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Guest Editor
School of Public Health, The University of Adelaide, Adelaide, SA 5005, Australia
Interests: climate change and population health; adaptation; vulnerability; infectious disease; disaster response; public health policy and health services
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Climate change has caused a range of complex health issues, including direct and indirect effects such as heat-related illnesses and mortality. Extreme weather events, including heatwaves, bushfires, cyclones, earthquakes, floods and severe storms have brought about a significant negative impact on population health. For example, in 2009, heatwaves killed over 370 people in Australia. Climate change, with predicted increasing temperatures and extreme weather events, will lead to more negative health outcomes for the population and challenge the already overloaded healthcare system in the world, especially in developing countries. Therefore, it is important to assess the health risks from the extreme weather events, to explore the adaptation strategies and measurements, to identify the barriers for adaptation and to provide scientific evidence to policy-makers and practitioners. Papers addressing these topics are invited for this Special Issue, especially those combining a high academic standard coupled with a practical focus on providing public health solutions.

Prof. Dr. Peng Bi
Guest Editor

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Keywords

  • extreme weather events
  • population health
  • adaptation strategy and measurement
  • barriers for adaptation
  • public health policy and practice

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Published Papers (12 papers)

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Research

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2897 KiB  
Article
Effects of Heat Stress on Construction Labor Productivity in Hong Kong: A Case Study of Rebar Workers
by Wen Yi and Albert P. C. Chan
Int. J. Environ. Res. Public Health 2017, 14(9), 1055; https://doi.org/10.3390/ijerph14091055 - 12 Sep 2017
Cited by 96 | Viewed by 11435
Abstract
Global warming is bringing more frequent and severe heat waves, and the result will be serious for vulnerable populations such as construction workers. Excessive heat stress has profound effects on physiological responses, which cause occupational injuries, fatalities and low productivity. Construction workers are [...] Read more.
Global warming is bringing more frequent and severe heat waves, and the result will be serious for vulnerable populations such as construction workers. Excessive heat stress has profound effects on physiological responses, which cause occupational injuries, fatalities and low productivity. Construction workers are particularly affected by heat stress, because of the body heat production caused by physically demanding tasks, and hot and humid working conditions. Field studies were conducted between August and September 2016 at two construction training grounds in Hong Kong. Onsite wet-bulb globe temperature (WBGT), workers’ heart rate (HR), and labor productivity were measured and monitored. Based on the 378 data sets of synchronized environmental, physiological, construction labor productivity (CLP), and personal variables, a CLP-heat stress model was established. It was found that WBGT, percentage of maximum HR, age, work duration, and alcohol drinking habits were determining factors for predicting the CLP (adjusted R2 = 0.68, p < 0.05). The model revealed that heat stress reduces CLP, with the percentage of direct work time decreasing by 0.33% when the WBGT increased by 1 °C. The findings in this study extend the existing practice notes by providing scientific data that may be of benefit to the industry in producing solid guidelines for working in hot weather. Full article
(This article belongs to the Special Issue Extreme Weather and Public Health)
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690 KiB  
Article
Heat Health Messages: A Randomized Controlled Trial of a Preventative Messages Tool in the Older Population of South Australia
by Monika Nitschke, Antoinette Krackowizer, Alana L. Hansen, Peng Bi and Graeme R. Tucker
Int. J. Environ. Res. Public Health 2017, 14(9), 992; https://doi.org/10.3390/ijerph14090992 - 31 Aug 2017
Cited by 22 | Viewed by 6262
Abstract
This study explores the efficacy of providing targeted information to older individuals to prevent adverse health outcomes during extreme heat. Participants ≥65 years of age (n = 637) were recruited from previous population-based studies and randomized into intervention and control groups. The [...] Read more.
