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Hopkins, Skylar R.; Jones, Isabel J.; Buck, Julia C.; LeBoa, Christopher; Kwong, Laura H.; Jacobsen, Kim; Rickards, Chloe; Lund, Andrea J.; Nova, Nicole; MacDonald, Andrew J.; et al(
, Frontiers in Public Health)
Humans live in complex socio-ecological systems where we interact with parasites and pathogens that spend time in abiotic and biotic environmental reservoirs (e.g., water, air, soil, other vertebrate hosts, vectors, intermediate hosts). Through a synthesis of published literature, we reviewed the life cycles and environmental persistence of 150 parasites and pathogens tracked by the World Health Organization's Global Burden of Disease study. We used those data to derive the time spent in each component of a pathogen's life cycle, including total time spent in humans versus all environmental stages. We found that nearly all infectious organisms were “environmentally mediated” tomore »some degree, meaning that they spend time in reservoirs and can be transmitted from those reservoirs to human hosts. Correspondingly, many infectious diseases were primarily controlled through environmental interventions (e.g., vector control, water sanitation), whereas few (14%) were primarily controlled by integrated methods (i.e., combining medical and environmental interventions). Data on critical life history attributes for most of the 150 parasites and pathogens were difficult to find and often uncertain, potentially hampering efforts to predict disease dynamics and model interactions between life cycle time scales and infection control strategies. We hope that this synthetic review and associated database serve as a resource for understanding both common patterns among parasites and pathogens and important variability and uncertainty regarding particular infectious diseases. These insights can be used to improve systems-based approaches for controlling environmentally mediated diseases of humans in an era where the environment is rapidly changing.« less
Free, publicly-accessible full text available July 8, 2023
Hopkins, Skylar R; Lafferty, Kevin D; Wood, Chelsea L; Olson, Sarah H; Buck, Julia C; De Leo, Giulio A; Fiorella, Kathryn J; Fornberg, Johanna L; Garchitorena, Andres; Jones, Isabel J; et al(
, The Lancet Planetary Health)
Free, publicly-accessible full text available August 1, 2023
Lund, Andrea J.; Rehkopf, David H.; Sokolow, Susanne H.; Sam, M. Moustapha; Jouanard, Nicolas; Schacht, Anne-Marie; Senghor, Simon; Fall, Assane; Riveau, Gilles; De Leo, Giulio A.; et al(
, Infectious Diseases of Poverty)
Abstract Background Water resources development promotes agricultural expansion and food security. But are these benefits offset by increased infectious disease risk? Dam construction on the Senegal River in 1986 was followed by agricultural expansion and increased transmission of human schistosomes. Yet the mechanisms linking these two processes at the individual and household levels remain unclear. We investigated the association between household land use and schistosome infection in children. Methods We analyzed cross-sectional household survey data ( n = 655) collected in 16 rural villages in August 2016 across demographic, socio-economic and land use dimensions, which were matched to Schistosoma haematobium ( nmore » = 1232) and S. mansoni ( n = 1222) infection data collected from school-aged children. Mixed effects regression determined the relationship between irrigated area and schistosome infection presence and intensity. Results Controlling for socio-economic and demographic risk factors, irrigated area cultivated by a household was associated with an increase in the presence of S. haematobium infection (odds ratio [ OR ] = 1.14; 95% confidence interval [95% CI ]: 1.03–1.28) but not S. mansoni infection ( OR = 1.02; 95% CI : 0.93–1.11). Associations between infection intensity and irrigated area were positive but imprecise ( S. haematobium: rate ratio [ RR ] = 1.05; 95% CI : 0.98–1.13, S. mansoni : RR = 1.09; 95% CI : 0.89–1.32). Conclusions Household engagement in irrigated agriculture increases individual risk of S. haematobium but not S. mansoni infection. Increased contact with irrigated landscapes likely drives exposure, with greater impacts on households relying on agricultural livelihoods.« less
Free, publicly-accessible full text available December 1, 2022
Liu, Zac Yung-Chun; Chamberlin, Andrew J.; Tallam, Krti; Jones, Isabel J.; Lamore, Lance L.; Bauer, John; Bresciani, Mariano; Wolfe, Caitlin M.; Casagrandi, Renato; Mari, Lorenzo; et al(
, Remote Sensing)
