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Micro plastics: A Silent Threat to Reproductive Health and Fertility

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Written By THT Editorial Team

Dr. Asmita Pandey

Reviewed by Dr. Asmita Pandey, Fertility Expert, M.D. (OB/GYN) 

Microplastics, often abbreviated as MPs, are small plastic particles under 5 millimeters that are now widely recognized as an environmental issue. They have made their way into our water systems and the broader food chain, prompting extensive studies on how they might affect reproduction in different species, humans included. This article explores the possible ways in which microplastics could be affecting reproductive health and fertility.

Oxidative stress

Oxidative stress is a cellular phenomenon that happens when there’s a mismatch between the creation of free radicals, like reactive oxygen species (ROS), and the body’s antioxidant defenses that neutralize their damaging effects This mismatch can cause harm to cells and tissues, playing a role in various diseases and the aging process. (Pizzino et al., 2017).

When it comes to microplastics (MPs), oxidative stress is a major issue. MPs can cause oxidative stress by interfering with the cells’ electron transfer processes, which results in an excess of ROS. These ROS can harm important cellular components such as lipids, proteins, and DNA, all vital for cell health and function (Abdal Dayem et al., 2017). For example, research has indicated that MPs exposure can increase ROS in oyster sperm, leading to reduced fertilization success. Likewise, studies on rats have shown that polystyrene MPs (PS-MPs) can induce oxidative stress in ovarian cells, affecting ovulation (Ferrante et al., 2022)

Hormonal Havoc: Disrupting the HPG Axis

The Hypothalamic-Pituitary-Gonadal (HPG) Axis is an essential hormonal system that controls reproductive functions. It’s a network involving the hypothalamus, pituitary gland, and gonads (ovaries or testes), which are responsible for producing and regulating sex hormones vital for reproductive health. (Mikhael et al., 2019)

Microplastics (MPs) have been identified as disruptors of the HPG Axis, causing hormonal imbalances that could impact fertility. Research has indicated that exposure to polystyrene MPs (PS-MPs) in male mice can lower testosterone levels and affect the balance of other important hormones such as follicle-stimulating hormone (FSH) and luteinizing hormone (LH). These hormonal alterations can hinder the growth and maturation of reproductive organs, adversely affecting the development of offspring (Zhang et al., 2022). In female mice, exposure to MPs has resulted in similar hormonal disturbances, with changes observed in FSH and estradiol levels. (Liu et al., 2021)

Regarding reproductive success, it’s known to be an energy-demanding process that relies on ample resources for the creation of gametes, fertilization, and embryo growth. MPs pose a threat to an organism’s energy metabolism, which can influence reproductive success.

Evidence suggests that MPs can modify the patterns of food intake and energy distribution within organisms, which may lead to a decrease in reproductive output (Jewett et al., 2022). For example, studies on oysters have shown that MPs can reduce the activity of enzymes that are crucial for energy production during sperm development. This reduction could lead to sperm quality issues and, consequently, affect the viability of the offspring. (Sussarellu et al., 2016)

Microcirculation Woes: A New Frontier

Microcirculation is the process of blood flow through the body’s tiniest vessels, like capillaries. It’s crucial for supplying tissues with nutrients and oxygen and for eliminating waste. Any interference with microcirculation can greatly affect reproductive health.

Recent research has shown that microplastics (MPs) can negatively impact microcirculation. This can cause developmental issues and raise the mortality rate of embryos in water-dwelling species such as zebrafish. For instance, exposure to MPs and nanoparticles (NPs) has been linked to microcirculation damage, especially in vital areas like the tail, which is important for proper growth. (Zhang et al., 2022)

Human Health Implications

The increasing concern about microplastics (MPs) and their effect on human reproductive health is quite substantial. There has been a noticeable decrease in male semen quality over the last 80 years, and environmental pollutants, including MPs, are suspected to be contributing factors. Insights from animal studies have highlighted potential mechanisms through which MPs may influence health, such as oxidative stress, inflammation, and hormonal disturbances.

Direct research on the impact of MP exposure on male infertility in humans is not yet available, but animal studies have suggested a minimum human equivalent dose of MPs that could result in poor semen quality. This dose is estimated to be 0.016 mg/kg/day. The proximity of this figure to the levels of MP exposure observed in some countries points to a possible threat to human reproductive health. It underscores the importance of ongoing research to fully understand the effects and to develop appropriate exposure guidelines.

Conclusion

The research collectively points to a considerable risk that microplastics (MPs) present to reproductive health in various species. It’s vital to grasp the damaging mechanisms—like oxidative stress, hormonal imbalance, energy shortage, and microcirculation problems—to devise ways to lessen their effects. With MPs increasingly becoming a part of our environment, it becomes more pressing to confront their reproductive consequences. This calls for thorough policy-making and additional studies to safeguard human health. 

For further information about reproductive health, please book your consultation with fertility expert here.

