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Annual theme 2024: Urban development
Collection Contents
5 results
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Socioeconomic position and urban environments as drivers of antimicrobial resistance? An ecological study in Germany, 2010 to 2019
BACKGROUNDGermany lacks comprehensive studies on the relationship between socioeconomic position (SEP) and antimicrobial resistance (AMR).
AIMWe assessed the association between area-level SEP and AMR infection and colonisation in Germany.
METHODSIn an ecological study design, we analysed statutory notifications of invasive meticillin-resistant Staphylococcus aureus (MRSA, n = 34,440) in 2010−2019, and colonisations and infections with carbapenem-resistant Acinetobacter spp. (CRA, n = 1,979) and Enterobacterales (CRE, n = 10,825) in 2017−2019. Area-level SEP was measured by the German index of socioeconomic deprivation (GISD), incorporating education, employment and income data. A multilevel Poisson regression analysis estimated the association between AMR incidence and GISD at district level, adjusting for age, sex, notification year and urbanisation degree.
RESULTSMedian ages of patients with carbapenem-resistant bacteria were between 66 (CRA colonisation) and 69 years (CRE infection). For MRSA infections, the median age was 74 years. Across each pathogen, approximately two thirds of patients were male. Estimated MRSA incidence was almost five times higher in districts with lowest vs highest area-level SEP (incidence rate ratio, IRR: 4.8; 95% CI: 2.8–8.2). This association was strongest in large cities (IRR: 9.1; 95% CI: 2.7–30.9), and sparsely populated rural districts (IRR: 6.5; 95% CI: 2.8–15.0). Associations of CRA (IRR: 0.6; 95% CI: 0.3–1.2) and CRE (IRR: 0.9; 95% CI: 0.6–1.4) infections with SEP were not statistically significant.
CONCLUSIONLower area-level SEP and degree of urbanisation were associated with MRSA incidence, however, no associations were uncovered between SEP and CRA or CRE infections. Further individual-level research could explore if health behaviours, living/working conditions or healthcare access explain the findings. Socioeconomic conditions should be considered for AMR prevention and control.
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Effect of urban structure, population density and proximity to contagion on COVID-19 infections during the SARS-CoV-2 Alpha and Omicron waves in Málaga, Spain, March 2020 to December 2021
BackgroundThe potential impact of urban structure, as population density and proximity to essential facilities, on spatial variability of infectious disease cases remains underexplored.
AimTo analyse the spatial variation of COVID-19 case intensity in relation to population density and distance from urban facilities (as potential contagion hubs), by comparing Alpha and Omicron wave data representing periods of both enacted and lifted non-pharmaceutical interventions (NPIs) in Málaga.
MethodsUsing spatial point pattern analysis, we examined COVID-19 cases in relation to population density, distance from hospitals, health centres, schools, markets, shopping malls, sports centres and nursing homes by non-parametric estimation of relative intensity dependence on these covariates. For statistical significance and effect size, we performed Berman Z1 tests and Areas Under Curves (AUC) for Receiver Operating Characteristic (ROC) curves.
ResultsAfter accounting for population density, relative intensity of COVID-19 remained consistent in relation to distance from urban facilities across waves. Although non-parametric estimations of the relative intensity of cases showed fluctuations with distance from facilities, Berman’s Z1 tests were significant for health centres only (p < 0.032) when compared with complete spatial randomness. The AUC of ROC curves for population density was above 0.75 and ca 0.6 for all urban facilities.
ConclusionResults reflect the difficulty in assessing facilities’ effect in propagating infectious disease, particularly in compact cities. Lack of evidence directly linking higher case intensity to proximity to urban facilities shows the need to clarify the role of urban structure and planning in shaping the spatial distribution of epidemics within cities.
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Potentially zoonotic pathogens and parasites in opportunistically sourced urban brown rats (Rattus norvegicus) in and around Helsinki, Finland, 2018 to 2023
BackgroundBrown rats (Rattus norvegicus) are synanthropic rodents with worldwide distribution, which are known to harbour many zoonotic pathogens and parasites. No systematic zoonotic surveys targeting multiple pathogens and parasites have previously been conducted in urban rats in Finland.
