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Research

New Insights into the Biology and Risk Factors of Childhood Obesity

New study integrates multi-omics analysis and early-life environmental exposures from over 800 European children

15.01.2025
Photo: Adobe Stock

A cutting-edge molecular approach provides a detailed picture of the biological pathways associated with childhood obesity and metabolic dysfunction, and identifies environmental risk factors during early life. The study, led by the Barcelona Institute for Global Health (ISGlobal), an institution supported by “la Caixa” Foundation, can help to develop strategies to prevent childhood obesity and its long-term health effects.

Childhood obesity is a major public health concern: 1 in 10 children are living with obesity across Europe, which puts them at high risk of metabolic disorders and cardiovascular disease later in life. Despite its prevalence, the biological mechanisms behind obesity-related health problems remain poorly understood, and not all children with obesity develop metabolic issues.

To address this gap, researchers used an advanced “multi-layered omics” approach to examine gene expression, proteins, and metabolites in blood samples from over 800 European children, together with detailed information about their health and prenatal environment. “Prenatal life is particularly important because environmental exposures during this critical developmental period can have pronounced effects later in life,” says Martine Vrijheid, ISGlobal researcher and senior author of the study.

The study is part of the Human Early Life Exposome (HELIX) project, which follows cohorts of children from Northern Europe (Bradford, UK; and Poitiers, France) and Southern Europe (Sabadell, Spain; and Heraklion, Greece).

A high-risk cluster of children

By analysing five “omics” layers- DNA methylation, microRNAs, mRNA, proteins and metabolites- the researchers identified three distinct clusters among the children. One of these groups stood out because the children not only had higher body fat but also showed more signs of metabolic complications. This high-risk cluster showed a higher expression of inflammation markers, which indicate an overactive immune system.

“Many of these inflammatory molecules can lead to insulin resistance and trigger a chronic inflammatory loop,” explains first author Nikos Stratakis. “By focusing on clusters derived from multi-omics profiles, our approach provides a better understanding of the biological pathways involved in metabolic health, beyond traditional clinical markers,” he adds.

Early-life environmental risk factors

The researchers also looked at environmental factors during pregnancy and found that the mother’s weight before pregnancy strongly influenced whether her child fell into the high-risk group. Interestingly, the environmental exposures linked to the high-risk cluster differed depending on the region. In Northern and Western Europe, maternal exposure to the industrial chemical perfluorooctanoate (used in non-stick coatings) was a significant risk factor. In Southern / Mediterranean Europe, maternal exposure to mercury, likely from higher fish consumption, was identified as a risk factor.

“These findings help us identify modifiable risk factors that could be targeted early in life,” says Vrijheid. “They also underscore the need to tailor prevention guidelines to diverse country contexts,” she adds.

 

Reference

Stratakis, N., Anguita-Ruiz, A., Fabbri, L. et al. Multi-omics architecture of childhood obesity and metabolic dysfunction uncovers biological pathways and prenatal determinants. Nat Commun 16, 654 (2025). https://doi.org/10.1038/s41467-025-56013-7

Global Think-Tank on Steatotic Liver Disease: Priorities for 2025 and Beyond

Prevention of liver disease in people living with obesity and/or diabetes

26.11.2024
Global think-tank on steatotic liver disease: prioridades para 2025 y más allá
Date
26/11/2024
Hour
17:30 -18:15 CET
Place
Virtual
Speakers
Jeffrey V Lazarus, Kenneth Cusi, Nuria Alonso, Didac Mauricio, Maru Rinella

El 26 de noviembre de 2024, un webinar online en español reunirá a un panel de expertos de España y EE.UU. para debatir los puntos clave tratados en la Cumbre anual de evidencias del mundo real e innovaciones en enfermedad hepática esteatósica (SLD) de la prueba no invasiva el pasado mes de mayo. Incluirá un animado debate sobre las prioridades para 2025, con especial atención a la prevención de las enfermedades hepáticas en personas que viven con obesidad y/o diabetes, así como la forma de abordar la amenaza para la salud pública de la enfermedad hepática esteatósica asociada a disfunción metabólica (MASLD) y la esteatohepatitis asociada a disfunción metabólica (MASH).

Se trata de una gran oportunidad para que los profesionales sanitarios, los pacientes y los investigadores se pongan al día sobre lo último en detección precoz, prevención, tratamiento y atención de las enfermedades hepáticas leves.

Temas clave que se abordarán:

  1. Cerrar la brecha diagnóstica: Abordar la desconexión entre la creciente prevalencia de la SLD y las bajas tasas de diagnóstico, debatiendo pruebas no invasivas, garantizando que más pacientes reciban un diagnóstico, educación y atención oportunos.
  2. La prevención como clave: Estrategias preventivas eficaces dirigidas a reducir la MASLD/MASH, haciendo hincapié en el papel de la dieta, el ejercicio y los contaminantes ambientales.
  3. El futuro de los tratamientos: La visión del tratamiento MASH recientemente aprobado por la FDA estadounidense.
  4. El enfoque multidisciplinar: La importancia de implicar a todas las partes interesadas, sin olvidar a los endocrinólogos.

 

Ponentes:

  • Jeffrey V Lazarus, jefe del Grupo de Salud Pública del Hígado, ISGlobal (España)
  • Kenneth Cusi, profesor de Medicina, División de Endocrinología, Diabetes y Metabolismo, Universidad de Florida, EE.UU.
  • Nuria Alonso, director del Departamento de Endocrinología y Nutrición, Hospital Germans Trias i Pujol, España
  • Dídac Mauricio, director del Departamento de Endocrinología y Nutrición, Hospital de la Santa Creu i Sant Pau Ciberdem, España
  • Maru Rinella, gastroenterólogo, director del Departamento de Enfermedades Metabólicas y del Hígado Graso, Universidad de Chicago, EE.UU.

 

Para más información sobre el grupo de reflexión mundial sobre la hepatopatía esteatósica, visite esta página web.

 

Research

New Tablet Shows Promise for the Control and Elimination of Intestinal Worms

The ALIVE clinical trial shows that a tablet combining albendazole and ivermectin is safe and more effective than albendazole alone in treating soil-transmitted helminths

11.01.2025
Photo: STOP Consortium

A new tablet combining albendazole and ivermectin is safe and more effective than albendazole alone in treating Trichuris trichiura and other soil-transmitted helminths (STH), according to a clinical trial conducted by the STOP consortium and led by the Barcelona Institute of Global Health (ISGlobal), a centre supported by “la Caixa” Foundation. The findings, published in The Lancet Infectious Diseases, open opportunities to improve the control of these neglected tropical infections, which affect around 1.5 billion people worldwide.

Soil-transmitted helminthiases (STH) are caused by four species of parasitic worms (Ascaris lumbricoides, Trichuris trichiura, and the hookworms Ancylostoma duodenale and Necator americanus) that are transmitted through contact with contaminated soil or water. They have a significant impact on nutrition and health, particularly in children and women of reproductive age living in endemic areas of Latin America, Asia and sub-Saharan Africa.