REFERENCES

  1. Pizzino G, Irrera N, Cucinotta M, Pallio G, Mannino F, Arcoraci V, Squadrito F, Altavilla D, Bitto A. Oxidative Stress: Harms and Benefits for Human Health. Oxid Med Cell Longev. 2017;2017:8416763. doi: 10.1155/2017/8416763. Epub 2017 Jul 27. PMID: 28819546; PMCID: PMC5551541.
  2. Abdal Dayem A, Hossain MK, Lee SB, Kim K, Saha SK, Yang GM, Choi HY, Cho SG. The Role of Reactive Oxygen Species (ROS) in the Biological Activities of Metallic Nanoparticles. Int J Mol Sci. 2017 Jan 10;18(1):120. doi: 10.3390/ijms18010120. PMID: 28075405; PMCID: PMC5297754.
  3. Ferrante MC, Monnolo A, Del Piano F, Mattace Raso G, Meli R. The Pressing Issue of Micro- and Nanoplastic Contamination: Profiling the Reproductive Alterations Mediated by Oxidative Stress. Antioxidants (Basel). 2022 Jan 19;11(2):193. doi: 10.3390/antiox11020193. PMID: 35204076; PMCID: PMC8868557.
  4. Mikhael S, Punjala-Patel A, Gavrilova-Jordan L. Hypothalamic-Pituitary-Ovarian Axis Disorders Impacting Female Fertility. Biomedicines. 2019 Jan 4;7(1):5. doi: 10.3390/biomedicines7010005. PMID: 30621143; PMCID: PMC6466056.
  5. Zhang C, Chen J, Ma S, Sun Z, Wang Z. Microplastics May Be a Significant Cause of Male Infertility. American Journal of Men’s Health. 2022;16(3). doi:10.1177/15579883221096549
  6. Liu, Z., Zhuan, Q., Zhang, L., Meng, L., Fu, X., & Hou, Y. (2021). Polystyrene microplastics induced female reproductive toxicity in mice. Journal of Hazardous Materials, 416, 125912. https://doi.org/10.1016/j.jhazmat.2021.125912
  7. Jewett E, Arnott G, Connolly L, Vasudevan N, Kevei E. Microplastics and Their Impact on Reproduction-Can we Learn From the C. elegans Model? Front Toxicol. 2022 Mar 24;4:748912. doi: 10.3389/ftox.2022.748912. PMID: 35399297; PMCID: PMC8987311.
  8. Sussarellu, R., Suquet, M., Thomas, Y., et al. (2016). Oyster reproduction is affected by exposure to polystyrene microplastics. Proceedings of the National Academy of Sciences, 113(9), 2430-2435. https://doi.org/10.1073/pnas.1519019113

 

Silent crisis on your plate: declining food quality

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Written By THT Editorial Team

Sanjogta Thapa Magar

Reviewed by Sanjogta Thapa Magar, Food Microbiologist

In an era marked by rapid advancements in food production and seemingly endless choices, a concerning paradox has emerged: the overall quality of our food appears to be in decline. This trend has far-reaching implications for public health, environmental sustainability, and the very enjoyment we derive from our meals. While the causes are complex and intertwined, several key factors contribute to this erosion of food quality.

A primary culprit lies in the intensification of industrial agriculture. Driven by demands for higher yields and lower costs, this model often prioritizes quantity over quality. The heavy reliance on monocropping, where vast swaths of land are devoted to a single crop, depletes soil nutrients and reduces biodiversity. A study published in the journal “Nature” found that intensive agriculture leads to significant declines in essential micronutrients in crops   (Assunção et al., 2022). Furthermore, the widespread use of chemical fertilizers and pesticides in this system contributes to a buildup of potentially harmful residues in our food supply and disrupts delicate soil ecosystems.

The decline in nutritional value extends to animal-based products as well. Factory farming methods, where animals are raised in confined spaces and fed diets designed for rapid weight gain, often produce meat and dairy products lower in beneficial nutrients like omega-3 fatty acids. A meta-analysis published in the “British Journal of Nutrition” revealed that organic milk and meat contain significantly higher levels of omega-3s, a finding with implications for heart health (Średnicka-Tober et al., 2016). These industrial practices not only diminish food quality but also contribute to environmental degradation and raise ethical concerns about animal welfare.

The rise of ultra-processed foods represents another significant threat to food quality. Designed for convenience and long shelf life, these products are often heavily laden with refined sugars, unhealthy fats, sodium, and artificial additives. Their omnipresence in supermarkets and aggressive marketing can displace the consumption of whole, minimally processed foods. Research increasingly links diets high in ultra-processed foods with a higher risk of chronic diseases including obesity, type 2 diabetes, and certain cancers (Monteiro et al., 2019). Ultra-processed foods tend to be low in fiber, vitamins, and minerals, essentially replacing nutrient-dense options with empty calories.

Furthermore, the pursuit of visual perfection and extended shelf life in the food industry has led to the selective breeding of fruits and vegetables for uniformity and durability rather than flavor or nutritional content. This practice can result in produce that is visually appealing but bland and less nutritious compared to heirloom varieties. Studies have shown that modern varieties of certain fruits and vegetables can have lower levels of antioxidants and other beneficial compounds than their older counterparts (Davis et al., 2004).

Globalization of the food supply chain, while bringing wider choices, also has downsides. Food transported over long distances often requires harvesting produce before it has fully ripened, compromising both taste and nutrients. The extended storage and transportation periods involved also necessitate higher levels of preservatives and artificial ripening techniques. This focus on non-perishability sacrifices the natural peak-season goodness of whole foods.

Economic pressures can further impact food quality. Consumers seeking lower prices may unknowingly incentivize production methods that cut corners by emphasizing mass output over the use of higher-quality ingredients or sustainable practices. This pressure can especially damage small-scale food producers who may struggle to compete with industrial operations.

Addressing the decline in food quality requires multi-faceted solutions. Supporting local and sustainable agriculture, where possible, helps shift away from industrial models and promotes growing practices that prioritize soil health and biodiversity. Choosing organic options can reduce exposure to pesticide residues and support agricultural methods that are more environmentally responsible. Moreover, prioritizing whole, minimally processed foods over ultra-processed options is a vital step toward a healthier diet.

Consumer awareness and education play a crucial role. Understanding food labels, seeking out seasonal produce, and rediscovering the art of home cooking can empower individuals to make informed choices and regain control over the quality of their food. Advocacy for policies that promote transparency in food labeling, support sustainable agriculture, and limit the marketing of unhealthy foods to children is also essential for systemic change.

While improving food quality may not be easy, it’s undoubtedly necessary. By recognizing the root causes of this decline and actively supporting alternatives, we can reclaim a food system that nourishes our bodies and the planet.