This study explores the efficacy of providing targeted information to older individuals to prevent adverse health outcomes during extreme heat. Participants ≥65 years of age (n = 637) were recruited from previous population-based studies and randomized into intervention and control groups. The intervention group received evidence-based information leaflets and summarised “Beat the Heat” tips. Post summer 2013–2014, participants responded to questions about their behaviours and their health experiences. Chi square analysis and risk ratios (RR) were used to determine the difference in effects. Responses were received from 216 intervention subjects and 218 controls. Behaviour modification during extreme heat was similar in both groups except for significant increases in the use of cooling systems and the use of a wet cloth to cool the skin in the intervention group. Both actions were recommended in the information package. More people in the intervention group also claimed to have had adequate heat health information. After adjusting for confounders, the RR for self-reported heat stress experienced during summer 2014 indicated a 63% (RR 0.37; 95% CI: 0.22–0.63) reduction in the intervention group compared to the control group. Access to intensive prevention information may have contributed to this positive outcome, indicating the potential usefulness of targeted heat-health information for seniors. Full article
(This article belongs to the Special Issue Extreme Weather and Public Health)
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8335 KiB  
Article
A Geographical Analysis of Emergency Medical Service Calls and Extreme Heat in King County, WA, USA (2007–2012)
by Aubrey C. DeVine, Phuong T. Vu, Michael G. Yost, Edmund Y. W. Seto and Tania M. Busch Isaksen
Int. J. Environ. Res. Public Health 2017, 14(8), 937; https://doi.org/10.3390/ijerph14080937 - 20 Aug 2017
Cited by 9 | Viewed by 5878
Abstract
This research analyzed the relationship between extreme heat and Emergency Medical Service (EMS) calls in King County, WA, USA between 2007 and 2012, including the effect of community-level characteristics. Extreme heat thresholds for the Basic Life Support (BLS) data and the Advanced Life [...] Read more.
This research analyzed the relationship between extreme heat and Emergency Medical Service (EMS) calls in King County, WA, USA between 2007 and 2012, including the effect of community-level characteristics. Extreme heat thresholds for the Basic Life Support (BLS) data and the Advanced Life Support (ALS) data were found using a piecewise generalized linear model with Akaike Information Criterion (AIC). The association between heat exposure and EMS call rates was investigated using a generalized estimating equations with Poisson mean model, while adjusting for community-level indicators of poverty, impervious surface, and elderly population (65+). In addition, we examined the effect modifications of these community-level factors. Extreme-heat thresholds of 31.1 °C and 33.5 °C humidex were determined for the BLS and ALS data, respectively. After adjusting for other variables in the model, increased BLS call volume was significantly associated with occurring on a heat day (relative rate (RR) = 1.080, p < 0.001), as well as in locations with higher percent poverty (RR = 1.066, p < 0.001). No significant effect modification was identified for the BLS data on a heat day. Controlling for other variables, higher ALS call volume was found to be significantly associated with a heat day (RR = 1.067, p < 0.001), as well as in locations with higher percent impervious surface (RR = 1.015, p = 0.039), higher percent of the population 65 years or older (RR = 1.057, p = 0.005), and higher percent poverty (RR = 1.041, p = 0.016). Furthermore, percent poverty and impervious surface were found to significantly modify the relative rate of ALS call volumes between a heat day and non-heat day. We conclude that EMS call volume increases significantly on a heat day compared to non-heat day for both call types. While this study shows that there is some effect modification between the community-level variables and call volume on a heat day, further research is necessary. Our findings also suggest that with adequate power, spatially refined analyses may not be necessary to accurately estimate the extreme-heat effect on health. Full article
(This article belongs to the Special Issue Extreme Weather and Public Health)
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Article
Quantifying Projected Heat Mortality Impacts under 21st-Century Warming Conditions for Selected European Countries
by Vladimir Kendrovski, Michela Baccini, Gerardo Sanchez Martinez, Tanja Wolf, Elizabet Paunovic and Bettina Menne
Int. J. Environ. Res. Public Health 2017, 14(7), 729; https://doi.org/10.3390/ijerph14070729 - 5 Jul 2017
Cited by 36 | Viewed by 16748
Abstract
Under future warming conditions, high ambient temperatures will have a significant impact on population health in Europe. The aim of this paper is to quantify the possible future impact of heat on population mortality in European countries, under different climate change scenarios. We [...] Read more.
