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Article

A Study of Climate-Sensitive Diseases in Climate-Stressed Areas of Bangladesh

by
Ahammadul Kabir
1,*,
Shahidul Alam
2,
Nusrat Jahan Tarin
2,
Shila Sarkar
1,
Anthony Eshofonie
1,
Mohammad Ferdous Rahman Sarker
3,
Abul Kashem Shafiqur Rahman
2 and
Tahmina Shirin
3
1
World Health Organization, Gulshan-1, Dhaka 1212, Bangladesh
2
Bangladesh Center for Communication Programs, Mirpur, Dhaka 1216, Bangladesh
3
Institute of Epidemiology Disease Control and Research, Mohakhali, Dhaka 1212, Bangladesh
*
Author to whom correspondence should be addressed.
Climate 2025, 13(8), 166; https://doi.org/10.3390/cli13080166
Submission received: 17 June 2025 / Revised: 8 July 2025 / Accepted: 10 July 2025 / Published: 5 August 2025
(This article belongs to the Section Climate and Environment)
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Abstract

The National Adaptation Plan of Bangladesh identifies eleven climate-stressed zones, placing nearly 100 million people at high risk of climate-related hazards. Vulnerable groups such as the poor, floating populations, daily laborers, and slum dwellers are particularly affected. However, there is a lack of data on climate-sensitive diseases and related hospital visits in these areas. This study explored the prevalence of such diseases using the Delphi method through focus group discussions with 493 healthcare professionals from 153 hospitals in 156 upazilas across 21 districts and ten zones. Participants were selected by district Civil Surgeons. Key climate-sensitive diseases identified included malnutrition, diarrhea, pneumonia, respiratory infections, typhoid, skin diseases, hypertension, cholera, mental health disorders, hepatitis, heat stroke, and dengue. Seasonal surges in hospital visits were noted, influenced by factors like extreme heat, air pollution, floods, water contamination, poor sanitation, salinity, and disease vectors. Some diseases were zone-specific, while others were widespread. Regions with fewer hospital visits often had higher disease burdens, indicating under-reporting or lack of access. The findings highlight the need for area-specific adaptation strategies and updates to the Health National Adaptation Plan. Strengthening resilience through targeted investment and preventive measures is crucial to reducing health risks from climate change.

1. Introduction

Climate change is a global concern that effects nations worldwide but is disproportionately hurting low- and middle-income countries (LMICs) [1]. Coastal and deltaic countries like Bangladesh have increased risks owing to their topographical susceptibility and constrained adaptive capacity. The global climate risk index indicates that Bangladesh is among the nations most impacted by climate change, exposing a wider pattern of intensifying climate-related difficulties in the regions [2]. The recent findings from the analysis of daily maximum/minimum temperature during the period of 1980–2020 indicated that the country is entering a warmer climate; the total precipitation for the period 1980–2023 indicated that there were no strong or widespread changes in the annual total rainfall, but spatial variation was observed across the country [3].
People are susceptible to different types of climate-related hazards such as floods, flash floods, cyclones, heat waves, cold waves, droughts, storms, hailstorms, shoreline recession, tidal surges, salinity intrusion, riverbank erosion, and relative sea-level rise [4]. It has been observed since 2000 that the number of extreme-weather-related events including droughts, floods, and cyclones affecting Bangladesh has increased by 46% [5], and these are expected to further increase and become frequent in coming years [6]. The recently published National Adaptation Plan (NAP) of Bangladesh [7] identified 11 climate-stressed areas in the country, which covers approximately 305,348 km2 of the land out of 147,570 km2 and a vulnerable population of 100 million out of 170 million based on different climate hazards. Poverty-stricken people, floating populations, daily laborers, and slum residents in Bangladesh are all vulnerable to a variety of climate-related risks. In Bangladesh, women are more sensitive to climate-related hazards than men [8].
Extreme climate events affect human health and health systems by changing the severity, duration, or frequency of different disease outcomes. Several scientific investigations have revealed new information to better identify health vulnerability in qualitative and quantitative dimensions than previously, e.g., a significant co-relationship found between the climatic factors and kala-azar incidence in three endemic districts of Bangladesh [9]. The number of dengue cases pre-monsoon (2016), post-monsoon (2018), and post-monsoon (2023) illustrated that it has been increasing significantly [10]. An explosion of chikungunya happened for the first time in Bangladesh in 2017 [11]. A study showed that if the average monthly temperature in Bangladesh increases by 1 °C then diarrhea patients will increase by 5% [12]. During the period before one El Niño episode (1997–1998), admissions for diarrhea increased by 8% per 1 °C increase in mean ambient temperature [13]. In addition, climate change also has significant indirect effects on the psycho-social well-being and food and health security [14] of individuals and communities [15].
Hence, it is evident that climate change has been creating health problems with variable degrees in an unprecedented or unanticipated way. It is essential to know which climate-sensitive diseases lead to the most hospital visits by people in the identified climate-stressed areas according to the NAP. In general, it needs to be noted that climate-sensitive diseases are those that are impacted by changes in the environment and climate. Hence, the WHO and IEDCR conducted this study with the objective of identifying the occurrence of different climate-sensitive diseases and gathering qualitative data on hospital visits among communities in 10 climate-stressed areas. The findings of this study will help develop stressed-area-specific health adaptation planning to address these health issues.

