Date

07/05/2024

Hour

18.30 - 20.00 h

Place

CaixaForum Macaya
(Paseo de Sant Joan, 108) Barcelona

Speakers

Nerea Morán (UPM), Pilar Sampietro y Raül Torán (ISGlobal).

¿Desde las ciudades podemos ser autosuficientes desde un punto de vista energético? ¿De qué manera podemos cultivar nuestros propios alimentos en las ciudades? ¿Es un sistema viable? ¿Tendría consecuencias en la economía de mercado y el sector de la alimentación?

El 7 de mayo trataremos de responder a estas y muchas otras preguntas relacionadas con la sostenibilidad y la autosuficiencia de nuestras urbes en un contexto social en que nuestra alimentación está muy vinculada al consumo, la inmediatez y los gustos gastronómicos nuevos y elaborados.

El evento tiene una duración aproximada de 90 minutos y es gratuito. Aún así, el aforo es limitado, por lo que recomendamos que llegar puntual y reservar las entradas con antelación.

Con la participación de:

• Nerea Morán, doctora arquitecta por la Universidad Politécnica de Madrid.
• Pilar Sampietro, periodista radiofónica especializada en ecología y cultura, y coautora del libro 'La ciudad comestible' (Morsa, 2018).
• Raül Torán, divulgador científico de ISGlobal. Moderador.

Date

21/05/2024

Hour

18.30 - 20.00 h

Place

CaixaForum Macaya
(Paseo de Sant Joan, 108) Barcelona

Speakers

Carolyn Daher, Mònica Ubalde y Raül Torán, de ISGlobal.

¿Qué consecuencias comporta tanto a nivel social como para nuestra salud el hecho de crecer en una ciudad donde predomina el tráfico y el ruido? ¿Cómo afectan estos determinantes a la población más joven?

Este debate abierto, de 90 minutos de duración, abordará cómo hacer compatible el crecimiento de la ciudad con el fomento de una buena salud de la ciudadanía, y cómo repensar las urbes para disponer de más espacios públicos donde los más pequeños puedan jugar y las personas mayores recrearse.

La entrada es gratuita aunque el aforo limitado por lo que se recomienda llegar puntuales y reservar la entrada.

Con la participación de:

• Carolyn Daher, coordinadora de la Iniciativa de Planificación Urbana, Medio Ambiente y Salud de ISGlobal.
• Mònica Ubalde, investigadora postdoctoral de ISGlobal.
• Raül Torán, divulgador científico de ISGlobal. Moderador.

Campus Clínic Solidari (Solidarity Campus Clínic) aims to optimise the synergies and commitment to international and local collaboration of all the entities that make up Campus Clínic: the Hospital Clínic Barcelona, the Faculty of Medicine and Health Sciences, CAPSBE, IDIBAPS, ISGlobal and the Món Clínic Barcelona Private Foundation.
Their experience, knowledge, people, resources and partnerships are all focused on contributing to the global challenges of global health.

The aim is for all Campus professionals and students to know and learn about the global needs and challenges of health cooperation; to participate in local and international health cooperation projects; to care for people in vulnerable situations; to encourage and promote teaching, training and research in health cooperation; and to establish Campus Clínic's cooperation and commitment as a value recognised by society.

In recent conflicts and emergencies, Campus Clínic Solidari has collaborated by sending medical equipment and materials from the Hospital Clinic that had been withdrawn for renewal, but which could have a second useful life by being used to create a field hospital in Ukraine, and also to help those affected by the earthquake in Morocco.

What does Campus Clínic Solidari do?

Campus Clínic Solidari works in different strategic lines:

• Twinning with health centres in Mozambique and other regions that have the potential to host healthcare, teaching and/or research projects
• Intervention in health emergencies by providing medical material for remote support, as in the case of the Field Hospital in Ukraine or the intervention in the Moroccan earthquake.
• Call for grants to fund projects proposed by Campus Clínic professionals to develop their own or third-party initiatives. To date, over 150 international projects have been funded.
• Collaboration with NGOs and the Third Sector through stable agreements and one-off actions to ensure help gets to where it is needed; such as for example Open Arms, Bombers Solidaris, Fundació Exit, Fundació Vicente Ferrer or the Fundació Convent de Santa Clara, promoted by Sister Lucia Caram.
• Training through courses and conferences to share knowledge with the twinned centres and others where cooperation projects can be developed.

Healthcare and non-healthcare professionals, teachers and students and research personnel from all the institutions in the Campus can all participate in Campus Clínic Solidari.

A new study led by the Barcelona Institute for Global Health (ISGlobal), a centre supported by the "la Caixa" Foundation, sheds light on the growth of lung function in children. The results show that increased levels of physical activity and a higher body mass index (BMI) play a key role in the recovery of early deficits. These findings, published in the journal Thorax, have important implications for clinical practice, research and public health policy, providing new insights into how to improve respiratory health from childhood to adulthood.