AimIn Helsinki, Finland, we explored the presence and prevalence in brown rats of certain pathogens and parasites (including helminths, viruses and bacteria) across potentially zoonotic taxa.
MethodsWe opportunistically received rat carcasses from pest management operators and citizens from 2018 to 2023. We searched for heart- or lungworms, performed rat diaphragm digestion to check for Trichinella and morphologically identified intestinal helminths. We assessed virus exposure by immunofluorescence assay or PCR, and detected bacteria by PCR (Leptospira) or culture (Campylobacter).
ResultsAmong the rats investigated for helminths, no heart- or lungworms or Trichinella species were detected and the most common finding was the cestode Hymenolepis nana (in 9.7% of individuals sampled, 28/288). For some of the surveyed virus taxa, several rats were seropositive (orthopoxviruses, 5.2%, 11/211; arenaviruses, 2.8%, 6/211; hantaviruses 5.2%, 11/211) or tested positive by PCR (rat hepatitis E virus, 1.8%, 4/216). Campylobacter jejuni (6.6%, 17/259) and Leptospira interrogans (1.2%, 2/163) bacteria were also present in the rat population examined.
ConclusionsPrevalences of potentially zoonotic pathogens and parasites in brown rats in Helsinki appeared low. This may explain low or non-existent diagnosis levels of rat-borne pathogen and parasite infections reported in people there. Nevertheless, further assessment of under-diagnosis, which cannot be excluded, would enhance understanding the risks of zoonoses.
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WILDbase: towards a common database to improve wildlife disease surveillance in Europe
BackgroundTo be better prepared for emerging wildlife-borne zoonoses, we need to strengthen wildlife disease surveillance.
AimThe aim of this study was to create a topical overview of zoonotic pathogens in wildlife species to identify knowledge gaps and opportunities for improvement of wildlife disease surveillance.
MethodsWe created a database, which is based on a systematic literature review in Embase focused on zoonotic pathogens in 10 common urban wildlife mammals in Europe, namely brown rats, house mice, wood mice, common voles, red squirrels, European rabbits, European hedgehogs, European moles, stone martens and red foxes. In total, we retrieved 6,305 unique articles of which 882 were included.
ResultsIn total, 186 zoonotic pathogen species were described, including 90 bacteria, 42 helminths, 19 protozoa, 22 viruses and 15 fungi. Most of these pathogens were only studied in one single animal species. Even considering that some pathogens are relatively species-specific, many European countries have no (accessible) data on zoonotic pathogens in these relevant animal species. We used the Netherlands as an example to show how this database can be used by other countries to identify wildlife disease surveillance gaps on a national level. Only 4% of all potential host–pathogen combinations have been studied in the Netherlands.
ConclusionsThis database comprises a comprehensive overview that can guide future research on wildlife-borne zoonotic diseases both on a European and national scale. Sharing and expanding this database provides a solid starting point for future European-wide collaborations to improve wildlife disease surveillance.
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Green cities and vector-borne diseases: emerging concerns and opportunities
More LessAligned with the Sustainable Development Goals, nature-based solutions such as urban greening e.g. public gardens, urban forests, parks and street trees, which aim to protect, sustainably manage or restore an ecosystem, have emerged as a promising tool for improving the health and well-being of an ever-increasing urban population. While urban greening efforts have undeniable benefits for human health and the biological communities inhabiting these green zones, disease vector populations may also be affected, possibly promoting greater pathogen transmission and the emergence of infectious diseases such as dengue, West Nile fever, malaria, leishmaniosis and tick-borne diseases. Evidence for the impact of urban green areas on vector-borne disease (VBD) transmission is scarce. Furthermore, because of vast disparities between cities, variation in green landscapes and differing scales of observation, findings are often contradictory; this calls for careful assessment of how urban greening affects VBD risk. Improved understanding of the effect of urban greening on VBDs would support planning, monitoring and management of green spaces in cities to sustainably mitigate VBD risks for surrounding urban populations.
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