Understanding diarrhoeal diseases in response to climate variability and drought in Cape Town, South Africa: a mixed methods approach
| dc.contributor.author | Lee, Tristan T. | |
| dc.contributor.author | Dalvie, Mohamed A. | |
| dc.contributor.author | Röösli, Martin | |
| dc.contributor.author | Merten, Sonja | |
| dc.contributor.author | Kwiatkowski, Marek | |
| dc.contributor.author | Mahomed, Hassan | |
| dc.contributor.author | Sweijd, Neville | |
| dc.contributor.author | Cissé, Guéladio | |
| dc.date.accessioned | 2023-09-13T12:39:42Z | |
| dc.date.available | 2023-09-13T12:39:42Z | |
| dc.date.issued | 2023-08-18 | |
| dc.date.updated | 2023-08-20T03:09:18Z | |
| dc.description.abstract | Background The 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. Methods Using 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. Results From 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. Conclusions We 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. | |
| dc.identifier.apacitation | Lee, Tristan T., Dalvie, Mohamed A., Röösli, M., Merten, S., Kwiatkowski, M., Mahomed, H., ... Cissé, G. (2023). Understanding diarrhoeal diseases in response to climate variability and drought in Cape Town, South Africa: a mixed methods approach. <i>Infectious Diseases of Poverty</i>, 12(1), 76. http://hdl.handle.net/11427/38586 | en_ZA |
| dc.identifier.chicagocitation | Lee, Tristan T., Mohamed A. Dalvie, Martin Röösli, Sonja Merten, Marek Kwiatkowski, Hassan Mahomed, Neville Sweijd, and Guéladio Cissé "Understanding diarrhoeal diseases in response to climate variability and drought in Cape Town, South Africa: a mixed methods approach." <i>Infectious Diseases of Poverty</i> 12, 1. (2023): 76. http://hdl.handle.net/11427/38586 | en_ZA |
| dc.identifier.citation | Lee, Tristan T., Dalvie, Mohamed A., Röösli, M., Merten, S., Kwiatkowski, M., Mahomed, H., Sweijd, N. & Cissé, G. et al. 2023. Understanding diarrhoeal diseases in response to climate variability and drought in Cape Town, South Africa: a mixed methods approach. <i>Infectious Diseases of Poverty.</i> 12(1):76. http://hdl.handle.net/11427/38586 | en_ZA |
| dc.identifier.ris | TY - Journal Article AU - Lee, Tristan T. AU - Dalvie, Mohamed A. AU - Röösli, Martin AU - Merten, Sonja AU - Kwiatkowski, Marek AU - Mahomed, Hassan AU - Sweijd, Neville AU - Cissé, Guéladio AB - Abstract Background The 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. Methods Using 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. Results From 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. Conclusions We 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. DA - 2023-08-18 DB - OpenUCT DP - University of Cape Town IS - 1 KW - Diarrhoea KW - Children KW - Climate variability KW - Climate change KW - Water scarcity KW - Sub-Saharan Africa LK - https://open.uct.ac.za PY - 2023 T1 - Understanding diarrhoeal diseases in response to climate variability and drought in Cape Town, South Africa: a mixed methods approach TI - Understanding diarrhoeal diseases in response to climate variability and drought in Cape Town, South Africa: a mixed methods approach UR - http://hdl.handle.net/11427/38586 ER - | en_ZA |
| dc.identifier.uri | https://doi.org/10.1186/s40249-023-01127-7 | |
| dc.identifier.uri | http://hdl.handle.net/11427/38586 | |
| dc.identifier.vancouvercitation | Lee Tristan T, Dalvie Mohamed A, Röösli M, Merten S, Kwiatkowski M, Mahomed H, et al. Understanding diarrhoeal diseases in response to climate variability and drought in Cape Town, South Africa: a mixed methods approach. Infectious Diseases of Poverty. 2023;12(1):76. http://hdl.handle.net/11427/38586. | en_ZA |
| dc.language.rfc3066 | en | |
| dc.publisher | BioMed Central | |
| dc.publisher.department | Centre for Environmental and Occupational Health Research | |
| dc.publisher.faculty | Health Science | |
| dc.rights.holder | National Institute of Parasitic Diseases | |
| dc.rights.uri | http://creativecommons.org/licenses/by/4.0/ | |
| dc.source | Infectious Diseases of Poverty | |
| dc.source.journalissue | 1 | |
| dc.source.journalvolume | 12 | |
| dc.source.pagination | 76 | |
| dc.source.uri | https://idpjournal.biomedcentral.com/ | |
| dc.subject | Diarrhoea | |
| dc.subject | Children | |
| dc.subject | Climate variability | |
| dc.subject | Climate change | |
| dc.subject | Water scarcity | |
| dc.subject | Sub-Saharan Africa | |
| dc.title | Understanding diarrhoeal diseases in response to climate variability and drought in Cape Town, South Africa: a mixed methods approach | |
| dc.type | Journal Article |