2. Methods

2.1. Study Design

The study design of this research was exploratory to understand the status of climate-sensitive disease (CSDs) in ten out of eleven climate-stressed areas of Bangladesh [16] in terms of hospital visits qualitatively. The study design is presented in Figure 1. Focus group discussions followed by group work were conducted in ten climate-vulnerable areas of the country with public health professionals of primary- (sub-district level), secondary- (district level), and tertiary-level (divisional level) hospitals. They received training on climate change and health before the group discussion. The participants provided information on climate-sensitive diseases with climatic reasons in the focus group discussions. The information provided by the participants in the group work was categorized at five levels of hospital visits: (i) severe, (ii) severe to moderate, (iii) moderate, (iv) moderate to mild, and (v) mild. The degree of severity of hospital visits with respect to the climate-stressed area and probable reasons were identified from the categorized hospital visits for different climate-sensitive diseases. This study was started in April 2024 and ended on 20 August 2024.

2.2. Method, Tools, and Sample Type and Size

The study method was qualitative, and the tool used was focus group discussion. The name of the qualitative method was Delphi [17], and it was used for achieving expert consensus on climate-sensitive diseases in different climate-stressed areas of the country. A format was developed (Supplementary Materials) and used for collecting data and information on climate-sensitive diseases and respective climatic reasons from the focus group discussion. The participants of the focus group discussion were the public hospital managers, doctors, and nurses of primary-, secondary-, and tertiary-level hospitals of the climate-stressed areas selected by the Civil Surgeon of the selected district. The total number of public healthcare facilities considered in the study was 153 (1 tertiary, 16 secondary, and 136 primary healthcare facilities), which were purposively selected due to their location considering the higher degree of climate variability and extreme events. A total of 493 participants (59% were male and 41% were female) participated in the focus group discussion through 25 sessions in different climate-stressed areas of the country. The distribution of participants with respect to climate-stressed area, district, and upazila (sub-district) is presented in Table 1.

2.3. Training of Participating Health Professionals

All the selected public health professionals (493) received training on climate change and health before the group discussion. The training method was a blend of lecture sessions and group work aimed at increasing participants’ knowledge of climate change, health impacts, and climate-sensitive diseases. The lecture sessions consisted of numerous topics on climate change and health, and these were climate change from a Bangladesh perspective, extreme weather, climate change and disease outcomes, vector-borne diseases, water-borne diseases, food security, air pollution, assessing health vulnerability, adaptation/mitigation, community engagement and community-based adaptation, management, and challenges to meet the health outcome. A questionnaire (Supplementary Materials) consisting of 20 questions was prepared for evaluating the improvement of knowledge of the participants with a total score of 20. Pre- and post-tests were conducted with the same questionnaire to measure the improvement of knowledge on climate change and health impact. The results of the pre- and post-test were categorized as follows: <5 points as low, 6 to 10 points as moderate, 11 to 15 points as high, and greater than 15 points as very high. Throughout the training, gender-neutral terminology was used to make the training event gender-sensitive. In the group work, the trained health professionals of each of the healthcare centers discussed the climate-sensitive diseases in consideration of the extent of impact, the attendance of patients in the hospitals, the frequency of illness, and the adaptation plan. The findings of the group work were presented in the plenary discussion, and the taring participants validated the results.

2.4. Sampling Sites

This study included 10 climate-stressed areas out of 11 (Figure 2, source: National Adaptation Plan Bangladesh) [8]. These areas represent diverse geographic and climatic conditions, including the southwestern coastal area and Sundarbans (SWM), the southeast and eastern coastal area (SEE), the Chattogram Hill Tracts (CHT), rivers, floodplains, and erosion-prone areas (FPE), Haor and flash flood areas (HFF), drought-prone and Barind areas (DBA), the northern northwestern region (NNW), Chalan Beel and low-lying areas of the northwestern region (CBL), Char and Islands (CHI), and the Bay of Bengal and Ocean (BoB). The characteristic features of the climate-stressed area varied considering the extreme climate events and experienced five or more climate disasters. The selected number of healthcare facilities in each climate-stressed area are presented in Table 1.

2.5. Data Collection and Analysis

The participants of the focus group discussion provided information about the climate-sensitive diseases in terms of hospital visits and the climatic reasons for hospital visits. The collected information from 25 events of the focus group discussion in different climate-stressed areas was organized considering the climate-stressed area. The information was reviewed and checked by the focus group facilitator by taking into consideration the discussion notes, audio recordings, and group presentations. In this study, the hospital visit severity index was defined as the degree to which a condition affects a person’s health.
Five scales of hospitals visits with definitions were created, and these were severe, moderate to severe, moderate, mild to moderate, and mild. A weight from 5 to 1 points was given for each condition of hospital visit based on severity. A “mild” severity hospital visit was defined as a disease with symptoms that are manageable, that does not require immediate medication, and that may improve over time even without medical consultancy or medication. A weight of 1 point was given to a mild severity hospital visit. A “moderate” severity hospital visit was labelled as a disease with symptoms that may affect daily routine and that need medical consultancy and some medication; this was given a weight of 3 points. A “severe” hospital visit was critical in terms of symptoms, which may cause significant impairment of daily activities and require thorough medical treatment while having a risk of complications or long-term health effects; it was given a weight of 5. A “mild to moderate” severity hospital visit was defined as one in which patients may need take primary medication to avoid deterioration of health; it was given a weight of 4. A “moderate to severe” hospital visit was denoted as requiring intensive medication with medical consultancy to prevent complications; it was given a weight of 2. The climate-sensitive disease hospital visit severity index was calculated at the national and climate-stressed area level by using the following formulas:
Climate stressed area wise severity of hospital visits of CSD = Σ (Weightage of CSD)/number of identified diseases
National level severity of hospital visits of CSD = Σ (Weightage of CSD)/number of areas