The study analysed data from the Spanish birth cohort of the INMA - Environment and Childhood project, which included a total of 1,151 children and adolescents aged 4-18 years. The researchers measured lung function using spirometry, a technique that assesses lung function through the amount of exhaled air. More specifically, the researchers measured forced expiratory volume in one second (FEV1), which is the volume of air exhaled in the first second during forced exhalation after a deep inhalation, and forced vital capacity (FVC), which is the maximum amount of air a person can exhale after a deep inhalation without a time limit. While FEV1 is an indicator of how open the airways are, FVC gives an indication of the size of the lungs.

Four trajectories of lung function growth were identified from the spirometries: a low trajectory (19% of the sample for both FEV1 and FVC), a normal trajectory (62% and 63%), a high trajectory (16% and 13%) and a final trajectory called "catch-up" (2% and 5% of the sample). The “catch-up” group started with lung function values below the low trajectory and showed accelerated growth between 4 and 10 years of age, reaching normal lung function values in adolescence.

"The key finding of our study is that low lung function in early childhood does not automatically translate into poor lung function in early adulthood, but that accelerated growth can recover early-life lung function deficits and result in normal values in adolescence," says Sarah Koch, ISGlobal researcher and first author of the study.

High levels of physical activity and body mass improve lung function

Using clinical records, questionnaires and results from face-to-face visits with participants and their families, the team gathered information on possible predictors of lung function growth. These were grouped into four categories: demographic and birth characteristics, allergic diseases, smoking and other environmental exposures, and physical activity and body mass.

The study results show that accelerated lung function growth is mainly associated with higher levels of physical activity in early childhood (between the ages of 4 and 7) and higher body mass index at the age of 4.

"Our study confirms and goes beyond previous research on known predictors of lung function. Children with less allergic disease were more likely to have normal or high FEV1 trajectories. This supports previous evidence on how children's allergic conditions affect lung function growth," says Judith Garcia-Aymerich, ISGlobal researcher and senior author of the study.

Clinical and public health implications

A clear risk factor for chronic respiratory disease is the early onset or accelerated lung function decline beyond that expected with normal ageing. . Therefore, understanding the determinants that predict lung function growth during childhood and adolescence is as important for preventing these diseases as understanding the determinants of lung function decline in later adulthood.

The results of this study have important implications for clinical practice and public health policy. "Both clinical management and public health policies should support and promote a healthy diet and high levels of physical activity in children with low baseline lung function, suboptimal environmental conditions or early-life allergies. This can help overcome growth limitations in lung function and improve respiratory health in childhood and adulthood," says Sarah Koch.

Reference
Koch, S., Prado Peralta, G., Carsin, AE., Abellan, A., Roda, C., Torrent, M., Iñiguez, C., Ballester, F., Ferrero, A., Zabaleta, C., Lertxundi, A., Guxens, M., Vrijheid, M., Sunyer, J., Casas, M., Garcia-Aymerich, J. Physical activity and body mass related to catch-up lung function growth in childhood: a population-based accelerated cohort study. Thorax, 2024. Doi: 10.1136/thorax-2022-219666

Genetic diversity of the malaria parasite in pregnant women and children declined in an area targeted for malaria elimination in Mozambique, according to a study led by the Barcelona Institute for Global Health (ISGlobal), a centre supported by “la Caixa” Foundation and the Manhiça Health Research Centre (CISM). The findings, published in Nature Communications, highlight the added value of routine sampling of pregnant women as a cost-effective strategy to enhance genomic surveillance of the parasite and detect changes in transmission within the community.

Genomic surveillance of the malaria parasite P. falciparum is essential to monitor the emergence and spread of drug-resistant parasites. But it can provide much more information. “We believe that the genomic diversity of the parasite population can also help us evaluate the effectiveness of interventions aimed at eliminating the disease: we expect lower genetic diversity of the parasite in areas with less transmission,” says ISGlobal researcher Alfredo Mayor. 

Regular collection of samples for genomic surveillance is challenging and costly, particularly in low-resource settings; but Mayor and his team have a solution: pregnant women attending their first antenatal care visit as an easy-to-reach sentinel population. The team previously showed that the malaria burden in pregnant women mirrors that of the community. In this study, they evaluated whether the genetic diversity of the parasite in pregnant women is also representative, and whether it can inform about changes in transmission levels.

Genomic surveillance of malaria in antenatal care

The research team sequenced P. falciparum sampled from 289 women attending their first antenatal visit and 93 children from the community, aged 2-10 years old. The samples were collected between 2015 and 2018 in three areas of southern Mozambique: one with high-transmission of the disease (Ilha Josina) and two with low-transmission (Magude, where elimination interventions were implemented, and Manhiça).

The analysis confirmed that genetic diversity and the prevalence of drug resistance markers were consistent between women attending antenatal care and children from the community. The parasite population in Ilha Josina had the highest genetic diversity, while Magude had the lowest. Furthermore, in Magude there was a clear decline in the diversity of parasites infecting a single individual (intra-host diversity), indicating a reduction in the size of the parasite population following the elimination interventions. No decrease in intra-host diversity was observed in Manhiça.

