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The Cochrane Database of Systematic... Sep 2021Anaemia is a prevalent health problem worldwide. Some types are preventable or controllable with iron supplementation (pills or drops), fortification (sprinkles or... (Review)
Review
BACKGROUND
Anaemia is a prevalent health problem worldwide. Some types are preventable or controllable with iron supplementation (pills or drops), fortification (sprinkles or powders containing iron added to food) or improvements to dietary diversity and quality (e.g. education or counselling).
OBJECTIVES
To summarise the evidence from systematic reviews regarding the benefits or harms of nutrition-specific interventions for preventing and controlling anaemia in anaemic or non-anaemic, apparently healthy populations throughout the life cycle.
METHODS
In August 2020, we searched MEDLINE, Embase and 10 other databases for systematic reviews of randomised controlled trials (RCTs) in anaemic or non-anaemic, apparently healthy populations. We followed standard Cochrane methodology, extracting GRADE ratings where provided. The primary outcomes were haemoglobin (Hb) concentration, anaemia, and iron deficiency anaemia (IDA); secondary outcomes were iron deficiency (ID), severe anaemia and adverse effects (e.g. diarrhoea, vomiting).
MAIN RESULTS
We included 75 systematic reviews, 33 of which provided GRADE assessments; these varied between high and very low. Infants (6 to 23 months; 13 reviews) Iron supplementation increased Hb levels and reduced the risk of anaemia and IDA in two reviews. Iron fortification of milk or cereals, multiple-micronutrient powder (MMNP), home fortification of complementary foods, and supplementary feeding increased Hb levels and reduced the risk of anaemia in six reviews. In one review, lipid-based nutrient supplementation (LNS) reduced the risk of anaemia. In another, caterpillar cereal increased Hb levels and IDA prevalence. Food-based strategies (red meat and fortified cow's milk, beef) showed no evidence of a difference (1 review). Preschool and school-aged children (2 to 10 years; 8 reviews) Daily or intermittent iron supplementation increased Hb levels and reduced the risk of anaemia and ID in two reviews. One review found no evidence of difference in Hb levels, but an increased risk of anaemia and ID for the intermittent regime. All suggested that zinc plus iron supplementation versus zinc alone, multiple-micronutrient (MMN)-fortified beverage versus control, and point-of-use fortification of food with iron-containing micronutrient powder (MNP) versus placebo or no intervention may increase Hb levels and reduce the risk of anaemia and ID. Fortified dairy products and cereal food showed no evidence of a difference on the incidence of anaemia (1 review). Adolescent children (11 to 18 years; 4 reviews) Compared with no supplementation or placebo, five types of iron supplementation may increase Hb levels and reduce the risk of anaemia (3 reviews). One review on prevention found no evidence of a difference in anaemia incidence on iron supplementation with or without folic acid, but Hb levels increased. Another suggested that nutritional supplementation and counselling reduced IDA. One review comparing MMN fortification with no fortification observed no evidence of a difference in Hb levels. Non-pregnant women of reproductive age (19 to 49 years; 5 reviews) Two reviews suggested that iron therapy (oral, intravenous (IV), intramuscular (IM)) increased Hb levels; one showed that iron folic acid supplementation reduced anaemia incidence; and another that daily iron supplementation with or without folic acid or vitamin C increased Hb levels and reduced the risk of anaemia and ID. No review reported interventions related to fortification or dietary diversity and quality. Pregnant women of reproductive age (15 to 49 years; 23 reviews) One review apiece suggested that: daily iron supplementation with or without folic acid increased Hb levels in the third trimester or at delivery and in the postpartum period, and reduced the risk of anaemia, IDA and ID in the third trimester or at delivery; intermittent iron supplementation had no effect on Hb levels and IDA, but increased the risk of anaemia at or near term and ID, and reduced the risk of side effects; vitamin A supplementation alone versus placebo, no intervention or other micronutrient might increase maternal Hb levels and reduce the risk of maternal anaemia; MMN with iron and folic acid versus placebo reduced the risk of anaemia; supplementation with oral bovine lactoferrin versus oral ferrous iron preparations increased Hb levels and reduced gastrointestinal side effects; MNP for point-of-use fortification of food versus iron and folic acid supplementation might decrease Hb levels at 32 weeks' gestation and increase the risk of anaemia; and LNS versus iron or folic acid and MMN increased the risk of anaemia. Mixed population (all ages; 22 reviews) Iron supplementation versus placebo or control increased Hb levels in healthy children, adults, and elderly people (4 reviews). Hb levels appeared to increase and risk of anaemia and ID decrease in two reviews investigating MMN fortification versus placebo or no treatment, iron fortified flour versus control, double fortified salt versus iodine only fortified salt, and rice fortification with iron alone or in combination with other micronutrients versus unfortified rice or no intervention. Each review suggested that fortified versus non-fortified condiments or noodles, fortified (sodium iron ethylenediaminetetraacetate; NaFeEDTA) versus non-fortified soy sauce, and double-fortified salt versus control salt may increase Hb concentration and reduce the risk of anaemia. One review indicated that Hb levels increased for children who were anaemic or had IDA and received iron supplementation, and decreased for those who received dietary interventions. Another assessed the effects of foods prepared in iron pots, and found higher Hb levels in children with low-risk malaria status in two trials, but no difference when comparing food prepared in non-cast iron pots in a high-risk malaria endemicity mixed population. There was no evidence of a difference for adverse effects. Anaemia and malaria prevalence were rarely reported. No review focused on women aged 50 to 65 years plus or men (19 to 65 years plus).