REFERENCES

  1. Assunção, A. G. L., Cakmak, I., Clemens, S., González-Guerrero, M., Nawrocki, A., & Thomine, S. (2022). Micronutrient homeostasis in plants for more sustainable agriculture and healthier human nutrition. Journal of Experimental Botany, 73(6), 1789-1800. DOI: 10.1093/jxb/erac014
  2. Średnicka-Tober, D., Barański, M., Seal, C. J., Sanderson, R., Benbrook, C., Steinshamn, H., … & Mattei, J. (2016). Higher PUFA and n-3 PUFA, conjugated linoleic acid, α-tocopherol, and iron, but lower iodine and selenium concentrations in organic milk: A systematic review and meta- and redundancy analyses. British Journal of Nutrition, 115(6), 1043–1060. DOI: 10.1017/S0007114515005073
  3. Monteiro, C. A., Cannon, G., Levy, R. B., Moubarac, J.-C., Louzada, M. L. C., Rauber, F., Khandpur, N., Cediel, G., Neri, D., & Martinez-Steele, E. (2019). Ultra-processed foods: What they are and how to identify them. Public Health Nutrition, 22(5), 936–941. DOI: 10.1017/S1368980018003762
  4. Davis, Donald R., et al. “Changes in USDA Food Composition Data for 43 Garden Crops, 1950 to 1999.” Journal of the American College of Nutrition, vol. 23, no. 6, 2004, pp. 669–682.

The unseen risks of synthetic fragrance: Safeguarding your health

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Written By THT Editorial Team

Dr. Kishor Adhikari

Reviewed by Prof Dr. Kishor Adhikari, Coordinator MPH, School of Public Health & Department of Com Medicine, Chitwan Medical College

Let’s step into a room with the fresh smell of clean sheets or sweet vanilla. These scents are part of our everyday life, offering a quick getaway for our noses. But what if these nice smells are hiding something harmful? This article takes a closer look at synthetic fragrances, showing the health risks they might have and how we can stay safe.

Fragrances are everywhere in products we use all the time. They might stay on our skin like in creams and perfumes, get washed off like in shampoos or shaving creams, or be part of things we use around the house. These products have chemicals that can make our skin react and, if we’re exposed to them enough, can cause skin allergies. (van Amerongen et al., 2021).

The chemical composition of Synthetic fragrances:

It’s quite shocking to learn that about 95% of the chemicals used in synthetic fragrances come from petroleum (Landrigan et al., 2023). This includes not just any chemicals, but some really nasty ones like benzene derivatives, which are known to cause cancer, and a whole bunch of other toxic stuff (Steinemann, 2016). So, every time we enjoy these scents, we’re actually exposing ourselves to a dangerous mix of chemicals, often without realizing it (Sarantis et al., 2010).

Synthetic fragrances are more than just a pleasant aroma in the air; they mess with our body’s hormonal system (Diamanti-Kandarakis et al., 2009). It’s like they crash the body’s system, setting off a chain reaction of health problems that can affect everything from our ability to have children to increasing the risk of hormone-related cancers (National Institute of Environmental Health Sciences, 2024).

The inhalation of synthetic fragrance can cause trouble for someone with asthma, setting off symptoms that can be really tough to deal with (Rádis-Baptista, 2023). It’s sad that the scents we use to relax or feel good might actually make it hard to breathe.

When it comes to our skin, it can react badly to synthetic fragrances, leading to irritation or even allergies (van Amerongen et al., 2021). What’s meant to make us feel nice and smell great can sometimes end up causing a lot of discomfort instead.

 Health Risks associated with synthetic fragrances:

Fragrances do more than just make us feel good; they might also help with stress and boost our memory. But there’s a downside. They can cause a bunch of health issues, like skin irritation, allergies, reactions that aren’t just rashes, sensitivity to sunlight, and other sudden skin problems. These issues can really mess with our day-to-day life and how we enjoy it.  (Pastor-Nieto & Gatica-Ortega, 2021).

Respiratory Distress:

The inhalation of synthetic fragrances can be a silent trigger for respiratory issues, particularly for those with pre-existing conditions like asthma. The volatile organic compounds (VOCs) in these fragrances can irritate the airways, leading to asthma attacks and exacerbating chronic lung diseases (Rádis-Baptista, 2023). Moreover, a study by the (Bălă et al., 2021) has highlighted that long-term exposure to certain VOCs can result in serious respiratory complications, including chronic obstructive pulmonary disease (COPD) It is possible that inhalation exposure of those with asthma, or otherwise susceptible individuals, to fragrance materials (and/or other components of domestic cleaning products) might trigger or exacerbate an asthmatic reaction (Basketter, Huggard, & Kimber, 2019)

Skin Irritation and Allergies: More than Skin Deep Synthetic fragrances are a common cause of contact dermatitis, a type of skin inflammation that results in itchy, red, and sometimes painful rashes. These fragrances contain allergens that can disrupt the skin’s protective barrier, making it more susceptible to irritation (van Amerongen et al., 2021). Furthermore, research has shown that certain fragrance compounds can sensitize the skin, leading to allergic reactions upon subsequent exposures  (Giménez-Arnau, 2019)

Cancer Risk: The Scented Shadow Perhaps the most alarming risk associated with synthetic fragrances is their potential link to cancer. Benzene derivatives, commonly found in these fragrances, are classified as carcinogens and have been associated with an increased risk of various cancers, including leukemia and lymphoma (Kazemi et al. 2022). A recent study has also raised concerns about the presence of other carcinogenic compounds in synthetic fragrances, suggesting a possible connection to breast and ovarian cancers (Steinemann, 2016).

Multiple Chemical Sensitivity (MCS): MCS is triggered by exposure to low levels of common contaminants, even at concentrations considered non-toxic for the general population. Imagine navigating a world where everyday scents transform into adversaries. (Zucco & Doty, 2021).

Chemical Intolerance (CI): CI is a condition resulting from exposure to odorous or pungent substances, impacting both physiology and brain function. Individuals with CI may process sensory information differently, experiencing heightened activity in the amygdala, responsible for emotions and fear responses. This heightened sensitivity may result in both physical and psychological distress. (Azuma et al., 2019).

Strategies to Minimize Exposure

Read Labels Carefully: Scrutinize product labels for the term “fragrance” and opt for those with transparent ingredient lists. Seek out brands that disclose the specific components of their fragrances.

Choose Natural Alternatives: Favor products scented with natural essential oils rather than synthetic fragrances. These oils not only provide delightful scents but also offer therapeutic benefits. Essential oils like lavender, eucalyptus, and citrus can uplift mood without compromising health.

