Kemajou Donald Njatang
University of Yaounde II-IFORD, Yaounde, Cameroon E-mail:
J Water Health. 2022 Apr;20(4):589-600. doi: 10.2166/wh.2022.199.
Climate variability is expected to increase the risk of diarrhea diseases, a leading cause of child mortality and morbidity in Sub-Saharan Africa (SSA). The risk of diarrhea is more acute when populations have poor access to improved water and sanitation. This study seeks to determine individual and joint effects of climate variation, water supply and sanitation on the occurrence of diarrhea among children under five in SSA using multilevel mixed-effect Poisson regression including cross-level interaction. We merged 57 Demographic and Health Surveys (DHS) from 25 SSA countries covering the period 2000-2019 with climatic data from the DHS geolocation databases. The results of the research indicate that 77.7% of the variation in the occurrence of diarrhea in Sub-Saharan households is due to climatic differences between clusters. Also, a household residing in a cluster with a high incidence of diarrhea is 1.567 times more likely to have diarrhea cases than a household from a cluster with a low incidence. In addition, when average temperature and rainfall increase, households using unimproved sanitation or unimproved water have more cases of diarrhea. For SSA, the results of the multilevel analysis suggest the adoption at both levels; macro (national) and micro (household), of climate change adaption measures in the water sector to reduce the prevalence of diarrhea.
预计气候变异性会增加腹泻疾病的风险，腹泻是撒哈拉以南非洲（SSA）儿童死亡和发病的主要原因。当人们难以获得改善的水和卫生设施时，腹泻风险会更加严峻。本研究旨在利用包含交叉层面交互作用的多层次混合效应泊松回归，确定气候变化、供水和卫生设施对撒哈拉以南非洲五岁以下儿童腹泻发生情况的个体和联合影响。我们将25个撒哈拉以南非洲国家在2000年至2019年期间的57项人口与健康调查（DHS）与来自DHS地理位置数据库的气候数据进行了合并。研究结果表明，撒哈拉以南非洲家庭中腹泻发生情况的77.7%的变异是由于不同群组之间的气候差异。此外，居住在腹泻高发群组的家庭出现腹泻病例的可能性是来自腹泻低发群组家庭的1.567倍。此外，当平均温度和降雨量增加时，使用未改善卫生设施或未改善供水的家庭会出现更多腹泻病例。对于撒哈拉以南非洲地区，多层次分析结果表明，应在宏观（国家）和微观（家庭）层面采取水部门的气候变化适应措施，以降低腹泻的流行率。
