This covers the role of urbanization in influencing the incidence and prevalence of infectious diseases. Urbanization operates within the urban built environment.
3. BACKGROUND
• Urbanization is the growth of cities, brought about by a
population shift from rural areas and small communities to
large ones, and the change from a largely agricultural
economy to an industrial one.
• It is normally caused by the natural increase and human
migration.
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5. KEY FACTS ABOUT URBANIZATION
• In 2009, a major demographic line was crossed:
– More people lived in urban areas than in the rural setting (Reyes et
al., 2013)
• The Urban center is expected to be absorbed by the entirety
of the world’s population by 2050
– Majority of this will be in the developing countries (Reyes et al.,
2013).
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6. KEY FACTS ABOUT URBANIZATION/2
• By 2030, about 60 percent of the world’s population
will be living in cities (United Nations, 2006).
• According to United Nations estimates, the global
urban population will top 6 billion by the year 2050
(Alirol et al., 2011).
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8. BACKGROUND/2
• Diseases can be said to be alteration of the normal
functioning of the body.
• They can be classified as:
– Communicable/infectious diseases
– Non-communicable/chronic diseases
– Injuries
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9. BACKGROUND/3
• Infectious diseases are diseases caused by pathogenic
microorganisms, such as bacteria, viruses, parasites or fungi.
• The disease can be spread, directly or indirectly, from one person
to another.
• The SDG 3.3 asserts that by 2030, there must be an end the
epidemics of AIDS, tuberculosis, malaria and neglected tropical
diseases and combat hepatitis, water-borne diseases and other
communicable diseases (WHO, 2015).
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10. EXAMPLES OF INFECTIOUS DISEASES
• Malaria
• Tuberculosis
• Ebola
• SARS
• HIV
• Zika
• Dengue fever
• Cholera
• Hepatitis B
• Influenza, etc.
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11. THEORETICAL FRAMEWORK
• This presentation is situated in the Epidemiological Transition
Model
– Stage 1: Age of Pestilence
– Stage 2: Receding pandemics
– Stage 3: Man-made/degenerative diseases
– Stage 4: Recurring infectious diseases
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12. KEY ASSUMPTIONS
• Basing on the Epidemiological Transition Model, it can be
assumed that, as nations urbanize:
– The diseases affecting populations evolve from infectious and
parasitic diseases to chronic and degenerative diseases.
– It will get to a point that infectious diseases will re-emerge.
– Highly urbanized areas will experience low incidence of
infectious diseases
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14. URBANIZATION-INFECTIOUS DISEASE
NEXUS
• Studies show that majority of urban dwellers reside in slums
and shanty dwellings (WHO, UNICEF, 2008).
– Typical examples of some settlements include the Favela of
Brazil, slums in Kibera, etc.
• This has ripple effects on the development and spread of
infectious diseases.
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18. MALARIA
• Malaria is an infectious disease
• Urbanization presents entomological, parasitological and
behavioural effects that assists in the reduction of malaria
in the urban and peri-urban centers (Tatem, Gething,
Smith & Hay, 2013).
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19. MALARIA
NUMBER OF DEATHS
Region 2015 2016 2017 % Urban 2017
Africa 432,000 413,000 403,000 43
Americas 320 460 630 80
Eastern Mediterranean 8,660 8,160 8,300 71
Europe 0 0 0 74
South-East Asia 25,200 25,600 19,700 48
Western Pacific 2,860 3,510 3,620 67
Source: World Malaria Report, 2018 p. 42; World Population Data Sheet,
2018
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20. DENGUE
• Dengue is spread by the same Aedes spp. mosquitoes that
also carry yellow fever (Gubler, 2011).
• Dengue is found in tropical and sub-tropical climates
worldwide, mostly in urban and semi-urban areas (WHO, 2019).
– It begins in cities and spreads centrifugally outward to neighboring city
areas, suburbs, and towns (Vazquez-Prokopec, 2010)
– About half of the world's population is now at risk (WHO, 2019).
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21. TUBERCULOSIS
WHO REGION TB % (2017) % URBAN (2017)
Africa 25 43
Americas 3 80
Eastern Mediterranean 7 71
Europe 3 74
South-East Asia 45 48
Western Pacific 17 67
21World TB Report, 2018; World Population Data Sheet, 2018
23. WAY FORWARD
• Effective immunization programmes, even when case
incidence is low.
– There are many reasons for this, including financial constraints and
civil instability, but keeping up and modernizing those programs
might have prevented the resurgence of yellow fever.
• Proper urban planning can help in preventing the incidence
of infectious diseases in the urban environment.
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24. WAY FORWARD
• Surveillance and public education should be constant and based
on a bottom-up community participation and community
ownership approach.
– Active surveillance also requires modern laboratory diagnostic
methods, which may not be readily available in many developing
countries.
– In these instances, a productive strategy is to develop ongoing
partnerships with scientists and laboratories in developed nations.
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26. NATIONAL URBAN POLICY
• National Urban Policy is a coherent set of decisions derived
through a deliberate government-led process of
coordinating and rallying various actors for a common
vision and goal that will promote more transformative,
productive, inclusive and resilient urban development for
the long term.
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27. NATIONAL URBAN POLICY/2
• Urbanization policies ought to cover certain areas
– Urban transportation
– Urban housing
– Education and health
– Urban government
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28. NATIONAL URBAN POLICY/3
•Urbanization policies include
–United Nations Habitat III policy paper (2017)
–South Africa National Urban Policy (2018)
–Ghana National Urban Policy Plan (2012)
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29. GNUPP & HEALTH
• The policy initiative 4.2 of the GNUPP (2012) focuses on preparing
and implementing sanitation action plans for all in the urban
space.
– Specifically, it will prepare and implement comprehensive programmes to
eliminate waste management problems.
– This will help in achieving SDG 3 (good health and wellbeing) and SDG 6
(clean water and sanitation.
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30. GNUPP & HEALTH/2
• The policy initiative 4.11 of the GNUPP (2012) focuses on
public education about the appropriate use of coastal,
wetland and marine resources in the urban space.
– This, when executed effectively will help to reduce the incidence of
open defecation along the coast, hence, reducing the incidence of
cholera and other infectious diseases.
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31. GNUPP & HEALTH/3
• The policy initiative 4.12 of the GNUPP (2012) focuses on hygiene
and quality of food of the urban public.
– Specifically, it strives to achieve this by assessing the sanitary conditions of
the preparation, storage, preservation, handling and presentation of food
in urban Ghana.
– This, when executed effectively will help to reduce the incidence of
infectious diseases such as cholera, diarrhoea, typhoid, dysentery, etc.
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32. CONCLUSION
• We therefore conclude that there is an association between
urbanization and the epidemiology of infectious diseases.
• Urbanization has a two-tail relationship with infectious
diseases
– It can either reduce the incidence of infectious diseases or speed up
the spread of infectious diseases
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