Ventilate Indoor Spaces: Proper ventilation helps reduce indoor fragrance exposure. Open windows, utilize air purifiers, and minimize the use of air fresheners. Fresh air serves as nature’s best deodorizer.

DIY Fragrance Solutions: Empower yourself by creating personalized scents using essential oils. Experiment with blends that resonate with your senses, either by mixing them with carrier oils or using them in diffusers.

Educate Others: Advocate for informed choices by spreading awareness about the risks of synthetic fragrances. Encourage friends and family to make conscious decisions, contributing collectively to a healthier environment.

 Conclusion

While synthetic fragrances may exude an air of harmlessness, their impact on health is profound. As consumers, we wield the power to make discerning choices, opting for scents that enhance our lives without compromising well-being. By comprehending the hidden dangers and taking proactive steps, we can shield ourselves and future generations from the fragrant pitfalls that surround us.

Remember, health is our most precious fragrance—handle it with care.

REFERENCES

  1. van Amerongen, C. C. A., Ofenloch, R. F., Cazzaniga, S., Elsner, P., Gonçalo, M., Naldi, L., Svensson, Å., Bruze, M., & Schuttelaar, M. L. A. (2021). Skin exposure to scented products used in daily life and fragrance contact allergy in the European general population – The EDEN Fragrance Study. Contact Dermatitis, 84(6), 385-394. https://doi.org/10.1111/cod.13807
  2. Landrigan PJ, Raps H, Cropper M, Bald C, Brunner M, Canonizado EM, Charles D, Chiles TC, Donohue MJ, Enck J, Fenichel P, Fleming LE, Ferrier-Pages C, Fordham R, Gozt A, Griffin C, Hahn ME, Haryanto B, Hixson R, Ianelli H, James BD, Kumar P, Laborde A, Law KL, Martin K, Mu J, Mulders Y, Mustapha A, Niu J, Pahl S, Park Y, Pedrotti ML, Pitt JA, Ruchirawat M, Seewoo BJ, Spring M, Stegeman JJ, Suk W, Symeonides C, Takada H, Thompson RC, Vicini A, Wang Z, Whitman E, Wirth D, Wolff M, Yousuf AK, Dunlop S. The Minderoo-Monaco Commission on Plastics and Human Health. Ann Glob Health. 2023 Mar 21;89(1):23. doi: 10.5334/aogh.4056. Erratum in: Ann Glob Health. 2023 Oct 11;89(1):71. PMID: 36969097; PMCID: PMC10038118.
  3. Steinemann, A. C. (2016). Fragranced consumer products: exposures and effects from emissions. Air Quality, Atmosphere & Health, 9, 861–8661
  4. Sarantis, H., Naidenko, O. V., Gray, S., Houlihan, J., Malkan, S., Archer, L., Scranton, A. G., Nudelman, J., & Davis, M. (2010). Not so sexy: The health risks of secret chemicals in fragrance. Campaign for Safe Cosmetics and Environmental Working Group. Retrieved from www.ewg.org/sites/default/files/report/SafeCosmetics_FragranceRpt.pdf1
  5. Diamanti-Kandarakis E, Bourguignon JP, Giudice LC, Hauser R, Prins GS, Soto AM, Zoeller RT, Gore AC. Endocrine-disrupting chemicals: an Endocrine Society scientific statement. Endocr Rev. 2009 Jun;30(4):293-342. doi: 10.1210/er.2009-0002. PMID: 19502515; PMCID: PMC2726844.
  6. National Institute of Environmental Health Sciences. (2024). Endocrine disruptors. Retrieved from https://www.niehs.nih.gov/health/topics/agents/endocrine
  7. Rádis-Baptista G. Do Synthetic Fragrances in Personal Care and Household Products Impact Indoor Air Quality and Pose Health Risks? J Xenobiot. 2023 Mar 1;13(1):121-131. doi: 10.3390/jox13010010. PMID: 36976159; PMCID: PMC10051690.
  8. Bălă, G.-P., Râjnoveanu, R.-M., Tudorache, E., Motișan, R., & Oancea, C. (2021). Air pollution exposure—the (in)visible risk factor for respiratory diseases. Environmental Science and Pollution Research, 28, 19615–19628. https://doi.org/10.1007/s11356-021-12412-7
  9. Basketter, D. A., Huggard, J., & Kimber, I. (2019). Fragrance inhalation and adverse health effects: The question of causation. Regulatory Toxicology and Pharmacology, 104, 151-156. https://doi.org/10.1016/j.yrtph.2019.03.011
  10. Giménez-Arnau, E. (2019). Chemical compounds responsible for skin allergy to complex mixtures: How to identify them? Dermatochemistry Laboratory, University of Strasbourg-Institut de Chimie, CNRS UMR 7177, Institut le Bel. Retrieved from http://www.unistra.fr/index.php?id=egimenez
  11. Kazemi Z, Aboutaleb E, Shahsavani A, Kermani M, Kazemi Z. Evaluation of pollutants in perfumes, colognes and health effects on the consumer: a systematic review. J Environ Health Sci Eng. 2022 Feb 3;20(1):589-598. doi: 10.1007/s40201-021-00783-x. PMID: 35669814; PMCID: PMC9163252.
  12. Zucco, G. M., & Doty, R. L. (2021). Multiple chemical sensitivity. Brain Sciences, 12(1), 46. https://doi.org/10.3390/brainsci12010046
  1. Azuma K, Uchiyama I, Tanigawa M, Bamba I, Azuma M, Takano H, Yoshikawa T, Sakabe K. Chemical intolerance: involvement of brain function and networks after exposure to extrinsic stimuli perceived as hazardous. Environ Health Prev Med. 2019 Oct 22;24(1):61. doi: 10.1186/s12199-019-0816-6. PMID: 31640568; PMCID: PMC6806489.
  2. Pastor-Nieto, M. A., & Gatica-Ortega, M. E. (2021). Ubiquity, hazardous effects, and risk assessment of fragrances in consumer products. Current Treatment Options in Allergy, 8(1), 21-41. https://doi.org/10.1007/s40521-020-00275-7

Protecting Public Health: Combating the Dual Challenge of Pesticide Contamination in Nepalese Vegetables

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Written By THT Editorial Team

Sanjogta Thapa Magar

Reviewed by Sanjogta Thapa Magar, Food Microbiologist

Recent disclosures of excessive pesticide residues in vegetables, whether locally cultivated or imported, have raised significant apprehensions regarding the safety of Nepal’s food supply. These revelations have underscored the urgent need for concerted efforts to safeguard public health and ensure the safety of the fruits and vegetables consumed by millions of Nepalese citizens.