3. Results

The participants’ knowledge about climate-sensitive diseases plays an important role in identifying the diseases. The results of the pre- and post-test scores on the understanding of climate-sensitive diseases, climate change, and health training are presented in Figure 3.
This figure illustrates how various health professionals’ understanding of climate change and health improved following the training, which ultimately resulted in the group project’s definition of climate-sensitive diseases. According to the figure, the majority of participants’ knowledge was moderate to poor, but after training, it increased high and very high.
Climate-stressed areas were used to organize the data and information on climate-sensitive diseases that the medical professionals gave. Different climate-stressed regions have varying levels of climate vulnerability. Cold, respiratory droplets, air pollution, tainted food and water, inadequate sanitation, insects, rising temperatures, flash floods, intense rains, heat waves, severe cold, lack of protein and energy, and salinity of water were among the hazards that were highlighted. The identified risks for various diseases varied according to the time of year and the country’s geographic location. A matrix (severe to mild) on climate-sensitive diseases with respect to the climate-stressed areas of Bangladesh is presented Table 2.
Table 3 illustrates the severity index that was computed for the diseases and climate-stress areas. According to the results, the patients’ frequent hospital visits were caused by diarrhea, AWD, and malnutrition. These visits were crucial in terms of symptoms that could seriously impair their ability to carry out daily tasks and necessitate extensive medical care, which carries a risk of complications or long-term health effects. The Bay of Bangla and Ocean (BoB) and Chars and Islands (CHI) regions had the greatest rates of hospital visits for climate-sensitive diseases. These visits were characterized by rigorous medication and medical consultation to avoid consequences.