Under future warming conditions, high ambient temperatures will have a significant impact on population health in Europe. The aim of this paper is to quantify the possible future impact of heat on population mortality in European countries, under different climate change scenarios. We combined the heat-mortality function estimated from historical data with meteorological projections for the future time laps 2035–2064 and 2071–2099, developed under the Representative Concentration Pathways (RCP) 4.5 and 8.5. We calculated attributable deaths (AD) at the country level. Overall, the expected impacts will be much larger than the impacts we would observe if apparent temperatures would remain in the future at the observed historical levels. During the period 2071–2099, an overall excess of 46,690 and 117,333 AD per year is expected under the RCP 4.5 and RCP 8.5 scenarios respectively, in addition to the 16,303 AD estimated under the historical scenario. Mediterranean and Eastern European countries will be the most affected by heat, but a non-negligible impact will be still registered in North-continental countries. Policies and plans for heat mitigation and adaptation are needed and urgent in European countries in order to prevent the expected increase of heat-related deaths in the coming decades. Full article
(This article belongs to the Special Issue Extreme Weather and Public Health)
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1773 KiB  
Article
The Use of Chemoprophylaxis after Floods to Reduce the Occurrence and Impact of Leptospirosis Outbreaks
by Maria Cristina Schneider, Jorge Velasco-Hernandez, Kyung-duk Min, Deise Galan Leonel, David Baca-Carrasco, Matthew E. Gompper, Rudy Hartskeerl and Claudia Munoz-Zanzi
Int. J. Environ. Res. Public Health 2017, 14(6), 594; https://doi.org/10.3390/ijerph14060594 - 3 Jun 2017
Cited by 29 | Viewed by 10133
Abstract
Record-breaking and devastating rainfall events have occurred in the past decade. Rain and floods are considered the main risk factors for leptospirosis and several outbreaks have been reported following extreme weather events. In such situations, one possible intervention to prevent leptospirosis cases in [...] Read more.
Record-breaking and devastating rainfall events have occurred in the past decade. Rain and floods are considered the main risk factors for leptospirosis and several outbreaks have been reported following extreme weather events. In such situations, one possible intervention to prevent leptospirosis cases in high-risk groups is the use of chemoprophylaxis. However, not enough evidence of its effect is available. The objectives of this study were to review the literature on the current practices of chemoprophylaxis for leptospirosis and to explore, using a mathematical model, how various chemoprophylaxis scenarios may affect the progression of a leptospirosis outbreak. Twenty-six peer-reviewed publications were selected (10 quantitative studies, two systematic reviews and 14 articles of other types). Oral doxycycline was the most used antibiotic for chemoprophylaxis of leptospirosis. Post-exposure prophylaxis was assessed in four studies following a natural disaster. Although evidence of the effectiveness of post-exposure prophylaxis is inconsistent, the direction of association supported a protective effect for morbidity and mortality. The theoretical model showed how the assumed benefit of chemoprophylaxis was influenced by the time and rate of administration. Future models should consider the heterogeneity of affected communities, improved estimates of the effect of chemoprophylaxis on leptospirosis infection and disease, as well as potential detrimental impacts. Additional research is critical to provide clear evidence-based recommendations for leptospirosis control during an outbreak. The results of this study suggest that chemoprophylaxis may provide some protection in reducing the number of leptospirosis cases after a high-risk exposure; however, the effective benefit may depend on a variety of factors such as the timing and coverage of prophylaxis. The information summarized can be used to support decision-making during a high-risk event. Full article
(This article belongs to the Special Issue Extreme Weather and Public Health)
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297 KiB  
Article
Developing Health-Related Indicators of Climate Change: Australian Stakeholder Perspectives
by Maryam Navi, Alana Hansen, Monika Nitschke, Scott Hanson-Easey and Dino Pisaniello
Int. J. Environ. Res. Public Health 2017, 14(5), 552; https://doi.org/10.3390/ijerph14050552 - 22 May 2017
Cited by 11 | Viewed by 6450
Abstract
Climate-related health indicators are potentially useful for tracking and predicting the adverse public health effects of climate change, identifying vulnerable populations, and monitoring interventions. However, there is a need to understand stakeholders’ perspectives on the identification, development, and utility of such indicators. A [...] Read more.