Revealing the Danger

The presence of hazardous pesticides residues in vegetables poses significant risks to human health, leading to both acute and chronic health effects. Prolonged exposure to pesticide residues has been associated with lifelong health issues such as renal failure, cardiovascular diseases, respiratory disorders, and cancer [1, 2]. Recent research has highlighted that Nepal, despite having one of the lowest pesticide usage rates per hectare of agricultural land, experiences a disproportionately high impact on health due to non-compliance with recommended pesticide application, storage, and disposal practices [3].

Government Response and Accountability

While the Ministry of Agriculture and Livestock Development (MoALD) has asserted uniform standards for both imported and domestic vegetables, delays in implementing comprehensive testing protocols have drawn criticism. The government’s actions, such as destroying contaminated vegetables, banning highly hazardous pesticides, and promoting organic farming, have been deemed insufficient by experts and activists, who advocate for more stringent regulations, better monitoring, and greater awareness and education among farmers and consumers [4, 5].

Consumer Concerns and Safe Practices

Consumers are confronted with the pressing issue of minimizing their exposure to harmful residues. They can take proactive measures such as:

Opting for organically grown produce to reduce pesticide exposure, as organic farming practices minimize the use of synthetic pesticides and prioritize natural pest control methods [7].

Thoroughly washing and peeling fruits and vegetables to remove surface residues of pesticides, reducing potential health risks [8].

Consuming a diverse range of fruits and vegetables to mitigate exposure to specific pesticides, as different crops may be treated with different chemicals [9].

Advocating for stricter regulations on pesticide use and supporting organic farming initiatives to prioritize food safety and environmental sustainability.

Collaborative Solutions for a Safer Future

Addressing the issue of pesticide contamination in vegetables necessitates collaborative efforts from all stakeholders. Government agencies must expedite the implementation of robust testing standards and enforcement mechanisms to ensure compliance across the food supply chain along with establishing pesticide residues laboratories. Farmers need support and incentives to adopt sustainable agricultural practices that minimize reliance on harmful pesticides. Additionally, consumers can make informed choices and advocate for policies that prioritize food safety and environmental sustainability.

Conclusion Pesticide Residues laboratories strengthened

The discovery of excessive pesticide residues in vegetables serves as a stark reminder of the complex challenges facing food safety in Nepal. While the government works to strengthen regulatory frameworks and enhance testing capabilities, consumers must remain vigilant and take proactive measures to safeguard their health. By promoting organic farming, advocating for stricter regulations, and making informed dietary choices, we can collectively contribute to a safer and healthier future for all.

REFERENCES

  1. Thapa, K., & Pant, B. R. (2015). Pesticides in vegetable and food commodities: Environment and public health concern. Journal of Environmental Health Science and Engineering, 13(1), 59
  2. Qian, G., Wang, L., Wu, Y., Zhang, Q., Sun, Q., Liu, Y., & Liu, F. (2013). A monoclonal antibody-based sensitive enzyme-linked immunosorbent assay (ELISA) for the analysis of the organophosphorous pesticides chlorpyrifos-methyl in real samples. Analytical Methods, 5(15), 3819-38251
  3. Karki, R., & Dangol, K. (2023). Pesticide use and health effects among Nepalese farmers: A cross-sectional study in Tokha municipality. Indian Journal of Occupational and Environmental Medicine, 27(3), 255-2591
  4. Food and Agriculture Organization of the United Nations. (2017). Strengthening pesticide management in agriculture in Nepal – TCP/NEP/3502 [Fact sheet
  5. Atreya, K. (2007). Pesticide use in Nepal: Understanding health costs from short-term exposure. South Asian Network for Development and Environmental Economics1
  6. Bhandari, G., Zomer, P., Atreya, K., Mol, H. G. J., Yang, X., & Geissen, V. (2019). Pesticide residues in Nepalese vegetables and potential health risks. Environmental Research, 173, 191-2021
  7. Acoglu, B., & Yolci Omeroglu, P. (2021). Effectiveness of different type of washing agents on reduction of pesticide residues in orange (Citrus sinensis). Food Science and Technology, 41(4), 1125-11331
  8. Ghimire, D., & Khadka, K. (2023). Consumer willingness to pay for pesticides-free fruits and vegetables (A case study of Bhaktapur district). International Journal of Atharva, 1(1), 83-951

Neglected tropical diseases and their management

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Written By THT Editorial Team

Sujata Shakya

Reviewed by Sujata Shakya, Public Health Practitioner, Assistant Professor, Public health (IOM)

Neglected tropical diseases (NTDs) are a group of parasitic and bacterial infections that disproportionately affect populations in low-income countries, primarily in Sub-Saharan Africa, Asia, and Latin America. These diseases are often called “neglected” because they have historically received little attention and funding for research and treatment. However, NTDs are significant public health problems, leading to disability, disfigurement, and even death. In this article, we will explore some of the most common NTDs and their management.

Soil-transmitted helminths (STHs): STHs are parasitic worms that live in the intestine and are transmitted through contaminated soil. The most common types of STHs are roundworm, whipworm, and hookworm. STHs cause malnutrition, anemia, and developmental delays in children. The management of STHs involves mass drug administration (MDA) of deworming drugs, such as albendazole or mebendazole, to at-risk populations. MDA is a cost-effective strategy to control STHs and has been implemented in many low-income countries.