4. Discussion

Climate change has been increasing the frequency and severity of extreme weather conditions. Consecutive hot, cold, and rainy days are becoming more frequent and intense. Nearly every year, flash floods and monsoon floods and other events like cyclones, hydrological droughts, etc., of various magnitude take place in different climate-stressed areas of Bangladesh [18]. Such events are secondarily causing environmental elements including water, air, and soil to deteriorate. Human health is greatly influenced by these climate and environmental conditions, which ultimately increases the burden of mortality and morbidity. This study identified 13 diseases that had higher rates of hospital visits (OPD) and admissions at different times of the year. The diseases are malnutrition; diarrhea; acute watery diarrhea (AWD); pneumonia/RTI/ARI; typhoid; skin diseases including tinea and scabies; non-communicable disease (NCD), e.g., hypertension; cholera; mental health; hepatitis; heat stroke; and dengue. Certain diseases are found in climate-stressed areas that are particularly affected by climate change, whereas others are found throughout all climate-stressed areas.
Hospitals are overwhelmed with the high number of cases of pneumonia/respiratory tract infection/acute respiratory infection throughout the winter season in Bangladesh. People’s livelihoods and health are impacted by these cold waves, particularly women, children, and the elderly in all climate-stressed areas. The causes behind the increased number of hospital visits are cold, respiratory droplets, and air pollution. This study found that pneumonia/respiratory tract infection/acute respiratory infection-related hospital visits have a moderate-to-severe hospital visit index value and are observed in all climate-stressed areas. It was found in another study that over the course of 20 years, Bangladesh experienced 81 cold wave episodes (spells) that claimed 5610 lives, with an average of 281 deaths annually. Additionally, cold waves (spells) lasted an average of 25.4 days annually, with a statistically significant upward trend during that time [19]. As there is no wind in winter, presumably the air pollution increases, especially the suspended particulate matter. A study in Australia showed that an increase in the incidence in childhood pneumonia has been associated with sharp temperature drops from one day to the next [20].
Throughout the summer due to the extreme heat and humidity, many water bodies dry up and the water table drops. This makes the environment miserable for people, and as the years have gone by, the temperature has risen along with the hot spells. In recent decades, heat waves have become more frequent and intense across the nation. These heat waves used to mostly happen right before the monsoon season, but they are increasingly occurring more frequently all year round [21]. Scabies and heat-stroke-related hospital visits are on the rise due to high temperatures, hot cycles, and contaminated water. In Bangladesh, prolonged spells of exceptionally high temperatures, typically above 36 °C, accompanied by excessive humidity, which exacerbates the heat, are referred to as heat waves. The consequences of heat waves and heat-related ailments are dehydration and heat stroke, particularly in vulnerable populations, including low-income communities, the elderly, and children. According to one study, heat stroke [22] was substantially linked to a higher risk of stroke death in the warm season, i.e., in summer, and the incidences of scabies are significantly associated with temperature and humidity [23]. This study found that heat-stress-related hospital visits have a low hospital visit index value and are more common in climate-stressed areas such as SEE, FPE, HFF, DBA, NNW, CBL, and BOB. Scabies-related hospital visits have a moderate hospital visit index value and are more common in climate-stressed areas such as SWM, SEE, CHT, FPE, and CBL. Scabies is also significantly influenced by human behaviors, such as making intimate contact and wearing the same clothing for longer periods of time than usual.
Climate change has significantly influenced the spread of waterborne diseases (WBDs), which affect environmental quality and human life in Southeast Asian Nations (ASEAN), including Bangladesh [24]. Cholera, diarrhea, and acute watery diarrhea have a positive association with temperature, humidity, and rainfall [25,26], and the risk of hepatitis is linked with any water-related climate event even after two weeks [27]. These diseases are mainly transmitted through contaminated water and poor sanitation in between the end of summer and the beginning of the rainy season. Environmental factors such as water temperature, erratic rainfall, salinity, and extreme weather events have a significant impact on the population dynamics of V. cholerae in the environment [28] Cyclones, storms, and droughts can make it harder to control the disease by limiting access to clean water and exacerbating food insecurity. This study identified that cholera-related hospital visit has mild-to-moderate (2) hospital visit index in five climate-stressed areas of the country. In the summer and rainy season due to drinking water contamination, it prevails in the SWM, SEE, FPE, CBL, and BOB areas.
Diarrhea- and acute watery diarrhea-related hospital visits have a severe (5) hospital visit index. The hospitals in the CHT (Chattogram Hill tracts), HFF (Haor and flash flood areas), and NNW (northern northwestern region) stressed areas receive acute watery diarrhea patients in excess because in these climate-stressed areas, flash floods and heavy rainfall occur every year. However, the hospital visits in all of the other climate-stressed areas across the country are higher for diarrhea in summer and rainy season due to water scarcity. In the rainy season, the surface and sub-surface water mix with human excreta due to poor sanitation facilities and contaminate the drinking water. The hospital professionals of this study of SWM, SEE, FPE and CHI mentioned that in summer and the rainy season, water contamination due to poor sanitation infrastructure increases the risk of hepatitis transmission. The hospital visit index value of hepatitis-related hospital visit was mild.
Bangladesh benefits greatly from the monsoon, which begins in late May and early June with heavy humidity. After the heat effects of summer on foliage, the foliage turns green. This is essential to the nation’s agricultural sector. One study illustrated that the rainfall in Bangladesh varies from 1527 mm in the west to 4197 mm in the east with a mean of 2488 mm, and the gradient of rainfall from west to east is approximately 7 mm km. The monthly distribution of rainfall shows that the rainfall is very much seasonal in Bangladesh; more than 89% of rainfall occurs during May to October [29]. Skin diseases including tinea, typhoid, and dengue are the common causes for hospital visits found from this study.
Another study showed that between 30 to 50 percent of young individuals with acne reported that their cutaneous condition worsened during the summer, primarily because of increased sweating brought on by hot and humid weather [30]. In various countries, it has been reported that the wet season is when more cases of tinea corporis are diagnosed, and in Mali, the highest frequency of tinea corporis was seen in areas with higher humidity levels. Numerous fungal, deep, and superficial infections are brought on by organisms that are known to be sensitive to climate factors including rainfall, humidity, and temperature. It has been noted that infections, especially tinea corporis, are more common after flooding [31]. Contaminated drinking water and insects are the common causes of skin fungal infections, including tinea. This study identified that tinea has a hospital visit index of moderate and occurs in the SWM, SEE, CHT, FPE, HFF, DBA, NNW, and CBL climate-stressed areas.
Temperature, rainfall, and river levels were found to increase the incidence of typhoid disease at time delays of three to five weeks. The highest typhoid occurrence was found in the monsoon months followed by the pre-monsoon and post-monsoon seasons [32]. This study found that the identified reasons for typhoid sickness were contaminated food and water. Typhoid occurred in the climate-stressed areas of SWM, SEE, CHT, FPE, CBL, CHI, and BOB, and its related hospital visit index value is moderate. Dengue outbreaks are significantly impacted by seasonal variations in climatic conditions, including surface temperature, rainfall, humidity, and ambient temperature [33]. Monsoon is the best season for propagation of the Ades aegypti mosquito responsible for dengue cases when a hot and humid climate prevails in Bangladesh. Bangladesh is one of the most vulnerable countries to fatal dengue outbreaks, and its occurrence is higher in urban areas than rural areas. A lack of awareness and delays in consultation with a doctor are major reasons for the increase in dengue case fatality. This study found that dengue occurred in the climate-stressed areas of SEE, CHT, FPE.HFF, DBA, CBL, and CHI, and its related hospital visit index value is low.
Malnutrition, hypertension (NCD), and mental health are significantly impacted by climate change year-round. Hospital visits due to hypertension have increased in the southwestern coastal area (SWM) year-round, i.e., all seasons, and its hospital visit index value is moderate (3). The reason behind this is the salinity of drinking water. One study illustrated that drinking water salinity is strongly associated with an increased risk of hypertension in coastal area of Bangladesh [34]. Temperature, extreme hot/cold days, and extreme weather events like floods, hydrological droughts, and hurricanes are associated with metal health conditions such as depression, anxiety, and/or PTSD [35]. These events increase the number of hospital or emergency department visits or hospital admissions in Bangladesh due to heat waves and extreme cold. This study found that the hospital visits due to these conditions increased in the SEE, NNW, DBA, and CBL climate-stressed areas, and the related hospital visit index value is low. These stressed areas are highly vulnerable to numerous types of extreme climate events, such as severe storm surges and cyclones, extreme cold days, lightning, and very severe drought in all seasons. Such events also increase mental anxiety due the loss of agricultural crops, housing, properties, and infrastructure and create a scarcity of safe drinking water, resulting in increased mortality and morbidity.
Climate change has both direct and indirect effects on nutrition. It affects food systems at various levels, resulting in changes in crop yield and soil fertility, food composition and nutrient bioavailability, pest resistance, etc. There are major threats to Bangladesh’s food and health security posed by climate change, including a higher risk of food shortage, hunger, and waterborne illnesses. People’s economic condition plays a catalytic role in remaining undernourished. A study found that there is a severe risk of food insecurity and nutrition deficiency, and nutrition is associated with climate change, specifically extreme climate events like drought, flooding, and precipitation [36]. This study found that hospital visits related to malnutrition are higher in two climate-stressed areas, namely FPE and NNW. These areas are highly susceptible to riverbank erosion, flood, and drought. Protein and energy deficiency are major causes of malnutrition, and its related hospital visit index value is severe.
All the climate-sensitive diseases do not prevail in all climate-stressed areas equally. In the southeast and eastern coastal area (SEE) and rivers, floodplains, and erosion-prone areas (FPE), 10 types of CSDs exist, whereas in the Bay of Bengal and Ocean (BoB) and the Chars and islands area (CHI), 5 types of CSDs exist. The hospital visit index value of all the CSDs in one climate-stressed area varied with other climate-stressed areas. The southeast and eastern coastal area (SEE) has the lowest value of all the CSD hospital visit index values, whereas the Bay of Bengal and Ocean (BoB) and Chars and Islands (CHI) have the highest hospital visit index values. This illustrates that the number of different types of CSDs is higher in lower-indexed hospital visits.

