| Records |
| Author |
Saunders, M.J.; Wingfield, T.; Tovar, M.A.; Baldwin, M.R.; Datta, S.; Zevallos, K.; Montoya, R.; Valencia, T.R.; Friedland, J.S.; Moulton, L.H.; Gilman, R.H.; Evans, C.A. |
| Title |
A score to predict and stratify risk of tuberculosis in adult contacts of tuberculosis index cases: a prospective derivation and external validation cohort study |
Type |
Journal Article |
| Year |
2017 |
Publication |
The Lancet. Infectious Diseases |
Abbreviated Journal |
Lancet Infect Dis |
| Volume |
17 |
Issue |
11 |
Pages |
1190-1199 |
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| Abstract |
BACKGROUND: Contacts of tuberculosis index cases are at increased risk of developing tuberculosis. Screening, preventive therapy, and surveillance for tuberculosis are underused interventions in contacts, particularly adults. We developed a score to predict risk of tuberculosis in adult contacts of tuberculosis index cases. METHODS: In 2002-06, we recruited contacts aged 15 years or older of index cases with pulmonary tuberculosis who lived in desert shanty towns in Ventanilla, Peru. We followed up contacts for tuberculosis until February, 2016. We used a Cox proportional hazards model to identify index case, contact, and household risk factors for tuberculosis from which to derive a score and classify contacts as low, medium, or high risk. We validated the score in an urban community recruited in Callao, Peru, in 2014-15. FINDINGS: In the derivation cohort, we identified 2017 contacts of 715 index cases, and median follow-up was 10.7 years (IQR 9.5-11.8). 178 (9%) of 2017 contacts developed tuberculosis during 19 147 person-years of follow-up (incidence 0.93 per 100 person-years, 95% CI 0.80-1.08). Risk factors for tuberculosis were body-mass index, previous tuberculosis, age, sustained exposure to the index case, the index case being in a male patient, lower community household socioeconomic position, indoor air pollution, previous tuberculosis among household members, and living in a household with a low number of windows per room. The 10-year risks of tuberculosis in the low-risk, medium-risk, and high-risk groups were, respectively, 2.8% (95% CI 1.7-4.4), 6.2% (4.8-8.1), and 20.6% (17.3-24.4). The 535 (27%) contacts classified as high risk accounted for 60% of the tuberculosis identified during follow-up. The score predicted tuberculosis independently of tuberculin skin test and index-case drug sensitivity results. In the external validation cohort, 65 (3%) of 1910 contacts developed tuberculosis during 3771 person-years of follow-up (incidence 1.7 per 100 person-years, 95% CI 1.4-2.2). The 2.5-year risks of tuberculosis in the low-risk, medium-risk, and high-risk groups were, respectively, 1.4% (95% CI 0.7-2.8), 3.9% (2.5-5.9), and 8.6%. (5.9-12.6). INTERPRETATION: Our externally validated risk score could predict and stratify 10-year risk of developing tuberculosis in adult contacts, and could be used to prioritise tuberculosis control interventions for people most likely to benefit. FUNDING: Wellcome Trust, Department for International Development Civil Society Challenge Fund, Joint Global Health Trials consortium, Bill & Melinda Gates Foundation, Imperial College National Institutes of Health Research Biomedical Research Centre, Foundation for Innovative New Diagnostics, Sir Halley Stewart Trust, WHO, TB REACH, and Innovation for Health and Development. |
| Address |
Section of Infectious Diseases and Immunity, Imperial College London, London, UK; Wellcome Trust Imperial College Centre for Global Health Research, London, UK; Innovation for Health and Development (IFHAD), Laboratory of Research and Development, Universidad Peruana Cayetano Heredia, Lima, Peru; Innovacion Por la Salud Y Desarrollo (IPSYD), Asociacion Benefica PRISMA, Lima, Peru |
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English |
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1473-3099 |
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PMID:28827142 |
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97505 |
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| Author |
Godin, K.M.; Chacon, V.; Barnoya, J.; Leatherdale, S.T. |
| Title |
The school environment and sugar-sweetened beverage consumption among Guatemalan adolescents |
Type |
Journal Article |
| Year |
2017 |
Publication |
Public Health Nutrition |
Abbreviated Journal |
Public Health Nutr |
| Volume |
20 |
Issue |
16 |
Pages |
2980-2987 |
| Keywords |
Latin America; Nutrition policy; School health; Sugar-sweetened beverages |
| Abstract |