AUTHORS' CONCLUSIONS
Compared to no treatment, daily iron supplementation may increase Hb levels and reduce the risk of anaemia and IDA in infants, preschool and school-aged children and pregnant and non-pregnant women. Iron fortification of foods in infants and use of iron pots with children may have prophylactic benefits for malaria endemicity low-risk populations. In any age group, only a limited number of reviews assessed interventions to improve dietary diversity and quality. Future trials should assess the effects of these types of interventions, and consider the requirements of different populations.
Topics: Adolescent; Adult; Aged; Anemia; Anemia, Iron-Deficiency; Animals; Child; Dietary Supplements; Female; Food, Fortified; Humans; Iron; Life Cycle Stages; Male; Micronutrients; Middle Aged; Pregnancy; Systematic Reviews as Topic; Young Adult
PubMed: 34564844
DOI: 10.1002/14651858.CD013092.pub2 -
International Journal of Oral and... Jul 2022Head and neck cancer patients represent a risk group for the development of fly larvae infestation in neoplastic wounds. This condition can accelerate the disease... (Review)
Review
Head and neck cancer patients represent a risk group for the development of fly larvae infestation in neoplastic wounds. This condition can accelerate the disease progression and increase its lethality due to local or systemic complications. The aim of this study was to conduct a scoping review on head and neck cancer associated with myiasis in order to answer the focal question: what are the occurrence, diagnosis, aetiology, treatment and outcomes of head and neck cancer associated with myiasis? This paper was structured based on the five-steps methodology proposed by Arksey and O'Malley (Int J Soc Res Methodol 2005;1:19-32), and followed the PRISMA Extension for Scoping Reviews (PRISMA-ScR), OSF Registries protocol. The electronic search was performed in the MEDLINE/PubMed, Embase and SciELO.org databases for articles published up to 28 February 2021. In total, 38 articles and 56 patients were included. Most patients were male (66%), and the mean age was 66.63 years. Cases were predominantly associated with squamous or basal cell cancer. The most affected anatomical sites were the eyes, scalp, ears and oral cavity, and the most frequent type of larva was Crisomyia (13%). Manual removal of the larvae was considered the standard treatment, associated or not with antibiotics, analgesics and antiparasitic drugs.
Topics: Animals; Female; Head and Neck Neoplasms; Humans; Larva; Male; Myiasis; Risk Factors; Skin Neoplasms
PubMed: 34602319
DOI: 10.1016/j.ijom.2021.08.011 -
Journal of Stomatology, Oral and... Jun 2022Oral myiasis is a rare condition caused by Dipteran larvae that feed on living or dead tissues, ingested food or body fluids. It affects immunocompromised individuals... (Review)
Review
INTRODUCTION
Oral myiasis is a rare condition caused by Dipteran larvae that feed on living or dead tissues, ingested food or body fluids. It affects immunocompromised individuals with low socioeconomic status or those unable to maintain proper hygiene. Cases of oral myiasis are scarce but debilitating in children. We conducted a systematic review to understand the nature of disease, its causative factors, treatment and ways to prevent the occurrence of this condition among children.
