Publications by authors named "Rafael Ruiz De Castaneda"

Snakebite envenoming (SBE) is a neglected tropical disease that kills and maims hundreds of thousands of people yearly, particularly in impoverished rural settings of the Global South. Understanding the complexity of SBE and tackling this disease demands a transdisciplinary, One Health approach. There is a long-standing research tradition on SBE in toxinology and human medicine.

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Integrated approaches to health such as One Health are needed to tackle complex problems that cannot be solved by a single discipline or country, such as climate change, biodiversity loss or antimicrobial resistance. The Swiss Tropical and Public Health Institute (Swiss TPH), one of the international pioneers in One Health with its African partners, the Institute of Global Health at the University of Geneva, which has also adopted One Health, and other activities in Berne and Zurich, make Switzerland a hub for One Health research and development worldwide. This article summarizes the development of the One Health approach in Switzerland, and uses examples to demonstrate its added value.

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Article Synopsis
  • Snakebite envenoming is a neglected tropical disease impacting poor rural populations, highlighting the need for timely treatment and improved resource allocation as per the WHO's roadmap.
  • A study conducted in Nepal's Terai region analyzed risk distribution and travel accessibility, finding that 2.07 million rural residents face high vulnerability primarily due to neurotoxic snakebite syndrome.
  • Results suggest that by optimizing treatment capacity across health facilities, coverage in rural areas could significantly increase from about 66% to nearly 94%, potentially benefiting over 3.8 million people.
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  • * An innovative AI model using Vision Transformer was developed, trained on a massive dataset of over 386,000 snake photos to accurately identify both venomous and non-venomous species from around the world.
  • * The model achieved high accuracy rates (96% for species and 99% for genus), providing a fast, low-cost solution for snake identification that can assist healthcare in low-resource environments and support conservation efforts.
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Environmental degradation, including climate change, is causing increasing threats to human health. To address these issues, health professionals, including future physicians, need to be educated in planetary health and sustainable healthcare. This article discusses possible content for pre-graduate education in planetary health and methods of implementation in the curriculum.

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The "One Health" approach is essential to better understand and manage a pandemic of animal origin. Sensitive geopolitical considerations seem to hamper the investigations into the origin of the pandemic, but everything points to the Rhinolophus bat as the starting point of this devastating pandemic. Through a phenomenon of reverse zoonosis, several hundred cases of contamination of animals by SARS-CoV-2 have been identified worldwide, involving about twenty species of mammals.

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  • Snakebite envenoming significantly impacts health and the economy in rural areas, but there's a lack of sufficient data for accurate assessments.
  • The study used data from the SNAKE-BYTE project in Nepal to quantify snakebite's health effects in Disability-Adjusted Life Years (DALYs) and assessed economic losses linked to healthcare costs, productivity, and livestock mortality.
  • Findings revealed an annual burden of approximately 200,799 DALYs due to snakebites, leading to about $2.8 million in economic losses, and highlighted the importance of better data collection for a comprehensive understanding of snakebite effects.
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Article Synopsis
  • Snakebite envenoming is a significant public health issue, leading to an estimated 81,000-138,000 deaths annually worldwide, with Nepal identified as an endemic area needing more research.
  • A cross-sectional survey conducted in Nepal's Terai lowlands revealed a snakebite incidence rate of 262 per 100,000 people, with 48.8% of victims envenomed and a mortality rate of 7.8%.
  • The study highlights the disparities in impact, with a higher incidence among females and children, and calls for improved prevention and access to treatment for both humans and domestic animals.
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  • Recent research on snakebite risk in Nepal shows that most studies have focused on small areas and human impacts, but this analysis expands on that using a national-scale survey and various environmental data.
  • The study emphasizes that poverty significantly increases snakebite risk for humans, making them 63.9 times more likely to be affected, while colder temperatures raise the risk for animals by 23.4 times.
  • The analysis identified risk hotspots across the Terai region, providing valuable insights that could inform similar studies and health interventions in other countries and for different diseases.
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Community empowerment and engagement is one of the four strategic aims highlighted in the WHO strategy to prevent and control snakebite envenoming. Inappropriate health-seeking behaviours contribute to adverse outcomes, and community engagement is key in driving behavioural change. WHO has highlighted East Africa as a geographical area of concern for snakebite envenoming.

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The secretive behavior and life history of snakes makes studying their biology, distribution, and the epidemiology of venomous snakebite challenging. One of the most useful, most versatile, and easiest to collect types of biological data are photographs, particularly those that are connected with geographic location and date-time metadata. Photos verify occurrence records, provide data on phenotypes and ecology, and are often used to illustrate new species descriptions, field guides and identification keys, as well as in training humans and computer vision algorithms to identify snakes.

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Article Synopsis
  • Snakebite envenoming poses significant health risks to both humans and domestic animals, particularly in rural areas of Nepal and Cameroon, as highlighted by a national survey of over 24,000 households conducted in late 2018 and early 2019.
  • The study documented 405 snakebite cases across different animal species, revealing high mortality rates of 85% in Nepal and 87% in Cameroon, with most bites occurring near homes or farms.
  • The findings emphasize the urgent need for affordable treatments and effective prevention strategies to mitigate the effects of snakebites on animal health and farmer livelihoods in low-income regions, aligning with the WHO's One Health approach.
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We trained a computer vision algorithm to identify 45 species of snakes from photos and compared its performance to that of humans. Both human and algorithm performance is substantially better than randomly guessing (null probability of guessing correctly given 45 classes = 2.2%).

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Background: Multidisciplinary and multisectoral approaches such as One Health and related concepts (e.g., Planetary Health, EcoHealth) offer opportunities for synergistic expertise to address complex health threats.

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Biodiversity is inextricably linked to human health. As an important area of research of the Convention on Biological Diversity and a key avenue for the dissemination of biodiversity and health knowledge, we investigated how well-embedded biodiversity and health interlinkages are in institutional higher education offerings. Using One Health education programs as a starting point, we collected a global list of institutions potentially carrying out education in the links between biodiversity and health through previously published research, academic partners of global conglomerates, and our own networks.

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Neglected tropical diseases (NTDs) are a diverse group of diseases that continue to affect >1 billion people, with these diseases disproportionately impacting vulnerable populations and territories. Climate change is having an increasing impact on public health in tropical and subtropical areas and across the world and can affect disease distribution and transmission in potentially diverse ways. Improving our understanding of how climate change influences NTDs can help identify populations at risk to include in future public health interventions.

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Today, the world counts millions of refugees but only a fraction of them have access to higher education. Despite the multiple public health problems in refugee camps and the need to build local capacities to prevent and combat them, University level courses in public health are largely unavailable for refugees. This paper describes the development, implementation and evaluation of an innovative two-module blended-learning programme on One Health in Kakuma refugee camp (Kenya).

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Background: Snakebite envenoming is a major global health problem that kills or disables half a million people in the world's poorest countries. Biting snake identification is key to understanding snakebite eco-epidemiology and optimizing its clinical management. The role of snakebite victims and healthcare providers in biting snake identification has not been studied globally.

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