Clinic of Infectious Diseases, Department of Precision and Regenerative Medicine and Ionian Area - (DiMePRe-J), University of Bari Aldo Moro, Bari, Italy.
Doctors with Africa CUAMM, Maputo, Mozambique.
BMC Public Health. 2024 Aug 21;24(1):2271. doi: 10.1186/s12889-024-19763-5.
Climate change is contributing to increase the frequency and severity of climate disasters in Mozambique, leading, since 2019, to extensive damage to infrastructure and displacement 1.3 million people. Aim of this study is to evaluate baseline preparedness to vector-borne and water-borne infections among households and internally displaced people exposed to climate disasters in Mozambique.
This was a cross-sectional, community-based survey assessing the preparedness to infectious diseases outbreaks among people exposed to climate disasters in six districts in Mozambique. Structured form was delivered via face-to-face between October 15th and November 7th, 2022. Study outcome was defined as a seven-point score of preparedness to infectious disease outbreaks. Multivariable analysis of the score was conducted using Conway-Maxwell-Poisson regression.
This study included 2,140 households and 11,239 people, with IDPs accounting for 30% of them. Overall, 1,186 (55.4%) households were overcrowded. Median score of preparedness was 3 points (IQR 2-4). At multivariable analyses, districts with low preparedness were Montepuez and Mueda. Higher preparedness was associated with family planning (p < 0.0001), access to primary education for all children living in the household (p < 0.001) and possession of a birth certificate for all children aged < 5y (p < 0.0001), while preparedness was heterogeneous among the districts (p < 0.05). Households composed by IDPs were not associated with a lower preparedness score.
In climate-vulnerable communities in Mozambique, households practicing family planning, providing access to primary education and birth certificate for all children were less vulnerable to water-borne and vector-borne infectious disease outbreaks. Being family planning and childcare primarily performed by women, our findings can inform policymakers and practitioners on the importance of addressing women to mitigate the impact of climate disasters and reduce the risk of infectious disease outbreaks.
气候变化导致莫桑比克气候灾害的频率和严重程度不断增加，自 2019 年以来，基础设施遭受广泛破坏，130 万人被迫流离失所。本研究旨在评估莫桑比克暴露于气候灾害的家庭和境内流离失所者对虫媒和水传播感染的基线准备情况。
这是一项横断面、基于社区的调查，评估了莫桑比克六个地区暴露于气候灾害的人群对传染病暴发的准备情况。2022 年 10 月 15 日至 11 月 7 日期间，通过面对面的方式提供了结构化表格。研究结果定义为对传染病暴发的准备情况的七点评分。使用 Conway-Maxwell-Poisson 回归对评分进行多变量分析。
本研究包括 2140 户家庭和 11239 人，其中境内流离失所者占 30%。总体而言，1186 户（55.4%）家庭过度拥挤。准备情况的中位数评分为 3 分（IQR 2-4）。在多变量分析中，准备情况较低的地区是蒙特普埃兹和穆埃达。家庭计划（p<0.0001）、为所有居住在家庭中的儿童提供小学教育（p<0.001）和为所有 5 岁以下儿童提供出生证明（p<0.0001）与较高的准备情况相关，而各地区之间的准备情况存在异质性（p<0.05）。由境内流离失所者组成的家庭与较低的准备评分无关。
在莫桑比克易受气候影响的社区中，实施家庭计划、为所有儿童提供小学教育和出生证明的家庭更容易受到水传播和虫媒传染病暴发的影响。由于家庭计划和儿童保育主要由妇女承担，我们的研究结果可以为政策制定者和实践者提供信息，即重视妇女在减轻气候灾害影响和降低传染病暴发风险方面的重要性。
