Background Climate change disproportionately affects socially minoritized populations, but migrants' vulnerability to extreme temperatures remains overlooked. We estimated short-term associations between extreme ambient temperatures and mortality among migrants and non-migrants across Brazil. Methods We linked the 100 Million Brazilian Cohort to mortality and temperature data (2000–2020) and conducted a space-time-stratified case-crossover study analysing the differential effects of extreme temperature on mortality among internal migrants (i.e., Individuals whose state of birth was different from their residence at registration or death) and non-migrants. We used conditional quasi-Poisson regression with distributed lag non-linear model (DLNM) to estimate relative risks (RRs) and 95% confidence intervals (CIs) for all-cause non-accidental and cause-specific mortality associated with extreme-cold (1st percentile) and extreme-heat (99th percentile) compared to minimum-mortality-temperature (i.e., the temperature associated with the lowest mortality risk), over 0–20 days in both groups. We further stratified by age, literacy, urbanicity and housing conditions. Findings We included 1,199,636 deaths among internal-migrants (mean age at death = 62.67 years (standard-deviation (SD) = 18.36), with 673,166 (56%) males) and 3,716,900 deaths among non-migrants (57.18 years (SD = 20.31), with 2,135,293 (57%) males). Over 0–20 days, we observed a consistent pattern of higher risks of all-cause, non-accidental mortality among internal-migrants than non-migrants following both extreme-heat (RRMig(95%CI):1.05(1.01–1.10) vs. RRNon-mig:1.01(0.99–1.04)) and extreme-cold (RRMig:1.27(1.22–1.32) vs. RRNon-mig:1.24(1.20–1.28)). Extreme cold-related circulatory mortality (mortality due to diseases of the circulatory system, based on the relevant International Classification of Diseases codes) (I00–I99) was higher among non-migrants (RRMig:1.32(1.20–1.45) vs. RRNon-mig:1.41(1.31–1.51)) while heat-related respiratory mortality (J00–J99) was higher among internal-migrants (RRMig:1.32(1.10–1.58) vs. RRNon-mig:1.06(1.00–1.17)), particularly those illiterate (RRMig:1.84(1.25–2.71) vs. RRNon-mig:1.10(0.89–1.36)). Other subcategories showed greater 95%CI overlap. Interpretation We found internal migrants are likely to experience higher heat-related respiratory mortality than non-migrants particularly low-educated migrants. Our results highlight the need to further consider migrants for targeted climate adaptation policies, with a focus on reducing social inequalities in the place of arrival. Funding The Wellcome Trust.
Dengue, an Aedes mosquito-borne viral infection, is on the rise with climate and demographic change. In 2023, WHO declared dengue its highest grade of emergency, following the largest number of cases and deaths in recorded history. This emergency highlighted the absence of safe and effective dengue-specific treatments as a gap in the product landscape for care for people with dengue. To accelerate development of dengue-specific treatments for wide implementation and access in all dengue-endemic countries, WHO conducted a landscape analysis of the dengue therapeutics pipeline and convened a global expert and public consultation to develop target product profiles for treatments for non-severe and severe dengue. These target product profiles provide strategic guidance for product developers, regulators, procurement agencies, and funders on the intended use, target populations, and key product characteristics of dengue-specific treatments required to meet public health needs, setting clear targets to drive development of dengue drugs accessible to those who need them the most.
Group B Streptococcus (GBS) is a leading cause of preterm birth and neonatal infection. The COVID-19 pandemic substantially altered healthcare access, antibiotic use, and pathogen circulation. However, its influence on GBS remains poorly understood. This study evaluated temporal changes in GBS colonization, serotypes, and antimicrobial susceptibility among pregnant women in the Brazilian Amazon before, during, and after the COVID-19 pandemic. A total of 1,449 pregnant women at 35–37 weeks of gestation attending public health units in Porto Velho, Brazil, between February 2018 and November 2023 were included. Rectovaginal samples were cultured for GBS detection. Capsular serotyping and antimicrobial susceptibility testing were performed using standardized methods. Colonization prevalence, serotype distribution, and resistance profiles were compared across pre-pandemic, pandemic, and post-pandemic periods. Overall GBS colonization was detected in 20.7
Landfill leachate is an environmental hazard requiring appropriate management and treatment. It is commonly co-treated with municipal wastewater at wastewater treatment plants. However, this approach produced environmentally harmful components associated with the increase in the color of the effluent and elevated levels of dissolved organic matter (DOM). This study aimed to assess the efficiency of applying a sequencing batch reactor (SBR) followed by a granular activated carbon (GAC) column for the co-treatment of wastewater and leachate, where the system was monitored for 490 days. No previous studies have utilized a biological process followed by adsorption to treat wastewater with leachate over an extended period. The addition of landfill leachate increased the dissolved organic carbon (DOC) content, true color, UV254nm absorbance, and specific ultraviolet absorbance (SUVA) of the raw wastewater. The integrated SBR-GAC system demonstrated a high treatment efficiency, achieving 90
This rapid review mapped how information and communication technologies (ICTs), particularly digital health applications, are being used within healthcare services for adults aged 55 years and older. Following the Joanna Briggs Institute methodology and guided by the Population–Concept–Context framework, studies published between 2016 and 2024 were identified and reported in accordance with the PRISMA extension for scoping reviews, based on a previously published protocol registered on the Open Science Framework. Nineteen studies were included after critical appraisal. The findings indicate that ICT use is most frequently associated with improved accessibility and coordination of healthcare services, support for health professionals’ training and care management practices, and positive health-related outcomes for older adults, particularly in the domains of mental health, social participation, and self-care. However, the evidence remains heterogeneous and often limited in its reporting of design and implementation processes, highlighting the need for further context-sensitive research that addresses ethical, equity, and implementation considerations in the use of digital health technologies for older populations.
