Ecological and socioeconomic factors associated with the human burden of environmentally mediated pathogens: a global analysis.
Journal
The Lancet. Planetary health
ISSN: 2542-5196
Titre abrégé: Lancet Planet Health
Pays: Netherlands
ID NLM: 101704339
Informations de publication
Date de publication:
11 2022
11 2022
Historique:
received:
05
10
2021
revised:
22
08
2022
accepted:
04
10
2022
entrez:
12
11
2022
pubmed:
13
11
2022
medline:
16
11
2022
Statut:
ppublish
Résumé
Billions of people living in poverty are at risk of environmentally mediated infectious diseases-that is, pathogens with environmental reservoirs that affect disease persistence and control and where environmental control of pathogens can reduce human risk. The complex ecology of these diseases creates a global health problem not easily solved with medical treatment alone. We quantified the current global disease burden caused by environmentally mediated infectious diseases and used a structural equation model to explore environmental and socioeconomic factors associated with the human burden of environmentally mediated pathogens across all countries. We found that around 80% (455 of 560) of WHO-tracked pathogen species known to infect humans are environmentally mediated, causing about 40% (129 488 of 359 341 disability-adjusted life years) of contemporary infectious disease burden (global loss of 130 million years of healthy life annually). The majority of this environmentally mediated disease burden occurs in tropical countries, and the poorest countries carry the highest burdens across all latitudes. We found weak associations between disease burden and biodiversity or agricultural land use at the global scale. In contrast, the proportion of people with rural poor livelihoods in a country was a strong proximate indicator of environmentally mediated infectious disease burden. Political stability and wealth were associated with improved sanitation, better health care, and lower proportions of rural poverty, indirectly resulting in lower burdens of environmentally mediated infections. Rarely, environmentally mediated pathogens can evolve into global pandemics (eg, HIV, COVID-19) affecting even the wealthiest communities. The high and uneven burden of environmentally mediated infections highlights the need for innovative social and ecological interventions to complement biomedical advances in the pursuit of global health and sustainability goals. Bill & Melinda Gates Foundation, National Institutes of Health, National Science Foundation, Alfred P. Sloan Foundation, National Institute for Mathematical and Biological Synthesis, Stanford University, and the US Defense Advanced Research Projects Agency.
Sections du résumé
BACKGROUND
Billions of people living in poverty are at risk of environmentally mediated infectious diseases-that is, pathogens with environmental reservoirs that affect disease persistence and control and where environmental control of pathogens can reduce human risk. The complex ecology of these diseases creates a global health problem not easily solved with medical treatment alone.
METHODS
We quantified the current global disease burden caused by environmentally mediated infectious diseases and used a structural equation model to explore environmental and socioeconomic factors associated with the human burden of environmentally mediated pathogens across all countries.
FINDINGS
We found that around 80% (455 of 560) of WHO-tracked pathogen species known to infect humans are environmentally mediated, causing about 40% (129 488 of 359 341 disability-adjusted life years) of contemporary infectious disease burden (global loss of 130 million years of healthy life annually). The majority of this environmentally mediated disease burden occurs in tropical countries, and the poorest countries carry the highest burdens across all latitudes. We found weak associations between disease burden and biodiversity or agricultural land use at the global scale. In contrast, the proportion of people with rural poor livelihoods in a country was a strong proximate indicator of environmentally mediated infectious disease burden. Political stability and wealth were associated with improved sanitation, better health care, and lower proportions of rural poverty, indirectly resulting in lower burdens of environmentally mediated infections. Rarely, environmentally mediated pathogens can evolve into global pandemics (eg, HIV, COVID-19) affecting even the wealthiest communities.
INTERPRETATION
The high and uneven burden of environmentally mediated infections highlights the need for innovative social and ecological interventions to complement biomedical advances in the pursuit of global health and sustainability goals.
FUNDING
Bill & Melinda Gates Foundation, National Institutes of Health, National Science Foundation, Alfred P. Sloan Foundation, National Institute for Mathematical and Biological Synthesis, Stanford University, and the US Defense Advanced Research Projects Agency.
Identifiants
pubmed: 36370725
pii: S2542-5196(22)00248-0
doi: 10.1016/S2542-5196(22)00248-0
pmc: PMC9669458
pii:
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.
Langues
eng
Sous-ensembles de citation
IM
Pagination
e870-e879Subventions
Organisme : FIC NIH HHS
ID : R01 TW010286
Pays : United States
Organisme : NIGMS NIH HHS
ID : R35 GM133439
Pays : United States
Informations de copyright
Copyright © 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of interests We declare no competing interests.