The current STH control strategy relies on regular deworming treatments with albendazole for at-risk populations, along with improvements in water, sanitation, and hygiene. Albendazole is highly efficient against Ascaris but its efficacy against T. trichiura has been declining, probably due to emerging drug resistance. Additionally, albendazole is not effective against Strongyloides stercoralis, another helminth that has been added to the list of intestinal parasites requiring control measures.

Two drugs in one tablet

To address these gaps, the EDCTP-funded STOP consortium tested an innovative tablet combining a fixed dose of albendazole and ivermectin. Ivermectin has been shown to be more effective against T. trichiura when combined with albendazole, and is the drug of choice to treat S. stercoralis and other parasitic infections.

“This fixed-dose co-formulation (FDC) has several advantages. It is easy to administer, as it is one single pill and does not require dose adjustments based on the child’s weight,” explains project leader Jose Muñoz, ISGlobal researcher and head of the International Health Department at Hospital Clinic Barcelona. “Also, we hope that combining two drugs with different mechanisms of action will reduce the risk of the parasites becoming drug-resistant,” he adds.

One clinical trial in three African countries

The ALIVE clinical trial, conducted in Ethiopia, Kenya and Mozambique, tested the safety and efficacy of the FDC in school-aged children (aged 5 to 18 years) infected with T. trichiura, hookworms, S. stercoralis or a combination. The children were randomly divided into three treatment groups: group 1 received a single dose of albendazole; group 2 received one dose of the FDC (FDCx1); and group 3 received three doses of the FDC (FDCx3) over three consecutive days.

Safety first

Phase 2 of the trial focused on safety. A small number of participants were recruited and treated sequentially according to weight, to monitor any adverse effects caused by higher-than-usual doses of ivermectin (above 200 µg/ml). No serious adverse effects were observed, and side effects were similar to those in the albendazole group. This allowed the trial to proceed to phase 3, where efficacy was assessed in a much larger number of participants, alongside continued safety monitoring.

In total, 4,353 children were screened for STH infections and 1,001 were randomised for treatment. Of those infected, 63% were positive for T. trichiura, 36% for hookworms and 10% for S. stercoralis.

Higher efficacy against T. trichiura and hookworms

Treatment efficacy was assessed based on cure rates (absence of eggs in stool samples post-treatment) and reduction in the number of eggs in stool compared to before the treatment. For T. trichiura, the FDC achieved higher cure rates at both regimens (97% for FDCx3, 83% for FDCx1) compared to albendazole alone (36%). For hookworms, the FDCx3 regimen showed a higher cure rate (95%), while the FDCx1 regimen was similar to albendazole (79% and 65% respectively). For S. stercoralis, the sample size was too small to assess efficacy, but the existing evidence suggests that the FDC would also be more effective, since ivermectin is far more effective than albendazole against this parasite.

Although most infections were classified as light, both FDC regimens achieved higher egg reduction rates than albendazole alone.

Implications for public health

“This is a pivotal trial that opens up the possibility of controlling all species of STH, including Strongyloides, and may lead to reconsider elimination goals that were deemed unattainable with albendazole alone,” says Alejandro Krolewiecki, clinical trial leader. The next step is to conduct larger-scale studies, such as the ongoing trial led by STOP2030, to further evaluate the safety of the FDC in the context of mass deworming campaigns.

Defining optimal implementation strategies will also be essential if the FDC is to be adopted by national programmes. The trial findings suggest that a single-dose regimen of the FDC may be simple to apply in mass deworming activities, while the three-day regimen, which offers superior efficacy, may be better for individual treatment decisions, or for programmes aiming to completely eliminate STH from the population.

"With its child-friendly formulation – orodispersable and mango-flavored - and its high acceptance, this tablet holds great potential for advancing health outcomes in regions affected by these diseases," says Stella Kepha, researcher from the Kenya Medical Research Institute (KEMRI).

 

Reference

Krolewiecki A, Kepha S, Fleitas PE et al. Albendazole–ivermectin co-formulation for the treatment of Trichuris trichiura and other soil-transmitted helminths: a randomised phase 2/3 trial.The Lancet Infectious Diseases. https://doi.org/10.1016/S1473-3099(24)00669-8

Funder

The ALIVE trial and the STOP projects were supported by the EDCTP2 program (grant number RIA2017NCT-1845 and PSIA2020-3072) with funding from Mundo Sano, the UK Medical Research Council, the UK FCDO and the European Union.  www.stoptheworm.org

Research

Interview with Xavier Rodó: "The Iberian Peninsula Is Particularly Vulnerable to Climate Change. We Are Not Tuvalu, but We Are Halfway There"

Xavier Rodó, head of the Climate and Health Research Group at ISGlobal, talks about the flooding in Valencia, climate change and the future of the Mediterranean

21.11.2024
Interview with Xavier Rodó:

With people still missing and mud covering the villages affected by the October 29th floods in Valencia, we pause to reflect on what happened in the sky that fateful day, what lies ahead of us in this part of the Mediterranean and beyond due to global warming, and how science is advancing to provide us with the best tool for action: knowledge. We interviewed Xavier Rodó (Terrassa, 1965), ICREA Research Professor and Head of the Climate and Health Research Group at ISGlobal.

 

-As a climatologist, were you surprised by what happened in Valencia?

-It is difficult not to be surprised by such an event. You are surprised by the magnitude of its consequences, although relatively speaking, and it is hard to say, it is very small compared to, for example, tropical cyclone Nargis, which killed more than 100,000 people and destroyed entire communities in Myanmar in 2008, or the drought in the Horn of Africa in 2011, which claimed more than 250,000 lives, according to estimates by the World Weather Attribution (WWA) group. However, in what we might call the “first world”, it is an extreme and catastrophic event in terms of its consequences. In terms of the specific meteorological situation, although such events don’t occur often, they are not uncommon in this part of the western Mediterranean and has been well known for many years. What was initially unexpected was the energetic load associated with this particular event, which caused very heavy rainfall. However, the forecasts pointed in the right direction.

-So we will have more extreme events?

-Unfortunately, they will become more frequent. It is no longer science fiction, we must begin to understand that the predictions are coming true. From a social point of view it is a disaster, but from a scientific point of view it is a success. What is happening in the Mediterranean is going to get worse, because we have a very active cyclogenesis zone in the western part, which is going to get stronger as the sea continues to warm.

-Is the western Mediterranean considered a planetary hotspot?

-Yes. On the one hand, we see a progressive and steady increase in surface air temperatures and the warming of the Mediterranean Sea, accompanied by less rainfall during the two main rainy seasons, as a long-term trend. On the other hand, we are witnessing an intensification of extremes: the Spanish Levant region has a very active cyclogenesis zone, where autumn conditions lead to collisions between cold air masses and warm, moisture-laden air masses. These interactions fill the air column and, when released, trigger energetic discharges in the form of torrential rains. These heavy rains are expected to become more frequent. We could go from drought conditions to situations where it rains heavily but the reservoirs remain half empty. This reflects a dichotomy between decreasing water resources and increasing extreme weather events. We must begin to adapt to these increasingly variable and diminishing resources.

-What other factors are at play?