5. Conclusions

This study complements the gap of understanding of incidences and types of climate-sensitive diseases and related hospital visits in climate-stressed areas of Bangladesh. Thirteen diseases with increased rates of hospital visits (OPD) and admissions at various periods of the year with a variable degree were identified by this study. Malnutrition, diarrhea, acute watery diarrhea (AWD), pneumonia, ARI, typhoid, infections of the skin like scabies and tinea, and non-communicable diseases (NCDs) like cholera, mental health, hepatitis, heat stroke, and dengue are among the illnesses. The patients’ frequent hospital visits were caused by diarrhea, AWD, and malnutrition, and the Bay of Bengal and Ocean (BoB) and Chars and Islands (CHI) regions had the greatest rates of hospital visits for climate-sensitive diseases. The number of different types of CSDs is higher in lower-indexed hospital visits. These diseases interfere with daily activities and necessitate medication and medical consultation. The findings of this study will contribute to the design and updating of the National Adaptation Plan specific to climate-stressed areas to reduce the health consequences of climate change in a preventive manner and increase investment and resilience.

Supplementary Materials

The following supporting information can be downloaded at: https://www.mdpi.com/article/10.3390/cli13080166/s1.

Author Contributions

A.K. and S.A. conceptualized the study, prepared the study design, conducted the study, interpreted data, and drafted and edited the manuscript. A.K. and S.S. analyzed and interpreted the data and reviewed the manuscript. A.E., M.F.R.S., T.S., A.K.S.R. and N.J.T. reviewed the article critically and provided inputs where necessary. All authors have read and agreed to the published version of the manuscript.

Funding

This study was conducted under a program of the WHO-EHU called “Building Resilience of Health Systems in Asian LDCs to Climate Change” for Bangladesh (PO 203430049); thus, it did not require any additional funding. All the authors dedicated their additional working hours to preparing the paper.

Informed Consent Statement

This study was conducted under a program of the WHO Environmental Health Unit of Bangladesh as part of the program implementation; the operational data were collected. Verbal consent from the participants before the group work was taken.

Data Availability Statement

The data sets used and analyzed during the current study are available from the corresponding author on reasonable request.

Acknowledgments

The authors thank Ferdous Hakim, Research and Publication Unit, WHO Bangladesh, Md Mamunur Rashid Joint Secretary (WH Wing) Health Services Division, Ministry of Health and Family Welfare, and all the clinicians and health professionals at the local and national level who supported and assisted in data collection, processing, and implementation support.

Conflicts of Interest

The authors declare no conflicts of interest. The authors alone are responsible for the views expressed in this article, and they do not necessarily represent the views, decisions, and policies of the institution with which they are affiliated.

Abbreviations

ARI: acute respiratory infection; BOB: Bay of Bengal and Ocean; CBL: Chalan Beel and low-lying areas of the northwestern region; CHI: Char and Islands; CHT: Chattogram Hill tracts; CSD: climate-sensitive disease; DBA: drought-prone and Barind areas; FPE: rivers, floodplains, and erosion-prone areas; HCF: healthcare facilities; HFF: Haor and flash flood areas; H-NAP: Health National Adaptation Plan; IEDCR: Institute of Epidemiology Disease Control and Research; NAP: National Adaptation Plan; NNW: northern northwestern area; RTI: respiratory tract infection; SEE: southeast and eastern coastal area; SWM: southwestern coastal area and Sundarbans; UH&FPO: Upazila Health and Family Planning Officer; WHO: World Health Organization.