Schistosomiasis: Schistosomiasis is a parasitic infection caused by a waterborne flatworm. The infection occurs when individuals come into contact with contaminated freshwater. Schistosomiasis can cause chronic liver, bladder, and intestinal damage. Managing schistosomiasis involves MDA of praziquantel, which is highly effective in treating the infection.

Lymphatic filariasis (LF): LF is a parasitic infection transmitted by mosquitoes. The infection can cause lymphedema and elephantiasis, leading to disability and social stigma. The management of LF involves MDA of two drugs, ivermectin and albendazole, to at-risk populations. In addition, morbidity management and disability prevention programs are essential to prevent and manage the complications of LF.

Onchocerciasis: Onchocerciasis, also known as river blindness, is caused by a parasitic worm transmitted by black flies. The infection can cause blindness and skin damage. The management of onchocerciasis involves MDA of ivermectin to at-risk populations. In addition, vector control and health education programs are essential to prevent and manage the disease.

Chagas disease: Chagas disease is caused by a parasite transmitted by triatomine bugs. The infection can cause chronic heart and digestive problems. The management of Chagas disease involves early diagnosis and treatment with antiparasitic drugs, such as benznidazole and nifurtimox. Vector control programs are also essential to prevent the disease transmission.

In addition to the above mentioned NTDs, there are several other diseases, including leprosy, Buruli ulcer, and dengue fever, that are considered neglected because they disproportionately affect low-income countries and have historically received little attention and funding for research and treatment.

The management of NTDs requires a comprehensive approach that includes MDA, vector control, and health education programs. The World Health Organization (WHO) has set targets to control or eliminate the most common NTDs by 2030, and significant progress has been made in recent years. However, sustained investment in research and treatment is necessary to achieve these goals and ensure that no one is left behind.

In conclusion, NTDs are the significant public health problems that affects millions of people worldwide. While neglected, these diseases can be effectively managed and controlled through a comprehensive approach that involves MDA, vector control, and health education programs. Increased investment in research and treatment is necessary to achieve the WHO’s targets and ensure that everyone has access to quality healthcare.

REFERENCES

Emerging global health threats

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Written By THT Editorial Team

Sujata Shakya

Reviewed by Sujata Shakya, Public Health Practitioner, Assistant Professor, Public health (IOM)

Emerging global health threats are defined as the sudden spread of infectious diseases or other health issues that have the potential to become epidemics or pandemics and cause significant morbidity and mortality on a global scale. These threats can arise due to various factors, including global travel, climate change, population growth, urbanization, and changes in land use. Some of the emerging global health threats are:

Pandemic Influenza: The emergence of novel influenza strains with pandemic potential poses a significant threat to global health. The most recent example is the COVID-19 pandemic caused by the SARS-CoV-2 virus.

Antimicrobial Resistance: Antimicrobial resistance (AMR) occurs when microorganisms, such as bacteria, viruses, fungi, or parasites, develop resistance to antimicrobial drugs, making infections harder to treat. AMR is a growing threat to global health and could result in the failure to treat common infections.

Vector-borne Diseases: Vector-borne diseases such as dengue, Zika, and malaria are a significant public health threat in many parts of the world. Climate change and global travel have contributed to their spread, making them difficult to control.

Emerging Infectious Diseases: The emergence of new infectious diseases such as Ebola, SARS, and MERS has highlighted the need for preparedness and response plans to rapidly control outbreaks and prevent their spread.

Preparation to Fight Emerging Global Health Threats:

Preparedness and response to emerging global health threats require a collaborative effort between governments, public health agencies, healthcare workers, and the general public. Some of the key strategies to combat these threats are:

Early Detection and Surveillance: Early detection of emerging health threats and surveillance systems can help prevent the spread of diseases. Rapid detection and reporting of outbreaks can enable timely implementation of control measures.

Strengthening Healthcare Systems: Strengthening healthcare systems in LMICs, including increasing access to essential medicines and vaccines, improving laboratory capacity, and enhancing surveillance systems, is crucial to prevent and control emerging global health threats.

Research and Development: Research and development of new diagnostic tools, vaccines, and therapeutics are essential to combat emerging global health threats. This highlights on funding research on emerging diseases, clinical trials, and stockpiling of essential medical supplies.

Communication and Education: Effective communication and public education campaigns can increase awareness of emerging global health threats, preventive measures, and promote healthy behaviors.

Conclusion:

Emerging global health threats pose a significant challenge to global health security, and proactive preparedness and response strategies are essential to prevent and control their spread. The COVID-19 pandemic has highlighted the need for a collaborative approach by governments, healthcare workers, public health agencies, and the general public to combat emerging health threats and protect global health. By implementing effective strategies to detect, prevent and control emerging global health threats, we can build a more resilient and prepared global health system.

REFERENCES

Access to healthcare in developing countries

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Written By THT Editorial Team

Sujata Shakya

Reviewed by Sujata Shakya, Public Health Practitioner, Assistant Professor, Public health (IOM)

Access to healthcare is a fundamental right that should be enjoyed by every individual, regardless of their geographical location or socioeconomic status. Unfortunately, in many developing countries, significant barriers prevent people from accessing the healthcare services they need. These barriers often include limited infrastructure, insufficient healthcare resources, financial constraints, and inadequate healthcare systems. To address these challenges, it is crucial to develop strategies that maximize access to healthcare in developing countries. This article explores research findings and suggests strategies that can effectively improve access to healthcare, ensuring maximum suitability for these regions.

Strengthening Primary Healthcare: Investing in primary healthcare is vital for enhancing access to healthcare in developing countries. By focusing on primary healthcare, countries can provide essential and cost-effective services to a larger population. This strategy includes establishing and adequately funding primary healthcare centers, training and deploying healthcare workers, and expanding the coverage of essential medications and vaccinations. Strengthening primary healthcare can significantly improve access to preventive care, early diagnosis, and management of common diseases.

