Coupling remote sensing and eDNA to monitor environmental impact: A pilot to quantify the environmental benefits of sustainable agriculture in the Brazilian Amazon.

Monitoring is essential to ensure that environmental goals are being achieved, including those of sustainable agriculture. Growing interest in environmental monitoring provides an opportunity to improve monitoring practices. Approaches that directly monitor land cover change and biodiversity annually by coupling the wall-to-wall coverage from remote sensing and the site-specific community composition from environmental DNA (eDNA) can provide timely, relevant results for parties interested in the success of sustainable agricultural practices. To ensure that the measured impacts are due to the environmental projects and not exogenous factors, sites where projects have been implemented should be benchmarked against counterfactuals (no project) and control (natural habitat) sites. Results can then be used to calculate diverse sets of indicators customized to monitor different projects. Here, we report on our experience developing and applying one such approach to assess the impact of shaded cocoa projects implemented by the Instituto de Manejo e Certificação Florestal e Agrícola (IMAFLORA) near São Félix do Xingu, in Pará, Brazil. We used the Continuous Degradation Detection (CODED) and LandTrendr algorithms to create a remote sensing-based assessment of forest disturbance and regeneration, estimate carbon sequestration, and changes in essential habitats. We coupled these remote sensing methods with eDNA analyses using arthropod-targeted primers by collecting soil samples from intervention and counterfactual pasture field sites and a control secondary forest. We used a custom set of indicators from the pilot application of a coupled monitoring framework called TerraBio. Our results suggest that, due to IMAFLORA's shaded cocoa projects, over 400 acres were restored in the intervention area and the community composition of arthropods in shaded cocoa is closer to second-growth forests than that of pastures. In reviewing the coupled approach, we found multiple aspects worked well, and we conclude by presenting multiple lessons learned.

The Arbovirus Mapping and Prediction (ArboMAP) system for West Nile virus forecasting.

Objectives: West Nile virus (WNV) is the most common mosquito-borne disease in the United States. Predicting the location and timing of outbreaks would allow targeting of disease prevention and mosquito control activities. Our objective was to develop software (ArboMAP) for routine WNV forecasting using public health surveillance data and meteorological observations. Materials and Methods: ArboMAP was implemented using an R markdown script for data processing, modeling, and report generation. A Google Earth Engine application was developed to summarize and download weather data. Generalized additive models were used to make county-level predictions of WNV cases. Results: ArboMAP minimized the number of manual steps required to make weekly forecasts, generated information that was useful for decision-makers, and has been tested and implemented in multiple public health institutions. Discussion and Conclusion: Routine prediction of mosquito-borne disease risk is feasible and can be implemented by public health departments using ArboMAP.

Trend analysis of malaria in urban settings in Ethiopia from 2014 to 2019.

BACKGROUND: Urbanization generally improves health outcomes of residents and is one of the potential factors that might contribute to reducing malaria transmission. However, the expansion of Anopheles stephensi, an urban malaria vector, poses a threat for malaria control and elimination efforts in Africa. In this paper, malaria trends in urban settings in Ethiopia from 2014 to 2019 are reported with a focus on towns and cities where An. stephensi surveys were conducted. METHODS: A retrospective study was conducted to determine malaria trends in urban districts using passive surveillance data collected at health facilities from 2014 to 2019. Data from 25 towns surveyed for An. stephensi were used in malaria trend analysis. Robust linear models were used to identify outliers and impute missing and anomalous data. The seasonal Mann-Kendal test was used to test for monotonic increasing or decreasing trends. RESULTS: A total of 9,468,970 malaria cases were reported between 2014 and 2019 through the Public Health Emergency Management (PHEM) system. Of these, 1.45 million (15.3%) cases were reported from urban settings. The incidence of malaria declined by 62% between 2014 and 2018. In 2019, the incidence increased to 15 per 1000 population from 11 to 1000 in 2018. Both confirmed (microscopy or RDT) Plasmodium falciparum (67%) and Plasmodium vivax (28%) were reported with a higher proportion of P. vivax infections in urban areas. In 2019, An. stephensi was detected in 17 towns where more than 19,804 malaria cases were reported, with most of the cases (56%) being P. falciparum. Trend analysis revealed that malaria cases increased in five towns in Afar and Somali administrative regions, decreased in nine towns, and had no obvious trend in the remaining three towns. CONCLUSION: The contribution of malaria in urban settings is not negligible in Ethiopia. With the rapid expansion of An. stephensi in the country, the receptivity is likely to be higher for malaria. Although the evidence presented in this study does not demonstrate a direct linkage between An. stephensi detection and an increase in urban malaria throughout the country, An. stephensi might contribute to an increase in malaria unless control measures are implemented as soon as possible. Targeted surveillance and effective response are needed to assess the contribution of this vector to malaria transmission and curb potential outbreaks.

