Abstract
Objectives: To summarize the existing knowledge of the impact of climate change on health from previous research in the Eastern Mediterranean region (EMR) and identify knowledge and research gaps.
Methods: Different databases were searched for relevant studies published in the region between 2000 and 2014. The review was limited to studies reporting the impacts of climate change on health or studying associations between meteorological parameters and well-defined human health outcomes.
Results: This systematic review of 78 studies identified many knowledge and research gaps. Research linking climate change and health is scarce in the most vulnerable countries of the region. There is limited information regarding how changes in temperature, precipitation and other weather variables might affect the geographic range and incidence of mortality and morbidity from various diseases. Available research has many limitations and shortcomings that arise from inappropriate study designs, poor assessment of exposure and outcomes, questionable sources of data, lack of standardized methods, poor adjustment of confounders, limited geographical area studies, small sample sizes, poor statistical modeling and not testing for possible interactions between exposures.
Conclusions: Research and information on the effect of climate change on health are limited. Longitudinal studies over extended periods of time that investigate the link between climate change and health are needed. There is a need for studies to be expanded to include more countries in the region and to include other environmental, social and economic factors that might affect the spread of the disease.
Acknowledgments
This research was supported by WHO/CEHA, Amman, Jordan. The funder had no role in the study design, data collection and analysis, interpretation of data, decision to publish or preparation of the manuscript.
References
1. World Meteorological Organization. WMO Statement on the status of the global climate in 2007. Available at: http://www.wmo.int/pages/prog/wcp/wcdmp/documents/WMO1031_EN_web.pdf. Accessed on 2 July 2015.Search in Google Scholar
2. Intergovernmental Panel on Climate Change – IPCC (2007). Climate change 2007: impacts, adaptation and vulnerability. Contribution of Working Group II to the Fourth Assessment Report of the Intergovernmental Panel on Climate Change. Available at: https://www.ipcc.ch/publications_and_data/publications_ipcc_fourth_assessment_report_wg2_report_impacts_adaptation_and_vulnerability.htm. Accessed on 2 July 2015.10.1017/CBO9780511546013Search in Google Scholar
3. El-Zein A, Tewtel-Salem M, Nehme G. A time-series analysis of mortality and air temperature in Greater Beirut. Sci Total Environ 2004;330(1–3):71–80.10.1016/j.scitotenv.2004.02.027Search in Google Scholar PubMed
4. Leone M, D’Ippoliti D, De Sario M, Analitis A, Menne B, et al. A time series study on the effects of heat on mortality and evaluation of heterogeneity into European and Eastern-Southern Mediterranean cities: results of EU CIRCE project. Environ Health 2013;12:55.10.1186/1476-069X-12-55Search in Google Scholar PubMed PubMed Central
5. MacDonald Gibson J, Thomsen J, Launay F, Harder E, DeFelice N. Deaths and medical visits attributable to environmental pollution in the United Arab Emirates. PLoS One 2013;8(3):e57536.10.1371/journal.pone.0057536Search in Google Scholar PubMed PubMed Central
6. Farajzadeh M, Darand M. Analyzing the influence of air temperature on cardiovascular, respiratory and stroke mortality in Tehran. Iran J Environ Health Sci Eng 2009;6:261–70.Search in Google Scholar