 “Our findings reveal the impact of interventions on the structure of the parasite population, which is not as apparent when looking only at the number of cases during the same time period”, says Nanna Brokhattingen, first co-author of the study. “Parasite surveillance in pregnant women can complement clinical and epidemiological data when evaluating the impact of malaria control and elimination interventions,” adds Mayor. The authors conclude that routine genomic surveillance at antenatal care clinics represents a cost-effective and convenient approach to inform about changes in disease transmission.

Reference

Nanna Brokhattingen, Glória Matambisso, Clemente da Silva et al. Genomic malaria surveillance of antenatal care users detects reduced transmission following elimination interventions in Mozambique. Nat Commun. https://doi.org/10.1038/s41467-024-46535-x.

A new study led by the Barcelona Institute for Global Health (ISGlobal), a centre supported by the "la Caixa" Foundation, has investigated the relationship between exposure to ambient air temperature and foetal size and growth during pregnancy. The results, published in Environment International, show that cumulative exposure to heat and cold is associated with changes in foetal head circumference, a measure linked to brain development.

The study used data from 23,408 pregnant women from three European birth cohorts: the English Born in Bradford cohort, the Dutch Generation R study, and the Spanish INMA - Environment and Childhood project. The UrbClim™ model was used to calculate weekly exposure to ambient temperature at the mothers' homes during pregnancy. Foetal measures from ultrasound examinations at mid and late pregnancy, including estimated foetal weight, head circumference, and femur length, were analysed. Foetal growth from mid to late pregnancy was calculated and weight, head circumference, and length at birth were also analysed.

The results showed an association between exposure to hotter temperatures and larger head circumference at late pregnancy. Colder temperatures were associated with smaller head circumference at late pregnancy and a slower growth in head circumference from mid to late pregnancy.

The team observed specific periods of vulnerability to cold during the first trimester of pregnancy, when several foetal brain development processes take place. Specifically, susceptibility periods for exposure to cold were identified during pregnancy weeks 1 to 7 for a smaller head circumference at late pregnancy and weeks 4 to 12 for a slower head circumference growth.

Long-term implications

The team found no associations between ambient air temperature and birth outcomes, suggesting that the effects observed during pregnancy may recover at birth. "However, the identified effects of temperature on foetal development may become more prominent in magnitude and duration, especially in the context of worsening climate change" says Esmée Essers, ISGlobal researcher and first author of the study.

The results of this study highlight the importance of further research into the link between temperature exposure and foetal size and growth by replicating this study in different climatic regions.

"This work is important because we need to better understand how and when temperature can affect the foetus, to identify the underlying biological mechanisms and to provide a basis for climate change mitigation strategies for pregnant women and their future children," says Mònica Guxens, ISGlobal researcher and last author of the study.

Reference

Essers, E., Granés, L., Delaney, S., Ballester, J., Santos, S., Petricola, S., C Yang, T., Fernández-Somoano, A., Bereziartua, A., Ballester, F., Tardón, A., Vrijheid, M., Lertxundi, A., McEachan RC, R., El Marroun, H., Tiemeier, H., Iñiguez C., Guxens, M. Ambient air temperature exposure and foetal size and growth in three European birth cohorts. Environment International, Volume 186, April 2024. Doi: 10.1016/j.envint.2024.108619

Clínica Universidad de Navarra and the Barcelona Institute for Global Health (ISGlobal), a centre supported by the ”la Caixa” Foundation, have launched a clinical trial to investigate the efficacy of ivermectin against COVID-19. The aim of the study, carried out in collaboration with Idifarma, is to determine whether administration of ivermectin is associated with a shorter viral clearance time .

“Ivermectin has been shown to have an antiviral effect against other single-chain RNA viruses, including dengue and yellow fever, and it has successfully inhibited the replication of those viruses in vitro,” explained Carlos Chaccour, a specialist affiliated with Clínica Universidad de Navarra and ISGlobal and principal investigator for the new study. “We are also interested in assessing the drug’s immunomodulatory role because one of the major problems with the SARS CoV-2 virus is the disordered immune response it causes.”

Ivermectin was recently shown to inhibit the replication of SARS-CoV-2 in vitro at very high doses , but this effect has not yet been studied in vivo. The new study will investigate this question in a randomised trial. Twenty-four patients with mild disease and no risk factors will be given a single oral dose of ivermectin or placebo less than 48 hours after the onset of symptoms.

These newly diagnosed patients will not require hospitalisation, so follow-up will be carried out in their homes during their period of self-isolation. “We will give patients a single dose when they come to the clinic for a diagnostic test,” explained Chaccour. “This will be followed by a month-long period of home-based follow-up, during which we will take five nasal swabs and monitor their symptoms. This will allow us to see whether ivermectin helps to clear the infection more quickly.”

The SARS-CoV‑2 Ivermectin Navarra ISGlobal Trial (SAINT) is being funded by Clínica Universidad de Navarra and ISGlobal.

All participants will be recruited from Clínica Universidad de Navarra in Pamplona and their immune response will be jointly analysed by the Clínica and ISGlobal.