METHODOLOGY
The review was carried out in accordance with Preferred Reporting Items for Systematic Review and Meta-analysis guidelines. A systematic electronic literature search was conducted on major databases using keywords in combination with Boolean Operators. Manuscripts discussing cases of oral myiasis in paediatric patients were included in the review.
RESULTS
The exhaustive literature search and evaluation of full texts revealed 32 studies that fulfilled the inclusion criteria. A total of 68 cases of oral myiasis were reported from 2 to 16 years of children, majorly involving gingiva of maxillary anterior region and palate.
CONCLUSION
The dreadful condition of myiasis can be prevented by decreasing the number of flies, maintenance of good hygiene and by educating the susceptible population. Affected children must be managed by following proper treatment regimens.
Topics: Animals; Child; Gingiva; Humans; Larva; Myiasis
PubMed: 34260982
DOI: 10.1016/j.jormas.2021.07.006 -
Ecotoxicology (London, England) Oct 2022Glyphosate herbicide is widely used in worldwide crop production. Consequently, its active ingredient, surfactants, and adjuvants commonly reach the aquatic ecosystem,... (Meta-Analysis)
Meta-Analysis Review
Glyphosate herbicide is widely used in worldwide crop production. Consequently, its active ingredient, surfactants, and adjuvants commonly reach the aquatic ecosystem, thereby harming the biota. An investigation into how this herbicide affects aquatic species is important, especially in fish, as they have the ability to absorb and concentrate toxins. We aimed to evaluate the effects of glyphosate on the embryonic, larval and adult stages of zebrafish (Danio rerio), an appreciable organismal model. In this sense, we performed a meta-analysis using published articles from online databases (PubMed and ScienceDirect), which covered studies published until 2022. From a massive compilation of studies evaluating the effects of active substance glyphosate and Glyphosate-Based Herbicides (GBH) on zebrafish, we selected 36 studies used in downstream analyses. Overall, we report that glyphosate affects developmental stages and demonstrates toxicity and damage in zebrafish. We observed that embryos exposed to glyphosate exhibit increased mortality. There was also an increase in the number of morphological abnormalities related to yolk sac oedema, pericardial oedema, spinal curvature and body malformations, and a decrease in body size was observed. Furthermore, there was a decrease in the number of beats. The biochemical results demonstrated an increase in reactive oxygen species and antioxidant capacity against peroxyl radicals in the gills. The literature shows that glyphosate decreased the distance covered and the mean speed of the animals and increased the number of rotations. We concluded that glyphosate causes damage in the embryonic, larval and adult stages of this species. These results are valid for zebrafish and can be applied to other freshwater fish species. Graphical abstract.
Topics: Animals; Antioxidants; Ecosystem; Embryo, Nonmammalian; Glycine; Herbicides; Larva; Reactive Oxygen Species; Surface-Active Agents; Zebrafish; Glyphosate
PubMed: 36065034
DOI: 10.1007/s10646-022-02581-z -
British Journal of Community Nursing Dec 2014Maggot debridement therapy is used extensively in the UK in both community and hospital situations, but remains a potentially under-used modality in many wound care... (Review)
Review
Maggot debridement therapy is used extensively in the UK in both community and hospital situations, but remains a potentially under-used modality in many wound care markets. It promotes wound healing by performing three key processes: debridement, disinfection and growth-promoting activity. It can be used for the debridement of non-healing necrotic skin and soft tissue wounds, including pressure ulcers, venous stasis ulcers, neuropathic foot ulcers and non-healing traumatic of post-surgical wounds. With the increase in chronic diabetic foot wounds, maggot debridement therapy is a promising tool for health professionals dealing with difficult wounds. This article presents an overview of the research evidence surrounding maggot debridement therapy that serves as a guide to health professionals who may be users of this form of treatment now and in the future.
Topics: Animals; Debridement; Diptera; Humans; Larva; Skin Care; Wound Healing; Wounds and Injuries
PubMed: 25478859
DOI: 10.12968/bjcn.2014.19.Sup12.S6 -
JAMA Aug 2014Hepatitis C virus (HCV) infects more than 185 million individuals worldwide. Twenty percent of patients chronically infected with HCV progress to cirrhosis. New, simpler... (Review)
Review
IMPORTANCE
Hepatitis C virus (HCV) infects more than 185 million individuals worldwide. Twenty percent of patients chronically infected with HCV progress to cirrhosis. New, simpler therapeutics using direct-acting antivirals that target various stages of the HCV life cycle are in development to eradicate HCV without concomitant interferon.