7. Khanjani N, Bahrampour A. Temperature and cardiovascular and respiratory mortality in desert climate. A case study of Kerman, Iran. Iranian J Environ Health Sci Eng 2013;10(1):11.10.1186/1735-2746-10-11Search in Google Scholar PubMed PubMed Central
8. Ahmadnezhad E, Holakouie Naieni K, Ardalan A, Mahmoudi M, Yunesian M, et al. Excess mortality during heat waves, Tehran Iran: an ecological time-series study. J Res Health Sci 2013;13(1):24–31.Search in Google Scholar
9. Jaber SM, Ibbini JH, Hijjawi NS, Amdar NM, Huwail MJ, et al. Exploring recent spatial patterns of cutaneous leishmaniasis and their associations with climate in some countries of the Middle East using geographical information systems. Geospat Health 2013;8(1):143–58.10.4081/gh.2013.62Search in Google Scholar PubMed
10. Fakoorziba MR, Baseri A, Eghbal F, Rezaee S, Azizi K, et al. Post-earthquake outbreak of cutaneous leishmaniasis in a rural region of Southern Iran. Ann Trop Med Parasitol 2011;105(3):217–24.10.1179/136485911X12899838683449Search in Google Scholar PubMed PubMed Central
11. Ahmadi NA, Modiri M, Mamdohi S. First survey of cutaneous leishmaniasis in Borujerd county, Western Islamic Republic of Iran. East Mediterr Health J 2013;19(10):847–53.10.26719/2013.19.10.847Search in Google Scholar
12. Toumi A, Chlif S, Bettaieb J, Ben Alaya N, Boukthir A, et al. Temporal dynamics and impact of climate factors on the incidence of zoonotic cutaneous leishmaniasis in central Tunisia. PLoS Negl Trop Dis 2012;6(5):e1633.10.1371/journal.pntd.0001633Search in Google Scholar PubMed PubMed Central
13. Mollalo A, Alimohammadi A, Shirzadi MR, Malek MR. Geographic information system-based analysis of the spatial and spatio-temporal distribution of zoonotic cutaneous leishmaniasis in golestan province, north-East of Iran. Zoonoses Public Health 2015;62(1):18–28.Search in Google Scholar
14. Kassem HA, Siri J, Kamal HA, Wilson ML. Environmental factors underlying spatial patterns of sand flies (Diptera: Psychodidae) associated with leishmaniasis in Southern Sinai, Egypt. Acta Trop 2012;123(1):8–15.10.1016/j.actatropica.2012.02.067Search in Google Scholar PubMed
15. Ben-Ahmed K, Aoun K, Jeddi F, Ghrab J, El-Aroui MA, et al. Visceral leishmaniasis in Tunisia: spatial distribution and association with climatic factors. Am J Trop Med Hyg 2009;81(1):40–5.10.4269/ajtmh.81.1.40Search in Google Scholar
16. Salahi-Moghaddam A, Mohebali M, Moshfae A, Habibi M, Zarei Z. Ecological study and risk mapping of visceral leishmaniasis in an endemic area of Iran based on a geographical information systems approach. Geospat Health 2010;5(1):71–7.10.4081/gh.2010.188Search in Google Scholar
17. Ghatee MA, Sharifi I, Haghdoost AA, Kanannejad Z, Hatam G, et al. Spatial correlations of population and ecological factors with distribution of visceral leishmaniasis cases in southwestern Iran. J Vector Borne Dis 2013;50(3):179–87.Search in Google Scholar
18. Elnaiem DE, Schorscher J, Bendall A,Obsomer V, Osman ME, et al. Risk mapping of visceral leishmaniasis: the role of local variation in rainfall and altitude on the presence and incidence of kala-azar in eastern Sudan. Am J Trop Med Hyg 2003;68(1):10–7.10.4269/ajtmh.2003.68.1.0680010Search in Google Scholar
19. van den Bogaart E, Berkhout MM, Nour AB, Mens PF, Talha AB, et al. Concomitant malaria among visceral leishmaniasis in-patients from Gedarif and Sennar States, Sudan: a retrospective case-control study. BMC Public Health 2013;13:332.10.1186/1471-2458-13-332Search in Google Scholar
20. Al-Mansoob MA, Al-Mazzah MM. The role of climate on Malaria Incidence Rate in four governorates of Yemen. Med J Malaysia 2005;60(3):349–57.Search in Google Scholar