-Global warming, which raises air and water temperatures, also changes general atmospheric circulation patterns. For example, as in the case of an isolated high-altitude cold air mass, it can cause "bubbles," or masses of very cold air at high altitudes, to break away from the usual mid-latitude flow over Europe and move toward the Mediterranean. In addition, certain planetary-scale phenomena can amplify this process in certain years - for example, the strong El Niño that began last year and continued well into 2024. This phenomenon transfers a significant amount of energy through climate teleconnections to latitudes outside the tropics. It's like heating up a pressure cooker: the heat has to escape somehow. The excess energy finds regional outlets, many of which are well known, including the Mediterranean Sea, especially its western part. As a result, when a large amount of energy accumulates, it can lead to extreme rainfall events, such as the one in Valencia, where almost a year's worth of rain fell in just eight hours.

3 degrees of warming is a different world

-We already know that 2024 will be the hottest year on record and the first to exceed 1.5 degrees of warming above pre-industrial levels, the limit set by the Paris Agreement. How does this data make you feel?

-It's hard to say. As a scientist, there is a sense of satisfaction in seeing the work of so many years validated. But as a citizen, the disappointment is immense. Nevertheless, I believe that knowledge gives us tools for action, and that the generation of new scientific knowledge can somehow mobilize action in various fields. What worries me most is that at the current rate of emissions, we are heading for 2.7 to 3 degrees of warming by the end of the century. That would be a very different world.

-What will be the consequences if we reach 3 degrees of warming?

-The models may not be perfect - they are always approximate - but they clearly show that at 3 degrees of warming, the Atlantic thermohaline circulation would collapse. This is the system of ocean currents that circulates water in the Atlantic, moving warm water north and cold water south, and is crucial to maintaining Europe's temperate climate. Its collapse would trigger numerous cascading effects across the planet. Let's be clear: while we often talk about limiting warming to 1.5 degrees, the reality ahead is much more alarming. This naturally fuels pessimism, but I also want to change the narrative and focus on solutions.

-How can the message be turned around?

-From a scientific perspective, we are gaining an increasingly detailed understanding of how the planet and climate systems behave. While there have been surprises, particularly regarding the planet's high climate sensitivity as seen recently, this knowledge should strengthen our conviction as a society to pressure governments to change the system. We need to redefine our relationship with the environment. It's essential to move away from the historical mindset of humans as limitless resource extractors and understand that infinite growth is not possible. We've already reached planetary limits, and this requires a reorganization of the distribution of wealth. This doesn't mean going back to the way we lived 50 years ago - although in many ways life was better then - but rather managing our development based on the finite resources available rather than on unchecked demand. This change must occur at the local, regional, state, and national levels. It's time to change the way we organize ourselves as a society and ensure that intelligence and foresight are reflected in decision-making at the highest levels.

Summits to avoid decisions

-How do scientists in this field feel about the fact that climate change denial is gaining momentum?

-It is not a scientific problem; it is a sociological problem - a problem of human behavior. It goes beyond what we as scientists can directly address. A broad societal debate is needed to address this issue, and we are not the only ones who should decide how to proceed. Climate denial exists and will continue to exist, and it is gaining strength under the current global political conditions. It has become a widely used tool to justify inaction.

-Can COP29 do anything?

-Climate summits have become increasingly bureaucratic, making transformative decisions more difficult than ever. In fact, such decisions are simply not being made. It often feels like summits are designed to avoid making them. We've become too used to the ritual: late-night negotiations on the last day, as if the previous two or three weeks had been wasted on procedural formalities. ISGlobal is an accredited observer at COP29, and I see the same pattern emerging: endless debates over the wording of minor clauses in sub-paragraphs, while the most critical issues are completely sidelined. Enough is enough - we have already had 29 climate summits! This is a major problem. It's the same dynamic with biodiversity summits; we've had 16 of them now and little has changed. This is dangerous. We need to change the way we work - not only within the scientific community, but also with the general public. Most importantly, we need to put pressure on governments to act decisively.

-What are the issues that need to be addressed urgently?

-The COP has been dealing with the same issues for many years. One is the mechanism and the size of the Loss and Damage Fund—how to compensate the countries and regions that have been suffering the effects of climate change for years, and who is responsible for paying for it. On the other hand, there is no subsequent verification mechanism or agency to ensure that states comply with their commitments and pay this debt (which, in fact, we must consider as a debt already incurred by developed countries and both historical and current emitters). In the end, everything will be purely voluntary, and we will get nowhere.

-What can we do about this lack of action by the summits?

-We need to create a new mechanism that forces countries to compensate for the effects of their historical actions, which are already well-documented. What we need is both the political will and a new framework, because it is clear that the theory of the "common good" does not work for this type of global issue. But this seems difficult, as we can see that UN decisions are very weak in other areas, such as armed conflicts, where resolutions often go unenforced. So, how can we expect the resolutions of a subordinate organization, which depends on the UN, to be respected? In any case, despite the risk of sounding pessimistic, I always end up believing that the power of the people, which is starting to shift in many countries due to climate disasters, will eventually change the way many governments act.

We are not Tuvalu, but we are halfway there.

-Is there anything we can do at the individual level, or should we focus on demanding action from governments?

-You can help reduce your environmental impact, for example, by following the "three Rs" (reduce, reuse, and recycle). However, it must also be said that the aware citizen has been overly blamed, while large corporations and multinational companies have been insufficiently held accountable. The major oil lobbies and business groups coined the term "carbon footprint" to put the spotlight on individuals, and this term has been used ad nauseam, even by left-wing politicians. As citizens, we should follow the guidance of experts on what to do, but the solution to a problem of this magnitude goes far beyond individual actions, and in some cases, beyond what the state can address alone. The Spanish state, in particular, is starting to suffer more than other countries because we are warming much faster than the rest of Europe, and because mitigation and adaptation policies and plans have been entirely inadequate so far. We're not Tuvalu, but we're halfway there, and the solution needs to come not only from our state, but also from international agreements. On a global scale, however, one might argue that it’s not entirely bad that the effects of climate change are now reaching wealthy countries, because this could spur action.

-Do politicians and administrations consult you on these issues?

-In Catalonia and Spain, we still operate in an outdated manner, and I'm sorry to say it, but we need to speak out. Here, if a politician knows someone or has been told that a person is an expert, they pick up the phone and get an expert opinion right away. We should aim to work much more objectively, as is done in countries with a long tradition of climate research, which are much more advanced than we are—by using the best available information at any given time. We have excellent researchers and research groups that are underutilized by our political class. Politicians, and especially the public, deserve to have the best possible information, even if they have to seek it from outside the country, because, unfortunately, not enough has been invested in this field of knowledge here.

Intensity and forgetfulness

-Will anything change after what happened in Valencia? Can it be a turning point?

-I would like to say yes, but if I had to bet, I would definitely say no. All we have to do is look at the example of the COVID-19 pandemic, where, in theory, we were all supposed to learn a lot, but the truth is that very little has changed since then. For starters, we still do not have a national epidemiological agency or a pandemic forecasting system that fully utilizes the available tools, because the political class neither understands nor believes in them. If we were to face that situation again, we would encounter the same problems and shortcomings. An event like the floods in Valencia, like all extreme phenomena, has an intense psychological impact in the first few weeks or months, but then it is forgotten. In this sense, I would say that there will be no changes. On a broader level, beyond politicians, there is no perception of the magnitude or seriousness of these events, and unfortunately, we are learning this the hard way, through the experiences and suffering of many people.

