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Neonates in Ahmedabad, India, during the 2010 heat wave: a climate change adaptation study.

ABSTRACT: Health effects from climate change are an international concern with urban areas at particular risk due to urban heat island effects. The burden of disease on vulnerable populations in non-climate-controlled settings has not been well studied. This study compared neonatal morbidity in a non-air-conditioned hospital during the 2010 heat wave in Ahmedabad to morbidity in the prior and subsequent years. The outcome of interest was neonatal intensive care unit (NICU) admissions for heat. During the months of April, May, and June of 2010, 24 NICU admissions were for heat versus 8 and 4 in 2009 and 2011, respectively. Both the effect of moving the maternity ward and the effect of high temperatures were statistically significant, controlling for each other. Above 42 degrees Celsius, each daily maximum temperature increase of a degree was associated with 43% increase in heat-related admissions (95% CI 9.2-88%). Lower floor location of the maternity ward within hospital which occurred after the 2010 heat wave showed a protective effect. These findings demonstrate the importance of simple surveillance measures in motivating a hospital policy change for climate change adaptation-here relocating one ward-and the potential increasing health burden of heat in non-climate-controlled institutions on vulnerable populations.

SUBMITTER: Kakkad K

PROVIDER: S-EPMC3964840 | biostudies-literature | 2014

REPOSITORIES: biostudies-literature

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Neonates in Ahmedabad, India, during the 2010 heat wave: a climate change adaptation study.

Kakkad Khyati K Barzaga Michelle L ML Wallenstein Sylvan S Azhar Gulrez Shah GS Sheffield Perry E PE

Journal of environmental and public health 20140310

Health effects from climate change are an international concern with urban areas at particular risk due to urban heat island effects. The burden of disease on vulnerable populations in non-climate-controlled settings has not been well studied. This study compared neonatal morbidity in a non-air-conditioned hospital during the 2010 heat wave in Ahmedabad to morbidity in the prior and subsequent years. The outcome of interest was neonatal intensive care unit (NICU) admissions for heat. During the ...[more]

PMID: 24734050

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Project description:IntroductionExtreme heat is a significant cause of morbidity and mortality, and the incidence of acute heat illness (AHI) will likely increase secondary to anthropogenic climate change. Prompt diagnosis and treatment of AHI are critical; however, relevant diagnostic and surveillance tools have received little attention. In this exploratory cross-sectional and diagnostic accuracy study, we evaluated three tools for use in the prehospital setting: 1) case definitions; 2) portable loggers to measure on-scene heat exposure; and 3) prevalence data for potential AHI risk factors.MethodsWe enrolled 480 patients who presented to emergency medical services with chief complaints consistent with AHI in Ahmedabad, India, from April-June 2016 in a cross-sectional study. We evaluated AHI case definition test characteristics in reference to trained prehospital provider impressions, compared on-scene heat index measured by portable loggers to weather station measurements, and identified AHI behavioral and environmental risk factors using logistic regression.ResultsThe case definition for heat exhaustion was 23.8% (12.1-39.5%) sensitive and 93.6% (90.9-95.7%) specific. The positive and negative predictive values were 33.5% (20.8-49.0%) and 90.1% (88.5-91.5%), respectively. Mean scene heat index was 6.7°C higher than the mean station heat index (P < 0.001), and station data systematically underestimated heat exposure, particularly for AHI cases. Heat exhaustion cases were associated with on-scene heat index ≥ 49°C (odds ratio [OR] 2.66 [1.13-6.25], P = 0.025) and a history of recent exertion (OR 3.66 [1.30-10.29], P = 0.014), while on-scene air conditioning was protective (OR 0.29 [0.10-0.85], P = 0.024).ConclusionSystematic collection of prehospital data including recent activity history and presence of air conditioning can facilitate early AHI detection, timely intervention, and surveillance. Scene temperature data can be reliably collected and improve heat exposure and AHI risk assessment. Such data may be important elements of surveillance, clinical practice, and climate change adaptation.