21. El Sayed BB, Arnot DE, Mukhtar MM, Baraka OZ, Dafalla AA, et al. A study of the urban malaria transmission problem in Khartoum. Acta Trop 2000;75(2):163–71.10.1016/S0001-706X(99)00098-4Search in Google Scholar
22. Creasey A, Giha H, Hamad AA, El Hassan IM, Theander TG, et al. Eleven years of malaria surveillance in a Sudanese village highlights unexpected variation in individual disease susceptibility and outbreak severity. Parasitology 2004;129(Pt 3):263–71.10.1017/S0031182004005724Search in Google Scholar
23. Himeidan YE, Hamid EE, Thalib L, Elbashir MI, Adam I. Climatic variables and transmission of falciparum malaria in New Halfa, eastern Sudan. East Mediterr Health J 2007;13(1):17–24.Search in Google Scholar
24. Ageep TB, Cox J, Hassan MM, Knols BG, Benedict MQ, et al. Spatial and temporal distribution of the malaria mosquito Anopheles arabiensis in northern Sudan: influence of environmental factors and implications for vector control. Malar J 2009;8:123.10.1186/1475-2875-8-123Search in Google Scholar
25. Hamad AA, Nugud Ael H, Arnot DE, Giha HA, Abdel-Muhsin AM, et al. A marked seasonality of malaria transmission in two rural sites in eastern Sudan. Acta Trop 2002;83(1):71–82.10.1016/S0001-706X(02)00059-1Search in Google Scholar
26. Himeidan YE, Elzaki MM, Kweka EJ, Ibrahim M, Elhassan IM. Pattern of malaria transmission along the Rahad River basin, Eastern Sudan. Parasit Vectors 2011;4:109.10.1186/1756-3305-4-109Search in Google Scholar PubMed PubMed Central
27. Musa MI, Shohaimi S, Hashim NR, Krishnarajah I. A climate distribution model of malaria transmission in Sudan. Geospat Health 2012;7(1):27–36.10.4081/gh.2012.102Search in Google Scholar PubMed
28. Noor AM, Clements AC, Gething PW, Moloney G, Borle M, et al. Spatial prediction of Plasmodium falciparum prevalence in Somalia. Malar J 2008;7:159.10.1186/1475-2875-7-159Search in Google Scholar
29. Yasinzai MI, Kakarsulemankhel JK. Incidence of human malaria infection in northern hilly region of Balochistan, adjoining with NWFP, Pakistan: district Zhob. Pak J Biol Sci 2008;11(12):1620–4.10.3923/pjbs.2008.1620.1624Search in Google Scholar
30. Adimi F, Soebiyanto RP, Safi N, Kiang R. Towards malaria risk prediction in Afghanistan using remote sensing. Malar 2010;9:125.10.1186/1475-2875-9-125Search in Google Scholar
31. Moemenbellah-Fard MD, Saleh V, Banafshi O, Dabaghmanesh T. Malaria elimination trend from a hypo-endemic unstable active focus in southern Iran: predisposing climatic factors. Pathog Glob Health 2012;106(6):35.10.1179/2047773212Y.0000000049Search in Google Scholar
32. Ostovar A, Raeisi A, Haghdoost AA, Ranjbar M, Rahimi A, et al. Lessons learnt from malaria epidemics in the Islamic Republic of Iran. East Mediterr Health J 2012;18(8):864–9.10.26719/2012.18.8.864Search in Google Scholar
33. Khalid B, Ghaffar A. Dengue transmission based on urban environmental gradients in different cities of Pakistan. Int J Biometeorol 2015;59(3):267–83.10.1007/s00484-014-0840-6Search in Google Scholar
34. Munir MA, Alam SE, Khan ZU, Saeed Q, Arif A, et al. Dengue fever in patients admitted in tertiary care hospitals in Pakistan. J Pak Med Assoc 2014;64(5):553–9.Search in Google Scholar
35. Khan E, Kisat M, Khan N, Nasir A, Ayub S, et al. Demographic and clinical features of dengue fever in Pakistan from 2003–2007: a retrospective cross-sectional study. PLoS One 2010;5(9):e12505.10.1371/journal.pone.0012505Search in Google Scholar
36. Khormi HM, Kumar L, Elzahrany RA. Modeling spatio-temporal risk changes in the incidence of Dengue fever in Saudi Arabia: a geographical information system case study. Geospat Health 2011;6(1):77–84.10.4081/gh.2011.159Search in Google Scholar