Primary health care, conditional cash transfers and social pensions have prevented 1.4 million deaths of all ages in Brazil over the past two decades, according to a study coordinated by the Barcelona Institute for Global Health (ISGlobal), a centre supported by “la Caixa” Foundation. If expanded, these programmes could avert an additional 1.3 million deaths and 6.6 million hospitalisations by 2030.

The COVID-19 pandemic has exacerbated poverty and social inequalities worldwide, particularly in low- and middle-income countries (LMICs). In addition, the economic consequences of the ongoing war in Ukraine and soaring inflation are expected to push even more people into poverty in the coming years. This is what we call a polycrisis: multiple crises interacting in such a way that their combined impact is greater than the sum of the parts.

In terms of public health, worsening socioeconomic conditions mean higher rates of disease and death, especially among the most vulnerable people in LMICs. But social programmes can mitigate the health consequences of economic crises. Brazil has led one of the largest welfare state expansions over the past two decades, implementing a public universal healthcare system along with conditional cash transfer programmes (Programa Bolsa Familia) for the poorest families and social pensions (Beneficio de Prestacao Continuada) for the elderly and disabled.

Reductions in hospitalisations and deaths

In this study, ISGlobal researcher Davide Rasella and his team evaluated the combined effect of these three programmes (conditional cash transfers, social pensions and primary health care) on hospitalisations and deaths over almost two decades (from 2004 to 2019). “This is the first study to conduct a nationwide combined evaluation of cash transfers, social pensions, and primary health care for a such long period in a LMIC,” says Rasella, who coordinated the study. 

Using data from 2,548 Brazilian municipalities, they show that high coverage of the three programmes led to reductions in overall hospitalisation and mortality rates, particularly among children under five years of age and adults over 70. A total of 1.46 million deaths were averted between 2004 and 2019. The research team then used forecasting methods to show that extending the programmes to the newly poor and vulnerable could avert up to 1.3 million additional deaths by 2030.

“We clearly show that expanding these three programmes is a viable strategy to mitigate the health impact of the current global polycrisis,” says Daniella Cavalcanti, co-first author of the study. “On the contrary, fiscal austerity measures would only result in a large number of preventable deaths.”

Reference

Aransiola TJ, Ordoñez JA, Cavalcanti D et al. Current and Projected Mortality and Hospitalization Rates Associated with Conditional Cash Transfer, Social Pension, and Primary Health Care Programs in Brazil, 2000-2030. JAMA Network Open. 2024; 7(4):e247519. doi: 10.1001/jamanetworkopen.2024.7519

The Barcelona Institute for Global Health (ISGlobal) has obtained, for the second consecutive time, accreditation as a Severo Ochoa Centre of Excellence. This distinction is awarded by the Ministry of Science, Innovation and Universities with the aim of "promoting the quality of Spanish scientific research by recognising the best centres and units that stand out for their international relevance and impact".

On Friday 22 March 2024, the State Research Agency published a provisional resolution proposal announcing the ten centres recognised with this prestigious accreditation in the 2023 call for applications. The distinction has a duration of four years and is accompanied by financial support of €4.5 million for institutional strengthening, plus €1.16 million for research staff training. 

The evaluation committee highlighted the "unique focus" of ISGlobal's proposal, whose strategic plan “targets the intersection of infectious diseases, non-communicable diseases, climate, and the environment". "The strategic plan, underpinned by basic science with a focus on strengthening multi-omics methodologies, emphasises translational and integrative multidisciplinary activities, reflecting the ethics and values of the centre," they added.

For his part, director general of ISGlobal, Quique Bassat, expressed his joy at the news, saying that "the Severo Ochoa is not only a hallmark that certifies us as one of the centres of excellence in research in Spain, but it will also help us to shape the ISGlobal of the coming years, in which we intend to break down silos and holistically address health challenges that go beyond disciplines and borders".

Bassat also wished to thank Mark Nieuwenhuijsen, who, as scientific director of ISGlobal's Severo Ochoa Programme, led the preparation of the proposal that was recognised by the evaluation committee.

A growing body of research shows that exposure to air pollution, especially during pregnancy and childhood, may have a negative impact on brain development. Now a study led by the Barcelona Institute for Global Health (ISGlobal), a centre supported by the "la Caixa" Foundation, has found that exposure to nitrogen dioxide (NO2) during the first two years of life is associated with poorer attention capacity in children aged 4 to 8, especially in boys. NO₂ is a pollutant that comes mainly from traffic emissions.

The study, published in Environment International, shows that higher exposure to NO2 was associated with poorer attentional function in 4- to 6-year-olds, with increased susceptibility to this pollutant observed in the second year of life. This association persisted at an age of 6 to 8 years of age only in boys, with a slightly greater susceptibility period from birth to 2 years of age.