Cloud-based applications for accessing satellite Earth observations to support malaria early warning.

Malaria epidemics can be triggered by fluctuations in temperature and precipitation that influence vector mosquitoes and the malaria parasite. Identifying and monitoring environmental risk factors can thus provide early warning of future outbreaks. Satellite Earth observations provide relevant measurements, but obtaining these data requires substantial expertise, computational resources, and internet bandwidth. To support malaria forecasting in Ethiopia, we developed software for Retrieving Environmental Analytics for Climate and Health (REACH). REACH is a cloud-based application for accessing data on land surface temperature, spectral indices, and precipitation using the Google Earth Engine (GEE) platform. REACH can be implemented using the GEE code editor and JavaScript API, as a standalone web app, or as package with the Python API. Users provide a date range and data for 852 districts in Ethiopia are automatically summarized and downloaded as tables. REACH was successfully used in Ethiopia to support a pilot malaria early warning project in the Amhara region. The software can be extended to new locations and modified to access other environmental datasets through GEE.

Comparing malaria early detection methods in a declining transmission setting in northwestern Ethiopia.

BACKGROUND: Despite remarkable progress in the reduction of malaria incidence, this disease remains a public health threat to a significant portion of the world's population. Surveillance, combined with early detection algorithms, can be an effective intervention strategy to inform timely public health responses to potential outbreaks. Our main objective was to compare the potential for detecting malaria outbreaks by selected event detection methods. METHODS: We used historical surveillance data with weekly counts of confirmed Plasmodium falciparum (including mixed) cases from the Amhara region of Ethiopia, where there was a resurgence of malaria in 2019 following several years of declining cases. We evaluated three methods for early detection of the 2019 malaria events: 1) the Centers for Disease Prevention and Control (CDC) Early Aberration Reporting System (EARS), 2) methods based on weekly statistical thresholds, including the WHO and Cullen methods, and 3) the Farrington methods. RESULTS: All of the methods evaluated performed better than a naïve random alarm generator. We also found distinct trade-offs between the percent of events detected and the percent of true positive alarms. CDC EARS and weekly statistical threshold methods had high event sensitivities (80-100% CDC; 57-100% weekly statistical) and low to moderate alarm specificities (25-40% CDC; 16-61% weekly statistical). Farrington variants had a wide range of scores (20-100% sensitivities; 16-100% specificities) and could achieve various balances between sensitivity and specificity. CONCLUSIONS: Of the methods tested, we found that the Farrington improved method was most effective at maximizing both the percent of events detected and true positive alarms for our dataset (> 70% sensitivity and > 70% specificity). This method uses statistical models to establish thresholds while controlling for seasonality and multi-year trends, and we suggest that it and other model-based approaches should be considered more broadly for malaria early detection.

Potential Bacillus anthracis Risk Zones for Male Plains Bison ( Bison bison bison) in Southwestern Montana, USA.