Drawing the line

-Are we at a point of no return or can we still slow down climate change?
-From a scientific point of view, we have a better understanding of how the planet behaves. However, this also leads us to see that, throughout many crucial moments in Earth's history, climate has played a fundamental role. In a positive sense, because we know that 600,000 years ago, climate was the trigger for the emergence of multicellular life, thanks to the end of the Snowball Earth period, when the planet was no longer frozen, and also because of the climatic role during a major episode of global oxygenation. But also in a negative sense, less than 250,000 years ago, during the Permian-Triassic transition, we know that the magnitude and frequency of El Niño events in the tropical Pacific were so extreme that they led to a major extinction of species and a massive loss of terrestrial and marine biodiversity. And this occurred under conditions of CO₂ emissions ranging from 410 ppm to 860 ppm. Warning! These values are already included in the climate change scenarios projected for the coming decades! This should give us pause for thought.

-How can science help us?

-We are now able to design "safe" climate scenarios, where certain planetary variables must not be exceeded. These are called safe pathways. In other words, we are anticipating what politicians might ask us to do in the coming years, and there is a significant international research effort in this direction. What are the planetary emissions limits? If we stop emitting, will the planet return to previous conditions, or will there be hysteresis (the transition of the climate to a new state of equilibrium, driven by a forcing that causes an irreversible chang), leading to a different world, depending on where we are? What are the deforestation limits in certain parts of the world to prevent the collapse of biodiversity or the transition from forests to savannas? Is the sequestration of greenhouse gases possible as a planetary solution? What should we avoid doing or going beyond? We are generating immense knowledge that we didn't have before. Ten or twenty years ago, it would have been impossible to argue that this could be done - and now we are doing it. We can simulate a parallel planet and manipulate it to better understand how it behaves. So even if we as a society are in a boat approaching a waterfall, we now know exactly how much time we have to get out of the boat or what we need to do to steer it to safety. All we have to do is decide to take action.

 

Interview by Yvette Moya-Angeler.

Institutional

Three ISGlobal Researchers Obtain ICREA Research Professor position

Mònica Guxens, Davide Rasella, and Anna Roca have been selected by the ICREA institution, an international benchmark of excellence funded by the Government of Catalonia.

12.12.2024

The Catalan Institution for Research and Advanced Studies (ICREA) has granted the prestigious position of research professor to Mònica Guxens and Davide Rasella, research staff at ISGlobal, and Anna Roca, who will join the team in February 2025. They thus join the four ISGlobal researchers who already have positions: Quique Bassat, Hernando del Portillo, Alfred Cortés and Xavier Rodó.

Attracting outstanding research talent

This institution, promoted by the Government of Catalonia, aims to attract and retain research talent of excellence in various areas of knowledge. ICREA positions are among the most prestigious recognitions in the international academic field, as they offer stability and resources to leaders of high-impact research. This call offered 20 senior research positions aimed at researchers from all over the world. Applicants had to have international experience, a track record of excellent research, and leadership skills to drive innovative projects.

Mònica Guxens, Research Professor at ISGlobal, is a Medical Doctor specialised in Preventive Medicine and Public Health. Her work focuses on analysing how various environmental factors, such as air pollution, affect children's growth and development, with particular attention to brain development and sleep. Additionally, she has extensive experience in birth cohort studies. In 2016, she won the prestigious Walter A. Rosenblith New Investigator Award from the Health Effects Institute in the United States, in recognition of her exceptional career and promising professional path.

Davide Rasella, Associate Research Professor and head of the Health Impact Assessment Group (HIAE) at ISGlobal, is a social epidemiologist. With over two decades dedicated to public health, his work focuses on evaluating interventions to mitigate poverty-related diseases and reduce inequalities in low- and middle-income countries. His expertise spans both health impact assessments and studies on prevalent diseases in disadvantaged settings, such as HIV/AIDS and tuberculosis.

Finally, Anna Roca is Professor in Infectious Disease Epidemiology at the MRC Unit The Gambia in the London School of Hygiene & Tropical Medicine, with more than 15 years of experience in Africa. Her work combines surveillance, diagnosis, clinical trials and evaluation of public health interventions, with a special emphasis on bacterial and viral pathogens. She has led studies on infection determinants and transmission routes, using various epidemiological methodologies.

This recognition by ICREA highlights the impact of their scientific contributions internationally, as the institution's key values are collaboration, international openness and excellence. Furthermore, it underscores the commitment of ISGlobal professionals to address crucial public health challenges and strengthens the institute's mission as a centre of reference in research and global health.

Research

One of the World’s Largest Social Programmes Greatly Reduced Tuberculosis Among the Most Vulnerable

A landmark study involving 54 million Brazilians shows that conditional cash transfer programmes such as Bolsa Família can help meet global tuberculosis targets

03.01.2025
Bolsa familia and tuberculosis
Photo: Agência Senado

Brazil’s Bolsa Família Program (BFP), one of the world's largest conditional cash transfer programmes, was responsible for the reduction of more than half the number of tuberculosis cases and deaths among those living in extreme poverty and indigenous groups, shows a large study coordinated by the Barcelona Institute for Global Health (ISGlobal), a centre supported by “la Caixa” Foundation, the Institute of Collective Health, and the CIDACS-FIOCRUZ in Bahia, Brazil. The findings, published in Nature Medicine, have strong implications for public policies on social protection and TB control worldwide.

Brazil’s Bolsa Família Program (BFP) is one of the largest conditional cash transfer programmes implemented worldwide. Since 2004, the BFP has provided financial support to the poorest families in Brazil, on the condition that they fulfil certain conditions such as taking their children to the doctor and ensuring school attendance. While these programmes are well-known for reducing economic and social inequalities, they have also been shown to improve health outcomes such as child mortality, maternal deaths, and HIV cases and deaths.

Tuberculosis (TB), one of the leading infectious killers in Brazil and other low- and middle-income countries, is closely linked to poverty. “We know that TB is driven by poverty, but until now, the effects of cash transfers on disease outcomes among the most vulnerable populations had not been fully analysed,” says the coordinator of the study, Davide Rasella, head of the Health Impact Assessment and Evaluation group at ISGlobal, ICREA research professor and collaborating professor of the Institute of Collective Health.

Rasella and his colleagues in Brazil analysed data, including ethnic and socioeconomic conditions, from 54.5 million low-income Brazilians between 2004 and 2015. They compared TB incidence (number of new cases), mortality (number of deaths in the population) and case fatality rate (how many people who have the disease die) among people who received BFP support (23.9 million) or not (30.6 million). In total, there were 159,777 new TB diagnoses and 7,993 TB deaths in the cohort under study. 

Stronger effects among indigenous and extremely poor people

The results show a large decrease in TB cases and deaths among those benefiting from cash transfers. The decrease was of over 50% in extremely poor people and more than 60% among the indigenous populations. Although the program reduced TB cases across all groups, its effect was smaller in those who were less poor, and there was no significant reduction in TB deaths in that group. The TB case fatality rate (i.e. how deadly the disease is in those affected) was also lower among Bolsa Família beneficiaries compared to non-beneficiaries, although the difference between the two groups was not statistically significant.