The researchers used data from 1,703 women and their children from the INMA Project birth cohorts in four Spanish regions. Using the home address, the researchers estimated daily residential exposure to NO2 during pregnancy and the first 6 years of childhood. In parallel, they assessed the attentional function (the ability to choose what to pay attention to and what to ignore) at 4-6 years and 6-8 years, and working memory (the ability to temporarily hold information) at 6-8 years, using validated computerised tests.

Periods of higher susceptibility to air pollution

A previous INMA study reported that exposure to NO2 during pregnancy and childhood was associated with impaired attentional function in children at 4-5 years of age. The present study found that:

• Higher exposure to NO2 between 1.3 and 1.6 years of age was associated with higher hit reaction time standard error, an indicator of speed consistency, in the attentional function test at 4–6 years of age.
• Higher exposure to NO2 between 1.5 and 2.2 years of age was associated with more omission errors.
• Higher exposure to NO2 between 0.3 and 2.2 years was associated with higher hit reaction time standard error at 6–8 years only in boys.
• No associations were found between higher exposure to NO2 and working memory in children aged 6 to 8 years.

“These findings underline the potential impact of increased traffic-related air pollution on delayed development of attentional capacity and highlight the importance of further research into the long-term effects of air pollution in older age groups”, explains Anne-Claire Binter, last author of the study and postdoctoral researcher at ISGlobal.

As the brain matures

Attentional function is crucial for the development of the brain’s executive functions, which manage and control actions, thoughts and emotions to achieve a goal or purpose. “The prefrontal cortex, a part of the brain responsible for executive functions, develops slowly and it is still maturing during pregnancy and childhood,” adds Binter. This makes it vulnerable to exposure to air pollution, which has been linked in animal studies to inflammation, oxidative stress, and impaired energy metabolism in the brain.

“In boys, the association between exposure to N0₂ and attentional function may last longer because their brains mature more slowly, which could make them more vulnerable”, she points out. To understand this better, future studies should follow people over time to see how age and gender affect the relationship between air pollution and attention span, especially in older age groups.

In conclusion, “this study suggests that early childhood, up to the age of 2, seems to be a relevant period for implementing preventive measures,” says Binter. “Even a small effect at the individual level from relatively low levels of exposure, as in this study, can have large consequences at the population level. Exposure to traffic-related air pollution is therefore a determinant of the health of future generations.”

Reference

Crooijmans, K.L.H.A., Iñiguez, C., Withworth, K.W., Estarlich, M., Lertxundi, A., Fernández-Somoano, A., Tardón, A., Ibarluzea, J., Sunyer, J., Guxens M., Binter, A.C. 2024, Nitrogen dioxide exposure, attentional function, and working memory in children from 4 to 8 years: Periods of susceptibility from pregnancy to childhood, Environment International. Volume 186, 2024, 108604, ISSN 0160-4120, https://doi.org/10.1016/j.envint.2024.108604

Stressful experiences in midlife or during childhood may be associated with a higher risk of developing Alzheimer's disease and neuroinflammation, respectively. This is one of the conclusions of a study published in Annals of Neurology and led by the Barcelona Institute for Global Health (ISGlobal), a centre supported by the "la Caixa" Foundation, in collaboration with the Barcelonaβeta Brain Research Center (BBRC), research centre of the Pasqual Maragall Foundation.

Stressful Life Events are those in which objective external threats activate behavioural and psychological responses on us, for example, death of a loved one, unemployment or illness. Mounting evidence suggests that stress could be associated with an increased risk of dementia and cognitive decline .

The purpose of this research was to assess whether the accumulation of stressful life events throughout life could influence the development of Alzheimer’s-related pathologies in older ages. To do so, the research team counted on 1,290 volunteers from the ALFA cohort in Barcelona , also supported by the ”la Caixa” Foundation, all of them cognitively unimpaired at the time of the study, but with a direct family history of Alzheimer's disease.

Participants went through interviews to assess the number of Stressful Life Events. Lumbar punctures and magnetic resonance imaging (MRI) were performed to test different biomarkers related to Alzheimer’s disease.

Midlife as a vulnerable period

The statistical analyses revealed that the accumulation of stressful events during midlife was associated with higher levels of β-amyloid (Aβ) protein , a key player in the development of Alzheimer’s disease.

“We know midlife is a period when Alzheimer’s disease pathologies start to build up. It is possible that these years represent a vulnerable period where experiencing psychological stress may have a long-lasting impact on brain health”, says Eleni Palpatzis, ISGlobal researcher and first author of the study.

Childhood stress and neuroinflammation

The research team also found that higher levels of stressful experiences in childhood were associated with higher risk of developing neuroinflammation in older ages. Inflammation has been recognized as a key molecular response in neurodegenerative diseases and these results are in line with emerging evidence suggesting childhood trauma to be linked with increased adulthood inflammation.

Sex differences on the impact of stressors

Accumulation of stressful life events over the course of life was associated with higher levels of β-amyloid (Aβ) protein only in men . In women, however, the researchers observed that more stressful experiences over the course of life were associated with lower volumes of grey matter, implying that stress may have sex-specific effects.