References

  1. Bianco, G.; Espinoza-Chávez, R.M.; Ashigbie, P.G.; Junio, H.; Borhani, C.; Miles-Richardson, S.; Spector, J. Projected Impact of Climate Change on Human Health in Low- and Middle-income countries: A Systematic Review. BMJ Glob. Health 2024, 8, e015550. [Google Scholar] [CrossRef] [PubMed]
  2. The World Bank Group. Climate Risk Country Profile: Bangladesh; The World Bank Group: Washington, DC, USA, 2021; Available online: https://climateknowledgeportal.worldbank.org/sites/default/files/country-profiles/15502-WB_Bangladesh%20Country%20Profile-WEB.pdf (accessed on 14 May 2025).
  3. Rashid, M.B.; Sultana, A.; Hassan, S.M.Q.; Kuya, E.; Parding, K.; Hygen, H.O. Changing Climate of Bangladesh—METreport, 04/2024. In Proceedings of the EMS Annual Meeting 2024, Barcelona, Spain, 1–6 September 2024; Available online: https://live6.bmd.gov.bd/file/2024/02/27/pdf/162368.pdf (accessed on 14 May 2025).
  4. Masum, J.H. Climatic Hazards in Bangladesh: A Literature Review; Coastal Development Partnership (CDP): Dhaka, Bangladesh, 2019; ISBN 978-984-34-7002-4. [Google Scholar]
  5. O’Leary, L.; Dasgupta, S.; Robinson, E.J.Z. Impacts of Climate Change on Health in Bangladesh: Policy Brief; Grantham Research Institute on Climate Change and the Environment and the Centre for Climate Change Economics and Policy, University of Leeds: Leeds, UK, 2023; Available online: https://www.lse.ac.uk/granthaminstitute/wp-content/uploads/2023/10/Impacts-of-climate-change-on-health-in-Bangladesh-Policy-brief.pdf (accessed on 14 May 2025).
  6. World Health Organization. United Nations Framework Convention on Climate Change: Climate and Health Country Profile—2015; World Health Organization: Geneva, Switzerland, 2015; Available online: https://cdn.who.int/media/docs/default-source/searo/wsh-och-searo/ban-c-h-profile.pdf?sfvrsn=8b172763_2 (accessed on 20 May 2025).
  7. Ministry of Environment, Forest and Climate Change, Government of the People’s Republic of Bangladesh. Summary Report: National Adaptation Plan of Bangladesh (2023–2050); Ministry of Environment, Forest and Climate Change, Government of the People’s Republic of Bangladesh: Dhaka, Bangladesh, 2022; Available online: https://www.undp.org/bangladesh/publications/national-adaptation-plan-bangladesh-2023-2050 (accessed on 20 May 2025).
  8. Shamsuddoha, M.; Jabed, M.A.; Islam, M.S.; Sultana, N.; Imran, A.; Rabbi, S.N.A.; Jenat, T.U.; Shams, S.; Sharif, M.M. Impacts of climate change-induced natural hazards on women and their human rights implications: A study in the southwest coast of Bangladesh. J. Migr. Health 2024, 9, 100221. [Google Scholar] [CrossRef] [PubMed]
  9. Amin, M.R.; Tareq, S.M.; Rahman, S.H. Effects of Climate Variables on Kala-azar Prevalence at Major Affected Districts in Bangladesh. J. Environ. Sci. Nat. Resour. 2013, 6, 79–87. [Google Scholar] [CrossRef]
  10. Mutsuddy, P.; Sanya, T.J.; Shamsuzzaman, A.K.M.; Kaisar, S.M.G.; Khan, M.N.A. Dengue Situation in Bangladesh: An Epidemiological Shift in terms of Morbidity and Mortality. Can. J. Infect. Dis. Med. Microbiol. 2019, 2019, 3516284. [Google Scholar] [CrossRef] [PubMed]
  11. Kabir, I.; Dhimal, M.; Müller, R.; Banik, S.; Haque, U. The 2017 Dhaka chikungunya outbreak. Lancet Infect. Dis. 2017, 17, 1118. [Google Scholar] [CrossRef] [PubMed]
  12. Ehsanur, P. An Analysis of the Impacts of Temperature on Diarrheal Disease in Bangladesh. Int. J. Soc. Sci. Econ. Res. 2017, 2, 5040–5049. [Google Scholar]
  13. Checkley, W.; Epstein, L.D.; Gilman, R.H.; Figueroa, D.; Cama, R.I.; Patz, J.A.; Black, R.E. Effects of EI Niño and ambient temperature on hospital admissions for diarrhoeal diseases in Peruvian children. Lancet 2000, 355, 442–450. [Google Scholar] [CrossRef] [PubMed]
  14. Moon, M.P. Food and health security impact of climate change in Bangladesh: A Review. J. Water Clim. Change 2023, 14, 3484–3495. [Google Scholar] [CrossRef]
  15. Hayes, K.; Blashki, G.; Wiseman, J.; Burke, S.; Reifels, L. Climate Change and Mental Health: Risks, Impacts and Priority Ac-tions. Int. J. Ment. Health Syst. 2018, 12, 28. [Google Scholar] [CrossRef] [PubMed]
  16. Chinyere, U.; Val, E. Qualitative Research. IDOSR J. Comput. Appl. Sci. 2023, 8, 20–35. Available online: https://www.researchgate.net/publication/367221023 (accessed on 22 May 2025).
  17. Ismail, G.; Taliep, N. The Delphi Method. In Handbook of Social Sciences and Global Public Health; Liamputtong, P., Ed.; Springer: Cham, Switzerland, 2023. [Google Scholar] [CrossRef]
  18. Huq, S.; Khan, M.; Islam, A.S.; Mirza, A.B. Climate Change Impacts in Bangladesh: What Climate Change Means for a Country and Its People. 2024. Available online: https://www.icccad.net/wp-content/uploads/2024/02/Bangladesh_Final_Covers_26-Jan-2024_ONLINE_compressed.pdf#:~:text=Even%20with%20ambitious%20climate%20action%20(RCP2.%206)%2C,century%2C%20increasing%20flooding%20in%20low%2D%20lying%20Bangladesh (accessed on 22 May 2025).
  19. Hasan, M.K.; Younos, T.B.; Chowdhury, R.I.; Masud, K.B.; González, P.A.; Castro-Delgado, R. Cold wave induced mortalities in Bangladesh: Spatiotemporal Analysis of 20 Years’ Data, 2000–2019. Nat. Hazards Res. 2024, 4, 604–615. [Google Scholar] [CrossRef]
  20. Mirsaeidi, M.; Motahari, H.; Taghizadeh, K.M.; Sharifi, A.; Campos, M.; Schraufnagel, D.E. Climate Change and Respiratory Infections. Ann. Am. Thorac. Soc. 2016, 13, 1223–1230. [Google Scholar] [CrossRef] [PubMed]
