Lancet Planetary Health最新文献

{"title":"The perceived impact of extreme weather events on care for people with HIV or tuberculosis and HIV in Zimbabwe: a survey-based multicentre cross-sectional observational study and formative evaluation.","authors":"Canice Christian, Rutendo Mukondwa, Cesar Aviles-Guaman, Mollie Hudson, Kudakwashe Takarinda, Nora West, Amrita Ayer, Karen A Webb, Priya B Shete","doi":"10.1016/j.lanplh.2026.101537","DOIUrl":"https://doi.org/10.1016/j.lanplh.2026.101537","url":null,"abstract":"<p><strong>Background: </strong>The growing threat to health systems posed by extreme weather events (EWEs) disproportionately affects people living with HIV and tuberculosis disease in high-burden, low-resource settings. In Zimbabwe, for example, the 2023-24 El Niño-induced drought intensified food insecurity and reduced access to clinics and medication for such vulnerable populations. We aimed to conduct a formative evaluation to assess the perceived impact of climate change and EWEs on HIV and tuberculosis determinants and service delivery and identify potential climate-adaptive health-service strategies.</p><p><strong>Methods: </strong>In this survey-based multicentre cross-sectional observational study with a formative evaluation supplemented by qualitative data, we surveyed people living with HIV from Sept 19 to Dec 19, 2024, across 321 clinics in Zimbabwe to describe their perceived impact of EWEs on their health. Participants were recruited using convenience sampling. The inclusion criteria were being diagnosed with HIV, being older than 18 years, and receiving HIV care at Organization for Public Health Interventions and Development (OPHID) clinics during the study period. Individuals who were not receiving HIV care at an OPHID clinic or who were younger than 18 years were excluded. A client satisfaction survey was used to collect data from in-person surveys. The survey included questions related to the general effects of EWEs, such as drought, extreme heat, and flooding; how EWEs had affected HIV or tuberculosis care; and what, if any, services were currently available or should be made available to mitigate climate impacts on health. We also conducted six focus group discussions (FGDs; five to eight participants per group) between March 12 and May 12, 2024, across the Bulilima, Mangwe, and Matobo districts. We used a convenience sampling approach to select patients who had visited the health facility for medical check-ups, medication resupply, or viral load testing, as recorded in clinical registers and verified by clinical staff. Eligible participants for the FGDs were adults (≥18 years) with HIV, or with current or previous tuberculosis treatment, receiving care at the study facility during the recruitment period; those under 18 years or not receiving care at the facility were excluded. Participants' sex was self-reported at enrolment. Quantitative data were analysed descriptively, whereas FGD data were analysed using a modified framework approach. The main outcomes were the perceived impact of climate change and EWEs on HIV and tuberculosis determinants and service delivery outcomes, as reported by affected communities, and community-prioritised mitigation strategies to feasibly address climate-sensitive determinants and barriers to care.</p><p><strong>Findings: </strong>Among 1804 eligible participants approached across 15 districts, all completed the survey and were included in the analysis. Most survey participants (1363 [75·6%] o","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":" ","pages":"101537"},"PeriodicalIF":20.5,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149225305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The evidence gap behind the data centre boom.","authors":"Tessa Mair","doi":"10.1016/j.lanplh.2026.101551","DOIUrl":"https://doi.org/10.1016/j.lanplh.2026.101551","url":null,"abstract":"","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":" ","pages":"101551"},"PeriodicalIF":20.5,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149207996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early career insights on boundary crossing for planetary health and a just future.","authors":"Angel M Kennedy, Carlos E Sanchez-Pimienta, Evan F Griffith, Chester Kalinda, Christina Pettan-Brewer, Tshepiso Galase Ramolefhe-Mutumwa, Margot W Parkes","doi":"10.1016/j.lanplh.2026.101507","DOIUrl":"https://doi.org/10.1016/j.lanplh.2026.101507","url":null,"abstract":"","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":" ","pages":"101507"},"PeriodicalIF":20.5,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149196563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cause-specific