“Our results suggest that the mechanisms through which life stressors affect brain health in men and women are different: amyloid protein accumulation in men and brain atrophy in women”, says Eider Arenaza-Urquijo , ISGlobal researcher and last author of the study.

Stronger effects in people with psychiatric history

Lastly, the authors found that stressful life events in people with a history of psychiatric disease were associated with higher levels of Aβ and tau proteins, neuroinflammation and with lower grey matter volume , suggesting that this population could be more susceptible to the effects of stressful life events, for example, due to impaired stress-coping abilities which could make them more vulnerable.

“Our study reinforces the idea that stress could play a significant role in the development of Alzheimer’s disease and provides initial evidence regarding the mechanisms behind this effect, but additional research is needed to replicate and validate our initial findings”, says Eider Arenaza-Urquijo .

Reference

Palpatzis E, Akinci M, Aguilar-Dominguez P, Garcia-Prat M, Blennow K, Zetterberg H, Carboni M, Kollmorgen G, Wild N, Fauria K, Falcon C, Gispert JD, Suárez-Calvet M, Grau-Rivera O, Sánchez-Benavides G, Arenaza-Urquijo EM; ALFA study. Lifetime Stressful Events Associated with Alzheimer's Pathologies, Neuroinflammation and Brain Structure in a Risk Enriched Cohort. Ann Neurol. 2024 Mar 11. doi: 10.1002/ana.26881 . Epub ahead of print. PMID: 38466157.

Sulfadoxine-pyrimethamine (SP) retains parasitological activity and remains effective for preventing P. falciparum infection in pregnant women and low birth weight in babies, even in areas with a high prevalence of mutations associated with SP resistance. This is the main conclusion of a study conducted in southern Mozambique and led by the Manhiça Health Research Institute (CISM) and the Barcelona Institute for Global Health (ISGlobal), a centre supported by "la Caixa" Foundation.

Providing preventive antimalarial treatment to pregnant women and children under five, regardless of whether they are infected, is an effective strategy for reducing the burden of malaria in these two highly vulnerable populations. In pregnant women, monthly doses of sulfadoxine-pyrimethamine (SP) after the first trimester have been shown to be safe and effective in reducing the severe consequences of malaria in mothers and their babies, including low birth weight. However, there is concern about the growing prevalence of malaria parasites that carry a series of mutations that decrease the efficacy of SP. Specifically, five mutations in two genes (quintuple mutants) are associated with SP resistance.

“Curiously, even in areas where the prevalence of quintuple mutants is high, chemoprevention with SP still seems to provide a benefit to pregnant women,” says ISGlobal researcher Alfredo Mayor. “Whether this sustained benefit is due to other non-malaria effects of sulfadoxine (which also acts as an antibiotic), or whether there is still a direct effect on malaria infections, is not clear,” he adds.

To answer this question, a team led by Mayor and CISM researcher Glòria Matambisso investigated malaria infections, antibodies, clinical outcomes and parasite resistance markers over three years in a total of 4,016 pregnant women in Southern Mozambique.

SP retains anti-parasite activity

Despite the fact that 94% of infected women at the first antenatal visit carried quintuple mutants, preventive treatment with SP (IPTp-SP) remained effective in those who took three or more doses of SP during pregnancy (84% of the participants). Specifically, they showed increased clearance of P. falciparum infections (the prevalence of infected women fell from 7.7% at the first visit to 1.9% at delivery); had a lower prevalence of antibodies resulting from parasite colonisation of the placenta; and their babies had a higher birth weight, compared to women who took less than three doses of SP.

“Our results suggest that SP retains activity against parasites carrying these five mutations, and that the observed benefit is not only due to sulfadoxine’s antibiotic properties,” says Glória Matambisso, first author of the study. In other words, the sustained parasitological effect of SP in clearing malaria infections, combined with the antibiotic properties of sulfadoxine, may explain why IPTp-SP remains beneficial even in areas where the quintuple mutation is dominant. The authors conclude that, until more effective alternatives are found, SP should continue to be used for malaria chemoprevention in pregnant women, despite the high prevalence of molecular markers of drug resistance.

“This is good news,” says Mayor. But the fact that many of the participants went to their first antenatal visit at week 21 (instead of during the first trimester, as recommended) and that 16% of them failed to receive three or more SP doses, means that there are still major barriers to the successful implementation of IPTp. “We need to strengthen our operational capacities to provide timely chemoprevention to pregnant women,” he adds.

Reference

Matambisso G, Brokhattingen N, Maculuve S et al. Parasitological and clinical effects of malaria chemoprevention with sulfadoxine-pyrimethamine in pregnant women from southern Mozambique. J Infection. 2024. Doi: 10.1016/j.jinf.2024.106144

Date

11/05/2024

Hour

9.30 - 15.00 h

Place

C/ de Casanova, 143

El próximo sábado 11 de mayo las diversas entidades del Campus Clínic celebrarán la primera edición del Clínic Obert. Un evento que ocupará más de 15.000 metros cuadrados en la calle y en el que se desarrollarán más de 100 actividades que se distribuirán en 4 escenarios, 5 salas de conferencias con 18 charlas, 15 visitas en espacios interiores y más de 60 carpas con talleres y puntos informativos. El objetivo es conectar con la ciudadanía, haciendo prevención de la salud y fomentando hábitos de vida saludable.