Climate-related health indicators are potentially useful for tracking and predicting the adverse public health effects of climate change, identifying vulnerable populations, and monitoring interventions. However, there is a need to understand stakeholders’ perspectives on the identification, development, and utility of such indicators. A qualitative approach was used, comprising semi-structured interviews with key informants and service providers from government and non-government stakeholder organizations in South Australia. Stakeholders saw a need for indicators that could enable the monitoring of health impacts and time trends, vulnerability to climate change, and those which could also be used as communication tools. Four key criteria for utility were identified, namely robust and credible indicators, specificity, data availability, and being able to be spatially represented. The variability of risk factors in different regions, lack of resources, and data and methodological issues were identified as the main barriers to indicator development. This study demonstrates a high level of stakeholder awareness of the health impacts of climate change, and the need for indicators that can inform policy makers regarding interventions. Full article
(This article belongs to the Special Issue Extreme Weather and Public Health)
475 KiB  
Article
Infectious Diseases and Tropical Cyclones in Southeast China
by Jietao Zheng, Weixiao Han, Baofa Jiang, Wei Ma and Ying Zhang
Int. J. Environ. Res. Public Health 2017, 14(5), 494; https://doi.org/10.3390/ijerph14050494 - 7 May 2017
Cited by 24 | Viewed by 5598
Abstract
Southeast China is frequently hit by tropical cyclones (TCs) with significant economic and health burdens each year. However, there is a lack of understanding of what infectious diseases could be affected by tropical cyclones. This study aimed to examine the impacts of tropical [...] Read more.
Southeast China is frequently hit by tropical cyclones (TCs) with significant economic and health burdens each year. However, there is a lack of understanding of what infectious diseases could be affected by tropical cyclones. This study aimed to examine the impacts of tropical cyclones on notifiable infectious diseases in southeast China. Disease data between 2005 and 2011 from four coastal provinces in southeast China, including Guangdong, Hainan, Zhejiang, and Fujian province, were collected. Numbers of cases of 14 infectious diseases were compared between risk periods and reference periods for each tropical cyclone. Risk ratios (RRs) were calculated to estimate the risks. TCs were more likely to increase the risk of bacillary dysentery, paratyphoid fever, dengue fever and acute hemorrhagic conjunctivitis (ps < 0.05) than to decrease the risk, more likely to decrease the risk of measles, mumps, varicella and vivax malaria (ps < 0.05) than to increase the risk. In conclusion, TCs have mixed effects on the risk of infectious diseases. TCs are more likely to increase the risk of intestinal and contact transmitted infectious diseases than to decrease the risk, and more likely to decrease the risk of respiratory infectious diseases than to increase the risk. Findings of this study would assist in developing public health strategies and interventions for the reduction of the adverse health impacts from tropical cyclones. Full article
(This article belongs to the Special Issue Extreme Weather and Public Health)
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1182 KiB  
Article
How Does Ambient Air Temperature Affect Diabetes Mortality in Tropical Cities?
by Xerxes T. Seposo, Tran Ngoc Dang and Yasushi Honda
Int. J. Environ. Res. Public Health 2017, 14(4), 385; https://doi.org/10.3390/ijerph14040385 - 5 Apr 2017
Cited by 20 | Viewed by 5844
Abstract
Diabetes is well-known as one of the many chronic diseases that affect different age groups. Currently, most studies that evaluated the effects of temperature on diabetes mortality focused on temperate and subtropical settings, but no study has been conducted to assess the relationship [...] Read more.
