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BMJ Glob Health ; 3(4): e000801, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30233829


Background: Responsible for considerable global human morbidity and mortality, Aedes aegypti and Ae. albopictus are the primary vectors of several important human diseases, including dengue and yellow fever. Although numerous variables that affect mosquito survival and reproduction have been recorded at the local and regional scales, many remain untested at the global level, potentially confounding mapping efforts to date. Methods: We develop a modelling ensemble of boosted regression trees and maximum entropy models using sets of variables previously untested at the global level to examine their performance in predicting the global distribution of these two vectors. The results show that accessibility, absolute humidity and annual minimum temperature are consistently the strongest predictors of mosquito presence. Both vectors are similar in their response to accessibility and humidity, but exhibit individual profiles for temperature. Their mapped ranges are therefore similar except at peripheral latitudes, where the range of Ae. albopictus extends further, a finding consistent with ongoing trapping studies. We show that variables previously identified as being relevant, including maximum and mean temperatures, enhanced vegetation index, relative humidity and population density, are comparatively weak performers. Results: The variables identified represent three key biological mechanisms. Cold tolerance is a critical biological parameter, controlling both species' distribution northwards, and to a lesser degree for Ae. albopictus which has consequent greater inland suitability in North America, Europe and East Asia. Absolute humidity restricts the distribution of both vectors from drier areas, where moisture availability is very low, and increases their suitability in coastal areas. The latter is exacerbated by accessibility with increased likelihood of vector importation due to greater potential for human and trade movement. Conclusion: Accessibility, absolute humidity and annual minimum temperatures were the strongest and most robust global predictors of Ae. aegypti and Ae. albopictus presence, which should be considered in control efforts and future distribution projections.

Lancet Planet Health ; 1(5): e180-e187, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29851639


BACKGROUND: Potential synergies between public health and environmental protection that offer new opportunities for achieving health and sustainable development targets have been postulated. However, empirical evidence of the effect of ecosystem degradation and protection on public health outcomes is scarce, which restricts policy makers' ability to assess the net health effects of land-use change. METHODS: We used generalised linear mixed-effects models to analyse data for 35 547 households in 1766 communities from the Cambodian Demographic Health Surveys to investigate the relation between health and protected areas across deforestation gradients in Cambodia between Feb 1, 2005, and April 30, 2014. Diarrhoea, acute respiratory infection, and fever in children younger than 5 years were used as population health indicators. Dense and mixed forest coverage were derived from Open Development Cambodia, and forest loss was calculated from 2000 to 2004, 2004 to 2009, and 2009 to 2014. The incidence of non-specific illness and injury in people older than 15 years was used as a negative control. Our analyses included rich pseudo-panel data (combining cross-sectional datasets from 2005, 2010, and 2014) that accounted for socioeconomic, demographic, and behavioural characteristics, and had a negative control, approximating a quasi-experimental study design. FINDINGS: Deforestation of dense forest was associated with an increased incidence of diarrhoea (p=0·007), fever (p=0·0495), and acute respiratory infection in children (p=0·003). For example, a 10 percentage point increase in loss of dense forest was estimated to be associated with an increase of 14·1% (95% CI 2·6-35·8) in the incidence of diarrhoea in children younger than 5 years per household in the 2 weeks before the Cambodian Demographic Health Surveys. Protected area coverage, but not type, was associated with decreased incidences of diarrhoea (p=0·028) and acute respiratory infection (p=0·030). Apart from an association between mixed forest coverage and increased incidence of diarrhoea, forest coverage was not associated with any health outcomes. INTERPRETATION: Deforestation is associated with increased risk of several major sources of global childhood morbidity and mortality. Although causal mechanisms are unclear, our findings suggest that protected areas could help to alleviate the global health burden, presenting new possibilities for simultaneous achievement of public health and conservation goals. FUNDING: Ministry of Education of Singapore.