OBJECTIVES
To summarize published evidence on safety, efficacy (measured by a sustained virologic response [SVR], which is the treatment goal of undetectable plasma HCV RNA 12 or 24 weeks after therapy completion), and tolerability of current US Food and Drug Administration-approved interferon-based regimens and oral interferon-free regimens used for treating HCV infection and coinfection with human immunodeficiency virus (HIV) and HCV; to provide treatment recommendations for specialists and generalists based on published evidence.
EVIDENCE REVIEW
A literature search of Web of Science, Scopus, Embase, Agricola, Cochrane Library, Cinahl Plus, ClinicalTrials.gov, Conference Papers Index, Gideon, PsycINFO, Google Scholar, and Oaister was conducted from January 1, 2009, to May 30, 2014. Publications describing phase 2, 3, and 4 studies evaluating the treatment of HCV were included. Forty-one studies involving 19,063 adult patients were included. Strength of clinical data and subsequent HCV treatment recommendations were graded according to the Oxford Centre for Evidence-Based Medicine.
FINDINGS
Patients infected with HCV genotype 1 represent 60% to 75% of HCV infections in the United States. Hepatitis C virus genotype 1 is more difficult to cure than genotype 2 or genotype 3. Patients with HCV genotype 1 should receive treatment with sofosbuvir + pegylated interferon + ribavirin because of the shorter duration of therapy and high rates of SVR (89%-90%). Simeprevir + pegylated interferon + ribavirin is an alternative for patients with HCV genotype 1 (SVR, 79%-86%). Patients with HCV genotypes 2 and 3, representing 20% to 29% of US HCV infections, should receive therapy with sofosbuvir + ribavirin alone (SVR for genotype 2, 12 weeks' duration: 82%-93%; SVR for genotype 3, 24 weeks' duration, 80%-95%). Patients with HIV-HCV coinfection and patients with compensated cirrhosis (ie, cirrhosis but preserved synthetic liver function) should receive the same treatment as HCV-monoinfected patients.
CONCLUSIONS AND RELEVANCE
New, short-duration, simpler therapies result in high SVR rates for HCV-infected patients. In conjunction with increased screening for HCV as suggested by recent Centers for Disease Control and Prevention guidelines, availability of new therapies may lead to the treatment of many more people with chronic HCV infection.
Topics: Antiviral Agents; Coinfection; Drug Therapy, Combination; Genotype; HIV Infections; Hepacivirus; Hepatitis C, Chronic; Humans; Life Cycle Stages; Liver Cirrhosis; Prevalence; United States
PubMed: 25117132
DOI: 10.1001/jama.2014.7085 -
The Science of the Total Environment Oct 2022It is recognised today that the global food system does not always deliver good nutrition for all human beings, and, additionally, dramatically contributes to climate... (Review)
Review
It is recognised today that the global food system does not always deliver good nutrition for all human beings, and, additionally, dramatically contributes to climate change, environmental degradation, and biodiversity loss. In particular, the cereal sector threatens biodiversity and ecosystem functions, due to environmentally harmful farming activities, that critically alter climate conditions, along with energy, land, and water resources. According to this paper's authors' opinion, this supports the rationale of conducting a systematic literature review of Life Cycle Assessments (LCAs) in the durum wheat (DW) sector, to highlight environmental hotspots and improvement potentials in the phases of cultivation and processing into finished products like pasta and bread. Methodological aspects were also discussed in this paper, to provide useful insights on how to best perform LCA in such agri-food supply chains. Given the findings from the papers reviewed, the authors could document that the cultivation phase is the primary environmental hotspot of DW-derived food products and suggested several mitigation and improvements solution including, organic farming practices, diversified cropping systems, reduction of N fertilisers and pesticides application, and irrigation optimisation strategies. Furthermore, the review highlighted that there exist two main gaps in the literature, mainly related to the scarce attention on the organic farming sector and DW landraces, and the lack of nutritional-property accounting in LCAs. Finally, although specific, the review may be of interest to researchers, LCA practitioners, farmers and producers, policy- and decision-makers, and other stakeholders, and could support the promotion of environmental sustainability in the DW sector.
