertapenem resistant bacteria were screened. Isolates were identified using MALDI-TOF-MS and analysed using whole-genome sequencing (WGS) to identify the resistome, sequence types, plasmid types, and virulence genes. RESULTS: Approximately 106 CFU/100 mL of faecal coliforms were detected in the water. Four drug-resistant Gram-negative bacteria were identified, namely Escherichia coli, Klebsiella pneumoniae, Enterobacter hormaechei, and Pseudomonas otitidis. Notably, the E. coli isolate harboured blaNDM-5 and a YRIN-inserted PBP3, representing an emerging public health challenge. The K. pneumoniae isolate carried blaSHV-187 as well as mutations in the gene encoding the OmpK37 porin. Enterobacter hormaechei and P. otitidis harboured blaACT-16 and blaPOM-1, respectively. CONCLUSION: This report provides comprehensive genomic analyses of MDR-B in irrigation water in Lebanon. Our results further support that irrigation water contaminated with faecal material can be a reservoir of important MDR-B, which can spread to adjacent agricultural fields and other water bodies, posing both public health and food safety issues. Therefore, there is an urgent need to implement effective water quality monitoring and management programs to control the proliferation of antibiotic-resistant pathogens in irrigation water in Lebanon.


Assuntos
Escherichia coli , Rios , Humanos , Escherichia coli/genética , Rios/microbiologia , Enterobacter/genética , Plasmídeos/genética , Klebsiella pneumoniae/genética , Bactérias Gram-Negativas
18.
AIDS Care ; 25(12): 1491-8, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23464799

RESUMO

Low body mass index (BMI) at the time of enrollment into HIV care has been shown to be a strong predictor of mortality independent of CD4 count. This study investigated socio-demographic associations with underweight (BMI < 18.5) among adults in Nyanza Province, Kenya, upon enrollment into HIV care. BMI, socio-demographic, and health data from a cross-sectional sample of 8254 women and 3533 men were gathered upon enrollment in the Family AIDS Care and Education Services (FACES) program in Nyanza Province, Kenya, between January 2005 and March 2010. Overall, 27.4% of adults were underweight upon enrollment in HIV care. Among each women [W] and men [M], being underweight was associated with younger age (W: adjusted odds ratio [AOR], 2.90; 95% confidence interval [CI], 1.85-4.55; M: AOR, 5.87; 95% CI, 2.80-12.32 for those aged 15-19 compared to ≥50 years old), less education (W: AOR, 2.92; 95% CI, 1.83-4.65; M: AOR, 1.55; 95% CI, 1.04-2.31 for primary education compared to some college/university), low CD4 count (W: AOR, 2.13; 95% CI, 1.50-3.03; M: AOR, 1.43; 95% CI, 0.76-2.70 for 0-250 compared to ≥750 cells/mm(3)), and poor self-reported health status (W: AOR, 1.72; 95% CI, 0.89-3.33; M: AOR, 9.78; 95% CI, 1.26-75.73 for poor compared to excellent). Among all enrollees to HIV care, low BMI was associated with male gender, lower educational attainment, younger age, and poor self-reported health. HIV care and treatment programs should consider using socio-demographic and health risk factors associated with low BMI to target and recruit patients with the goal of preventing late enrollment into care.


Assuntos
Índice de Massa Corporal , Infecções por HIV/terapia , Nível de Saúde , Adulto , Fatores Etários , Antropometria , Contagem de Linfócito CD4 , Estudos Transversais , Escolaridade , Feminino , Humanos , Quênia , Masculino , Pessoa de Meia-Idade , Razão de Chances , Autorrelato , Fatores Sexuais , Classe Social , Adulto Jovem
20.
Front Nutr ; 10: 1222610, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37731401

RESUMO

Introduction: COVID-19 acutely shocked both socio-economic and food systems in 2020. We investigated the impact of COVID-19 on production and consumption of gardened produce, backyard poultry, wild game and fish, and foraged mushrooms, berries, and other plants in New York State, aiming to understand crisis influenced food choice and motivations, including food security. Methods: We conducted an online, cross-sectional survey in October-December 2020 with a convenience sample of participants (n = 505) with an interest in gardening, poultry rearing, foraging, hunting, and/or fishing from six counties in upstate New York. We recruited through the New York Department of Environmental Conservation, Cornell Cooperative Extension, and other relevant email and social media pages. Results: Across the wild and backyard food production strategies, 4.0-14.3% of respondents reported engaging for the first time and 39.6-45.7% reported increased production (a little or a lot more), and 31.6-42.7% of respondents' production was the same as the previous year. Consumption of foods produced was widespread, including fruit and vegetables (97.6% of producers also consumed), backyard eggs (92.7%), and foraged foods (93.8%). For meats, a majority consumed backyard poultry meat (51.2%), wild-caught fish (69.7%), and wild game they hunted (80.1%). The frequency of consumption of fruit and vegetables (average of 13.5 times/month) and eggs (16.4 times/month) was very high, while average consumption of poultry meat, foraged foods, fish, and wild game ranged from 3.1 to 5.8 times/month. The number of respondents who reported "have more control over food availability" as motivation to produce all wild and backyard foods increased from 2019 to 2020 (p < 0.05 - p < 0.001). There was also a significant relationship between experiences of COVID-19 related hardship (i.e., food insecurity, income loss) with gardening and poultry-rearing (p ≤ 0.05), but not with other production methods or with consumption of wild and backyard foods. Discussion: Our findings help to locate wild and backyard foods within COVID-19 impacted food environments, and describe food security as a particularly relevant motivation, among others, reported by respondents in 2020. Given this, New York State service providers can use these findings to tailor current future support for households exerting control over their own food environments with wild and backyard foods, allowing the state to be better prepared for future crises.

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