Schistosomiasis is a debilitating parasitic disease of poverty that affects more than 200 million people worldwide, mostly in sub-Saharan Africa, and is clearly associated with the construction of dams and water resource management infrastructure in tropical and subtropical areas. Changes to hydrology and salinity linked to water infrastructure development may create conditions favorable to the aquatic vegetation that is suitable habitat for the intermediate snail hosts of schistosome parasites. With thousands of small and large water reservoirs, irrigation canals, and dams developed or under construction in Africa, it is crucial to accurately assess the spatial distribution of high-risk environments thatmore »are habitat for freshwater snail intermediate hosts of schistosomiasis in rapidly changing ecosystems. Yet, standard techniques for monitoring snails are labor-intensive, time-consuming, and provide information limited to the small areas that can be manually sampled. Consequently, in low-income countries where schistosomiasis control is most needed, there are formidable challenges to identifying potential transmission hotspots for targeted medical and environmental interventions. In this study, we developed a new framework to map the spatial distribution of suitable snail habitat across large spatial scales in the Senegal River Basin by integrating satellite data, high-definition, low-cost drone imagery, and an artificial intelligence (AI)-powered computer vision technique called semantic segmentation. A deep learning model (U-Net) was built to automatically analyze high-resolution satellite imagery to produce segmentation maps of aquatic vegetation, with a fast and robust generalized prediction that proved more accurate than a more commonly used random forest approach. Accurate and up-to-date knowledge of areas at highest risk for disease transmission can increase the effectiveness of control interventions by targeting habitat of disease-carrying snails. With the deployment of this new framework, local governments or health actors might better target environmental interventions to where and when they are most needed in an integrated effort to reach the goal of schistosomiasis elimination.« less
Free, publicly-accessible full text available March 1, 2023
Lund, Andrea J.; Sokolow, Susanne H.; Jones, Isabel J.; Wood, Chelsea L.; Ali, Sofia; Chamberlin, Andrew; Sy, Alioune Badara; Sam, M. Moustapha; Jouanard, Nicolas; Schacht, Anne-Marie; et al(
, PLOS Neglected Tropical Diseases)
Lamberton, Poppy H.
(Ed.)
Background Infectious disease risk is driven by three interrelated components: exposure, hazard, and vulnerability. For schistosomiasis, exposure occurs through contact with water, which is often tied to daily activities. Water contact, however, does not imply risk unless the environmental hazard of snails and parasites is also present in the water. By increasing reliance on hazardous activities and environments, socio-economic vulnerability can hinder reductions in exposure to a hazard. We aimed to quantify the contributions of exposure, hazard, and vulnerability to the presence and intensity of Schistosoma haematobium re-infection. Methodology/Principal findings In 13 villages along the Senegal River, we collected parasitologicalmore »data from 821 school-aged children, survey data from 411 households where those children resided, and ecological data from all 24 village water access sites. We fit mixed-effects logistic and negative binomial regressions with indices of exposure, hazard, and vulnerability as explanatory variables of Schistosoma haematobium presence and intensity, respectively, controlling for demographic variables. Using multi-model inference to calculate the relative importance of each component of risk, we found that hazard (Ʃw i = 0.95) was the most important component of S . haematobium presence, followed by vulnerability (Ʃw i = 0.91). Exposure (Ʃw i = 1.00) was the most important component of S . haematobium intensity, followed by hazard (Ʃw i = 0.77). Model averaging quantified associations between each infection outcome and indices of exposure, hazard, and vulnerability, revealing a positive association between hazard and infection presence (OR = 1.49, 95% CI 1.12, 1.97), and a positive association between exposure and infection intensity (RR 2.59–3.86, depending on the category; all 95% CIs above 1) Conclusions/Significance Our findings underscore the linkages between social (exposure and vulnerability) and environmental (hazard) processes in the acquisition and accumulation of S . haematobium infection. This approach highlights the importance of implementing both social and environmental interventions to complement mass drug administration.« less
Free, publicly-accessible full text available October 5, 2022
Schistosome parasites infect more than 200 million people annually, mostly in sub-Saharan Africa, where people may be co-infected with more than one species of the parasite. Infection risk for any single species is determined, in part, by the distribution of its obligate intermediate host snail. As the World Health Organization reprioritizes snail control to reduce the global burden of schistosomiasis, there is renewed importance in knowing when and where to target those efforts, which could vary by schistosome species. This study estimates factors associated with schistosomiasis risk in 16 villages located in the Senegal River Basin, a region hyperendemic formore »Schistosoma haematobium and S . mansoni . We first analyzed the spatial distributions of the two schistosomes’ intermediate