Project description:COVID-19 pandemic has affected all age groups globally including pregnant women and their neonates. The aim of the study was to understand outcomes in neonates of mothers with COVID-19 during the first and second waves of COVID-19 pandemic. A retrospective analysis of 2524 neonates born to SARS-CoV-2-infected mothers was conducted during the first wave (n = 1782) and second wave (n = 742) of the COVID-19 pandemic at five study sites of the PregCovid registry in Maharashtra, India. A significant difference was noted in preterm birth, which was higher in the second wave (15.0%, 111/742) compared to the first wave (7.8%, 139/1782) (P < 0.001). The proportion of neonates requiring NICU admission was significantly higher in the second wave (19.0%, 141/742) as compared to that in the first wave (14.8%, 264/1782) (P < 0.05). On comparing regional differences, significantly higher neonatal complications were reported from Mumbai metropolitan region (P < 0.05). During the second wave of COVID-19, birth asphyxia and prematurity were 3.8- and 2.1-fold higher respectively (P < 0.001). Neonatal resuscitation at birth was significantly higher in second wave (3.4%, 25/742 vs 1.8%, 32/1782) (P < 0.05). The prevalence of SARS-CoV-2 infection in neonates was comparable (4.2% vs 4.6%) with no significant difference between the two waves.ConclusionHigher incidence of adverse outcomes in neonates born to SARS-CoV-2-infected mothers in the second wave of COVID-19 as compared to the first wave.Trial registrationPregCovid study is registered with the Clinical Trial Registry of India (CTRI/2020/05/025423, Registered on 28/05/2020).What is known• The second wave of COVID-19 was more lethal to pregnant women than the first wave. Newborns are at risk of developing complications.What is new• Birth asphyxia, prematurity, and neonatal resuscitation at birth were significantly higher in the second wave as compared to those in the first wave of the COVID-19 pandemic in India.

Project description:Groundnut is one of the significant sources of oil, food, and fodder in India. It is grown in marginal arid and semi-arid agro-ecosystems with wide yield fluctuations due to spatial variability of rainfall and soil. Climate change, which is predicted to increase the intra- and inter-annual rainfall variability will further constrain the groundnut economy in India besides the global and domestic economic, social and policy changes. Through this study we aim to examine the biophysical and social economic impacts of climate change on groundnut production and prices to provide a comprehensive analysis of how agriculture and the food system will be affected. Using projected climate data for India, we estimated the biophysical impacts of climate change on groundnut during mid-century using representative concentration pathway (RCP 8.5) scenario. We examined the impacts of changes in population and income besides environmental factors on groundnut productivity. This is to highlight the importance of holistic assessment of biophysical and socioeconomic factors to better understand climate change impacts. Modelled projections show that by 2050, climate change under an optimistic scenario will result in −2.3 to 43.2% change in groundnut yields across various regions in India when climate alone was factored in. But the change in groundnut yields ranged from −0.9% to 16.2% when economic (population and income) and market variables (elasticities, trade, etc.) were also considered. Similarly, under pessimistic climate change scenario, the percent change in groundnut yields would be −33.7 to 3.4 with only the climate factored in and −11.2 to 4.3 with the additional economic and market variables included. This indicates the sensitivity of climate change impacts to differences in socioeconomic factors. This study highlights the need to take into account market effects to gain a holistic understanding of how economic and environmental factors impact agricultural food systems and economies. Graphical abstract Unlabelled Image Highlights • Projected climate change will impact groundnut yields by −34 to 43% across India.• Adaptation synergies developed showed promising in adverse climate conditions.• Biophysical and economic model integration is crucial for assessment of climate change.

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Neonates in Ahmedabad, India, during the 2010 heat wave: a climate change adaptation study.

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Neonates in Ahmedabad, India, during the 2010 heat wave: a climate change adaptation study.

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