Meeting Report on an Integrated Research Agenda for Mosquito-Borne Arboviruses.

The emergence and re-emergence of mosquito-borne arbovirus (MBV) diseases pose a rapidly expanding global health threat fueled by the convergence of multiple ecologic, economic, and social factors, including climate change, land use, poverty, deficiencies of water storage and sanitation, and limitations of vector control programs. On December 6, 2023, the Wellcome Trust and the University of Minnesota's Center for Infectious Disease Research and Policy held a meeting titled "An integrated approach to mosquito-borne arboviruses: a priority research agenda." The meeting comprised presentations, panels, and facilitated discussions aimed at describing the state of the field, highlighting recent accomplishments, identifying novel strategies, and defining priority research goals and approaches for addressing MBV disease preparedness and response.

Metabolic profile of biodiverse diets in a healthy European cohort.

Background: There is increasing evidence that diets characterized by food biodiversity could contribute to health outcomes. Greater dietary species diversity has been linked to reduced gastrointestinal cancer risk and all-cause mortality. However, mechanistic pathways supporting the association between food biodiversity and health are just beginning to be explored.

Gaps and opportunities for data systems and economics to support priority setting for climate-sensitive infectious diseases in sub-Saharan Africa: A rapid scoping review.

Climate change alters risks associated with climate-sensitive infectious diseases (CSIDs) with pandemic potential. This poses additional threats to already vulnerable populations, further amplified by social factors such as gender inequalities. Currently, critical evidence gaps, along with inadequate institutional and governance mechanisms, hinder African states' ability to prevent, detect and respond to CSIDs.

Dietary species richness provides a comparable marker for better nutrition and health across contexts.

Ecological diversity indices such as Hill numbers have been developed to estimate effective species numbers, yet the ability of Hill numbers to compare food biodiversity across contexts is unclear. Here we computed the between- and within-country variability of similarity-insensitive Hill numbers using dietary intake collected from prospective cohorts in nine European countries and cross-sectional studies in five low- and middle-income countries. We also assessed the relationships between more biodiverse diets, mortality rates and micronutrient adequacy.

Human animal contact, land use change and zoonotic disease risk: a protocol for systematic review.

Background: Zoonotic diseases pose a significant risk to human health globally. The interrelationship between humans, animals, and the environment plays a key role in the transmission of zoonotic infections. Human-animal contact (HAC) is particularly important in this relationship, where it serves as the pivotal interaction for pathogen spillover to occur from an animal reservoir to a human.

Study protocol for an observational cohort study of heat stress impacts in pregnancy in The Gambia, West Africa.

Climate change has resulted in an increase in heat exposure globally. There is strong evidence that this increased heat stress is associated with poor maternal and fetal outcomes, especially in vulnerable populations. However, there remains poor understanding of the biological pathways and mechanisms involved in the impact of heat in pregnancy.

Affordability of healthy and water-saving dietary patterns in The Gambia.

Dietary modification has the potential to improve nutritional status and reduce environmental impacts of the food system. However, for many countries, the optimal composition of locally contextualized healthy and sustainable diets is unknown. The Gambia is vulnerable to climate-change-induced future water scarcity which may affect crop yields and the ability to supply healthy diets.

Coping strategies for household water insecurity in rural Gambia, mediating factors in the relationship between weather, water and health.

Background: Rural communities in low- and middle-income countries, such as The Gambia, often experience water insecurity periodically due to climate drivers such as heavy rainfall and reduced rainfall, as well as non-climate drivers such as infrastructural issues and seasonal workloads. When facing these challenges households use a variety of coping mechanisms that could pose a risk to health. We aimed to understand the drivers of water insecurity (climate and non-climate), the behavioural responses to water insecurity and the risks these responses pose to the health of communities in rural Gambia and map these findings onto a conceptual framework.

Multi-level determinants of timely routine childhood vaccinations in The Gambia: Findings from a nationwide analysis.

Introduction: Achieving the ambitious goals of the Immunisation Agenda 2030 (IA2030) requires a deeper understanding of factors influencing under-vaccination, including timely vaccination. This study investigates the demand- and supply-side determinants influencing the timely uptake of key childhood vaccines scheduled throughout the first year of life in The Gambia.

Methods: We used two nationally-representative datasets: the 2019-20 Gambian Demographic and Health Survey and the 2019 national immunisation facility mapping.

Socioeconomic deprivation modifies green space and mental health associations: A within person study.

Living in an area with good availability and accessibility of residential green spaces such as parks, woodlands, and residential gardens can improve mental health and reduce the global disease burden. Unlike for physical health, it is not well understood if mental health and green space associations might be modified by local area deprivation. Existing evidence for this association comes from cross-sectional studies, widely considered vulnerable to confounding and bias.