Topics: Agriculture; Animals; Ecosystem; Fertilizers; Humans; Life Cycle Stages; Triticum
PubMed: 35809725
DOI: 10.1016/j.scitotenv.2022.157230 -
The Cochrane Database of Systematic... Dec 2017Adult female Anopheles mosquitoes can transmit Plasmodium parasites that cause malaria. Some fish species eat mosquito larvae and pupae. In disease control policy... (Review)
Review
BACKGROUND
Adult female Anopheles mosquitoes can transmit Plasmodium parasites that cause malaria. Some fish species eat mosquito larvae and pupae. In disease control policy documents, the World Health Organization (WHO) includes biological control of malaria vectors by stocking ponds, rivers, and water collections near where people live with larvivorous fish to reduce Plasmodium parasite transmission. In the past, the Global Fund has financed larvivorous fish programmes in some countries, and, with increasing efforts in eradication of malaria, policymakers may return to this option. Therefore, we assessed the evidence base for larvivorous fish programmes in malaria control.
OBJECTIVES
To evaluate whether introducing larvivorous fish to anopheline larval habitats impacts Plasmodium parasite transmission. We also sought to summarize studies that evaluated whether introducing larvivorous fish influences the density and presence of Anopheles larvae and pupae in water sources.
SEARCH METHODS
We searched the Cochrane Infectious Diseases Group Specialized Register; the Cochrane Central Register of Controlled Trials (CENTRAL), published in the Cochrane Library; MEDLINE (PubMed); Embase (Ovid); CABS Abstracts; LILACS; and the metaRegister of Controlled Trials (mRCT) up to 6 July 2017. We checked the reference lists of all studies identified by the search. We examined references listed in review articles and previously compiled bibliographies to look for eligible studies. Also we contacted researchers in the field and the authors of studies that met the inclusion criteria for additional information regarding potential studies for inclusion and ongoing studies. This is an update of a Cochrane Review published in 2013.
SELECTION CRITERIA
Randomized controlled trials (RCTs) and non-RCTs, including controlled before-and-after studies, controlled time series, and controlled interrupted time series studies from malaria-endemic regions that introduced fish as a larvicide and reported on malaria in the community or the density of the adult anopheline population. In the absence of direct evidence of an effect on transmission, we performed a secondary analysis on studies that evaluated the effect of introducing larvivorous fish on the density or presence of immature anopheline mosquitoes (larvae and pupae forms) in water sources to determine whether this intervention has any potential that may justify further research in the control of malaria vectors.
DATA COLLECTION AND ANALYSIS
Two review authors independently screened each article by title and abstract, and examined potentially relevant studies for inclusion using an eligibility form. At least two review authors independently extracted data and assessed risk of bias of included studies. If relevant data were unclear or were not reported, we contacted the study authors for clarification. We presented data in tables, and we summarized studies that evaluated the effects of introducing fish on anopheline immature density or presence, or both. We used the GRADE approach to summarize the certainty of the evidence. We also examined whether the included studies reported any possible adverse impact of introducing larvivorous fish on non-target native species.
MAIN RESULTS
We identified no studies that reported the effects of introducing larvivorous fish on the primary outcomes of this review: malaria infection in nearby communities, entomological inoculation rate, or on adult Anopheles density.For the secondary analysis, we examined the effects of introducing larvivorous fish on the density and presence of anopheline larvae and pupae in community water sources, and found 15 small studies with a follow-up period between 22 days and five years. These studies were undertaken in Sri Lanka (two studies), India (three studies), Ethiopia (one study), Kenya (two studies), Sudan (one study), Grande Comore Island (one study), Korea (two studies), Indonesia (one study), and Tajikistan (two studies). These studies were conducted in a variety of settings, including localized water bodies (such as wells, domestic water containers, fishponds, and pools (seven studies); riverbed pools below dams (two studies)); rice field plots (five studies); and water canals (two studies). All included studies were at high risk of bias. The research was insufficient to determine whether larvivorous fish reduce the density of Anopheles larvae and pupae (12 studies, unpooled data, very low certainty evidence). Some studies with high stocking levels of fish seemed to arrest the increase in immature anopheline populations, or to reduce the number of immature anopheline mosquitoes, compared with controls. However, this finding was not consistent, and in studies that showed a decrease in immature anopheline populations, the effect was not always consistently sustained. In contrast, some studies reported larvivorous fish reduced the number of water sources withAnopheles larvae and pupae (five studies, unpooled data, low certainty evidence).None of the included studies reported effects of larvivorous fish on local native fish populations or other species.