hospital admissions associated with short-term PM_2·5 exposure: a multicountry time-series analysis.","authors":"Pei Yu, Wenzhong Huang, Rongbin Xu, Zhengyu Yang, Zhihu Xu, Gongbo Chen, Yanming Liu, Lidia Morawska, Fay H Johnston, Michael J Abramson, Luke Knibbs, Geoffrey G Morgan, Guy B Marks, Jane Heyworth, Ho Kim, Kraichat Tantrakarnapa, Wissanupong Kliengchuay, Patricia Matus, Simon Hales, Eric Lavigne, Paulo H N Saldiva, Micheline S Z S Coelho, Yue Leon Guo, Tingting Ye, Wenhua Yu, Ke Ju, Yiwen Zhang, Yao Wu, Bo Wen, Shuang Zhou, Shanshan Li, Yuming Guo","doi":"10.1016/j.lanplh.2026.101526","DOIUrl":"https://doi.org/10.1016/j.lanplh.2026.101526","url":null,"abstract":"<p><strong>Background: </strong>Fine particulate matter (PM_2·5) pollution constitutes a leading global health burden. However, multicountry evidence about the impact of PM_2·5 on cause-specific hospitalisations, which are key markers of clinically substantial morbidity, is scarce. This study aimed to examine the association of short-term exposure to ambient PM_2·5 pollution with hospital admissions for specific causes across multiple countries.</p><p><strong>Methods: </strong>We collected 346·5 million hospitalisation records from 949 communities across six countries and territories (Australia, Brazil, Canada, Chile, New Zealand, and Taiwan) between 2000 and 2019. At each location, we fitted quasi-Poisson generalised linear time-series models to estimate PM_2·5-associated hospitalisation risks. These location-specific estimates were then pooled in a meta-analysis. We conducted stratified analyses by country, demographic factors, income, and time period.</p><p><strong>Findings: </strong>Short-term PM_2·5 exposure was significantly associated with increases in all-cause and cause-specific hospitalisations, with effects persisting for up to 21 days. For all-cause admissions, each 10 μg/m³ increase in PM_2·5 concentration was associated with an 8% higher risk of hospitalisation (relative risk [RR] 1·080; 95% CI 1·074-1·086), with substantial heterogeneity across countries and territories. Short-term PM_2·5 exposure was associated with increased hospitalisation risks across all disease categories, with the strongest associations observed for malignant neoplasms (RR 1·108, 95% CI 1·094-1·123), mental disorders (1·100, 1·085-1·114), other neoplasms (1·096, 1·078-1·114), and nervous system diseases (1·085, 1·069-1·102), all exceeding the RR for respiratory diseases (1·067, 1·060-1·074). Attenuated but significant risks were observed in 2010-19, compared with those in 2000-09, for all disease categories. Using a PM_2·5 concentration of 15 μg/m³ according to the WHO daily guideline as reference, attributable measures estimated from the observed PM_2·5-hospitalisation associations declined over time, with the attributable fraction decreasing from 8·9% in 2000-09 to 3·9% in 2010-19 and the cumulative attributable hospitalisation rate decreasing from 11·6 to 3·5 per 1000 population per year.</p><p><strong>Interpretation: </strong>Our findings revealed that short-term PM_2·5 exposure was associated with persistent increased risks of hospitalisation across diverse settings. Reducing PM_2·5 exposure remains an important preventive measure to lower hospitalisation risk.</p><p><strong>Funding: </strong>Australian Research Council and Australian National Health and Medical Research Council.</p>","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":" ","pages":"101526"},"PeriodicalIF":20.5,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149166400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Seven principles for a critical transdisciplinary approach to planetary health.","authors":"Joan Benach, Lucinda Cash-Gibson, Christos Zografos, Laila Vivas, Joana Morrison, Eliana Martínez-Herrera, Ornella Moreno-Mattar, Natalia Tumas, Ferran Muntané, Mariana Gutiérrez-Zamora Navarro, Juan Manuel Pericàs, Carles Muntaner","doi":"10.1016/j.lanplh.2026.101529","DOIUrl":"https://doi.org/10.1016/j.lanplh.2026.101529","url":null,"abstract":"<p><p>The ecological, social, and health crises of the Anthropocene demand approaches to knowledge that confront complexity, uncertainty, and structural injustice. Transdisciplinarity is an approach that can transcend disciplinary silos by integrating academic and non-academic knowledge. Yet, action on public health, planetary