Chemical Characterization and Source Apportionment of Household Fine Particulate Matter in Rural, Peri-urban, and Urban West Africa

Household air pollution in sub-Saharan Africa and other developing regions is an important cause of disease burden. Little is known about the chemical composition and sources of household air pollution in sub-Saharan Africa, and how they differ between rural and urban homes. We analyzed the chemical composition and sources of fine particles (PM2.5) in household cooking areas of multiple neighborhoods in Accra, Ghana, and in peri-urban (Banjul) and rural (Basse) areas in The Gambia. In Accra, biomass burning accounted for 39–62% of total PM2.5 mass in the cooking area in different neighborhoods; the absolute contributions were 10–45 μg/m3. Road dust and vehicle emissions comprised 12–33% of PM2.5 mass. Solid waste burning was also a significant contributor to household PM2.5 in a low-income neighborhood but not for those living in better-off areas. In Banjul and Basse, biomass burning was the single dominant source of cooking-area PM2.5, accounting for 74–87% of its total mass; the relative and absolute contributions of biomass smoke to PM2.5 mass were larger in households that used firewood than in those using charcoal, reaching as high as 463 μg/m3 in Basse homes that used firewood for cooking. Our findings demonstrate the need for policies that enhance access to cleaner fuels in both rural and urban areas, and for controlling traffic emissions in cities in sub-Saharan Africa

Small area variations and factors associated with blood pressure and body-mass index in adult women in Accra, Ghana: Bayesian spatial analysis of a representative population survey and census data

Background Body-mass index (BMI) and blood pressure (BP) levels are rising in sub-Saharan African cities, particularly among women. However, there is very limited information on how much they vary within cities, which could inform targeted and equitable health policies. Our study aimed to analyse spatial variations in BMI and BP for adult women at the small area level in the city of Accra, Ghana. Methods and findings We combined a representative survey of adult women’s health in Accra, Ghana (2008 to 2009) with a 10% random sample of the national census (2010). We applied a hierarchical model with a spatial term to estimate the associations of BMI and systolic blood pressure (SBP) and diastolic blood pressure (DBP) with demographic, socioeconomic, behavioural, and environmental factors. We then used the model to estimate BMI and BP for all women in the census in Accra and calculated mean BMI, SBP, and DBP for each enumeration area (EA). BMI and/or BP were positively associated with age, ethnicity (Ga), being currently married, and religion (Muslim) as their 95% credible intervals (95% CrIs) did not include zero, while BP was also negatively associated with literacy and physical activity. BMI and BP had opposite associations with socioeconomic status (SES) and alcohol consumption. In 2010, 26% of women aged 18 and older had obesity (BMI ≥ 30 kg/m2), and 21% had uncontrolled hypertension (SBP ≥ 140 and/or DBP ≥ 90 mm Hg). The differences in mean BMI and BP between EAs at the 10th and 90th percentiles were 2.7 kg/m2 (BMI) and in BP 7.9 mm Hg (SBP) and 4.8 mm Hg (DBP). BMI was generally higher in the more affluent eastern parts of Accra, and BP was higher in the western part of the city. A limitation of our study was that the 2010 census dataset used for predicting small area variations is potentially outdated; the results should be updated when the next census data are available, to the contemporary population, and changes over time should be evaluated. Conclusions We observed that variation of BMI and BP across neighbourhoods within Accra was almost as large as variation across countries among women globally. Localised measures are needed to address this unequal public health challenge in Accra

Spatial-temporal patterns of ambient fine particulate matter (PM2.5) and black carbon (BC) pollution in Accra