AUTHORS' CONCLUSIONS
We do not know whether introducing larvivorous fish reduces malaria transmission or the density of adult anopheline mosquito populations.In research studies that examined the effects on immature anopheline stages of introducing fish to potential malaria vector larval habitats, high stocking levels of fish may reduce the density or presence of immature anopheline mosquitoes in the short term. We do not know whether this translates into impact on malaria transmission. Our interpretation of the current evidence is that countries should not invest in fish stocking as a stand alone or supplementary larval control measure in any malaria transmission areas outside the context of research using carefully controlled field studies or quasi-experimental designs. Such research should examine the effects on native fish and other non-target species.
Topics: Animals; Anopheles; Disease Reservoirs; Disease Vectors; Feeding Behavior; Fishes; Larva; Malaria; Mosquito Control; Plasmodium; Population Density; Water
PubMed: 29226959
DOI: 10.1002/14651858.CD008090.pub3 -
NPJ Science of Food Aug 2023The consumption of insects as food and feed has been recently suggested as a possible alternative to the rising global food need, thus it is crucial to monitor any... (Review)
Review
The consumption of insects as food and feed has been recently suggested as a possible alternative to the rising global food need, thus it is crucial to monitor any potential food safety hazards in the insect supply chain. The aims of this systematic review were to collect, select, and evaluate studies investigating the persistence of Salmonella in insects. We searched PUBMED, EMBASE, WEB of Science Core Collection, and Food Science and Technology Abstracts. In total, 36 papers investigating the persistence of Salmonella in insects (both holometabolous and heterometabolous) were included after screening. Regarding complete metamorphosis insects, the longest Salmonella persistence was reported in Phormia regina, in which the pathogen persisted for 29 days at 5 °C. Similarly, Salmonella persisted in the feces of Alphitobius diaperinus for 28 days. The incomplete metamorphosis insect showing the longest Salmonella persistence (>10 months) was Blatella germanica. Periplaneta americana excreted Salmonella via feces for 44 days until all the insects were dead. The retrieved data on the persistence of Salmonella can be useful for further analysis by risk assessors and decision-makers involved in the safety of insect-based food, contributing to defining the sanitary requirements and risk mitigation measures along the supply chain. The review protocol is registered in PROSPERO database (CRD42022329213).
PubMed: 37640696
DOI: 10.1038/s41538-023-00223-0 -
Journal of Water and Health Mar 2015Global climate change is expected to impact drinking water quality through multiple weather-related phenomena. We conducted a systematic review and meta-analysis of the... (Meta-Analysis)
Meta-Analysis Review
Global climate change is expected to impact drinking water quality through multiple weather-related phenomena. We conducted a systematic review and meta-analysis of the relationship between various weather-related variables and the occurrence and concentration of Cryptosporidium and Giardia in fresh surface waters. We implemented a comprehensive search in four databases, screened 1,228 unique citations for relevance, extracted data from 107 relevant articles, and conducted random-effects meta-analysis on 16 key relationships. The average odds of identifying Cryptosporidium oocysts and Giardia cysts in fresh surface waters was 2.61 (95% CI = 1.63-4.21; I² = 16%) and 2.87 (95% CI = 1.76-4.67; I² = 0%) times higher, respectively, during and after extreme weather events compared to baseline conditions. Similarly, the average concentration of Cryptosporidium and Giardia identified under these conditions was also higher, by approximately 4.38 oocysts/100 L (95% CI = 2.01-9.54; I(2) = 0%) and 2.68 cysts/100 L (95% CI = 1.08-6.55; I² = 48%). Correlation relationships between other weather-related parameters and the density of these pathogens were frequently heterogeneous and indicated low to moderate effects. Meta-regression analyses identified different study-level factors that influenced the variability in these relationships. The results can be used as direct inputs for quantitative microbial risk assessment. Future research is warranted to investigate these effects and potential mitigation strategies in different settings and contexts.
Topics: Climate Change; Cryptosporidium; Environmental Monitoring; Fresh Water; Giardia; Oocysts; Water Pollutants; Weather
PubMed: 25719461
DOI: 10.2166/wh.2014.079