Références
Philos Trans R Soc Lond B Biol Sci. 2017 Jun 5;372(1722):
pubmed: 28438914
Proc Biol Sci. 2010 Apr 22;277(1685):1185-92
pubmed: 20007179
PLoS Negl Trop Dis. 2014 Sep 04;8(9):e3012
pubmed: 25188455
Lancet Planet Health. 2022 Nov;6(11):e870-e879
pubmed: 36370725
J Glob Health. 2019 Dec;9(2):020201
pubmed: 31489184
Ecology. 2014 Apr;95(4):817-32
pubmed: 24933803
Science. 2009 Dec 4;326(5958):1362-7
pubmed: 19965751
Vaccines (Basel). 2019 Sep 20;7(4):
pubmed: 31547081
J Helminthol. 1997 Jun;71(2):125-32
pubmed: 9192711
J Am Med Assoc. 1946 Dec 7;132(14):833-8
pubmed: 20274881
Philos Trans R Soc Lond B Biol Sci. 2001 Jul 29;356(1411):983-9
pubmed: 11516376
Lancet. 2021 May 15;397(10287):1809-1818
pubmed: 33964223
Nat Med. 2013 Feb;19(2):150-5
pubmed: 23389615
Proc Natl Acad Sci U S A. 2015 Jul 14;112(28):8667-71
pubmed: 26069208
PLoS Negl Trop Dis. 2015 Apr 23;9(4):e0003657
pubmed: 25905621
PLoS Negl Trop Dis. 2016 Jul 21;10(7):e0004794
pubmed: 27441556
PLoS Negl Trop Dis. 2015 Jan 29;9(1):e0003422
pubmed: 25634641
Lancet. 2015 Nov 14;386(10007):1973-2028
pubmed: 26188744
Infect Dis Poverty. 2018 Jul 03;7(1):63
pubmed: 29966535
Philos Trans R Soc Lond B Biol Sci. 2017 Jun 5;372(1722):
pubmed: 28438921
Infect Dis Poverty. 2019 Jul 15;8(1):62
pubmed: 31303174
Epidemics. 2009 Sep;1(3):196-206
pubmed: 21352766
Am J Trop Med Hyg. 2006 Jan;74(1):3-11
pubmed: 16407338
PLoS Med. 2016 Mar 29;13(3):e1001984
pubmed: 27022739
PLoS One. 2012;7(8):e42689
pubmed: 22905160
Ecol Lett. 2013 May;16(5):679-86
pubmed: 23489376
Trends Parasitol. 2014 Aug;30(8):386-93
pubmed: 25028088
Ethn Dis. 2019 Feb 21;29(Suppl 1):159-172
pubmed: 30906165
Nature. 2015 Oct 8;526(7572):207-211
pubmed: 26375008
Proc Natl Acad Sci U S A. 2013 May 21;110(21):8399-404
pubmed: 23671097
Philos Trans R Soc Lond B Biol Sci. 2017 Jun 5;372(1722):
pubmed: 28438916
J Res Med Sci. 2014 Dec;19(12):1207-8
pubmed: 25709667
Ecology. 2009 Apr;90(4):888-900
pubmed: 19449681
Lancet Infect Dis. 2006 Jul;6(7):411-25
pubmed: 16790382
Lancet. 2006 Dec 2;368(9551):1946-7
pubmed: 17141687
Lancet Planet Health. 2022 Aug;6(8):e694-e705
pubmed: 35932789
Proc Natl Acad Sci U S A. 2019 Oct 29;116(44):22212-22218
pubmed: 31611369
PLoS Negl Trop Dis. 2007 Oct 31;1(1):e74
pubmed: 17989787
PLoS Biol. 2012;10(12):e1001456
pubmed: 23300379
FEMS Immunol Med Microbiol. 2007 Jun;50(1):1-26
pubmed: 17428307
Proc Natl Acad Sci U S A. 2016 Aug 9;113(32):8900-2
pubmed: 27482081
Philos Trans R Soc Lond B Biol Sci. 2017 Jun 5;372(1722):
pubmed: 28438917
Nat Ecol Evol. 2020 Jan;4(1):24-33
pubmed: 31819238
Am J Trop Med Hyg. 2006 Jul;75(1):1-2
pubmed: 16837698
N Engl J Med. 2016 Dec 22;375(25):2435-2445
pubmed: 27723434
Front Public Health. 2022 Jul 08;10:892366
pubmed: 35875032
Cell. 2020 Apr 16;181(2):223-227
pubmed: 32220310
Philos Trans R Soc Lond B Biol Sci. 2017 Jun 5;372(1722):
pubmed: 28438911