  21. Miah, M.; Ullah, S.; Siddique, M. Heat Waves in Bangladesh: Understanding the Threats and Finding Solutions. Asia Pac. J. Energy Environ. 2022, 9, 89–98. [Google Scholar] [CrossRef]
  22. Zhou, L.; He, C.; Kim, H.; Honda, Y.L.W.; Hashizume, M.; Chen, R.; Kan, H. The Burden of Heat-Related Stroke Mortality under Climate Change Scenarios in 22 East Asian Cities. Environ. Int. 2022, 170, 107602. [Google Scholar] [CrossRef] [PubMed]
  23. Liu, J.M.; Wang, H.W.; Chang, F.W.; Liu, Y.P.; Chiu, F.H.; Lin, Y.C.; Cheng, K.C.; Hsu, R.J. The Effects of Climate Factors on Scabies: A 14-Year Population-Based Study in Taiwan. Parasite 2016, 23, 54. [Google Scholar] [CrossRef] [PubMed]
  24. Jung, Y.J.; Khant, N.A.; Kim, H.; Namkoong, S. Impact of Climate Change on Waterborne Diseases: Directions towards Sustainability. Water 2023, 15, 1298. [Google Scholar] [CrossRef]
  25. Chowdhury, F.R.; Ibrahim, Q.S.U.; Bari, M.S.; Alam, M.M.J.; Dunachie, S.J.; Rodriguez-Morales, A.J.; Patwary, M.I. The Association between Temperature, Rainfall and Humidity with Common Climate-Sensitive Infectious Diseases in Bangladesh. PLoS ONE 2020, 15, e0232285. [Google Scholar] [CrossRef] [PubMed]
  26. Luby, S.P.; Rahman, M.; Arnold, B.F.; Unicomb, L.; Ashraf, S.; Winch, P.J.; Stewart, C.P.; Begum, F.; Hussain, F.; Benjamin-Chung, J.; et al. Effects of Water Quality, Sanitation, Handwashing, and Nutritional Interventions on Diarrhoea and Child Growth in Rural Bangladesh: A Cluster Randomised Controlled Trial. Lancet Glob. Health 2018, 6, e302–e315. [Google Scholar] [CrossRef] [PubMed]
  27. Gullón, P.; Varela, C.; Martínez, E.V.; Barroso, D.G. Association between Meteorological Factors and Hepatitis A in Spain 2010–2014. Environ. Int. 2017, 102, 230–235. [Google Scholar] [CrossRef] [PubMed]
  28. Lipp, E.K.; Huq, A.; Colwell, R.R. Effects of Global Climate on Infectious Disease: The Cholera Model. Clin. Microbiol. Rev. 2002, 15, 757–770. [Google Scholar] [CrossRef] [PubMed]
  29. Shamsuddin, S. Rainfall Variability and Changes in Bangladesh during the last Fifty Years. In Rainfall: Behavior Forecasting and Distribution; National Center for Meteorology: Jeddah, Saudi Arabia, 2012; pp. 23–44. Available online: https://www.researchgate.net/publication/286565576 (accessed on 20 May 2025).
  30. Balato, N.; Megna, M.; Ayala, F.; Balato, A.; Napolitano, M.; Patruno, C. Effects of Climate Changes on Skin Diseases. Expert Rev. Anti Infect. Ther. 2014, 12, 171–181. [Google Scholar] [CrossRef] [PubMed]
  31. Aditi, G.; Wendemagegn, E.; Louise, K.A.; Sarah, J.C. The Effects of Climate Change on Fungal Diseases with Cutaneous Manifestations: A Report from the International Society of Dermatology Climate Change Committee. J. Clim. Change Health 2022, 6, 100156. [Google Scholar] [CrossRef]
  32. Dewan, A.M.; Corner, R.; Hashizume, M.; Ongee, E.T. Typhoid Fever and Its Association with Environmental Factors in the Dhaka Metropolitan Area of Bangladesh: A Spatial and Time-Series Approach. PLoS Negl. Trop. Dis. 2013, 7, e1998. [Google Scholar] [CrossRef] [PubMed]
  33. Islam, S.; Haque, C.E.; Hossain, S.; Hanesiak, J. Climate Variability, Dengue Vector Abundance and Dengue Fever Cases in Dhaka, Bangladesh: A Time-Series Study. Atmosphere 2021, 12, 905. [Google Scholar] [CrossRef]
  34. Khan, J.R.; Awan, N.; Archie, R.J.; Sultana, N.; Muurlink, O. The Association between Drinking Water Salinity and Hyper-tension in Coastal Bangladesh. Glob. Health J. 2020, 4, 153–158. [Google Scholar] [CrossRef]
  35. Mishu, M.P.; Rabbani, M.M.G.; Vereeken, S.; Martin-Kerry, J.; Chowdhury, T.F.; Wahab, A.; Mashreky, S.R.; Huque, R.; Friend, R. Exploring the Association between Mental Health and Extreme Weather Events Related to Climate Change: A Scoping review. Lancet 2024, 404, S28. [Google Scholar] [CrossRef]
  36. Mirzabaev, A.; Kerr, R.B.; Hasegawa, T.; Pradhan, P.; Wreford, A.; von der Pahlen, M.C.T.; Gurney-Smith, H. Severe Climate Change Risks to Food Security and Nutrition. Clim. Risk Manag. 2023, 39, 100473. [Google Scholar] [CrossRef]
Climate 13 00166 g001
Figure 1. Summary of the methods deployed in this study.
Figure 1. Summary of the methods deployed in this study.
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Figure 2. Climate-stressed areas of Bangladesh. Source: National Adaptation Plan Bangladesh.
Figure 2. Climate-stressed areas of Bangladesh. Source: National Adaptation Plan Bangladesh.
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Figure 3. Qualitative result of pre-test and post-test of participants. Low = ≤ 5 points, moderate = 6–10 points, high = 11–15 points, and very high = 16–20 points).
Figure 3. Qualitative result of pre-test and post-test of participants. Low = ≤ 5 points, moderate = 6–10 points, high = 11–15 points, and very high = 16–20 points).
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Table 1. Distribution of participants with respect to HCF and climate-stressed areas.
Table 1. Distribution of participants with respect to HCF and climate-stressed areas.
Sl. No.Climate-Stressed AreaBoBCBLCHICHTDBAFPEHFFNNWSEESWMTotal
1Number of districts122313213321
2Number of upazilas7131319112117131923156
3Number of selected HCFs7131319102116131823153
4Total public health professionals in the selected HCFsUH&FPOs7131425111921131922162
Doctors46183182164811701522282981871691
Nurses23231239323620453634292
