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Climate Change and Human Health Literature Portal Water, sanitation and hygiene risk factors for the transmission of cholera in a changing climate: Using a systematic review to develop a causal process diagram

Climate Change and Human Health Literature Portal

Jones N, Bouzid M, Few R, Hunter P, Lake, I
2020
Journal of Urban Health. 18 (2): 145-158

Cholera is a severe diarrhoeal disease affecting vulnerable communities. A long-term solution to cholera transmission is improved access to and uptake of water, sanitation and hygiene (WASH). Climate change threatens WASH. A systematic review and meta-analysis determined five overarching WASH factors incorporating 17 specific WASH factors associated with cholera transmission, focussing upon community cases. Eight WASH factors showed lower odds and six showed higher odds for cholera transmission. These results were combined with findings in the climate change and WASH literature, to propose a health impact pathway illustrating potential routes through which climate change dynamics (e.g. drought, flooding) impact on WASH and cholera transmission. A causal process diagram visualising links between climate change dynamics, WASH factors, and cholera transmission was developed. Climate change dynamics can potentially affect multiple WASH factors (e.g. drought-induced reductions in handwashing and rainwater use). Multiple climate change dynamics can influence WASH factors (e.g. flooding and sea-level rise affect piped water usage). The influence of climate change dynamics on WASH factors can be negative or positive for cholera transmission (e.g. drought could increase pathogen desiccation but reduce rainwater harvesting). Identifying risk pathways helps policymakers focus on cholera risk mitigation, now and in the future.

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Resource Description

    General Exposure
    General Geographic Feature, Freshwater
    Global or Unspecified Location
    Infectious Disease
    • Infectious Disease: Waterborne Disease
      • Waterborne Disease: Cholera (waterborne)
      Waterborne Disease
    Review Article
    Adaptation, Communication, Mitigation
    • Adaptation, Communication, Mitigation : Intervention
    • Adaptation, Communication, Mitigation : Researcher
    • Adaptation, Communication, Mitigation : Mitigation Co-Benefit/Co-Harm
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