Diabetes is well-known as one of the many chronic diseases that affect different age groups. Currently, most studies that evaluated the effects of temperature on diabetes mortality focused on temperate and subtropical settings, but no study has been conducted to assess the relationship in a tropical setting. We conducted the first multi-city study carried out in tropical cities, which evaluated the temperature–diabetes relationship. We collected daily diabetes mortality (ICD E10–E14) of four Philippine cities from 2006 to 2011. Same period meteorological data were obtained from the National Oceanic and Atmospheric Administration. We used a generalized additive model coupled with a distributed lag non-linear model (DLNM) in determining the relative risks. Results showed that both low and high temperatures pose greater risks among diabetics. Likewise, the study was able to observe the: (1) high risk brought about by low temperature, aside from the largely observed high risks by high temperature; and (2) protective effects in low temperature percentile. These results provide significant policy implications with strategies related to diabetes risk groups in relation to health service and care strategies. Full article
(This article belongs to the Special Issue Extreme Weather and Public Health)
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737 KiB  
Article
Heat Wave Vulnerability Mapping for India
by Gulrez Azhar, Shubhayu Saha, Partha Ganguly, Dileep Mavalankar and Jaime Madrigano
Int. J. Environ. Res. Public Health 2017, 14(4), 357; https://doi.org/10.3390/ijerph14040357 - 30 Mar 2017
Cited by 58 | Viewed by 14157
Abstract
Assessing geographic variability in heat wave vulnerability forms the basis for planning appropriate targeted adaptation strategies. Given several recent deadly heatwaves in India, heat is increasingly being recognized as a public health problem. However, to date there has not been a country-wide assessment [...] Read more.
Assessing geographic variability in heat wave vulnerability forms the basis for planning appropriate targeted adaptation strategies. Given several recent deadly heatwaves in India, heat is increasingly being recognized as a public health problem. However, to date there has not been a country-wide assessment of heat vulnerability in India. We evaluated demographic, socioeconomic, and environmental vulnerability factors and combined district level data from several sources including the most recent census, health reports, and satellite remote sensing data. We then applied principal component analysis (PCA) on 17 normalized variables for each of the 640 districts to create a composite Heat Vulnerability Index (HVI) for India. Of the total 640 districts, our analysis identified 10 and 97 districts in the very high and high risk categories (> 2SD and 2-1SD HVI) respectively. Mapping showed that the districts with higher heat vulnerability are located in the central parts of the country. On examination, these are less urbanized and have low rates of literacy, access to water and sanitation, and presence of household amenities. Therefore, we concluded that creating and mapping a heat vulnerability index is a useful first step in protecting the public from the health burden of heat. Future work should incorporate heat exposure and health outcome data to validate the index, as well as examine sub-district levels of vulnerability. Full article
(This article belongs to the Special Issue Extreme Weather and Public Health)
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591 KiB  
Article
General Population Knowledge about Extreme Heat: A Cross-Sectional Survey in Lisbon and Madrid
by Julita Gil Cuesta, Joris Adriaan Frank Van Loenhout, Maria Da Conceição Colaço and Debarati Guha-Sapir
Int. J. Environ. Res. Public Health 2017, 14(2), 122; https://doi.org/10.3390/ijerph14020122 - 28 Jan 2017
Cited by 17 | Viewed by 7894
Abstract
Extreme heat is associated with an increased mortality and morbidity. National heat plans have been implemented to minimize the effect of extreme heat. The population’s awareness and knowledge of national heat plans and extreme heat is essential to improve the community’s behavior and [...] Read more.