The reason behind the BFP’s effect on TB outcomes is not a mystery. “We know that the program improves access to food, both in quantity and quality, which reduces food insecurity and malnutrition- a major risk factor for TB- and strengthens people’s immune defences as a result. It also reduces barriers to accessing healthcare,” says Gabriela Jesus, co-first author of the study along with Priscila Pinto, both from FIOCRUZ.

Global implications

Expanding the BFP can help Brazil address the worrying increase in TB cases among vulnerable populations following the COVID-19 pandemic. But the implications of these findings extend beyond Brazil.

“Our study has far-reaching implications for policy-making in all countries with a high burden of TB,” says Rasella. The message is clear: social protection programmes not only help reduce poverty and malnutrition, but can also play a crucial role in achieving the targets of the END-TB strategy and those of the Sustainable Development Goals.


Reference

Jesus GS, Pinto PFPS, Silva AF et al. Effects of conditional cash transfers on tuberculosis incidence and mortality according to race, ethnicity and socioeconomic factors in the 100 Million Brazilians cohort. Nat Med10.1038/s41591-024-03381-0

Research

Ultrasound Method Could Improve Diagnoses of Perinatal Deaths in Low-Resource Settings

Study validates ultrasound measurements of the cerebellum’s diameter to estimate gestational age- a key factor to establish causes of foetal and perinatal deaths

09.12.2024
Photo: Canva

Perinatal mortality—deaths occurring some weeks before or after birth—remains unacceptably high in low- and middle-income countries (LMICs). Understanding the causes of these deaths is critical to designing effective prevention and care strategies. A new study led by the Barcelona Institute for Global Health (ISGlobal), a centre supported by “la Caixa” Foundation, shows that a simple ultrasound method could improve the accuracy of gestational age estimates in foetal and perinatal deaths, paving the way for better diagnoses.

The challenge: missing gestational age data

Determining gestational age is vital to distinguish between two leading causes of perinatal death: prematurity and intrauterine growth restriction. While both conditions are common, they require very different approaches to prevention and management. However, in many low-resource settings, data on gestational age is often incomplete.

“This is because recall of the last menstrual period is frequently imprecise, and first-trimester ultrasounds are rarely performed,” explains Natalia Rakislova, co-senior author of the study together with Jaume Ordi, both researchers at ISGlobal. To address this challenge, they explored whether post-mortem ultrasound measurements of the cerebellum—a part of the brain—could provide an accurate estimate of gestational age in foetal and perinatal deaths.

The test: validating the ultrasound method

Between August 2020 and November 2022, Rakislova and colleagues conducted a study at Barcelona’s Hospital Clinic, performing post-mortem ultrasound assessments on the cerebellums of 137 foetal and perinatal deaths. These assessments included measurements taken both within the uterus and after the foetus had been removed.

The results were promising. Among the various types of cerebellum measurements tested, the extrauterine transcerebellar diameter emerged as the most reliable predictor of gestational age. Importantly, its accuracy was not affected by factors like the trimester of gestation, restriction growth, or central nervous system abnormalities.

“Our results demonstrate that this method is valid for estimating gestational age,” says Núria Peñuelas, first author of the study.

What This Means for LMICs

This relatively simple and non-invasive method holds particular promise for low- and middle-income countries (LMICs) where MITS – a technique pioneered by ISGlobal – is being used to determine causes of death with almost the same precision than complete autopsies. By integrating ultrasound-based gestational age estimates into MITS, researchers and healthcare providers could significantly improve diagnostic accuracy.

Certainly, access to ultrasound equipment may pose challenges in LMICs. But low-cost, portable ultrasound devices have been successfully used in these settings, even when operated by personnel without highly specialised training.

“Future studies should validate our findings in larger and more diverse populations, especially in low-resource settings,” emphasises Rakislova. “Importantly, the technique can be done by trained laboratory technicians, without the need of a doctor,” she adds. Ultimately, this ultrasound method could improve the understanding of the causes of perinatal deaths, and help to design targeted interventions to prevent them.

 

Reference

Peñuelas N, Saco A, Marimón L et al. Gestational age assessment by ultrasound cerebellar measurements in fetal and perinatal deaths. AJOG. 2024. https://doi.org/10.1016/j.ajog.2024.11.016

Research

SPHERA Consortium Denounces Lack of European Funding for Climate Change and Health Research

Researchers warn that the next Horizon Europe 2025 call for proposals will not include funds to study the relationship between climate and human health

28.11.2024
Científicos del consorcio SPHERA denuncian la falta de financiación europea para proyectos de clima y salud

“On the basis of information about the upcoming Horizon Europe 2025 call for proposals, the European Commission has proposed a budget of around €970 million for health research—yet, alarmingly, no funds are allocated to research on the effects of climate change on health. This needs to change.”

Thus, with the above paragraph, begins a statement with which the SPHERA consortium denounces what it understands to be a “disappointing omission” in the European Commission's draft Horizon 2025 research grant program. SPHERA brings together Europe's leading environmental, climate and health research institutions, including ISGlobal.

“Let's not wait for the next crisis to act,” SPHERA demands, while recalling that the data show that the Mediterranean region is suffering a more accelerated warming than the world average. “The European Union, along with the World Health Assembly and global authorities, has recognized the grave risks climate change poses to human health”, they argue. For this reason, they believe that by omitting specific approaches to climate change and health from research agendas, a contradiction is being made.

Extreme weather events, warming and other health threats

The scientific staff signing the document recalls that climate change already poses a serious threat to health in Europe, giving as an example the extreme weather events, such as the recent floods in Valencia or those that have occurred in Italy, Germany, Poland or Central Europe.

Another of the key issues to be addressed is the risk posed by rising temperatures, after a year, 2024, which will again beat heat records and when studies are available that quantify in about 70,000 and 47,000, respectively, deaths attributable to heat in the summers of 2022 and 2023.

“Furthermore recent results from the large  EXHAUSTION project pointed out at synergistic health effects of air pollution and heat on cardiorespiratory health across Europe”, they note.

Other climate-related health issues of concern to the scientific community are “longer pollen season and introduction of new pollen species” or “sharp increases in forest fires and related air pollution episodes.”

Common front

SPHERA's statement closes with an offer to work together to find solutions: “Our institutions stand ready to support the EU in developing and delivering the evidence-based solutions needed to protect public health and build a resilient Europe in the face of climate change.”

SPHERA statement

The full SPHERA statement is available here

Workshop Series: Multi-Omics Data Integration in Human Exposome Studies

Supported by Severo Ochoa

04.09.2024
Date
04/09/2024 - 20/11/2024
Hour
Wednesdays, 16:30 -17:30 CET
Place
Virtual
Speakers
Anna Young, Arthur Tenenhaus, Augusto Anguita, Congrong Wang, Chris Gennings, Inès Amine, Jesse A. Goodrich, Lea Maitre, Nikolaos Stratakis, Ville Pimenoff, Vishal Midya

This program consisted of 9 sessions spanning over three months, covering different topics related to multi-omics data integration in Human Exposome Studies. The detailed workshop program with further information about each session content can be consulted HERE.