health, and health inequities is often implemented in technocratic, depoliticised, and tokenistic ways. Such practices risk marginalising lived experience, reinforcing epistemic hierarchies, and overlooking structural drivers such as capitalism, colonialism, and patriarchy. Drawing on examples from the exposome, One Health, and planetary health paradigms, we argue that current applications of transdisciplinarity privilege biomedical or technical framings, underplay systemic power relations, and fail to deliver transformative impact. A critical transdisciplinary approach is needed-one that is political, reflexive, justice oriented, and grounded in collaboration with affected communities, social movements, and practitioners. It should integrate diverse knowledge systems, value experiential and Indigenous perspectives, and align research with agendas for structural change. We propose seven guiding principles. The approach should be: critical, systemic, structural, sociohistorical, democratic, timely, and transformative. Advancing planetary health equity requires more than an understanding of the systemic determinants of disease and environmental degradation-it requires dismantling the political, economic, and cultural systems that perpetuate them. A critical transdisciplinary approach that follows these principles can guide research, policy, and practice, positioning knowledge not only as a tool for explanation but also as an instrument for transformation.</p>","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":" ","pages":"101529"},"PeriodicalIF":20.5,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From El Niño-Southern Oscillation warning to proportionate health action.","authors":"Ankur Rakesh, Rajesh Sreedharan, Joy Shumake-Guillemot, Stella Chungong, Virginia Murray, Kristie Ebi","doi":"10.1016/j.lanplh.2026.101544","DOIUrl":"https://doi.org/10.1016/j.lanplh.2026.101544","url":null,"abstract":"","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":" ","pages":"101544"},"PeriodicalIF":20.5,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149128532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Navigating global health futures under the Shared Socioeconomic Pathways.","authors":"Carole Green, Marina Andrijevic, Jeremy J Hess, Shonali Pachauri, Sam Sellers, Bas van Ruijven, Kristie L Ebi, Fatimah Ahamad, Christofer Åström, Kristin Aunan, Peng Bi, Robbert Biesbroek, Josephine Borghi, Kathryn Bowen, Cyril Caminade, Timothy R Carter, Luiz Augusto Cassanha Galvao, Guéladio Cissé, Shouro Dasgupta, Alex de Sherbinin, Asya Dimitrova, Neal Fann, Katja Frieler, Jan Fuglestvedt, Santu Ghosh, Georgiana Gordon-Strachan, Yuming Guo, Sarath Guttikunda, Jimmy Hilly, Roman Hoffmann, Samir Kc, Gregor Kiesewetter, Ho Kim, Brama Kone, Whanhee Lee, Anna Lipsanen, Simon J Lloyd, Hermann Lotze-Campen, Shuaib Lwasa, Glenn McGregor, Robert McLeman, Andy Morse, Kris A Murray, Nicholas H Ogden, Yasna Palmeiro-Silva, Anand Patwardhan, Helen Pineo, Poornima Prahhakaran, Keywan Riahi, Sadie J Ryan, Vanessa Schweizer, Jan C Semenza, Sokhna Thiam, Edmond Totin, Roberto O Valdivia, Detlef van Vuuren","doi":"10.1016/j.lanplh.2026.101514","DOIUrl":"https://doi.org/10.1016/j.lanplh.2026.101514","url":null,"abstract":"<p><p>The Shared Socioeconomic Pathways (SSPs) provide valuable insights to understand how future socioeconomic changes could alter the magnitude and pattern of climate-related risks across sectors, which might facilitate or hinder adaptation and mitigation responses. Many sectors have created SSP narrative extensions to specify insights for their domains. In this Viewpoint, we created health narrative extensions for the SSPs, considering socioeconomic and demographic drivers and population health and health-system drivers. The projected health-relevant trajectories diverge substantially over the course of the 21st century. The SSP3 and SSP4 narratives detail changes that could contribute considerable risks to health, whereas the SSP1 and SSP5 narratives highlight the role of effective governance and adequate resourcing in reducing climate-sensitive population health outcomes and health-system drivers. Given that climate forcing is considered exogenous to these narrative extensions, SSP5's favourable health driver paths do not account for the potential adverse impacts of this high-emissions pathway. The narratives elaborate population health drivers that can improve the policy relevance of population health and health-system risk projections associated with climate change across a range of possible pathways, and link these drivers with relevant cross-sectoral issues (eg, water and energy). Further research is required to quantify key drivers of population health and health-system risks at global to local scales.