host snails ( Bulinus spp. and Biomphalaria pfeifferi , respectively) at village water access sites. Then, we separately evaluated the relationships between human S . haematobium and S . mansoni infections and (i) the area of remotely-sensed snail habitat across spatial extents ranging from 1 to 120 m from shorelines, and (ii) water access site size and shape characteristics. We compared the influence of snail habitat across spatial extents because, while snail sampling is traditionally done near shorelines, we hypothesized that snails further from shore also contribute to infection risk. We found that, controlling for demographic variables, human risk for S . haematobium infection was positively correlated with snail habitat when snail habitat was measured over a much greater radius from shore (45 m to 120 m) than usual. S . haematobium risk was also associated with large, open water access sites. However, S . mansoni infection risk was associated with small, sheltered water access sites, and was not positively correlated with snail habitat at any spatial sampling radius. Our findings highlight the need to consider different ecological and environmental factors driving the transmission of each schistosome species in co-endemic landscapes.« less
Free, publicly-accessible full text available September 27, 2022
Tallam, Krti; Liu, Zac Yung-Chun; Chamberlin, Andrew J.; Jones, Isabel J.; Shome, Pretom; Riveau, Gilles; Ndione, Raphael A.; Bandagny, Lydie; Jouanard, Nicolas; Eck, Paul Van; et al(
, Frontiers in Public Health)
In recent decades, computer vision has proven remarkably effective in addressing diverse issues in public health, from determining the diagnosis, prognosis, and treatment of diseases in humans to predicting infectious disease outbreaks. Here, we investigate whether convolutional neural networks (CNNs) can also demonstrate effectiveness in classifying the environmental stages of parasites of public health importance and their invertebrate hosts. We used schistosomiasis as a reference model. Schistosomiasis is a debilitating parasitic disease transmitted to humans via snail intermediate hosts. The parasite affects more than 200 million people in tropical and subtropical regions. We trained our CNN, a feed-forward neural network,more »on a limited dataset of 5,500 images of snails and 5,100 images of cercariae obtained from schistosomiasis transmission sites in the Senegal River Basin, a region in western Africa that is hyper-endemic for the disease. The image set included both images of two snail genera that are relevant to schistosomiasis transmission – that is, Bulinus spp. and Biomphalaria pfeifferi – as well as snail images that are non-component hosts for human schistosomiasis. Cercariae shed from Bi. pfeifferi and Bulinus spp. snails were classified into 11 categories, of which only two, S. haematobium and S. mansoni , are major etiological agents of human schistosomiasis. The algorithms, trained on 80% of the snail and parasite dataset, achieved 99% and 91% accuracy for snail and parasite classification, respectively, when used on the hold-out validation dataset – a performance comparable to that of experienced parasitologists. The promising results of this proof-of-concept study suggests that this CNN model, and potentially similar replicable models, have the potential to support the classification of snails and parasite of medical importance. In remote field settings where machine learning algorithms can be deployed on cost-effective and widely used mobile devices, such as smartphones, these models can be a valuable complement to laboratory identification by trained technicians. Future efforts must be dedicated to increasing dataset sizes for model training and validation, as well as testing these algorithms in diverse transmission settings and geographies.« less
Lund, Andrea J.; Lopez-Carr, David; Sokolow, Susanne H.; Rohr, Jason R.; De Leo, Giulio A.(
, Sustainability)
null
(Ed.)
Dams enable the production of food and renewable energy, making them a crucial tool for both economic development and climate change adaptation in low- and middle-income countries. However, dams may also disrupt traditional livelihood systems and increase the transmission of vector- and water-borne pathogens. These livelihood and health impacts diminish the benefits of dams to rural populations dependent on rivers, as hydrological and ecological alterations change flood regimes, reduce nutrient transport and lead to the loss of biodiversity. We propose four agricultural innovations for promoting equity, health, sustainable development, and climate resilience in dammed watersheds: (1) restoring migratory aquatic species,more »(2) removing submerged vegetation and transforming it into an agricultural resource, (3) restoring environmental flows and (4) integrating agriculture and aquaculture. As investment in dams accelerates in low- and middle-income countries, appropriately addressing their livelihood and health impacts can improve the sustainability of modern agriculture and economic development in a changing climate.« less