To maximize the impact of this course, all sessions were recorded and are available on YouTube for asynchronous consultation.

Additionally, the materials generated during the course—slides and code—have been compiled HERE, creating a valuable resource for the research community. These resources not only offer lasting value but also allow us to track the long-term impact of the workshop.

Organisers

This workshop series has been organised by Léa Maitre and Augusto Anguita. Please contact Rodney Ortiz (rodney.ortiz@isglobal.org) for any queries or further information.

About the workshop series

The field of exposomics delves into the complex interplay of environmental, social, lifestyle, genetic, and other biological factors and warrants promise to advance precision environmental health. Beyond genetics, the integration of exposomics and multi-omics in epidemiology research can enable a more precise understanding of disease and promote health, especially for the most vulnerable population subgroups.

In this series of virtual workshops, we will introduce novel designs and analytical approaches for multi-omics integration that were recently developed and applied in the exposomics field to address critical data analysis challenges (dimensionality reduction approaches, mediation, predictive modelling, feature selection, networks, etc). The focus is on the practical application of these methods.

Do you want to revisit the course?

Recording for all the sessions have been already uploaded to YouTube, so you can revisit it whenever you want. For accessing slides and codes, please, click HERE or inspect the workshop proceedings HERE.

Introduction, overview, and multi-modal data integration - Session 1, Part 1

https://youtu.be/ecgh8FRZ1BM

Introductory session:

  • Introduction to multi-omics data integration challenges in exposome studies - Dr. Léa Maitre
  • Overview of approaches - Dr. Augusto Anguita
  • Multi-modal data integration through dimensionality reduction: Motivation, concepts and theory - Dr. Arthur Tenenhaus

Introduction, overview, and multi-modal data integration - Session 1, Part 2

https://youtu.be/pCDsn0iTfDM

Continuation of the following introductory presentation (see video part 1 first)

  • Multi-modal data integration through dimensionality reduction: Motivation, concepts and theory - Dr. Arthur Tenenhaus

Dimensionality reduction - Session 2 

https://youtu.be/xeCNueFLQYw

  • Practical aspects of multi-modal data integration through dimensionality reduction (MOFA, PLS, RGCCA, etc). By Inès Amine, Inserm.
  • Case studies of multi-omics and exposome data integration through dimensionality reduction in HELIX cohorts. By Congron Wang, UHasselt.

Strategies for Multivariate Mediation Frameworks – Session 3

https://youtu.be/RVaYY6zucDk

By Vishal Midya, Icahn School of Medicine at Mount Sinai, New York

Multi-Omic Analysis Framework for Precision Health: Omic mediation analysis in exposome research – Session 4

https://youtu.be/pNh770YYrn0

By Jesse Goodrich, from University of Southern California Keck School of Medicine

Networks visualisation for multi-omics integration – Session 5

By Léa Maitre, ISGlobal

https://youtu.be/fw99Rtz2VHk

Development of exposome mixture methods for high-dimensional omics data to investigate environmental risk factors of disease – Session 6

By Dr. Chris Gennings from Icahn School of Medicine at Mount Sinai, and Dr. Anna Young from Emory Rollins School of Public Health

https://youtu.be/PSDHhw75zP4

Comprehensive biotic exposome estimation from wearable device metagenomes – Session 7

By Dr. Ville Pimenoff, Adjunct Professor in Evolutionary Medicine at the University of Oulu, Finland

https://youtu.be/ldzPVn4g1X4

Multi-omics and eXplainable Artificial Intelligence (XAI) for predictive purposes: a focus on interpretability and explainability – Session 8

By Dr. Augusto Anguita, a biological data scientist specialised in the analysis of complex epidemiological datasets such as those composed of clinical, omics, biochemical, and environmental data at ISGlobal

https://youtu.be/HVsuGh3D0so

Patient similarity networks for the identification of molecular endotypes of obesity – Session 9

By Dr. Nikolaos Stratakis, an Environmental Epidemiologist and Postdoctoral Fellow at the Environmental and Health over the Lifecourse programme at ISGlobal.

https://youtu.be/AD_Yclu99YE

Target audience

This workshop is aimed at Master/PhD students, researchers, clinicians, and other professionals working in the fields of exposomics, epidemiology, or toxicology with an interest in understanding how omics data, including the exposome, can be integrated in epidemiological research.

With over 800 people registered, this program achieved an average attendance of ~90 participants per session and more than 2,000 views in our Youtube channel.


 

With the support of the grant CEX2023-001290-S funded by MCIN/AEI/ 10.13039/501100011033.

Research

ISGlobal, Among the Spanish Organisations Receiving the Most Funding from the Horizon Europe Research Programme

In the first three years of the European programme (2021-2023), Spain is the third most funded country, after Germany and France.

04.12.2024

The Barcelona Institute for Global Health (ISGlobal) consolidates its position as one of the key entities in Spain's participation in Horizon Europe, the largest research and innovation programme in Europe. During the programme's first three years (2021-2023), ISGlobal has positioned itself among the 20 Spanish entities with the most funding received and ranks third among the category of research centres.

In this same period, Spain has become the third most funded country in Horizon Europe, behind only Germany and France, achieving a record economic return that underlines its growing prominence in the European field of research and innovation.

Leading role in health research funding

Horizon Europe is Europe's largest research and innovation programme, with a budget of close to 100 billion euros. This programme has been instrumental in boosting strategic sectors such as life sciences and health research.

During 2021-2023, ISGlobal has stood out at the European level, leading fundraising in the EDCTP3 programme (European Developing Countries Clinical Trials Partnership), which focuses on the fight against infectious diseases in global contexts. In addition, it has led fundraising in Spain within Cluster 1 - Health, Demographic Change and Well-being, which includes the Innovative Health Initiative (IHI) and Mission Cancer.

Horizon Europe boosts research and innovation in Spain and Catalonia

In global terms, Spain has achieved a return of 3,416.9 million euros in the calls awarded during the first three years of the programme, with a rate of return of 11.7%. This success reflects the growing prominence of Spanish entities, which coordinate 16% of the funded projects and participate in one of every three successful proposals.

For its part, Catalonia has consolidated its position as a national benchmark in fundraising, attracting 1,076.4 million euros, which represents 31% of the national total. In the health sector, Catalonia accounts for 52% of these funds, as well as 50.4% of the funds from the European Research Council (ERC) and 46.7% of those from the European Innovation Council (EIC).

ISGlobal's achievements strengthen Spain's position in research and innovation and highlight the institute's ability to lead projects with international impact in global health.

The Barcelona Exposome Symposium

Photo: Exposoma, Iolanda Filella Cubells. Institut d'Estudis Catalans
Date
25/09/2024
Hour
9.30 - 16.40 h
Place
PRBB
(Dr. Aiguader, 88) Barcelona

For the first time, institutions across the Barcelona area gathered for the Barcelona Exposome Symposium, an event designed to promote collaboration within the growing exposome research community. The exposome is the integrated compilation of all the physical, chemical, biological and psychosocial factors, and their interactions, which have an impact on biology and health.