OBJECTIVE: The current study sought to examine Guatemalan adolescents' consumption of sugar-sweetened beverages (SSB), identify which individual-level characteristics are associated with SSB consumption and describe school characteristics that may influence students' SSB consumption. DESIGN: Within this observational pilot study, a questionnaire was used to assess students' consumption of three varieties of SSB (soft drinks, energy drinks, sweetened coffees/teas), as well as a variety of sociodemographic and behavioural characteristics. We collected built environment data to examine aspects of the school food environment. We developed Poisson regression models for each SSB variety and used descriptive analyses to characterize the sample. SETTING: Guatemala City, Guatemala. SUBJECTS: Guatemalan adolescents (n 1042) from four (two public, two private) secondary schools. RESULTS: Built environment data revealed that students from the two public schools lacked access to water fountains/coolers. The SSB industry had a presence in the schools through advertisements, sponsored food kiosks and products available for sale. Common correlates of SSB consumption included school type, sedentary behaviour, frequency of purchasing lunch in the cafeteria, and frequency of purchasing snacks from vending machines in school and off school property. CONCLUSIONS: Guatemalan adolescents frequently consume SSB, which may be encouraged by aspects of the school environment. Schools represent a viable setting for equitable population health interventions designed to reduce SSB consumption, including increasing access to clean drinking-water, reducing access to SSB, restricting SSB marketing and greater enforcement of existing food policies. |
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1School of Public Health and Health Systems,University of Waterloo, 200 University Avenue West,Waterloo,ON,Canada,N2L 3G1 |
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1368-9800 |
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PMID:28803573 |
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ref @ user @ |
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97506 |
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Corvalan, C.; Garmendia, M.L.; Jones-Smith, J.; Lutter, C.K.; Miranda, J.J.; Pedraza, L.S.; Popkin, B.M.; Ramirez-Zea, M.; Salvo, D.; Stein, A.D. |
| Title |
Nutrition status of children in Latin America |
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Journal Article |
| Year |
2017 |
Publication |
Obesity Reviews : an Official Journal of the International Association for the Study of Obesity |
Abbreviated Journal |
Obes Rev |
| Volume |
18 Suppl 2 |
Issue |
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Pages |
7-18 |
| Keywords |
Latin America; childhood obesity; children; nutrition and physical activity situation |
| Abstract |
The prevalence of overweight and obesity is rapidly increasing among Latin American children, posing challenges for current healthcare systems and increasing the risk for a wide range of diseases. To understand the factors contributing to childhood obesity in Latin America, this paper reviews the current nutrition status and physical activity situation, the disparities between and within countries and the potential challenges for ensuring adequate nutrition and physical activity. Across the region, children face a dual burden of undernutrition and excess weight. While efforts to address undernutrition have made marked improvements, childhood obesity is on the rise as a result of diets that favour energy-dense, nutrient-poor foods and the adoption of a sedentary lifestyle. Over the last decade, changes in socioeconomic conditions, urbanization, retail foods and public transportation have all contributed to childhood obesity in the region. Additional research and research capacity are needed to address this growing epidemic, particularly with respect to designing, implementing and evaluating the impact of evidence-based obesity prevention interventions. |
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Hubert Department of Global Health of the Rollins School of Public Health, Emory University, Atlanta, GA, USA |
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1467-7881 |
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PMID:28741907 |
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ref @ user @ |
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97507 |
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| Author |
Perez-Martinez, P.J.; de Fatima Andrade, M.; de Miranda, R.M. |
| Title |
Heavy truck restrictions and air quality implications in Sao Paulo, Brazil |
Type |
Journal Article |
| Year |
2017 |
Publication |
Journal of Environmental Management |
Abbreviated Journal |
J Environ Manage |
| Volume |
202 |
Issue |
Pt 1 |
Pages |
55-68 |
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Air pollution trends; Sao Paulo; Traffic-pollutant relationships; Transport emission factors |
| Abstract |