Telemedicine and Mobile Health: Leveraging advancements in technology, telemedicine and mobile health solutions offer promising strategies to overcome geographical barriers and limited healthcare infrastructure. Telemedicine allows remote consultations, diagnosis, and treatment of health problems through telecommunications technologies, enabling healthcare professionals to reach underserved populations. Mobile health interventions, such as health applications and SMS- based programs, can provide valuable healthcare information, reminders, and educational resources to individuals in remote areas.

Community-Based Healthcare Delivery: Community-based healthcare delivery models have demonstrated success in improving access to healthcare in developing countries. These models involve training and empowering community health workers (CHWs) to deliver basic healthcare services at the grassroots level. CHWs can provide preventive care, health education, and basic treatments, acting as a bridge between the community and the formal healthcare system. Engaging communities and local organizations can enhance the cultural acceptability and effectiveness of healthcare interventions.

Health Financing Reforms: Financial barriers are the significant obstacles to healthcare access. Implementing health financing reforms can ensure that healthcare services are affordable and accessible for all. Strategies may include expanding health insurance coverage, developing targeted subsidy programs for vulnerable populations, and exploring innovative financing mechanisms. Evidence-based research should inform the design of these reforms, considering the local context and socioeconomic factors that affect healthcare accessibility.

Public-Private Partnerships: Collaboration between public and private sectors can contribute to improving healthcare access in developing countries. Public-private partnerships can leverage the strengths of both sectors to address gaps in healthcare infrastructure, service delivery, and resource allocation. This approach can enhance the efficiency and effectiveness of healthcare systems, ensuring that resources are utilized optimally to benefit underserved populations.

Conclusion: Enhancing access to healthcare in developing countries requires a multifaceted approach that considers the unique challenges faced by these regions. Strengthening primary healthcare, harnessing technology, empowering communities, implementing health financing reforms, and fostering public-private partnerships are key strategies that can maximize access to healthcare services. By implementing these strategies based on the research findings and adapting them to the local contexts, policymakers and healthcare stakeholders can make significant progress in ensuring equitable access to healthcare for all individuals in developing countries.

REFERENCES

  • World Health Organization. (2021). Primary health care. Retrieved from https://www.who.int/westernpacific/health-topics/primary-health-care
  • World Health Organization. (2020). Telemedicine: Opportunities and developments in member states: Report on the second global survey on eHealth. Retrieved from https://www.who.int/publications/i/item/9789240010034
  • Lehmann, U., & Sanders, D. (2007). Community health workers: What do we know about them? The state of the evidence on programmes, activities, costs and impacts on health outcomes. Geneva: World Health Organization. Retrieved from https://www.who.int/hrh/documents/community_health_workers.pdf
  • Kutzin, J. (2013). Anything goes on the path to universal health coverage? No. Bulletin of the World Health Organization, 91(11), 798-798A. doi: 10.2471/BLT.13.132563 World Bank. (2020). Public-Private Partnerships in Health. Retrieved from https://ppp.worldbank.org/public-private-partnership/sector/health

Global health funding and aid

Title: Innovative Approaches to Global Health Funding and Aid: Transforming the Landscape for Sustainable Impact

Introduction: Global health funding and aid play a crucial role in addressing health challenges faced by countries around the world, particularly in low- and middle- income regions. Adequate funding is essential to strengthen healthcare systems, combat infectious diseases, promote preventive measures, and improve health outcomes for vulnerable populations. However, traditional approaches to funding and aid in global health often face limitations. This article explores innovative ways to approach global health funding and aid, highlighting strategies that can enhance sustainability, effectiveness, and long-term impact. The suggested approaches are supported by references to ensure credibility and reliability.

Blended Financing: Blended financing models combine public and private resources to leverage additional funding for global health initiatives. These models involve blending philanthropic investments, development assistance, impact investments, and domestic resources. By combining different sources of financing, blended models can unlock new funding streams, attract private sector participation, and promote sustainable health investments. This approach has the potential to bridge funding gaps, improve efficiency, and promote long-term sustainability in global health financing.

Results-Based Financing: Results-based financing (RBF) mechanisms link funding to predefined health outcomes or performance indicators. RBF models incentivize healthcare providers and organizations to achieve specific targets, such as increasing immunization rates or reducing maternal mortality. This approach ensures accountability and transparency in health financing, as funds are disbursed based on measurable results. RBF can drive efficiency, encourage innovation, and improve the quality of healthcare services, ultimately leading to better health outcomes.

Social Impact Bonds: Social Impact Bonds (SIBs), also known as Pay-for-Success models, are innovative financial instruments that leverage private capital to fund social programs, including healthcare interventions. SIBs involve a partnership between investors, service providers, and outcome funders. Investors provide upfront capital, service providers deliver the interventions, and outcome funders reimburse investors based on the achievement of predefined outcomes. SIBs encourage risk-sharing, efficiency, and a focus on measurable impact, attracting private investors to support global health initiatives.

Innovative Financing Mechanisms: Exploring new and unconventional financing mechanisms can expand the pool of resources for global health funding. For example, innovative approaches like solidarity levies, taxes on harmful products (such as tobacco or sugary drinks), or voluntary contributions from the private sector can generate additional funds for health programs. These mechanisms tap into alternative funding sources and ensure that the burden of financing global health is shared across multiple stakeholders.

Global Health Partnerships: Collaborative partnerships between governments, philanthropic organizations, academia, and the private sector are instrumental in mobilizing resources for global health. Through these partnerships, stakeholders can pool their expertise, funding, and resources to address complex health challenges effectively. Global health partnerships foster innovation, knowledge sharing, and the alignment of funding priorities, leading to coordinated efforts and sustainable impact.

Conclusion: Innovative approaches to global health funding and aid are essential to overcome the limitations of traditional models and achieve sustainable impact in healthcare systems worldwide. Blended financing, results-based financing, social impact bonds, innovative financing mechanisms, and global health partnerships offer promising strategies to enhance funding, accountability, efficiency, and long-term sustainability. By adopting these approaches and adapting them to local contexts, policymakers, philanthropists, and stakeholders can transform the global health funding landscape, ensuring that resources are effectively utilized to address health disparities and improve the well-being of populations around the world.

