Tree cover loss due to fires and pneumonia incidence in the Bolivian Amazon from 2002-2023: An ecological study

The following abstract is part of the collection for the Planetary Health Annual Meeting 2025.

ABSTRACT

Background: Bolivia has lost approximately 12% of its forest cover since 2000. Preserving the Amazon is crucial for both planetary health and local population wellbeing. Deforestation has been linked to adverse health outcomes, notably through slash-and-burn techniques that increase air pollution and contribute to respiratory and infectious diseases. This study examines the relationship between tree cover loss due to fire and pneumonia incidence in the Biogeographical Bolivian Amazon.

Methods: We analyzed yearly municipal panel data from 2002-2023 (n=89 municipalities) on registered pneumonia cases from the National System of Health Information – Epidemiological Surveillance (SNISVE) alongside tree cover loss (especially due to fires) data from Global Forest Watch. We used negative binomial regression models with fixed effects for year and municipality and a population offset to estimate rate ratios (RRs). Models were adjusted for socioeconomic covariates obtained from the National Institute of Statistics (INE) and were stratified by sex, age and pre/post-pneumococcal vaccine introduction (2014).

Findings: Overall tree cover loss was consistently associated with pneumonia incidence, with stronger effects for fire-related loss. In the adjusted model for the total population studied, a 1% increase in the rate of tree cover loss due to fires was associated with a 37% rise in pneumonia incidence (95% CI=14– 65, p=0.001). This association remained notable even after vaccine introduction (18%, 95% CI=2–37, p=0.02).

Interpretation: Tree cover loss due to fire is strongly associated with increased pneumonia incidence in the Bolivian Amazon, emphasizing the need for effective forest preservation to protect both tropical ecosystems and public health.