The program featured 3 invited talks, 18 abstract-selected presentations, and 15 posters that provided a panoramic view of local exposome research. Key topics included technological advances in measuring environmental exposures in biological samples, novel biomarkers for pollutants and dietary intake, and the role of environmental exposures in chronic diseases and early-life development. They were also discussions on how to integrate the exposome in clinical studies with deep phenotyping such as the Barcelona Brain Health Initiative (BBHI) - A Cohort Study to Define and Promote Determinants of Brain Health, led by the Institut Guttmann. 

This event, which brought together around 90 participants, was made possible through the joint efforts of ISGlobal’s Exposome Hub, CSIC, the University of Barcelona, and EMBL - Human Ecosystems Transversal Theme, reflecting the forefront of exposome research in Barcelona. Through the open abstract call, further institutions were represented such as the Universitat Rovira i Virgili and Eurocat. It also highlighted key community needs such as increased networking opportunities, knowledge exchange, interdisciplinary collaboration, and additional funding. 

The symposium marks a step forward in the larger initiative to build an International Human Exposome Network and advance the integration of exposome research into public health and policy. There will be further editions.

 

This event aimed to facilitate the sharing of knowledge, ideas, and resources within the exposome research community in the Barcelona area. With a series of invited presentations, abstract-selected presentations and posters, it provided a panorama of exposome research across different institutions in the Barcelona area.

The exposome represents the comprehensive set of environmental exposures that an individual encounters throughout their life. The exposomics field aims to evaluate how the exposome impacts on biology and health through discovery-based analytical approaches. This local-level symposium was part of a larger initiative to build an International Human Exposome Network.

The symposium covered the following topics:

1. Technological Innovations and Methodologies in Exposomics

  • Advanced Analytical Techniques: Innovations in non-targeted chemical exposome characterization, including anthropogenic pollutants and diet related compounds.
  • Computational Methods and Data Science: Application of big data, artificial intelligence, and machine learning in exposome studies
  • Novel Biomarkers and Detection Methods: Development of new biomarkers and tools for measuring environmental exposures, e.g. microplastics, accurately and comprehensively
  • Sensors and Geospatial Modeling Applications: to collect and analyze spatial data on environmental exposures. This includes wearable sensors, remote sensing, and GIS for mapping and analyzing the spatial distribution of exposures and their health impacts.

2. Exposome and Human Health

  • Social and physical environment in Low and Middle Income Countries' contexts.
  • Early-life Exposures and Child Health: Research on multiple early-life exposures and their effects on child health and development.
  • Chronic Diseases and Aging: The role of cumulative environmental exposures in the development of chronic diseases such as cancer, respiratory diseases, and neurodegenerative disorders.
  • Precision Medicine: Utilising exposome data to advance precision medicine and improve health outcomes in clinical settings.

3. Biological Impacts and Experimental Modeling in Exposomics

  • Molecular and Cellular Responses: Investigating how environmental exposures influence molecular and cellular processes, including gene expression, epigenetic modifications, and metabolic pathways.
  • Animal and In Vitro Models: Use of animal models and in vitro systems to study the biological effects of environmental exposures and to identify potential mechanisms of toxicity.
  • Integrative Omics Approaches: Combining genomics, proteomics, metabolomics, and other omics data to understand the comprehensive biological impact of the exposome.

4. Translational Research: Bridging experimental findings with clinical and epidemiological studies to better understand the health implications of exposome-related findings​.

Scientific Core Committee

Agenda Outline

  • 09.30 - 10.00 h — Welcome Coffee - Networking
  • 10.00 - 10.30 h — Introduction local and global exposome research landscape (ISGlobal)
  • 10.30 - 11.30 h — Part 1: Invited scientific presentations
  • 11.30 - 12.30 h — Coffee Break - Poster session for early career researchers (selected based on abstract selection before the event)
  • 12.30 - 13.30 h — Part 2: Invited and abstract-selected scientific presentations

Find here the detailed programme of the symposium. 

DETAILED AGENDA

ABSTRACT BOOK

Abstract Submission and Review Process

Abstracts submitted to the Barcelona Exposome Symposium underwent a streamlined review process, starting with an initial screening and coordination by the core team, followed by a detailed evaluation by committee members. The scientific committee then selected the final abstracts. Authors of accepted abstracts were notified by July 27th. The selection criteria focused on relevance to the symposium's topics, scientific rigour, clarity of presentation, interdisciplinary merit, and potential public health impact. This thorough and fair evaluation ensured that the symposium featured high-quality discussions that were both impactful and informative.

Oral presentations (12 min) and Posters were invited for broadly defined exposomics and environmental health related topics. Posters covered a wide range of subjects within these fields.

Coordinated by:


 

Support provided by:


 

 

Research

ISGlobal Holds a Stimulating Annual Scientific Meeting, With Partnerships and Impact as Common Thread

The meeting, with more than 250 participants, opened with an inspiring lecture on frugal science and showcased the breadth, depth and reach of the institution’s research

05.12.2024
Photo: Aleix Cabrera / ISGlobal

Judging by the comments of the more than 250 attendees, ISGlobal’s Annual Scientific Meeting, which took place on Tuesday 3 December at the CosmoCaixa, was a clear success. Key to that success was the “action-packed agenda” prepared by the organisers Carmen Fernandez and Payam Dadvand including the keynote lecture on frugal science delivered by Manu Prakash of Stanford University. In her opening remarks, ISGlobal’s scientific director Denise Naniche already set the tone: “we need to ensure our research goes beyond publications and reaches society”.


 

Frugal science: scaling impact with low-cost solutions

“Don’t create a pen that does not eradicate ignorance and shame”. With this Arabic saying, Manu Prakash introduced his uplifting talk on frugal science – or how to invent cost-effective solutions that can be scaled up. He presented examples of how he and his team have designed inexpensive tools that can reach everyone, everywhere, and help to address some of the planetary-scale challenges we are facing. To list just a few: the foldscope – a folding paper microscope costing just one dollar - 1000 times less than an optical microscope- which has reached over 2 million people across the world, forming the largest online microscope community. Or the 20 cents paperfuge, inspired by an ancient toy, capable of spinning biological samples at incredibly high speeds in places where there is no electricity. Or Abuzz, an AI-powered app that identifies mosquito species by their buzz, empowering citizens to help researchers track disease-transmitting mosquitoes. Or Octopi, a low-cost, modular AI-driven microscope that allows to detect malaria parasites, as well as bacteria in bodily fluids.

Beyond producing these tools, Prakash emphasised the importance of making their designs open-access and sharing them early on with the people who will use them. “Never forget to ask yourself who is that science for” he urged. Many of his ideas have come from talking with community health workers, who often have to perform diagnostics “under a tree” and whom he described as “the world’s largest citizen science program”.

The day before, Prakash engaged with students from the Master of Global Health, sharing his ideas and demonstrating some of the tools developed by his lab.