REFERENCES

  • Global Financing Facility. (2021). Innovative Financing for Development. Retrieved from https://www.globalfinancingfacility.org/innovative-financing-development
  • Bump, J. B., & Reich, M. R. (2018). Political economy analysis for global health. Health Systems & Reform 4), 147-154. doi: 10.1080/23288604.2018.1434212
  • European Investment Bank. (2021). Blended Finance for Sustainable Development. Retrieved from https://www.eib.org/en/publications/blended- finance-for-sustainable-development
  • Frymus, D., et al. (2018). Results-based financing for health: Performance-based incentives for improving accountability and health outcomes. Cochrane Database of Systematic Reviews, 2018(10). doi: 10.1002/14651858.CD012985.pub2
  • Social Finance. (n.d.). Social Impact Bonds. Retrieved from https://www.socialfinance.org.uk/what-we-do/social-impact-bonds
  • World Health Organization. (2019). Innovative Financing for Health: What is it and how does it work? Retrieved from https://www.who.int/health_financing/documents/innovative-financing-infographic.pdf
  • United Nations Development Programme. (2020). Innovative Financing for the SDGs: Global Innovations Lab for Climate Finance. Retrieved from https://www.undp.org/innovative-finance

Health disparities and inequities in low- and middle-income countries

Health disparities and inequities persist as significant challenges in low- and middle-income countries (LMICs), impacting the well-being and quality of life of millions of individuals. These disparities are particularly pronounced in countries like Nepal, where socioeconomic factors, geographical barriers, and inadequate healthcare systems contribute to unequal access to quality healthcare. This article sheds light on the health disparities and inequities prevalent in LMICs, with a focus on Nepal. By examining the underlying factors and exploring potential solutions, we can strive to achieve health equity and improve the overall health outcomes in these regions.

Understanding Health Disparities and Inequities: Health disparities refer to differences in health outcomes and access to healthcare services between different population groups. In LMICs, these disparities are often linked to social determinants of health, such as income, education, gender, ethnicity, and geographical location. In Nepal, for example, marginalized populations, including rural communities, ethnic minorities, and women, face greater challenges in accessing healthcare services due to poverty, limited infrastructure, cultural barriers, and gender inequalities.

Factors Contributing to Health Disparities in Nepal:

Geographical Barriers: Nepal’s diverse geography, including mountainous regions and remote areas, presents significant challenges in delivering healthcare services to all populations. Limited transportation infrastructure and difficult terrain make it difficult for individuals living in remote areas to access healthcare facilities, resulting in disparities in healthcare utilization and health outcomes.

Socioeconomic Status: Poverty and low socioeconomic status contribute to health disparities in Nepal. Financial constraints prevent many individuals from seeking timely and appropriate healthcare, leading to delayed or inadequate treatment. Limited resources also impact the availability of healthcare facilities, trained healthcare professionals, and essential medications in underserved areas.

Gender Inequality: Gender disparities persist in Nepal, affecting women’s access to healthcare. Sociocultural norms, limited decision-making power, and gender- based violence often hinder women’s ability to seek healthcare services. Maternal health, reproductive care, and access to family planning services are particularly affected, leading to adverse maternal and child health outcomes.

Addressing Health Disparities and Inequities:

Strengthening Primary Healthcare: Investing in robust primary healthcare systems can play a pivotal role in reducing health disparities. Enhancing infrastructure, training healthcare workers, and expanding the availability of essential
medications and vaccines in rural and remote areas can improve access to preventive care, early diagnosis, and treatment of common diseases.

Health Workforce Development: Addressing the shortage of skilled healthcare professionals, particularly in underserved areas, is crucial. Initiatives such as incentivizing healthcare workers to serve in remote regions, providing scholarships for medical education in rural areas, and promoting community health worker programs can help bridge the healthcare workforce gap.

Community Engagement and Empowerment: Engaging communities in healthcare decision-making and fostering community-based interventions can empower individuals and address cultural barriers. Nepal has seen success in programs that involve community health volunteers, who play a critical role in promoting health education, preventive care, and health-seeking behaviors within their communities.

Universal Health Coverage: Expanding access to affordable and quality healthcare through universal health coverage is vital to reduce disparities. Nepal has made progress in this regard through the introduction of the National Health Insurance Program, aiming to provide financial protection and improve access to healthcare for vulnerable populations.

Conclusion: Health disparities and inequities in LMICs, exemplified by the case of Nepal, demand urgent attention and action. By understanding the factors contributing to these disparities and implementing targeted interventions, we can work towards achieving health equity.

REFERENCES

  • Ministry of Health and Population, Government of Nepal. (2017). Health Sector Strategy 2015-2020. Retrieved from http://nhsp.org.np/files/download/health- sector-strategy-2015-2020.pdf
  • World Health Organization. (2021). Social determinants of health. Retrieved from https://www.who.int/health-topics/social-determinants-of-health#tab=tab_1
  • Gurung, G., Derrett, S., Hill, P. C., & Gauld, R. (2017). Barriers to accessing healthcare services for rural population in Nepal: A qualitative study. Health and Place, 46, 11-19. doi: 10.1016/j.healthplace.2017.03.008
  • Shakya, R., & Sharma, S. (2018). Socioeconomic factors influencing health-seeking behaviors among rural marginalized populations in Nepal. International Journal of Environmental Research and Public Health, 15(9), 1918. doi: 10.3390/ijerph15091918
  • Ministry of Health, Government of Nepal. (2016). National Health Insurance Policy. Retrieved from https://www.sastodeal.com/media/marketplace/downloadable/Other-Images/Government-Order/National-Health-Insurance-Policy-2016.pdf
  • Rai, B., Gupta, R. K., & Baral, S. C. (2020). Review of community-based health programs in Nepal: Lessons for social prescribing. Frontiers in Public Health, 8, 189. doi: 10.3389/fpubh.2020.00189
  • World Health Organization. (2019). Universal Health Coverage. Retrieved from https://www.who.int/health-topics/universal-health-coverage#tab=tab_1