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

Jones, Natalia ORCID: https://orcid.org/0000-0003-4025-2985, Bouzid, Maha, Few, Roger, Hunter, Paul ORCID: https://orcid.org/0000-0002-5608-6144 and Lake, Iain ORCID: https://orcid.org/0000-0003-4407-5357 (2020) 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. Journal of Water and Health, 18 (2). 145–158. ISSN 1477-8920

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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.

Item Type: Article
Uncontrolled Keywords: causal process diagram,cholera,climate change,health impact pathway,systematic review,wash,water science and technology,waste management and disposal,public health, environmental and occupational health,microbiology (medical),infectious diseases,sdg 3 - good health and well-being,sdg 13 - climate action ,/dk/atira/pure/subjectarea/asjc/2300/2312
Faculty \ School: Faculty of Science > School of Environmental Sciences
Faculty of Social Sciences > School of International Development
University of East Anglia > Faculty of Science > Research Centres > Tyndall Centre for Climate Change Research
Faculty of Medicine and Health Sciences > Norwich Medical School
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Depositing User: LivePure Connector
Date Deposited: 01 Nov 2019 12:30
Last Modified: 22 Oct 2022 05:23
URI: https://ueaeprints.uea.ac.uk/id/eprint/72842
DOI: 10.2166/wh.2020.088

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