A re-emergence of anthrax, a zoonosis caused by the long-lived, spore-forming Bacillus anthracis, occurred with a multispecies outbreak in southwestern Montana, US in 2008. It substantially impacted a managed herd of about 3,500 free-ranging plains bison ( Bison bison bison) on a large, private ranch southwest of Bozeman, with about 8% mortality and a disproportionate 28% mortality of mature males; a similar high rate occurred in male Rocky Mountain elk ( Cervus canadensis nelson). Grazing herbivores are particularly at risk for anthrax from ingesting spore-contaminated soil and grasses in persistent environmental reservoirs. We predicted areas of mature male bison habitat preference on the landscape by using GPS collar data and a resource selection function model using environmental covariates. We overlaid preferred areas with ecologic niche, model-based predictions of B. anthracis environmental reservoirs to identify areas of high anthrax risk. Overlapping areas were distributed across the ranch and were not confined to pastures associated with the previous outbreak, suggesting that ongoing pasture exclusion alone will not prevent future outbreaks. The data suggested vaccination campaigns should continue for bison, and the results can be used to prioritize carcass surveillance in areas of greatest overlap.

Decoupling environmental effects and host population dynamics for anthrax, a classic reservoir-driven disease.

Quantitative models describing environmentally-mediated disease transmission rarely focus on the independent contribution of recruitment and the environment on the force of infection driving outbreaks. In this study we attempt to investigate the interaction between external factors and host's population dynamics in determining the outbreaks of some indirectly transmitted diseases. We first built deterministic and stochastic compartmental models based on anthrax which were parameterized using information from literature and complemented with field observations. Our force of infection function was derived modeling the number of successful transmission encounters as a pure birth process that depends on the pathogen's dispersion effort. After accounting for individual heterogeneity in pathogen's dispersion effort, we allowed the force of infection to vary seasonally according to external factors recreating a scenario in which disease transmission increases in response to an environmental variable. Using simulations we demonstrate that anthrax disease dynamics in mid-latitude grasslands is decoupled from hosts population dynamics. When seasonal forcing was ignored, outbreaks matched hosts reproductive events, a scenario that is not realistic in nature. Instead, when allowing the force of infection to vary seasonally, outbreaks were only present in years were environmental variables were appropriate for the outbreaks to develop. We used the stochastic formulation of the force of infection to derive R0 under scenarios with different assumptions. The derivation of R0 allowed us to conclude that during epizootic years, pathogen contribution to disease persistence is nearly independent of dispersion. In endemic years, only pathogens with high dispersion significantly prevent disease extinction. Finally, we used our model in a maximum likelihood framework to estimate the parameters that determined a significant anthrax outbreak in Montana in 2008. Our study highlights the importance of the environment in determining anthrax outbreak intensity and could be useful to predict future events that could result in significant wildlife and domestic livestock losses.

Dentists' preparedness for responding to bioterrorism: A survey of Hawaii dentists.

BACKGROUND: The authors conducted a survey of dentists in Hawaii to assess their knowledge of, perceived readiness for and willingness to respond to bioterrorist (BT) events. METHODS: Using a cross-sectional study design to access a random sample (n = 240) of all licensed dentists residing in the state of Hawaii (N = 1,016), the authors mailed study participants an anonymous survey up to three times during June and July 2004. Knowledge-based questions were taken from accredited Internet-based free continuing medical education offerings. RESULTS: Of 234 deliverable surveys, 133 were returned (response rate of 56.8 percent). Only 2.3 percent of respondents reported having received prior BT preparedness training. A total of 14.5 percent felt able to identify and recognize a BT event, and 9.2 percent indicated they were able to respond effectively to a BT attack. A total of 73.8 percent expressed willingness to provide assistance to the state in the event of a BT attack. Dentists scored a mean of 62 percent correct (5.6 of nine questions) on the objective knowledge-based questions. CONCLUSIONS: A low prevalence of prior training coupled with a high degree of willingness to provide assistance indicates the need for additional BT preparedness training. This should be provided as continuing education offerings to practicing dentists and incorporated into the dental school curriculum. CLINICAL IMPLICATIONS: Dentists have the basic knowledge and experience to perform a number of key roles in a BT event; however, additional training must be provided to develop BT preparedness competencies.