This study quantified the effects of traffic restrictions on diesel fuel heavy vehicles (HVs) on the air quality of the Bandeirantes corridor using hourly data obtained by continuous monitoring of traffic and air quality at sites located on this avenue. The study addressed the air quality of a city impacted by vehicular emissions and that PM10 and NOX concentrations are mainly due to diesel burning. Data collection was split into two time periods, a period of no traffic constraint on HVs (Nov 2008 and 2009) and a period of constraint (Nov 2010, 2011 and 2012). We found that pollutants on this corridor, mainly PM10 and NOX, decreased significantly during the period from 2008 to 2012 (28 and 43%, 15.8 and 86.9 ppb) as a direct consequence of HV traffic restrictions (a 72% reduction). Rebound effects in the form of increased traffic of light vehicles (LVs) during this time had impacts on the concentration levels, explaining the differences between rates of reduction in HV traffic and pollutants. Reductions in the number of trucks resulted in longer travel times and increased traffic congestion as a consequence of the modal shift towards LVs. We found that a 51% decrease in PM10 (28.8 mug m-3) was due to a reduction in HV traffic (vehicle emissions were estimated to be 71% of total sources, 40.1 mug m-3). This percentage was partially offset by 10% more PM10 emissions related to an increase in LV traffic, while other causes, such as climatic conditions, contributed to a 13% increase in PM10 concentrations. The relationships analyzed in this research served to highlight the need to apply urban transport policies aimed at decreasing pollutant concentrations in Sao Paulo, especially in heavily congested urban corridors on working days. |
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School of Arts, Sciences and Humanities, University of Sao Paulo (USP), Sao Paulo, Brazil |
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0301-4797 |
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PMID:28719822 |
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ref @ user @ |
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97508 |
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Villalobos, A.M.; Barraza, F.; Jorquera, H.; Schauer, J.J. |
| Title |
Wood burning pollution in southern Chile: PM2.5 source apportionment using CMB and molecular markers |
Type |
Journal Article |
| Year |
2017 |
Publication |
Environmental Pollution (Barking, Essex : 1987) |
Abbreviated Journal |
Environ Pollut |
| Volume |
225 |
Issue |
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Pages |
514-523 |
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Aerosols/analysis; Air Pollutants/*analysis; Chile; Cities; Coal; Dust; *Environmental Monitoring; Fires; Heating; Nitrates/analysis; Particulate Matter/*analysis; Seasons; Smoke; Sulfates/analysis; Wood/chemistry; Cmb-Mm; Fuel poverty; Source apportionment; Southern Chile; Sustainable urban development; Wood burning |
| Abstract |
Temuco is a mid-size city representative of severe wood smoke pollution in southern Chile; i.e., ambient 24-h PM2.5 concentrations have exceeded 150 mug/m3 in the winter season and the top concentration reached 372 mug/m3 in 2010. Annual mean concentrations have decreased but are still above 30 mug/m3. For the very first time, a molecular marker source apportionment of ambient organic carbon (OC) and PM2.5 was conducted in Temuco. Primary resolved sources for PM2.5 were wood smoke (37.5%), coal combustion (4.4%), diesel vehicles (3.3%), dust (2.2%) and vegetative detritus (0.7%). Secondary inorganic PM2.5 (sulfates, nitrates and ammonium) contributed 4.8% and unresolved organic aerosols (generated from volatile emissions from incomplete wood combustion), including secondary organic aerosols, contributed 47.1%. Adding the contributions of unresolved organic aerosols to those from primary wood smoke implies that wood burning is responsible for 84.6% of the ambient PM2.5 in Temuco. This predominance of wood smoke is ultimately due to widespread poverty and a lack of efficient household heating methods. The government has been implementing emission abatement policies but achieving compliance with ambient air quality standards for PM2.5 in southern Chile remains a challenge. |
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Environmental Chemistry and Technology Program, University of Wisconsin-Madison, 660 North Park Street, Madison, WI 53706, USA |
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0269-7491 |
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PMID:28318790 |
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ref @ user @ |
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97509 |
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