Human-animal contact to inform zoonotic disease risk across gradients of agricultural land use change in the Central River Region (CRR) of The Gambia (ZooContact): a formative study.

Introduction: Pilot studies are important initial steps in research, providing a preliminary assessment of the practicality, feasibility, and potential challenges of a proposed study. This study attempts to assess the feasibility, practicality, and acceptability of a study that integrates a human-animal contact (HAC) questionnaire, animal biodiversity survey using acoustic analysis, and zoonotic disease investigation in animals among rural households in the Central River Region (CRR) of The Gambia. The pilot study revealed granular insights that would otherwise go unnoticed, providing vital information that directly guided the design and implementation of the subsequent full-scale study on zoonotic disease risk.

Food biodiversity and gastrointestinal cancer risk in nine European countries: Analysis within a prospective cohort study.

Background: Food biodiversity in human diets has potential co-benefits for both public health and sustainable food systems. However, current evidence on the potential relationship between food biodiversity and cancer risk, and particularly gastrointestinal cancers typically related to diet, remains limited. This study evaluated how dietary species richness (DSR) was associated with gastrointestinal cancer risk in a pan-European population.

Effects of global change on snakebite envenoming incidence up to 2050: a modelling assessment.

Background: Human activities are driving climate, land cover, and population change (global change), and shifting the baseline geographical distribution of snakebite. The interacting effects of global change on snakes and communities at risk of snakebite are poorly understood, limiting capacity to anticipate and manage future changes in snakebite risk.

Methods: In this modelling study, we projected how global change will affect snakebite envenoming incidence in Sri Lanka, as a model system that has a high incidence of snakebite.

Impact of the COVID-19 pandemic on the coverage and timeliness of routine childhood vaccinations in the Gambia, 2015-2021.

Introduction: The COVID-19 pandemic caused widespread morbidity and mortality and resulted in the biggest setback in routine vaccinations in three decades. Data on the impact of the pandemic on immunisation in Africa are limited, in part, due to low-quality routine or administrative data. This study examined coverage and timeliness of routine childhood immunisation during the pandemic in The Gambia, a country with an immunisation system considered robust.

The 2023 report of the Lancet Countdown on health and climate change: the imperative for a health-centred response in a world facing irreversible harms.

Unlabelled: The Countdown is an international research collaboration that independently monitors the evolving impacts of climate change on health, and the emerging health opportunities of climate action. In its eighth iteration, this 2023 report draws on the expertise of 114 scientists and health practitioners from 52 research institutions and UN agencies worldwide to provide its most comprehensive assessment yet. In 2022, the Countdown warned that people’s health is at the mercy of fossil fuels and stressed the transformative opportunity of jointly tackling the concurrent climate change, energy, cost-of-living, and health crises for human health and wellbeing.

Mapping the timeliness of routine childhood vaccination in The Gambia: A spatial modelling study.

Introduction: Timeliness of routine vaccination shapes childhood infection risk and thus is an important public health metric. Estimates of indicators of the timeliness of vaccination are usually produced at the national or regional level, which may conceal epidemiologically relevant local heterogeneities and makeitdifficultto identify pockets of vulnerabilities that could benefit from targeted interventions. Here, we demonstrate the utility of geospatial modelling techniques in generating high-resolution maps of the prevalence of delayed childhood vaccination in The Gambia.

Timeliness of routine childhood vaccination among 12-35 months old children in The Gambia: Analysis of national immunisation survey data, 2019-2020.

The Gambia's routine childhood vaccination programme is highly successful, however, many vaccinations are delayed, with potential implications for disease outbreaks. We adopted a multi-dimensional approach to determine the timeliness of vaccination (i.e.

Cholera past and future in Nigeria: Are the Global Task Force on Cholera Control's 2030 targets achievable?

Background: Understanding and continually assessing the achievability of global health targets is key to reducing disease burden and mortality. The Global Task Force on Cholera Control (GTFCC) Roadmap aims to reduce cholera deaths by 90% and eliminate the disease in twenty countries by 2030. The Roadmap has three axes focusing on reporting, response and coordination.

The impact of social and environmental extremes on cholera time varying reproduction number in Nigeria.

Nigeria currently reports the second highest number of cholera cases in Africa, with numerous socioeconomic and environmental risk factors. Less investigated are the role of extreme events, despite recent work showing their potential importance. To address this gap, we used a machine learning approach to understand the risks and thresholds for cholera outbreaks and extreme events, taking into consideration pre-existing vulnerabilities.

Climate change maladaptation for health: Agricultural practice against shifting seasonal rainfall affects snakebite risk for farmers in the tropics.

Snakebite affects more than 1.8 million people annually. Factors explaining snakebite variability include farmers' behaviors, snake ecology and climate.