37. Aziz AT, Dieng H, Ahmad AH, Mahyoub JA, Turkistani AM, et al. Household survey of container-breeding mosquitoes and climatic factors influencing the prevalence of Aedes aegypti (Diptera: Culicidae) in Makkah City, Saudi Arabia. Asian Pac J Trop Biomed 2012;2(11):849–57.10.1016/S2221-1691(12)60242-1Search in Google Scholar
38. Ansari H, Shahbaz B, Izadi S, Zeinali M, Tabatabaee SM, et al. Crimean-Congo hemorrhagic fever and its relationship with climate factors in southeast Iran: a 13-year experience. J Infect Dev Ctries 2014;8(6):749–57.10.3855/jidc.4020Search in Google Scholar PubMed
39. Mostafavi E, Chinikar S, Bokaei S, Haghdoost A. Temporal modeling of Crimean-Congo hemorrhagic fever in Eastern Iran. Int J Infect Dis 2013;17(7):e524–8.10.1016/j.ijid.2013.01.010Search in Google Scholar PubMed
40. Sheikh AS, Sheikh AA, Sheikh NS, Rafi-U-Shan, Asif M, et al. Bi-annual surge of Crimean-Congo haemorrhagic fever (CCHF): a five-year experience. Int J Infect Dis 2005;9(1):37–42.10.1016/j.ijid.2004.02.007Search in Google Scholar PubMed
41. Hassan OA, Ahlm C, Evander M. A need for One Health approach – lessons learned from outbreaks of Rift Valley fever in Saudi Arabia and Sudan. Infect Ecol Epidemiol 2014;4:20710.10.3402/iee.v4.20710Search in Google Scholar PubMed PubMed Central
42. Hassan OA, Ahlm C, Sang R, Evander M. The 2007 Rift Valley fever outbreak in Sudan. PLoS Negl Trop Dis 2011;5(9):e1229.10.1371/journal.pntd.0001229Search in Google Scholar PubMed PubMed Central
43. Conley AK, Fuller DO, Haddad N, Hassan AN, Gad AM, et al. Modeling the distribution of the West Nile and Rift Valley Fever vector Culex pipiens in arid and semi-arid regions of the Middle East and North Africa. Parasit Vectors 2014;7:289.10.1186/1756-3305-7-289Search in Google Scholar PubMed PubMed Central
44. Feki I, Marrakchi C, Ben Hmida M, Belahsen F, Ben Jemaa M, et al. Epidemic West Nile virus encephalitis in Tunisia. Neuroepidemiology 2005;24(1–2):1–7.10.1159/000081042Search in Google Scholar PubMed
45. Baig SA, Xu X, Khan R. Microbial water quality risks to public health: potable water assessment for a flood-affected town in northern Pakistan. Rural Remote Health 2012;12:2196.10.22605/RRH2196Search in Google Scholar
46. Bokhari H, Shah MA, Asad S, Akhtar S, Akram M, et al. Escherichia coli pathotypes in Pakistan from consecutive floods in 2010 and 2011. Am J Trop Med Hyg 2013;88(3):519–25.10.4269/ajtmh.12-0365Search in Google Scholar PubMed PubMed Central
47. Alam M, Akhtar YN, Ali SS, Ahmed M, Atiq M, et al. Seasonal variation in bacterial pathogens isolated from stool samples in Karachi, Pakistan. J Pak Med Assoc 2003;53(3):125–9.Search in Google Scholar
48. El-Gilany AH, Hammad S. Epidemiology of diarrhoeal diseases among children under age 5 years in Dakahlia, Egypt. East Mediterr Health J 2005;11(4):762–75.Search in Google Scholar
49. Wierzba TF, Abdel-Messih IA, Abu-Elyazeed R, Putnam SD, Kamal KA, et al. Clinic-based surveillance for bacterial- and rotavirus-associated diarrhea in Egyptian children. Am J Trop Med Hyg 2006;74(1):148–53.10.4269/ajtmh.2006.74.148Search in Google Scholar
50. Ben Aissa R, Al-Gallas N, Troudi H, Belhadj N, Belhadj A. Trends in Salmonella enterica serotypes isolated from human, food, animal, and environment in Tunisia, 1994-2004. J Infect 2007;55(4):324–39.10.1016/j.jinf.2007.06.007Search in Google Scholar PubMed
51. Battikhi MN. Occurrence of Salmonella typhi and Salmonella paratyphi in Jordan. New Microbiol 2003;26(4):363–73.Search in Google Scholar
52. Pezeshki Z, Tafazzoli-Shadpour M, Mansourian A, Eshrati B, Omidi E, et al. Model of cholera dissemination using geographic information systems and fuzzy clustering means: case study, Chabahar, Iran. Public Health 2012;126(10):881–7.10.1016/j.puhe.2012.07.002Search in Google Scholar PubMed