Extreme heat is associated with an increased mortality and morbidity. National heat plans have been implemented to minimize the effect of extreme heat. The population’s awareness and knowledge of national heat plans and extreme heat is essential to improve the community’s behavior and adaptation. A general population survey was conducted in Lisbon and in Madrid to assess this knowledge. We used a questionnaire to interview passers-by. Results were compared between Lisbon and Madrid and between locals and foreigners, using Pearson Chi-square tests and Fisher's exact test. We conducted 260 interviews in six locations of different socio-economic backgrounds in each city. The most frequently mentioned extreme heat-related risk groups were the elderly (79.2%), children (49.6%) and babies (21.5%). The most frequently reported protective measures were increased fluid intake (73.1%) and avoiding exposure to the sun (50.8%). Knowledge about the heat plan was higher in Lisbon (37.2%) than in Madrid (25.2%) (p-value = 0.03). Foreigners had less knowledge of risk groups compared to locals. Heat plans were not widely known in Madrid and Lisbon. Nonetheless, knowledge of practical concepts to face extreme heat, such as certain risk groups and protective measures, was found. Our results were similar to comparable surveys where specific respondents’ groups were identified as less knowledgeable. This highlighted the importance of addressing these groups when communicating public health messages on heat. Foreigners should be specifically targeted to increase their awareness. Full article
(This article belongs to the Special Issue Extreme Weather and Public Health)

Review

Jump to: Research

435 KiB  
Review
Heat Exposure and Maternal Health in the Face of Climate Change
by Leeann Kuehn and Sabrina McCormick
Int. J. Environ. Res. Public Health 2017, 14(8), 853; https://doi.org/10.3390/ijerph14080853 - 29 Jul 2017
Cited by 132 | Viewed by 28468
Abstract
Climate change will increasingly affect the health of vulnerable populations, including maternal and fetal health. This systematic review aims to identify recent literature that investigates increasing heat and extreme temperatures on pregnancy outcomes globally. We identify common research findings in order to create [...] Read more.
Climate change will increasingly affect the health of vulnerable populations, including maternal and fetal health. This systematic review aims to identify recent literature that investigates increasing heat and extreme temperatures on pregnancy outcomes globally. We identify common research findings in order to create a comprehensive understanding of how immediate effects will be sustained in the next generation. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guide, we systematically reviewed articles from PubMed and Cochrane Reviews. We included articles that identify climate change-related exposures and adverse health effects for pregnant women. There is evidence that temperature extremes adversely impact birth outcomes, including, but not limited to: changes in length of gestation, birth weight, stillbirth, and neonatal stress in unusually hot temperature exposures. The studies included in this review indicate that not only is there a need for further research on the ways that climate change, and heat in particular, may affect maternal health and neonatal outcomes, but that uniform standards for assessing the effects of heat on maternal fetal health also need to be established. Full article
(This article belongs to the Special Issue Extreme Weather and Public Health)
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438 KiB  
Review
Implications of Changing Temperatures on the Growth, Fecundity and Survival of Intermediate Host Snails of Schistosomiasis: A Systematic Review
by Chester Kalinda, Moses Chimbari and Samson Mukaratirwa
Int. J. Environ. Res. Public Health 2017, 14(1), 80; https://doi.org/10.3390/ijerph14010080 - 13 Jan 2017
Cited by 49 | Viewed by 7283
Abstract
Climate change has been predicted to increase the global mean temperature and to alter the ecological interactions among organisms. These changes may play critical roles in influencing the life history traits of the intermediate hosts (IHs). This review focused on studies and disease [...] Read more.
Climate change has been predicted to increase the global mean temperature and to alter the ecological interactions among organisms. These changes may play critical roles in influencing the life history traits of the intermediate hosts (IHs). This review focused on studies and disease models that evaluate the potential effect of temperature rise on the ecology of IH snails and the development of parasites within them. The main focus was on IH snails of schistosome parasites that cause schistosomiasis in humans. A literature search was conducted on Google Scholar, EBSCOhost and PubMed databases using predefined medical subject heading terms, Boolean operators and truncation symbols in combinations with direct key words. The final synthesis included nineteen published articles. The studies reviewed indicated that temperature rise may alter the distribution, optimal conditions for breeding, growth and survival of IH snails which may eventually increase the spread and/or transmission of schistosomiasis. The literature also confirmed that the life history traits of IH snails and their interaction with the schistosome parasites are affected by temperature and hence a change in climate may have profound outcomes on the population size of snails, parasite density and disease epidemiology. We concluded that understanding the impact of temperature on the growth, fecundity and survival of IH snails may broaden the knowledge on the possible effects of climate change and hence inform schistosomiasis control programmes. Full article
(This article belongs to the Special Issue Extreme Weather and Public Health)
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