Total762192082281242251932863532432145
5Selected health professionals in the selected HCFsUH&FPOs79121971716121720136
Doctors8171422213125162523202
Nurses6161119113016121519155
Total21423760397857405762493
BOB: Bay of Bengal and Ocean; CBL: Chalan Beel and low-lying areas of the northwestern region; CHI: Char and islands; CHT: Chattogram Hill tracts; DBA: drought-prone and Barind areas; FPE: rivers, floodplains, and erosion-prone areas; HFF: Haor and flash flood areas; NNW: northern northwestern area; SEE: southeast and eastern coastal area; SWM: southwestern coastal area and Sundarbans; UH&FPO: Upazila Health and Family Planning Officer.
Table 2. Weighted matrix of hospital visits of climate-sensitive diseases with respect to climate-stressed areas of Bangladesh.
Table 2. Weighted matrix of hospital visits of climate-sensitive diseases with respect to climate-stressed areas of Bangladesh.
NoMost Severe Climate Stress Disease NameOutbreak/Prevalence Period/SeasonReason/Caused BySouth-Western Coastal Area and SundarbansSoutheast and Eastern Coastal AreaChattogram Hill TractsRivers, Floodplains, and Erosion-Prone AreasHaor and Flash Flood AreasDrought-Prone and Barind AreasNorthern Northwestern RegionChalan Beel and Low-Lying Areas of Northwestern RegionChars and IslandsBay of Bengal and Ocean
SWMSEECHTFPEHFFDBANNWCBLCHIBOB
1Pneumonia/RTI/ARIWinterCold, respiratory droplets, air pollution 4444444444
2ScabiesSummerContaminated water, temperature rise3333 3
3Heat strokeSummerHeat wave 1 11111 1
4CholeraSummer, rainyContaminated water22 2 2 2
5DiarrheaSummer, rainyContaminated water5555555555
6AWDSummer, rainyFlash flood, heavy rainfall 5 5 5
7HepatitisSummer, rainyContaminated water and poor sanitation11 1 1 1
8Skin diseases including tineaRainyContaminated water, insects33333333
9TyphoidRainyContaminated food and water3333 333
10DengueRainyVector borne (mosquitoes) 11111 11
11MalnutritionAll seasonProtein and energy deficiency 5 5
12Mental health All seasonHeat wave, extreme cold 1 111
13NCD, e.g., hypertensionAll seasonSalinity of water3
SevereModerate to SevereModerateMild to ModerateMild
54321
A “severe” hospital visit was labelled as critical in terms of symptoms, which may cause significant impairment of daily activities and require thorough medical treatment while having a risk of complications or long-term health effects.A “moderate to severe” hospital visits was denoted as needing intensive medication with medical consultancy to prevent complications.A “moderate” severity of hospital visit was labelled as a disease with symptoms that may affect daily routine and need medical consultancy and some medication.A “mild to moderate” severity hospital visit was defined as patients possibly needing to take primary medication to avoid the deterioration of their health condition.A “mild” severity hospital visit was defined as patients with symptoms of a disease that are manageable, do not require immediate medication, and may improve over time even without medical consultancy or medication.
Summer season: April, May, and June. Rainy season: June, July, August, and September. Winter season: December, January, and February. All season: all months of the year.
Table 3. Results of hospital visit severity index with respect to disease and stressed area.
Table 3. Results of hospital visit severity index with respect to disease and stressed area.
NoNational Level Severity Index of Hospital Visits of CSD = ∑ (Weightage of CSD)/Number of Areas (0–5)Climate Stressed Area Wise Severity Index of Hospital Visits of CSD = ∑ (Weightage of CSD)/Number of Identified Diseases (0–5)
DiseaseIndexStressed AreaIndex
1Diarrhea5Bay of Bangla and Ocean (BoB)4
2AWD5Chars and islands (CHI)4
3Malnutrition5Chattogram Hill tracts (CHT)3
4Pneumonia/RTI/ARI4Haor and flash flood areas (HHF)3
5Scabies3Northern northwestern region (NNW)3
6Skin diseases including tinea3Southwestern coastal area and Sundarbans (SWM)3
7Typhoid3Rivers, floodplains, and erosion-prone areas (FPE)3
8NCD, e.g., hypertension3Chalan Beel and low-lying areas of north-western region (CBL)3
9Cholera2Drought-prone and Barind areas (DBA)3
10Heat stroke1Southeast and eastern coastal area (SEE)2
11Hepatitis1
12Dengue1
13Mental health 1
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Kabir, A.; Alam, S.; Tarin, N.J.; Sarkar, S.; Eshofonie, A.; Sarker, M.F.R.; Rahman, A.K.S.; Shirin, T. A Study of Climate-Sensitive Diseases in Climate-Stressed Areas of Bangladesh. Climate 2025, 13, 166. https://doi.org/10.3390/cli13080166

AMA Style

Kabir A, Alam S, Tarin NJ, Sarkar S, Eshofonie A, Sarker MFR, Rahman AKS, Shirin T. A Study of Climate-Sensitive Diseases in Climate-Stressed Areas of Bangladesh. Climate. 2025; 13(8):166. https://doi.org/10.3390/cli13080166

Chicago/Turabian Style

Kabir, Ahammadul, Shahidul Alam, Nusrat Jahan Tarin, Shila Sarkar, Anthony Eshofonie, Mohammad Ferdous Rahman Sarker, Abul Kashem Shafiqur Rahman, and Tahmina Shirin. 2025. "A Study of Climate-Sensitive Diseases in Climate-Stressed Areas of Bangladesh" Climate 13, no. 8: 166. https://doi.org/10.3390/cli13080166

APA Style

Kabir, A., Alam, S., Tarin, N. J., Sarkar, S., Eshofonie, A., Sarker, M. F. R., Rahman, A. K. S., & Shirin, T. (2025). A Study of Climate-Sensitive Diseases in Climate-Stressed Areas of Bangladesh. Climate, 13(8), 166. https://doi.org/10.3390/cli13080166

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