Entre otros, habrá un espacio dedicado a la investigación, la tecnología y la innovación. Se podrá visitar el primer quirófano del mundo con tecnología 5G. También se realizarán talleres familiares de ciencia, una visita al 'Biobanc', el taller 'El café de la inmunoterapia' o una visita al laboratorio de diabetes del IDIBAPS.

Más información aquí.

Actividades de ISGlobal

Malaria Escape 

Sábado, 11 de mayo de 2024. De 9:30h a 15:00h

Público: Todas las edades
Tipo de actividad: Taller

Juego de pistas para tomar conciencia de esta enfermedad y el parásito que la causa. Resolviendo varias pruebas se podrá aprender más sobre la transmisión, las zonas del mundo más afectadas y qué se puede hacer para evitar el contagio. ¡Ven a hacer de detective!

Juego de Genes: descifrando genes para combatir la malaria

Sábado, 11 de mayo de 2024. De 9:30h a 15:00h

Público: Infantil / Juvenil
Tipo de actividad: Taller

¿Te gustaría sentirte como un científico investigando la malaria? En este taller utilizaremos fresas como sustitutos del parásito causante de esta enfermedad y extraeremos el ADN con utensilios de cocina, haciendo una analogía con el proceso que se realiza en el laboratorio.

Viaja con salud

Sábado, 11 de mayo de 2024. De 9:30h a 15:00h

Público: Todas las edades
Tipo de actividad: Mesa informativa

Planifica tu viaje, emprende la aventura y vuelve a casa sin olvidar la salud. ¿Sabes qué debe tener un botiquín de viaje como es debido? ¿Sabrías decir qué riesgos corres allá donde viajas? ¿Conoces algunos de los falsos mitos que corren sobre enfermedades tropicales? El equipo del Servicio de Atención al Viajero Internacional del hospital Clínic Barcelona (@saviclinicbcn) te invitamos a jugar, pintar y participar en nuestras actividades para que cuando viajes lo hagas siempre con la mejor salud.

Salud Global: Postgrados de la Universidad de Barcelona e ISGlobal

Sábado, 11 de mayo de 2024. De 9:30h a 15:00h

Público: Adultos
Tipo de actividad: Mesa informativa

¿Quieres contribuir a hacer realidad la equidad en salud? Ven a hablar con el equipo de formación de ISGlobal sobre los programas de postgrado en salud global/internacional de la Universidad de Barcelona e ISGlobal.

Virus emergentes y reemergentes: ¿qué nos espera?

Sábado, 11 de mayo de 2024. De 13:15h a 13:45h

Público: Adultos
Tipo de actividad: Charla
Lugar: Aula Magna.
Punto de encuentro: Vestíbulo de la Facultad de Medicina (C/ de Casanova, 143), llegar 10 minutos antes 

Charla informativa sobre las emergencias de especies virales y los mecanismos por los que los virus pueden emerger. Hablaremos de algunos virus que circulan en la actualidad y que pueden ser relevantes en nuestro medio por las condiciones climáticas, ecológicas o sociales.

A study led by the Barcelona Institute for Global Health (ISGlobal), a centre supported by the "la Caixa" Foundation, and the Barcelona Supercomputing Center - Centro Nacional de Supercomputación (BSC-CNS), has consistently estimated daily ambient concentrations of PM_2.5, PM₁₀, NO₂ and O₃ across a large ensemble of European regions between 2003 and 2019 based on machine learning techniques. The aim was to assess the occurrence of days exceeding the 2021 guidelines of the World Health Organization (WHO) for one or multiple pollutants, referred to as “unclean air days”.

The research team analysed pollution levels in more than 1,400 regions in 35 European countries, representing 543 million people. The results, published in Nature Communications, show that overall suspended particulate matter (PM_2.5 and PM₁₀) and nitrogen dioxide (NO₂) levels have decreased in most parts of Europe. In particular, PM₁₀ levels decreased the most over the study period, followed by NO₂ and PM_2.5, with annual decreases of 2.72%, 2.45% and 1.72% respectively. In contrast, O₃ levels increased annually by 0.58% in southern Europe, leading to a nearly fourfold rise in unclean air days.

The study also looked at the number of days on which the limits for two or more pollutants were exceeded simultaneously, a confluence known as a “compound unclean air day”. Despite the overall improvements, 86.3% of the European population still experienced at least one compound unclean day per year during the study period, with PM_2.5-NO₂ and PM_2.5-O₃ emerging as the most common compound combinations.

The results highlight the significant improvements in air quality in Europe followed by the decline of PM₁₀ and NO₂, while PM_2.5 and O₃ levels have not followed a similar positive trend, resulting in a higher number of people exposed to unclean air levels. "Targeted efforts are needed to address PM_2.5 and O₃ levels and associated compound unclean days, especially in the context of rapidly increasing threats from climate change in Europe," says Zhao-Yue Chen, ISGlobal researcher and lead author of the study.

