Understanding diarrhoeal diseases in response to climate variability and drought in Cape Town, South Africa: a mixed methods approach

Infectious Diseases of Poverty

Research Article

Neville Sweijd¹  Mohamed Aqiel Dalvie²  Hassan Mahomed³  Sonja Merten⁴  Tristan Taylor Lee⁴  Martin Röösli⁴  Marek Kwiatkowski⁴  Guéladio Cissé⁴ 

[1]Alliance for Collaboration on Climate and Earth Systems Science, Council for Scientific and Industrial Research, Pretoria, South Africa

[2]Centre for Environmental and Occupational Health Research, School of Public Health, University of Cape Town, Cape Town, South Africa

[3]Metro Health Services, Western Cape Government: Health and Wellness, Western Cape, South Africa

[4]Division of Health Systems and Public Health, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa

[5]Swiss Tropical and Public Health Institute, Allschwil, Switzerland

[6]University of Basel, Basel, Switzerland

关键词: Diarrhoea;    Children;    Climate variability;    Climate change;    Water scarcity;    Sub-Saharan Africa;   

DOI  :  10.1186/s40249-023-01127-7

 received in 2023-04-28, accepted in 2023-08-03,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundThe climate of southern Africa is expected to become hotter and drier with more frequent severe droughts and the incidence of diarrhoea to increase. From 2015 to 2018, Cape Town, South Africa, experienced a severe drought which resulted in extreme water conservation efforts. We aimed to gain a more holistic understanding of the relationship between diarrhoea in young children and climate variability in a system stressed by water scarcity.MethodsUsing a mixed-methods approach, we explored diarrhoeal disease incidence in children under 5 years between 2010 to 2019 in Cape Town, primarily in the public health system through routinely collected diarrhoeal incidence and weather station data. We developed a negative binomial regression model to understand the relationship between temperature, precipitation, and relative humidity on incidence of diarrhoea with dehydration. We conducted in-depth interviews with stakeholders in the fields of health, environment, and human development on perceptions around diarrhoea and health-related interventions both prior to and over the drought, and analysed them through the framework method.ResultsFrom diarrhoeal incidence data, the diarrhoea with dehydration incidence decreased over the decade studied, e.g. reduction of 64.7% in 2019 [95% confidence interval (CI): 5.5–7.2%] compared to 2010, with no increase during the severe drought period. Over the hot dry diarrhoeal season (November to May), the monthly diarrhoea with dehydration incidence increased by 7.4% (95% CI: 4.5–10.3%) per 1 °C increase in temperature and 2.6% (95% CI: 1.7–3.5%) per 1% increase in relative humidity in the unlagged model. Stakeholder interviews found that extensive and sustained diarrhoeal interventions were perceived to be responsible for the overall reduction in diarrhoeal incidence and mortality over the prior decade. During the drought, as diarrhoeal interventions were maintained, the expected increase in incidence in the public health sector did not occur.ConclusionsWe found that that diarrhoeal incidence has decreased over the last decade and that incidence is strongly influenced by local temperature and humidity, particularly over the hot dry season. While climate change and extreme weather events especially stress systems supporting vulnerable populations such as young children, maintaining strong and consistent public health interventions helps to reduce negative health impacts.

【 授权许可】

CC BY   
© National Institute of Parasitic Diseases 2023

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