Synergies across research programmes

ISGlobal’s five research programmes presented highlights of their work, with clear examples of synergies between programmes and potential for societal impact. Examples included: DENMAL, a simple diagnostic test to simultaneously detect dengue and malaria infections in travellers; a new antimalarial compound that seems to be also effective, in vitro, against Leishmania and T. cruzi; an ongoing project in Sierra Leone to evaluate whether adding azithromycin to preventive malaria chemotherapy can reduce under-five mortality; and early warning systems that can forecast, and help to mitigate, the health impacts of extreme heat and cold (Forecaster.health) or air pollution (Forecast-AIR).

The session also celebrated the recently renewed Severo Ochoa programme, followed by a round table on how to further unlock synergies between programmes.

Equity, Innovation and Early Career Development

The afternoon sessions delved into gender equity in ISGlobal and reflections on decolonization. The innovation team showcased concrete examples of how it is helping early stage or advanced research projects to protect intellectual property, and find funding and partnerships to develop and transfer their outputs as part of their pathway to impact.

Additionally, predoctoral and postdoctoral researchers had the opportunity of presenting some of their work and have an open discussion on the challenges and opportunities of being an early career researcher at ISGlobal.

Looking ahead

In his concluding remarks, ISGlobal general director Quique Bassat, with a touch of humour, praised the quality of the presentations and expressed his belief that ISGlobal is now operating as “a single, united institution.” He emphasised the importance of “concentrating on our work” amidst the current global political landscape, highlighting the need to strengthen partnerships particularly in LMICs. “We must firmly believe in the impact we can generate,” he concluded.

Carmen and Payam are very grateful would like to express their sincere thenks to all those who helped with the organisation of the event, especially Yolanda Salleras and Gemma Punyet.

 


 

Research

Air Pollution Linked to Longer Duration of Long-COVID Symptoms

New study explores the association between different environmental exposures and Long-COVID in a Catalan population cohort

27.11.2024
Photo: canva

Exposure to air pollutants (PM2.5 and PM10) is associated with an increased risk of persistent long-COVID symptoms, partly due to its impact on the severity of the acute infection. This is the main conclusion of a study led by the Barcelona Institute for Global Health (ISGlobal), a centre supported by “la Caixa” Foundation, in collaboration with the Germans Trias i Pujol Research Institute (IGTP), and published in Environmental Health Perspectives

Long-COVID is a heterogeneous condition in which symptoms like fatigue, breathlessness, and cognitive issues persist for months after a COVID-19 infection and cannot be explained by other diagnoses. The real burden of long-COVID remains unclear, but millions of people are estimated to be affected worldwide. Its risk factors are also not well understood, since even people with mild or no symptoms during acute infection can develop long-COVID.

“We previously found that air pollution exposure is linked to a higher risk of severe COVID-19 and a lower vaccine response, but there are very few studies on long-COVID and the environment,” explains Manolis Kogevinas, ISGlobal researcher and senior author of the study. In this study, he and his colleagues investigated whether air pollution and other environmental exposures such as noise, artificial light at night, and green spaces, were associated with the risk- or persistence- of Long-COVID.

The study followed over 2,800 adults of the COVICAT cohort, aged 40- 65 years living in Catalonia who during the pandemic completed three online questionnaires (2020, 2021, 2023). These surveys collected information on COVID-19 infections, vaccination status, health status, and sociodemographic data. Researchers estimated residential exposure to noise, particulate matter, ozone, nitrogen dioxide, green spaces, and light at night for each participant.

Long-COVID risk factors

The analysis showed that one in four people who contracted COVID-19 experienced lingering symptoms for three months or more, with 5% experiencing persistent symptoms for two years or more. Women, individuals with lower education levels, those with prior chronic conditions, and those who had severe COVID-19 were at highest risk of long-COVID. Vaccination, on the other hand, made a positive difference: only 15% of vaccinated participants developed long-COVID compared to 46% of unvaccinated ones.

Air pollution and persistence of symptoms

Exposure to particulate matter (PM2.5 and PM10) in the air was associated with a slight increase in the risk of persistent long-COVID (i.e. people who reported long-Covid in 2021 and whose symptoms were still present the last week before the 2023 interview). The risk of persistent long-COVID increased linearly with greater exposure to particulate matter in the air. In contrast, factors such as nearby green spaces or traffic noise showed little impact on long-COVID.

The researchers note that while air pollution may not directly cause long-COVID, it could increase the severity of the initial infection, which, in turn, raises the risk of long COVID. “This hypothesis is supported by the association between particulate matter and the most severe and persistent cases of long-COVID, but not with all cases of long-COVID,” says Apolline Saucy, first author of the study.

Further research is needed to break down the different types of long-term symptoms and get a more detailed picture of how environmental factors might play a role. “This type of studies is particularly relevant as more people continue to recover from COVID-19 and deal with its potential long-term effects,” says Kogevinas.

 

About COVICAT

The COVICAT cohort is a COVID-19-population-based cohort designed to characterize the health impact of the COVID-19 pandemic on the population in Catalonia, Spain. Baseline data originates from the GCAT (Genomes for Life) project of the Germans Trias i Pujol Research Institute (IGTP).

Reference

Saucy A, Espinosa A, Iraola-Guzman S, Castaño-Vinyals G, Harding BN, Karachaliou M, Ranzani I, De Cid R, Garcia-Aymerich J, Kogevinas M. Environmental exposures and Long-COVID in a Prospective Population-Based Study in Catalonia (COVICAT study). Environmental Health Perspectives. 2024. https://doi.org/10.1289/EHP15377

Policy & Global Development, Research

Quique Bassat, New Board Member of the European Centre for Disease Prevention and Control

The epidemiologist and Director General of ISGlobal joins the EU agency that coordinates the response to health threats

20.11.2024

Quique Bassat, an epidemiologist and Director General of the Barcelona Institute for Global Health (ISGlobal), has been appointed to the Management Board of the European Centre for Disease Prevention and Control (ECDC) as a representative of the European Parliament. This appointment underlines his track record in infectious disease epidemiology and public health and strengthens the representation of Spanish experts in high-level European bodies. 

Coordinating the response to health threats

The ECDC, based in Stockholm, Sweden, is a European Union agency coordinating and strengthening the EU’s public health response to communicable disease threats. Its tasks include collecting and analysing public health data, supporting surveillance systems and issuing recommendations for preparedness and response to health emergencies. It works closely with other EU bodies and international agencies to ensure a coherent and effective health response. Its work has been particularly prominent during recent health crises, such as the COVID-19 pandemic and other infectious disease outbreaks, including Mpox.

Scientific leadership to strengthen the European response

Quique Bassat, a paediatrician and ICREA Research Professor, has combined clinical work with biomedical research on infectious diseases affecting the poorest and most vulnerable populations, with his two main areas of interest being childhood malaria and respiratory infections (bacterial or viral). With his appointment, ISGlobal's Director General will join a select group of experts charged with advising on the agency's strategies and policies, ensuring that its activities are relevant and aligned with the needs of member states. 

“It is a privilege to be part of such an important institution for the health of European citizens. In an increasingly interconnected world, the ability to respond to health threats in a coordinated and effective way is vital. I look forward to contributing my expertise in infectious diseases to the ECDC's mission of strengthening prevention and control capacities across Europe,” he said after his appointment was confirmed.