"Our consistent estimation of population exposure to compound air pollution events provides a solid basis for future research and policy development to address air quality management and public health concerns across Europe," points out Carlos Pérez García-Pando, ICREA and AXA Research Professor at the BSC-CNS.

Heterogeneous geographical distribution

The research team has developed machine learning models to estimate high-resolution daily concentrations of major air pollutants like PM_2.5, PM₁₀, NO₂ and O₃. This data-driven approach creates a comprehensive daily air quality picture for the European continent, going beyond sparsely distributed monitoring stations. The models gather data from multiple sources, including satellite-based aerosol estimates, existing atmospheric and climate data, and land use information. By analysing these air pollution estimates, the team calculated the annual average number of days in which the WHO daily limit for one or more air pollutants is exceeded.

Despite air quality improvements, 98.10%, 80.15% and 86.34% of the European population lives in areas exceeding the WHO recommended annual levels for PM_2.5, PM₁₀ and NO₂, respectively. These results closely match the European Environment Agency (EEA)'s estimates for 27 EU countries using data from urban stations only. Additionally, no country met the ozone (O₃) annual standard during the peak season from 2003 to 2019. Looking at short-term exposure, over 90.16% and 82.55% of the European population lived in areas with at least 4 days exceeding WHO daily guidelines for PM_2.5 and O₃ in 2019, while the numbers for NO₂ and PM₁₀ were 55.05% and 26.25%.

During the study period, PM_2.5 and PM₁₀ levels were highest in northern Italy and eastern Europe, while PM₁₀ levels were highest in southern Europe. High NO₂ levels were mainly observed in northern Italy and in some areas of western Europe, such as in the south of the United Kingdom, Belgium and the Netherlands. Similarly, O₃ increased by 0.58% in southern Europe, while it decreased or showed a non-significant trend in the rest of the continent. On the other hand, the most significant reductions in PM_2.5 and PM₁₀ were observed in central Europe, while for NO₂ they were found in mostly urban areas of western Europe.

The complex management of ozone

The average exposure time and population exposed to unclean air concentrations of PM_2.5 and O₃ is much higher than for the other two pollutants. According to the research team, this highlights the urgency of greater control for these pollutants and the importance of addressing the increasing trend and impact of O₃ exposure.

Ground-level or tropospheric O₃ is found in the lower layers of the atmosphere and is considered a secondary pollutant because it is not emitted directly into the atmosphere, but is formed from certain precursors - such as volatile organic compounds (VOCs), carbon monoxide (CO) and nitrogen oxides (NOx) - that are produced in combustion processes, mainly in transport and industry. In high concentrations, ozone can damage human health, vegetation and ecosystems.

"Ozone management presents a complex challenge due to its secondary formation pathway. Conventional air pollution control strategies, which focus on reducing primary pollutant emissions, may not be sufficient to effectively mitigate O₃ exceedances and associated compound unclean days," says Joan Ballester Claramunt, ISGlobal researcher and senior author of the study. However, addressing climate change, which influences ozone formation through increased sunlight and rising temperatures, is crucial for long-term ozone management and protection of public health," he adds.

The challenge of compound episodes

Despite improvements in air pollution, the research team reported that over 86% of Europeans experienced at least one day with compound air pollution events each year between 2012 and 2019, where multiple pollutants exceeded WHO limits simultaneously. Among those compound days, the contribution of PM_2.5-O₃ compound days increased from 4.43% in 2004 to 35.23% in 2019, becoming the second most common type in Europe, indicating a worrying trend. They mainly occur in lower latitudes during warm seasons and are likely linked to climate change and the complex interplay between PM_2.5 and O₃.

Warmer temperatures and stronger sunlight in summer boost O₃ formation through chemical reactions. Subsequently, higher levels of O₃ will accelerate the oxidation of organic compounds in the air. This oxidation process leads to the condensation of certain oxidized compounds, forming new PM_2.5 particles. Additionally, climate change increases the likelihood of wildfires, which further elevate both O₃ and PM_2.5 levels. “This complex interplay creates a harmful loop, highlighting the urgent need to address climate change and air pollution simultaneously,” explains Ballester Claramunt.

Reference

Main study: Chen, Z.Y., Petetin, H., Turrubiates, R.F.M., Achebak, H., García-Pando, C.P. and Ballester, J., 2024. Population exposure to multiple air pollutants and its compound episodes in Europe, Nature Communications. Doi: 10.1038/s41467-024-46103-3

Related study: Chen, Z.Y., Turrubiates, R.F.M., Petetin, H., Lacima, A., García-Pando, C.P. and Ballester, J., 2024. Estimation of pan-European, daily total, fine-mode and coarse-mode Aerosol Optical Depth at 0.1° resolution to facilitate air quality assessments. Science of The Total Environment, p.170593. Doi: 10.1016/j.scitotenv.2024.170593

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