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Laboratorio de
Innovación en salud
PUBLICATIONS

Joint effect of heat and air pollution on mortality in 620 cities of 36 countries

Mortality risks associated with floods in 761 communities worldwide: time series study

Aircraft and road traffic noise, insulin resistance, and diabetes: The role of neighborhood socioeconomic status in San Diego County
![Climate change constitutes an unprecedented challenge for public health and one of its main direct effects are extreme temperatures. It varies between intra-urban areas and this difference is called surface urban heat island (SUHI) effect. We aimed to assess SUHI distribution among socioeconomic levels in Lima, Peru by conducting a cross-sectional study at the block-level. The mean land surface temperature (LST) from 2017 to 2021 were estimated using the TIRS sensor (Landsat-8 satellite [0.5 km scale]) and extracted to block level. SUHI was calculated based on the difference on mean LST values (2017–2021) per block and the lowest LST registered in a block. Socioeconomic data were obtained from the 2017 Peruvian census. A principal component analysis was performed to construct a socioeconomic index and a mixture analysis based on quantile g-computation was conducted to estimate the joint and specific effects of socioeconomic variables on SUHI. A total of 69 618 blocks were included in the analysis. In the Metropolitan Lima area, the mean SUHI estimation per block was 6.44 (SD = 1.44) Celsius degrees. We found that blocks with high socioeconomic status (SES) showed a decreased exposure to SUHI, compared to those blocks where the low SES were predominant (p-value < 0.001) and that there is a significant SUHI exposure variation (p-value < 0.001) between predominant ethnicities per block (Non-White, Afro-American, and White ethnicities). The mixture analysis showed that the overall mixture effect estimates on SUHI was −1.01 (effect on SUHI of increasing simultaneously every socioeconomic variable by one quantile). Our study highlighted that populations with low SES are more likely to be exposed to higher levels of SUHI compared to those who have a higher SES and illustrates the importance to consider SES inequalities when designing urban adaptation strategies aiming at reducing exposure to SUHI.](https://static.wixstatic.com/media/6bf5a0_84970e6420604c05a097f9ebe301ea2e~mv2.png/v1/fill/w_298,h_168,q_90/6bf5a0_84970e6420604c05a097f9ebe301ea2e~mv2.png)
Disproportionate exposure to surface-urban heat islands across vulnerable populations in Lima city, Peru

Mapping Malaria Vector Habitats in West Africa:
Drone Imagery and Deep Learning Analysis for Targeted Vector Surveillance
![BACKGROUND: Epidemiological evidence on the health risks of sulfur dioxide (SO2) is more limited compared with other pollutants, and doubts remain on several aspects, such as the form of the exposure–response relationship, the potential role of copollutants, as well as the actual risk at low concentrations and possible temporal variation in risks.
OBJECTIVES: Our aim was to assess the short-term association between exposure to SO2 and daily mortality in a large multilocation data set, using advanced study designs and statistical techniques.
METHODS: The analysis included 43,729,018 deaths that occurred in 399 cities within 23 countries between 1980 and 2018. A two-stage design was applied to assess the association between the daily concentration of SO2 and mortality counts, including first-stage time-series regressions and second-stage multilevel random-effect meta-analyses. Secondary analyses assessed the exposure–response shape and the lag structure using spline terms and distributed lag models, respectively, and temporal variations in risk using a longitudinal meta-regression. Bi-pollutant models were applied to examine confounding effects of particulate matter with an aerodynamic diameter of ≤10 lm (PM10) and 2:5 lm (PM2:5), ozone, nitrogen dioxide, and carbon monoxide. Associations were reported as relative risks (RRs) and fractions of excess deaths.
RESULTS: The average daily concentration of SO2 across the 399 cities was 11:7lg=m3, with 4.7% of days above the World Health Organization (WHO) guideline limit (40lg=m3, 24-h average), although the exceedances occurred predominantly in specific locations. Exposure levels decreased considerably during the study period, from an average concentration of 19:0 lg=m3 in 1980–1989 to 6:3 lg=m3 in 2010–2018. For all locations com- bined, a 10-lg=m3 increase in daily SO2 was associated with an RR of mortality of 1.0045 [95% confidence interval (CI): 1.0019, 1.0070], with the risk being stable over time but with substantial between-country heterogeneity. Short-term exposure to SO2 was associated with an excess mortality fraction of 0.50% [95% empirical CI (eCI): 0.42%, 0.57%] in the 399 cities, although decreasing from 0.74% (0.61%, 0.85%) in 1980–1989 to 0.37% (0.27%, 0.47%) in 2010–2018. There was some evidence of nonlinearity, with a steep exposure–response relationship at low concentrations and the risk attenuating at higher levels. The relevant lag window was 0–3 d. Significant positive associations remained after controlling for other pollutants.
DISCUSSION: The analysis revealed independent mortality risks associated with short-term exposure to SO2, with no evidence of a threshold. Levels below the current WHO guidelines for 24-h averages were still associated with substantial excess mortality, indicating the potential benefits of stricter air quality standards.](https://static.wixstatic.com/media/6bf5a0_e88464d17bd64e33a38714f3d1ea3f50~mv2.png/v1/fill/w_298,h_168,q_90/6bf5a0_e88464d17bd64e33a38714f3d1ea3f50~mv2.png)
Short-Term Association between Sulfur Dioxide and Mortality: A Multicountry Analysis in 399 Cities