Background: Sub-Saharan Africa (SSA) is rapidly urbanizing, and ambient air pollution has emerged as a major environmental health concern in SSA cities. Yet, effective air quality management is hindered by limited data. We deployed robust, low-cost and low-power devices in a large-scale measurement campaign and characterized within-city variations in fine particulate matter (PM2.5) and black carbon (BC) pollution in Accra, Ghana. Methods: Between April 2019 and June 2020, we measured weekly gravimetric (filter-based) and minute-by-minute PM2.5 concentrations at 146 unique locations, comprising of 10 fixed (~1-year) and 136 rotating (7-day) sites covering a range of land-use and source influences. Filters were weighed for mass, and light absorbance (10−5m−1) of the filters was used as proxy for BC concentration. Year-long data at four fixed sites that were monitored in a previous study (2006-2007) were compared to assess change in PM2.5 concentrations. Results: The mean annual PM2.5 across the fixed sites ranged from 26 μg/m3 at a peri-urban site to 40 μg/m3 at commercial, business, and industrial (CBI) areas. CBI areas had the highest PM2.5 levels (mean: 37 μg/m3), followed by high-density residential neighborhoods (mean: 36 μg/m3), while peri-urban areas recorded the lowest (mean: 26 μg/m3). Both PM2.5 and BC levels were highest during the dry dusty Harmattan period (mean PM2.5: 89 μg/m3) compared to non-Harmattan season (mean PM2.5: 23 μg/m3). PM2.5 at all sites peaked at dawn and dusk, coinciding with morning and evening heavy traffic. We found about a ~50% reduction (71 vs 37 μg/m3) in mean annual PM2.5 concentrations when compared to measurements in 2006-2007 in Accra. Conclusion: Ambient PM2.5 concentrations in Accra may have plateaued at levels lower than those seen in large Asian megacities. However, levels are still 2- to 4-fold higher than the WHO guideline. Effective and equitable policies are needed to reduce pollution levels and protect public health

Within-Neighborhood Patterns and Sources of Particle Pollution: Mobile Monitoring and Geographic Information System Analysis in Four Communities in Accra, Ghana

BACKGROUND: Sources of air pollution in developing country cities include transportation and industrial pollution, biomass and coal fuel use, and resuspended dust from unpaved roads. OBJECTIVES: Our goal was to understand within-neighborhood spatial variability of particulate matter (PM) in communities of varying socioeconomic status (SES) in Accra, Ghana, and to quantify the effects of nearby sources on local PM concentration. METHODS: We conducted 1 week of morning and afternoon mobile and stationary air pollution measurements in four study neighborhoods. PM with aerodynamic diameters RESULTS: In our measurement campaign, the geometric means of PM2.5 and PM10 along the mobile monitoring path were 21 and 49 microg/m3, respectively, in the neighborhood with highest SES and 39 and 96 microg/m3, respectively, in the neighborhood with lowest SES and highest population density. PM2.5 and PM10 were as high as 200 and 400 microg/m3, respectively, in some segments of the path. After adjusting for other factors, the factors that had the largest effects on local PM pollution were nearby wood and charcoal stoves, congested and heavy traffic, loose dirt road surface, and trash burning. CONCLUSIONS: Biomass fuels, transportation, and unpaved roads may be important determinants of local PM variation in Accra neighborhoods. If confirmed by additional or supporting data, the results demonstrate the need for effective and equitable interventions and policies that reduce the impacts of traffic and biomass pollution

High-resolution spatiotemporal measurement of air and environmental noise pollution in sub-Saharan African cities: Pathways to Equitable Health Cities Study protocol for Accra, Ghana

Introduction: Air and noise pollution are emerging environmental health hazards in African cities, with potentially complex spatial and temporal patterns. Limited local data is a barrier to the formulation and evaluation of policies to reduce air and noise pollution. Methods and analysis: We designed a year-long measurement campaign to characterize air and noise pollution and their sources at high-resolution within the Greater Accra Metropolitan Area, Ghana. Our design utilizes a combination of fixed (year-long, n = 10) and rotating (week-long, n = ~130) sites, selected to represent a range of land uses and source influences (e.g. background, road-traffic, commercial, industrial, and residential areas, and various neighbourhood socioeconomic classes). We will collect data on fine particulate matter (PM2.5), nitrogen oxides (NOx), weather variables, sound (noise level and audio) along with street-level time-lapse images. We deploy low-cost, low-power, lightweight monitoring devices that are robust, socially unobtrusive, and able to function in the Sub-Saharan African (SSA) climate. We will use state-of-the-art methods, including spatial statistics, deep/machine learning, and processed-based emissions modelling, to capture highly resolved temporal and spatial variations in pollution levels across Accra and to identify their potential sources. This protocol can serve as a prototype for other SSA cities. Ethics and dissemination: This environmental study was deemed exempt from full ethics review at Imperial College London and the University of Massachusetts Amherst; it was approved by the University of Ghana Ethics Committee. This protocol is designed to be implementable in SSA cities to map environmental pollution to inform urban planning decisions to reduce health harming exposures to air and noise pollution. It will be disseminated through local stakeholder engagement (public and private sectors), peer-reviewed publications, contribution to policy documents, media, and conference presentations

Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight

From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions

Base molecular para resistência a fluazifop-p-butyl em capim-camalote (rottboellia cochinchinensis) da Costa Rica

Rottboellia cochinchinensis is an annual grass weed species known as itchgrass, or “caminadora” in America´s Spanish speaking countries, and has become a major and troublesome weed in several crops. The application of fluazifop-P-butyl at recommended rates (125 g a.i. ha-1) was observed to be failing to control itchgrass in a field in San José, Upala county, Alajuela province, Costa Rica. Plants from the putative resistant R. cochinchinensis population survived fluazifop-P-butyl when treated with 250 g a.i. ha-1 (2X label rate) at the three- to four-leaf stage under greenhouse conditions. PCR amplification and sequencing of partial carboxyl transferase domain (CT) of the acetyl-CoA carboxylase (ACCase) gene were used to determine the molecular mechanism of resistance. A single non-synonymous point mutation from TGG (susceptible plants) to TGC (putative resistant plants) that leads to a Trp-2027-Cys substitution was found. This Trp-2027-Cys mutation is known to confer resistance to all aryloxyphenoxyproprionate (APP) herbicides to which fluazifop-P-butyl belongs. To the best of our knowledge, this is the first report of fluazifop-P-butyl resistance and a mutation at position 2027 for a Costa Rican R. cochinchinensis population.Rottboellia cochinchinensis, espécie de planta daninha anual conhecida como capim-camalote, ou “caminadora”, em países de língua espanhola das Américas, tornou-se uma planta daninha significativa e problemática em diversas culturas. Observou-se que a aplicação de fluazifop-p-butyl nas doses recomendadas (125 g i.a. ha-1) não conseguiu controlar capim-camalote em uma região em San José, condado de Upala, província de Alajuela, Costa Rica. As plantas da população supostamente resistente de R. cochinchinensis sobreviveram a fluazifop-p-butyl quando tratadas com 250 g i.a. ha-1 (2X a dose do rótulo) na fase de três a quatro folhas em condições de estufa. Amplificação e sequenciamento de reação em cadeia da polimerase de domínio de transferase de ácido carboxílico parcial (TC) do gene acetil-CoA carboxilase (ACCase) foram utilizados para determinar o mecanismo molecular de resistência. Foi encontrada uma mutação de ponto não sinônimo individual de TGG (plantas suscetíveis) para TGC (plantas supostamente resistentes) que conduz a uma substituição de Trp-2027-Cys. Sabe-se que essa mutação de Trp-2027-Cys confere resistência a todos os herbicidas ariloxifenoxipropionatos (AFP) a que fluazifop-p-butyl pertence. Pelo visto, este é o primeiro relato de resistência a fluazifop-p-butyl de uma mutação na posição 2027 para uma população costarriquenha de R. cochinchinensisWest Florida Research and Education Center, University of Florida/[]//United States of AmericaUCR::Vicerrectoría de Investigación::Unidades de Investigación::Ciencias Agroalimentarias::Estación Experimental Agrícola Fabio Baudrit Moreno (EEAFBM

Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants

Background Hypertension can be detected at the primary health-care level and low-cost treatments can effectively control hypertension. We aimed to measure the prevalence of hypertension and progress in its detection, treatment, and control from 1990 to 2019 for 200 countries and territories. Methods We used data from 1990 to 2019 on people aged 30-79 years from population-representative studies with measurement of blood pressure and data on blood pressure treatment. We defined hypertension as having systolic blood pressure 140 mm Hg or greater, diastolic blood pressure 90 mm Hg or greater, or taking medication for hypertension. We applied a Bayesian hierarchical model to estimate the prevalence of hypertension and the proportion of people with hypertension who had a previous diagnosis (detection), who were taking medication for hypertension (treatment), and whose hypertension was controlled to below 140/90 mm Hg (control). The model allowed for trends over time to be non-linear and to vary by age. Findings The number of people aged 30-79 years with hypertension doubled from 1990 to 2019, from 331 (95% credible interval 306-359) million women and 317 (292-344) million men in 1990 to 626 (584-668) million women and 652 (604-698) million men in 2019, despite stable global age-standardised prevalence. In 2019, age-standardised hypertension prevalence was lowest in Canada and Peru for both men and women; in Taiwan, South Korea, Japan, and some countries in western Europe including Switzerland, Spain, and the UK for women; and in several low-income and middle-income countries such as Eritrea, Bangladesh, Ethiopia, and Solomon Islands for men. Hypertension prevalence surpassed 50% for women in two countries and men in nine countries, in central and eastern Europe, central Asia, Oceania, and Latin America. Globally, 59% (55-62) of women and 49% (46-52) of men with hypertension reported a previous diagnosis of hypertension in 2019, and 47% (43-51) of women and 38% (35-41) of men were treated. Control rates among people with hypertension in 2019 were 23% (20-27) for women and 18% (16-21) for men. In 2019, treatment and control rates were highest in South Korea, Canada, and Iceland (treatment >70%; control >50%), followed by the USA, Costa Rica, Germany, Portugal, and Taiwan. Treatment rates were less than 25% for women and less than 20% for men in Nepal, Indonesia, and some countries in sub-Saharan Africa and Oceania. Control rates were below 10% for women and men in these countries and for men in some countries in north Africa, central and south Asia, and eastern Europe. Treatment and control rates have improved in most countries since 1990, but we found little change in most countries in sub-Saharan Africa and Oceania. Improvements were largest in high-income countries, central Europe, and some upper-middle-income and recently high-income countries including Costa Rica, Taiwan, Kazakhstan, South Africa, Brazil, Chile, Turkey, and Iran. Interpretation Improvements in the detection, treatment, and control of hypertension have varied substantially across countries, with some middle-income countries now outperforming most high-income nations. The dual approach of reducing hypertension prevalence through primary prevention and enhancing its treatment and control is achievable not only in high-income countries but also in low-income and middle-income settings. Copyright (C) 2021 World Health Organization; licensee Elsevier

Diminishing benefits of urban living for children and adolescents’ growth and development

Optimal growth and development in childhood and adolescence is crucial for lifelong health and well-being1–6. Here we used data from 2,325 population-based studies, with measurements of height and weight from 71 million participants, to report the height and body-mass index (BMI) of children and adolescents aged 5–19 years on the basis of rural and urban place of residence in 200 countries and territories from 1990 to 2020. In 1990, children and adolescents residing in cities were taller than their rural counterparts in all but a few high-income countries. By 2020, the urban height advantage became smaller in most countries, and in many high-income western countries it reversed into a small urban-based disadvantage. The exception was for boys in most countries in sub-Saharan Africa and in some countries in Oceania, south Asia and the region of central Asia, Middle East and north Africa. In these countries, successive cohorts of boys from rural places either did not gain height or possibly became shorter, and hence fell further behind their urban peers. The difference between the age-standardized mean BMI of children in urban and rural areas was <1.1 kg m–2 in the vast majority of countries. Within this small range, BMI increased slightly more in cities than in rural areas, except in south Asia, sub-Saharan Africa and some countries in central and eastern Europe. Our results show that in much of the world, the growth and developmental advantages of living in cities have diminished in the twenty-first century, whereas in much of sub-Saharan Africa they have amplified