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SPACE-BASED WATERBORNE DISEASE SURVEILLANCE IN COASTAL COMMUNITIES: Actionable risk assessment of enteric pathogens in a changing climate

机译:沿海社区的基于空间的水性疾病监测:在变化气候中肠道病原体的可行风险评估

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Coastal communities are increasingly vulnerable to waterborne disease, and particularly to pathogens whose range and abundance are sensitive to the effects of a changing climate. Increased precipitation and coastal flooding events are associated with a greater risk of drinking water contamination by enteric pathogens such as hepatitis A and E, as well as multiple Vibrio bacterial species, including the causative agent of cholera, Vibrio cholerae. The greatest incidence of these emerging and re-emerging waterborne threats is in the developing world, primarily among highly populated coastal cities in Southeast Asia and East Africa. Risk of enteric disease outbreaks can be characterized by space-based remote sensing measurements of indicators such as turbidity, biochemical oxygen demand, colored dissolved organic matter (CDOM), total suspended solids (TSS) and water temperature. Recent work has characterized individual waterborne diseases based on these criteria, although most studies have focused on pathogen abundance at a static point in time. Here, we describe efforts to integrate multiple remotely sensed indicators of enteric pathogens with climate models to characterize short to medium-term risk of waterborne disease outbreaks in highly populated urban environments in the developing world. We present a detailed case study of a recent cholera outbreak in Mombasa, Kenya, and present a forecasting method that can be utilized by local ministries of health. We consider the spatial and temporal accuracy needs of public health surveillance systems, and describe methods to integrate multiple space-based indicators into alert-based forecasting systems. We conclude by describing the iterative, community-based design methods space agencies can utilize when working with communities to combat waterborne disease.
机译:沿海社区越来越容易受到水性疾病的群体,特别是对群体和丰度对变化气候的影响敏感的病原体。增加降水和沿海洪水事件与肠道病原体如甲型肝炎病原体等饮用水污染的风险更大,以及多种弧菌细菌物种,包括霍乱的致病剂,霍乱霍乱。这些新兴和重新出现水性威胁的最大发病率在发展中国家,主要是在东南亚和东非的高度人口稠密的沿海城市中。肠疾病爆发的风险可以通过基于空间的遥感测量来表征浊度​​,生化需氧量,彩色溶解有机物(CDom),总悬浮固体(TSS)和水温。最近的工作表征了基于这些标准的个体水性疾病,尽管大多数研究都集中在静态时间点的病原体丰富。在这里,我们描述了将多种远程感测的肠道病原体指标与气候模型结合在一起,以表征发展中国家高度人口稠密的城市环境中水性疾病爆发的中期风险。我们在蒙巴萨,肯尼亚的最近霍乱爆发的详细案例研究,并提出了一种可以通过当地健康部门使用的预测方法。我们考虑了公共卫生监控系统的空间和时间准确性需求,并描述了将多个基于空间的指标集成到基于警报的预测系统的方法。我们通过描述迭代,基于社区的设计方法的结论空间机构可以在与社区合作打击水性疾病时使用。

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