Improvements in housing quality, including private treated water and toilets, and the planning of community spaces can prevent human and animal exposure to infectious diseases. Climate change is increasing the amount and frequency of rain events, which in urban settings increases the demand on stormwater systems for management of floodwater. Informal settlements, common in cities around the world, tend to have little to no stormwater infrastructure and as a result experience severe pluvial (runoff-based) flooding events that transmit pathogens in the environment and trigger outbreaks of diarrhea, typhoid, cholera, and other waterborne diseases. The transdisciplinary NIH-funded US and Kenya-led PATHOME Study (PATHOME -) aims to identify which urban community development interventions alone or in combination are most effective at preventing the transmission of enteric pathogens that cause those diseases to young children. Among other questions, the research team is examining how household vulnerability to pluvial flooding varies between low- and middle-income urban communities and the extent to which flooding causes infections in infants.
Climate change is increasing the duration and severity of drought in already dry regions of the world, which disrupts local food supply and causes widespread food insecurity and malnutrition. Dr. Baker’s group is collaborating with Addis Ababa University and the University of Memphis to identify strategies that can be implemented to prevent food insecurity and malnutrition in children in drought-prone regions of rural Ethiopia. Sustainable strategies for drought resiliency may require multi-pronged efforts that strengthen reliance upon native plant and animal food sources, community-led social support systems, and individual resiliency practices..
Millions of Americans and their animals rely upon rural wells for water. National water safety regulations (EPA Safe Drinking Water Act) do not regulate and protect well water quality. However, severe flooding can carry surface pollution down into the aquifers that supply rural wells, potentially posing a variety of health risks to humans and animals when consumed. Droughts, in combination with sustained water withdrawals, could also exacerbate health risks. Dr. Baker is collaborating with the Center for Health Effects of Environmental Contamination on a study examining how the microbial ecology of water from rural wells in Iowa is influenced by recent flood and drought conditions and whether these conditions may contribute to contamination by known disease causing microbes.
The Carter Center and their national and community partners throughout Africa have successfully reduced the number of cases of guinea worm from over 3 million cases per year around four decades ago to just a handful of cases per year as of last year. Eradication of this disease would make it only the third disease after smallpox and rinderpest to disappear from the planet. Eradication efforts have been challenged by the discovery in recent decades that primates, as well as animals with close human contact like dogs, can also carry the disease and pass it to humans. The primary source of animal infections is unknown but could be caused by movement between different ecological settings, which varies with seasonal weather conditions. Thus, changes in seasonal climates may also be disrupting eradication efforts. Dr. Baker’s team is working with the Carter Center and their national and community partners to understand where, how, and when animals in transmission areas acquire infects to inform on which One Health interventions could eradicate infections in animals and humans.
Many social, environmental, and individual lifestyle factors can negatively affect the growth and development of children in utero. “Environmental deprivation” refers to living in an environment with limited resources to protect one’s health and is an outcome of environmental injustice in investment in neighborhoods. In the US it has been linked to higher rates of delivery of preterm and low birth weight infants. Dr. Baker’s work with colleagues in India, Texas, and Iowa has shown that rural Indian women who lack nearby access to drinking and bathing water face higher risks of delivering preterm and low birth weight infants. This team is working to understand causal mechanisms between water insecurity and birth outcomes to identify targeted intervention strategies that can improve the number of healthy term babies born in India.
Seasonal weather patterns correlate with peaks in infectious diseases, including waterborne cholerae and typhoid fever. The frequency, geographic area, and severity of seasonal infectious disease outbreaks are expected to grow with projected changes in climate. In parallel, more cases are being detected in outbreaks that are caused by bacteria that have developed resistance to frontline antibiotics, increasing the chances of prolonged disease and death in patients. Rapid accurate diagnostics and surveillance tools that that can be locally manufactured to detect enteric and antimicrobial resistant enteric infections could significantly improve early detection of outbreaks and effective diagnosis and treatment of patients, especially if deployed through climate early warning systems. Dr. Baker collaborates with GoDiagnostics Inc., a biotech start-up company, and her long-standing research partners in Bangladesh and Kenya on two NIH-supported studies to develop and test rapid diagnostic tools for enteric and antimicrobial pathogens.