Hawaii physician and nurse bioterrorism preparedness survey.

INTRODUCTION: Physicians and nurses are integral components of the public health bioterrorism surveillance system. However, most published bioterrorism preparedness surveys focus on gathering information related to self-assessed knowledge or perceived needs and abilities. OBJECTIVE: A survey of physicians and nurses in Hawaii was conducted to assess objective knowledge regarding bioterrorism agents and diseases and perceived response readiness for a bioterrorism event. METHODS: During June and July 2004, an anonymous survey was mailed up to three times to a random sample of all licensed physicians and nurses residing in Hawaii. RESULTS: The response rate was 45% (115 of 255) for physicians and 53% (146 of 278) for nurses. Previous bioterrorism preparedness training associated significantly with knowledge-based test performance in both groups. Only 20% of physicians or nurses had had previous training in bioterrorism preparedness, and < 15% felt able to respond effectively to a bioterrorism event. But, > 70% expressed willingness to assist the state in the event of a bioterrorist attack. CONCLUSIONS: Additional bioterrorism preparedness training should be made available through continuing education and also should become a component of both medical and nursing school curricula. It is important to provide the knowledge necessary for physicians and nurses to improve their ability to perform in the event of a bioterrorist attack.

Hawaii veterinarians' bioterrorism preparedness needs assessment survey.

The purpose of this study was to assess the objective bioterrorism-related knowledge base and the perceived response readiness of veterinarians in Hawaii to a bioterrorism event, and also to identify variables associated with knowledge-based test performance. An anonymous survey instrument was mailed to all licensed veterinarians residing in Hawaii (N = 229) up to three times during June and July 2004, using numeric identifiers to track non-respondents. The response rate for deliverable surveys was 59% (125 of 212). Only 12% (15 of 123) of respondents reported having had prior training on bioterrorism. Forty-four percent (55 of 125) reported being able to identify a bioterrorism event in animal populations; however, only 17% (21 of 125) felt able to recognize a bioterrorism event in human populations. Only 16% (20 of 123) felt they were able to respond effectively to a bioterrorist attack. Over 90% (106 of 116) expressed their willingness to provide assistance to the state in its response to a bioterrorist event. Veterinarians scored a mean of 70% correct (5.6 out of 8 questions) on the objective knowledge-based questions. Additional bioterrorism preparedness training should be made available, both in the form of continuing educational offerings for practicing veterinarians and as a component of the curriculum in veterinary schools.

Bartonella-associated endothelial proliferation depends on inhibition of apoptosis.

Bartonella is a Gram-negative pathogen that is unique among bacteria in being able to induce angioproliferative lesions. Cultured human endothelial cells have provided an in vitro system in which to study the basis of angioproliferation. Previous studies have attributed the organism's ability to induce angioproliferative lesions to direct mitotic stimulation of endothelial cells by these bacteria. Here we show that Bartonella inhibits apoptosis of endothelial cells in vitro, and that its ability to stimulate proliferation of endothelial cells depends to a large extent on its antiapoptotic activity. Bartonella suppresses both early and late events in apoptosis, namely caspase activation and DNA fragmentation, respectively. Its ability to inhibit death of endothelial cells after serum starvation can be recapitulated by media conditioned by bacteria, indicating that direct cell contact is not necessary. Among tested strains, the activity is produced only by Bartonella species that are significant human pathogens and are associated with angioproliferative lesions. We suggest that endothelial cells normally respond to infection by undergoing apoptosis and that Bartonella evolved the antiapoptotic activity to enhance survival of the host cells and therefore itself. We propose that Bartonella's antiapoptotic mechanism accounts at least in part for its ability to induce vascular proliferation in vivo.