53. Shah MA, Mutreja A, Thomson N, Baker S, Parkhill J, et al. Genomic epidemiology of Vibrio cholerae O1 associated with floods, Pakistan, 2010. Emerg Infect Dis 2014;20(1):13–20.10.3201/eid2001.130428Search in Google Scholar
54. Hashizume M, Faruque AS, Terao T, Ynus M, Streatfield K, et al. The Indian Ocean dipole and cholera incidence in Bangladesh: a time-series analysis. Environ Health Perspect 2011;119(2):239–44.10.1289/ehp.1002302Search in Google Scholar PubMed PubMed Central
55. Masjedi MR, Jamaati HR, Dokouhaki P, Ahmadzadeh Z, Taheri SA, et al. The effects of air pollution on acute respiratory conditions. Respirology 2003;8(2):213–30.10.1046/j.1440-1843.2003.00455.xSearch in Google Scholar PubMed
56. Ghozikali MG, Mosaferi M, Safari GH, Jaafari J. Effect of exposure to O3, NO2, and SO2 on chronic obstructive pulmonary disease hospitalizations in Tabriz, Iran. Environ Sci Pollut Res Int 2015;22(4):2817–23.10.1007/s11356-014-3512-5Search in Google Scholar PubMed
57. Abu Sham’a F, Skogstad M, Nijem K, Bjertness E, Kristensen P. Lung function and respiratory symptoms in male Palestinian farmers. Arch Environ Occup Health 2010;65(4):191–200.10.1080/19338241003730911Search in Google Scholar PubMed
58. Thalib L, Al-Taiar A. Dust storms and the risk of asthma admissions to hospitals in Kuwait. Sci Total Environ 2012;433:347–51.10.1016/j.scitotenv.2012.06.082Search in Google Scholar PubMed
59. Al-Taiar A, Thalib L. Short-term effect of dust storms on the risk of mortality due to respiratory, cardiovascular and all-causes in Kuwait. Int J Biometeorol 2014;58(1):69–77.10.1007/s00484-012-0626-7Search in Google Scholar PubMed
60. Meo SA, Al-Kheraiji MF, Alfaraj ZF, Alwehaibi NA, Aldereihim AA. Respiratory and general health complaints in subjects exposed to sandstorm at Riyadh, Saudi Arabia. Pak J Med Sci 2013;29(2):642–6.10.12669/pjms.292.3065Search in Google Scholar PubMed PubMed Central
61. Talaei A, Hedjazi A, Rezaei Ardani A, Fayyazi Bordbar MR, Talaei A. The relationship between meteorological conditions and homicide, suicide, rage, and psychiatric hospitalization. J Forensic Sci 2014;59(5):1397–402.10.1111/1556-4029.12471Search in Google Scholar PubMed
62. Amr M, Volpe FM. Seasonal influences on admissions for mood disorders and schizophrenia in a teaching psychiatric hospital in Egypt. J Affect Disord 2012;137(1–3):56–60.10.1016/j.jad.2011.12.039Search in Google Scholar PubMed
63. Zawahri MZ. Weather and the first episode of schizophrenia. Neurosciences (Riyadh) 2002;7(1):43–5.Search in Google Scholar
64. El-Shaer M, Rosenzweig C, Iglesias A, Eid H, Hellil D. Impact of climate change on possible scenarios for Egyptian agriculture in the future. Mitigation Adapt Strateg Glob Change 1997;1: 233–50.10.1007/BF00517805Search in Google Scholar
65. Doocy S, Leidman E, Aung T, Kirsch T. Household economic and food security after the 2010 Pakistan floods. Food Nutr Bull 2013;34(1):95–103.10.1177/156482651303400110Search in Google Scholar PubMed
66. Gohari A, Eslamian S, Abedi-Koupaei J, Massah Bavani A, Wang D, et al. Climate change impacts on crop production in Iran’s Zayandeh-Rud River Basin. Sci Total Environ 2013;442:405–19.10.1016/j.scitotenv.2012.10.029Search in Google Scholar PubMed
67. Shabani F, Shahhosseini Z, Shabani A. Comparison of the effects of mediterranean temperate and cold mountain climates on human fertility. Mater Sociomed 2014;26(2):119–21.10.5455/msm.2014.119-121Search in Google Scholar