</p>","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":" ","pages":"101514"},"PeriodicalIF":20.5,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Planetary Health Research Digest.","authors":"Cahal McQuillan","doi":"10.1016/j.lanplh.2026.101549","DOIUrl":"https://doi.org/10.1016/j.lanplh.2026.101549","url":null,"abstract":"","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":" ","pages":"101549"},"PeriodicalIF":20.5,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accounting for heterogeneity in mosquito exposure to forecast chikungunya outbreaks in Reunion Island and Paraguay: a mathematical modelling study.","authors":"Lina Cristancho-Fajardo, Muriel Vincent, Xavier Deparis, Lucie Fournier, Lucie Fauré, Fabian Thouillot, Mohammed Elarouti, Michael White, Henrik Salje, Pierre Gallian, Xavier de Lamballerie, Henriette de Valk, Juliette Paireau, Patrick Gerardin, Paolo Bosetti, Simon Cauchemez","doi":"10.1016/j.lanplh.2026.101522","DOIUrl":"https://doi.org/10.1016/j.lanplh.2026.101522","url":null,"abstract":"<p><strong>Background: </strong>Heterogeneity in mosquito exposure at a fine spatial scale is well documented but often neglected in mathematical models of arbovirus transmission, particularly for real-time forecasting. We aimed to assess whether accounting for heterogeneity in mosquito exposure improves the ability of transmission models to reproduce past chikungunya outbreaks and to forecast an ongoing outbreak in real time.</p><p><strong>Methods: </strong>We extended an existing transmission model, originally developed to forecast dengue outbreaks in Reunion Island and incorporating seasonality, to include heterogeneity in mosquito exposure. We compared this model to versions assuming homogeneous exposure, evaluating their ability to reproduce the 2005-06 Reunion Island outbreak and the 2023 Paraguay Metropolitana subregion outbreak. We then used the heterogeneity model to forecast the 2025 Reunion Island outbreak in real time.</p><p><strong>Findings: </strong>Accounting for heterogeneity in mosquito exposure at a fine spatial scale was crucial to accurately reproduce Reunion Island's 2005-06 outbreak. Homogeneity models either overestimated final seroprevalence (80% vs 38% observed) or required a reduction of approximately 50% in the basic reproduction number following interventions, which is implausible. The heterogeneity level estimated from this outbreak transferred successfully to the Metropolitana outbreak, accurately forecasting epidemic trajectory and final seroprevalence (∼40% vs ∼75% for the homogeneity model). Under the same assumption, the heterogeneity model successfully forecasted the peak of the 2025 Reunion Island outbreak (∼400 emergency room visits per week) and timing (April), nearly two months ahead. A post-outbreak serosurvey indicated that the heterogeneity model underestimated final seroprevalence (46·1% vs 61·6% observed), whereas the homogeneity model overestimated final seroprevalence (78·5%), suggesting that heterogeneity in 2025 might have been lower than that in 2005-06.</p><p><strong>Interpretation: </strong>These results highlight how incorporating heterogeneity in mosquito exposure can improve chikungunya outbreaks forecasting. Our approach showed strong predictive performance in settings with climatic seasonality and holds promise for forecasting future chikungunya and other arbovirus outbreaks.</p><p><strong>Funding: </strong>EU; Laboratoire d'Excellence Integrative Biology of Emerging Infectious Diseases programme; Agence Nationale de Recherches Sur le Sida, les Hépatites Virales et les Maladies Infectieuses Émergentes; Agence Nationale de la Recherche.</p>","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":" ","pages":"101522"},"PeriodicalIF":20.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"International organisations agree on the importance of surveillance, but not on its definition.","authors":"Iris A Holmes, Caylee Falvo, Kendra Gilbertson, Charley E Willison, Phillip M Singer, Scott L Greer","doi":"10.1016/j.lanplh.2026.101539","DOIUrl":"https://doi.org/10.1016/j.lanplh.2026.101539","url":null,"abstract":"","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":" ","pages":"101539"},"PeriodicalIF":20.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}