Essential childhood immunization in 43 low- and middle-income countries: Analysis of spatial trends and socioeconomic inequalities in vaccine coverage

The use of drones for mosquito surveillance and control

Bovine lactoferrin for the prevention of COVID-19 infection in health care personnel: a double-blinded randomized clinical trial (LF-COVID)

Effect of out-of-village working activities on recent malaria exposure in the Peruvian Amazon using parametric g-formula

The association of COVID-19 incidence with temperature, humidity, and UV radiation – A global multi-city analysis

Quantifying the effect of human population mobility on malaria risk in the Peruvian Amazon

Missed opportunities for vaccination in Peru 2010–2020: A study of socioeconomic inequalities

Insights into Plasmodium vivax Asymptomatic Malaria Infections and Direct Skin-Feeding Assays to Assess Onward Malaria Transmission in the Amazon

Global, regional, and national burden of mortality associated with short-term temperature variability from 2000–19: a three-stage modelling study

Malaria transmission structure in the Peruvian Amazon through antibody signatures to Plasmodium vivax

Nyssorhynchus darlingi genome-wide studies related to microgeographic dispersion and blood-seeking behavior
![Studies have investigated the effects of heat and temperature variability (TV) on mortality. However, few assessed whether TV modifies the heat-mortality association. Data on daily temperature and mortality in the warm season were collected from 717 locations across 36 countries. TV was calculated as the standard deviation of the average of the same and previous days’ minimum and maximum temperatures. We used location-specific quasi-Poisson regression models with an interaction term between the cross-basis term for mean temperature and quartiles of TV to obtain heat-mortality associations under each quartile of TV, and then pooled estimates at the country, regional, and global levels. Results show the increased risk in heat-related mortality with increments in TV, accounting for 0.70% (95% confidence interval [CI]: −0.33 to 1.69), 1.34% (95% CI: −0.14 to 2.73), 1.99% (95% CI: 0.29–3.57), and 2.73% (95% CI: 0.76–4.50) of total deaths for Q1–Q4 (first quartile–fourth quartile) of TV. The modification effects of TV varied geographically. Central Europe had the highest attributable fractions (AFs), corresponding to 7.68% (95% CI: 5.25–9.89) of total deaths for Q4 of TV, while the lowest AFs were observed in North America, with the values for Q4 of 1.74% (95% CI: −0.09 to 3.39). TV had a significant modification effect on the heat-mortality association, causing a higher heat-related mortality burden with increments of TV. Implementing targeted strategies against heat exposure and fluctuant temperatures simultaneously would benefit public health.](https://static.wixstatic.com/media/6bf5a0_b12df0e2ac5748b9a6d1b2b953083c99~mv2.png/v1/fill/w_298,h_168,q_90/6bf5a0_b12df0e2ac5748b9a6d1b2b953083c99~mv2.png)
Fluctuating temperature modifies heat-mortality association around the globe

Air pollution and metabolic disorders: Dynamic versus static measures of exposure among Hispanics/Latinos and non-Hispanics

Heat Waves and Emergency Department Visits Among the Homeless, San Diego, 2012–2019

Technical Workflow Development for Integrating Drone Surveys and Entomological Sampling to Characterise Aquatic Larval Habitats of Anopheles funestus in Agricultural Landscapes in Côte d’Ivoire

A cross-sectional analysis of meteorological factors and SARS-CoV-2 transmission in 409 cities across 26 countries

Time-Varying Effects of Meteorological Variables on Malaria Epidemiology in the Context of Interrupted Control Efforts in the Amazon Rainforest, 2000–2017

Geographical Variations of the Minimum Mortality Temperature at a Global Scale: A Multicountry Study

Mortality risk attributable to wildfire-related PM2·5 pollution: a global time series study in 749 locations
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