68. Nasiri R, Ahmadi Shadmehri A, Khajeh Ghiassi P, Sarafraz Yazdi M, Mazloum Farsi Baf M. Association of meteorological factors and seasonality with preeclampsia: a 5-year study in northeast of Iran. Clin Exp Hypertens 2014;36(8):586–9.10.3109/10641963.2014.881847Search in Google Scholar PubMed
69. Shakoor S, Beg MA, Mahmood SF, Bandea R, Sriram R, et al. Primary amebic meningoencephalitis caused by Naegleria fowleri, Karachi, Pakistan. Emerg Infect Dis 2011;17(2):258–61.10.3201/eid1702.100442Search in Google Scholar PubMed PubMed Central
70. Muhammad R, Khan F, ul Abrar S, Khan MR, Rehman F, et al. Effect of temperature and humidity on epistaxis in Hazara division. J Ayub Med Coll Abbottabad 2013;25(3–4):61–3.Search in Google Scholar
71. Saad-Hussein A, El-Mofty HM, Hassanien MA. Climate change and predicted trend of fungal keratitis in Egypt. East Mediterr Health J 2011;17(6):468–73.10.26719/2011.17.6.468Search in Google Scholar
72. Aminzadeh M, Chomeili B, Riahi K, Dehdashtian M, Cheraghian B, et al. Effect of temperature changes on the occurrence of congenital hypothyroidism. J Med Screen 2010;17(3):121–4.10.1258/jms.2010.010026Search in Google Scholar PubMed
73. Freeg MA, Sreedharan J, Muttappallymyalil J, Venkatramana M, Shaafie IA, et al. A retrospective study of the seasonal pattern of urolithiasis. Saudi J Kidney Dis Transpl 2012;23(6):1232–7.Search in Google Scholar
74. Qasem JA, Nasrallah H, Al-Khalaf BN, Al-Sharifi F, Al-Sherayfee A, et al. Meteorological factors, aeroallergens and asthma-related visits in Kuwait: a 12-month retrospective study. Ann Saudi Med 2008;28(6):435–41.Search in Google Scholar
75. Hasnain SM, Akhter T, Waqar MA. Airborne and allergenic fungal spores of the Karachi environment and their correlation with meteorological factors. J Environ Monit 2012;14(3):1006–13.10.1039/c2em10545dSearch in Google Scholar PubMed
76. Li Y, Gibson JM, Jat P, Puggioni G, Hasan M, et al. Burden of disease attributed to anthropogenic air pollution in the United Arab Emirates: estimates based on observed air quality data. Sci Total Environ 2010;408(23):5784–93.10.1016/j.scitotenv.2010.08.017Search in Google Scholar PubMed
77. Gholampour A, Nabizadeh R, Naseri S, Yunesian M, Taghipour H, et al. Exposure and health impacts of outdoor particulate matter in two urban and industrialized area of Tabriz, Iran. J Environ Health Sci Eng 2014;12(1):27.10.1186/2052-336X-12-27Search in Google Scholar PubMed PubMed Central
78. Leski TA, Malanoski AP, Gregory MJ, Lin B, Stenger DA. Application of a broad-range resequencing array for detection of pathogens in desert dust samples from Kuwait and Iraq. Appl Environ Microbiol 2011;77(13):4285–92.10.1128/AEM.00021-11Search in Google Scholar PubMed PubMed Central
79. Elshabrawy WO, Ismail HA, Hassanein KM. The impact of environmental and agricultural pollutants on the prevalence of allergic diseases in people from Qassim, KSA. Int J Health Sci (Qassim) 2014;8(1):21–31.10.12816/0006068Search in Google Scholar PubMed PubMed Central
80. Mahboub B, Al-Hammadi S, Prakash VP, Sulaiman N, Blaiss MS, et al. Prevalence and triggers of allergic rhinitis in the United Arab Emirates. World Allergy Organ J 2014;7(1):19.10.1186/1939-4551-7-19Search in Google Scholar PubMed PubMed Central
81. Habib RR, Zein KE, Ghanawi J. Climate change and health research in the Eastern Mediterranean Region. Ecohealth 2010;7(2):156–75.10.1007/s10393-010-0330-1Search in Google Scholar PubMed
82. Khan N, Awan H, Malik S. A study of the effects of climate change on human health in Pakistan: evidence-based policy advocacy. Available at: http://pk.sightsavers.org/in_depth/policy_and_research/15837_climatechange.pdf.Search in Google Scholar
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