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自然灾害引发的洪水过后的传染病爆发:全球模式及地方影响

Infectious disease outbreaks in the wake of natural flood disasters: global patterns and local implications.

作者信息

Acosta-España Jaime David, Romero-Alvarez Daniel, Luna Camila, Rodriguez-Morales Alfonso J

机构信息

Health Sciences Faculty, Universidad Internacional SEK (UISEK), Quito, 170120, Ecuador.

School of Medicine, Pontificia Universidad Católica del Ecuador, Quito, Ecuador.

出版信息

Infez Med. 2024 Dec 1;32(4):451-462. doi: 10.53854/liim-3204-4. eCollection 2024.

Abstract

Climate change is an urgent global health challenge, with floods becoming increasingly frequent and exacerbating the spread of infectious diseases. With its diverse climates and recurring natural disasters, Latin America is particularly susceptible to outbreaks following floods. These events disrupt ecosystems and create ideal conditions for the spread of waterborne and vector-borne pathogens. Floods also damage infrastructure, displace populations, and restrict access to clean water and healthcare services, further compounding public health risks. This review assesses the impact of floods on infectious disease outbreaks in Latin America, focusing on key epidemiological trends, vulnerabilities, and strategies for mitigation. This narrative review aims to analyse the incidence and transmission of infectious diseases during and after floods in Latin America. Particular emphasis is placed on waterborne diseases, such as cholera and leptospirosis, vector-borne diseases, including dengue and malaria, and respiratory infections in displaced populations. The review also considers how socioeconomic factors, healthcare limitations, and climate vulnerabilities amplify the public health risks in flood-affected regions. We extensively searched PubMed, Google Scholar, Scopus, Science Direct, and Web of Science from 2010 to May 2024, examining articles in English, Spanish, and Portuguese. The search focused on original descriptive studies on flooding and infectious diseases, particularly in Latin America. Keywords such as 'flooding,' 'waterborne diseases,' 'vector-borne diseases,' 'skin and soft tissue infections,' 'respiratory infections,' and specific disease names like leishmaniasis and malaria were employed. A descriptive analysis of the relevant articles was performed to synthesise the key findings. The results show a clear association between floods and infectious disease outbreaks in several countries. Waterborne diseases, especially cholera and leptospirosis, are frequently reported following floods due to contaminated water. Vector-borne diseases like dengue and malaria see increased transmission as stagnant water forms ideal breeding grounds for mosquitoes. Respiratory infections are also prevalent in overcrowded, unsanitary shelters for displaced populations. Additionally, fungal infections and skin diseases are notable concerns, especially in areas with prolonged exposure to floodwaters. Floods disproportionately affect vulnerable populations, particularly low-income areas with insufficient infrastructure and limited healthcare access. Climate change is likely to intensify the frequency and severity of floods further, increasing the health risks. Finally, this review underscores the critical need for improved disaster preparedness, enhanced healthcare infrastructure, and better water and sanitation systems in flood-prone regions. Strengthening public health interventions and implementing climate adaptation strategies are essential to mitigating the impact of infectious diseases in future flood events.

摘要

气候变化是一项紧迫的全球健康挑战,洪水日益频繁,加剧了传染病的传播。拉丁美洲气候多样,自然灾害频发,尤其容易在洪水后爆发疫情。这些事件破坏生态系统,为水传播和病媒传播病原体的传播创造了理想条件。洪水还会破坏基础设施,使人口流离失所,并限制获得清洁水和医疗服务的机会,进一步加剧公共卫生风险。本综述评估了洪水对拉丁美洲传染病爆发的影响,重点关注关键的流行病学趋势、脆弱性和缓解策略。本叙述性综述旨在分析拉丁美洲洪水期间及之后传染病的发病率和传播情况。特别强调水传播疾病,如霍乱和钩端螺旋体病;病媒传播疾病,包括登革热和疟疾;以及流离失所人群中的呼吸道感染。该综述还考虑了社会经济因素、医疗保健限制和气候脆弱性如何加剧受洪水影响地区的公共卫生风险。我们在2010年至2024年5月期间广泛检索了PubMed、谷歌学术、Scopus、科学Direct和科学网,查阅了英文、西班牙文和葡萄牙文的文章。检索重点是关于洪水与传染病的原始描述性研究,特别是在拉丁美洲。使用了“洪水”、“水传播疾病”、“病媒传播疾病”、“皮肤和软组织感染”、“呼吸道感染”等关键词以及利什曼病和疟疾等特定疾病名称。对相关文章进行描述性分析,以综合关键发现。结果显示,在几个国家,洪水与传染病爆发之间存在明显关联。洪水过后,由于水污染,经常报告水传播疾病,尤其是霍乱和钩端螺旋体病。登革热和疟疾等病媒传播疾病的传播增加,因为积水为蚊子形成了理想的滋生地。呼吸道感染在流离失所人群拥挤、不卫生的避难所中也很普遍。此外,真菌感染和皮肤病也是值得关注的问题,特别是在长时间接触洪水的地区。洪水对弱势群体的影响尤为严重,特别是基础设施不足、获得医疗保健机会有限的低收入地区。气候变化可能会进一步加剧洪水的频率和严重程度,增加健康风险。最后,本综述强调,在易发生洪水的地区,迫切需要改善灾害准备、加强医疗基础设施以及改善水和卫生系统。加强公共卫生干预措施和实施气候适应战略对于减轻未来洪水事件中传染病的影响至关重要。

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