Orals: Thu, 1 May | Room 1.31/32
Dengue has emerged as a significant public health challenge and the world's most prevalent climate-sensitive mosquito-borne disease. No antiviral drugs are currently available to treat the disease, but vaccine development has led to promising results in reducing dengue’s burden. As climate change is predicted to lead to geographic expansion of vector populations and increases in dengue outbreaks, the development of early warning systems is critical to improving outbreak preparedness to respond to dengue epidemics. Here, we investigate the remote response of tropical Indian Ocean sea surface temperature (SST) variability to dengue case counts in South Central Asia (SCA). More specifically, we provide new evidence on the association between the main modes of oceanic SST variability and dengue case counts using singular value decomposition (SVD) analysis. A cross-correlation analysis is then performed to quantify the maximum correlations and lags between SST climate indices and dengue case counts in SCA. We used traveler data from the GeoSentinel global infectious disease surveillance network and dengue case counts from the OpenDengue project. SST data was retrieved from the latest fifth generation global reanalysis of the European Centre for Medium-Range Weather Forecasts (ECMWF), ERA5. The results were compared with gridded SST datasets from observational reports and satellite data (HadISST1 and ERSSTv5). The SVD analysis reveals significant influence of SST anomalies on dengue case counts. The first leading SVD mode, which accounts for 25% of the total square covariance, represents the Indian Ocean basin mode, which is characterized by basin-wide warming and is statistically significantly correlated with dengue case counts. We found that positive SST anomalies over the western tropical Indian Ocean were associated with a surge in dengue cases in SCA after a lag time of 1-2 months. Our study demonstrated potential for predicting regional dengue epidemics based on remote SSTs. Combining dengue surveillance data and climatological data may be a promising mechanism to anticipate the geographic locations of future dengue outbreaks.
How to cite: Dafka, S., Huits, R., Libman, M., Hamer, D. H., Duvignaud, A., and Rocklöv, J.: Potential utility of Indian Ocean sea surface temperature for predicting dengue outbreaks in South Central Asia, EGU General Assembly 2025, Vienna, Austria, 27 Apr–2 May 2025, EGU25-6669, https://doi.org/10.5194/egusphere-egu25-6669, 2025.
Abstract
Climate change significantly influences the spread of infectious diseases, including leishmaniasis, a vector-borne disease transmitted by infected sand flies. Leishmaniasis affects approximately 12 million people globally, with significant health, economic, and social impacts.
Despite ongoing research, there is no registered vaccine, and treatment options remain limited due to drug toxicity and emerging resistance.
The geographical range of sand flies has expanded from the Mediterranean region toward Northern Europe, exacerbating public health challenges.
Current prediction models for sand fly populations are hindered by limitations in temporal and spatial scales, high data collection costs, and highly skewed observation data.
Recent advancements in climate modeling, data assimilation, and remote sensing offer opportunities to enhance these models.
This study utilizes the largest observational dataset on sand flies from the European CLIMOS project (https://climos-project.eu), incorporating data from VectorNet and EDENext, combined with high-resolution climate and hydrological datasets, to create a sand fly population prediction model named Sand Flies Extreme Prediction Population (FEPO). By enhancing predictive accuracy and speed, it can facilitate targeted public health interventions while also strengthening strategies for climate change adaptation.
The initial findings indicate that the proposed model achieves a mean absolute error that is 12% lower than the classical regression approach when validated against observational data. Moreover, the FEPO model successfully maps the distribution of sand fly species responsible for transmitting leishmaniasis across Europe with high spatial resolution.
Acknowledgments:
Funding:
The CLIMOS consortium is co-funded by the European Commission grant 101057690 and UKRI grants 10038150 and 10039289.
The six Horizon Europe projects, BlueAdapt, CATALYSE, CLIMOS, HIGH Horizons, IDAlert, and TRIGGER, form the Climate Change and Health Cluster. \\
Sand Flies Data Contribution:
- EDENext: The data for EDENext was obtained from the Palebludata website (https://www.palebludata.com).
- VectorNet: The data for VectorNet was obtained from the ECDC.
How to cite: Soheili, M., Rakovec, O., Berriatua, E., modiri, E., Blesic, S., and Samaniego, L. and the Majid Soheili: Towards proactive disease control: predicting sand fly population dynamics over Europe for enhanced public health outcomes, EGU General Assembly 2025, Vienna, Austria, 27 Apr–2 May 2025, EGU25-13586, https://doi.org/10.5194/egusphere-egu25-13586, 2025.
Anticipatory action (AA) refers to actions taken by humanitarian actors and governments to reduce the humanitarian impacts of a forecasted hazard before it occurs. To date, most AA initiatives have focused on hydrometeorological events, but initiatives for in particular climate-sensitive diseases are gaining traction. Acting ahead of a disease outbreak or controlling an epidemic early on can significantly reduce the impacts. Cameroon has experienced recurrent cholera epidemics since 1971. The Cameroon Red Cross has been working with the French Red Cross, technical partners (510 an initiative of the Netherlands Red Cross and EHESP), and in-country actors such as the Ministry of Health to co-create an Early Action Protocol (EAP) for cholera. An EAP contains a model that triggers early actions once a certain forecast or observation reaches a threshold that indicates there could be severe negative impacts corresponding to a one-in-five-year return period. Cholera is a water-borne disease, where climatic, environmental, and socio-economic factors contribute to its risk. The development of a trigger model requires historical data on these factors, but this data is often difficult to obtain or not available with sufficient spatial and temporal resolution. Also, for an operational trigger model, the input data of the trigger model has to be available in near-real time. A data-sharing agreement with the Ministry of Health was put in place to get access to the sensitive cholera incidence data. Correlation analyses between daily rainfall (as floods impact WASH infrastructure) and cholera case data were done for delays between 7 to 14 days, as it is known from the literature that the first cholera cases usually occur after a few days of flooding. However, only very weak correlations were found. A moving average of rainfall over 50 mm/day for four consecutive days did correspond to a significant number of cholera cases. The trigger model proposed relies only on observed data and consists of two parts. Trigger 1 is a climatic trigger that triggers when a district experiences flooding with over 2000 people affected or when it experiences 4 days with an average daily rainfall of at least 50 mm. Trigger 2 goes off whenever at least 5 suspected cases or 1 confirmed cholera case are identified through community-based or national surveillance systems. To activate trigger 2, trigger 1 must already have been activated. The next steps will include gaining experience with activations with this protocol, while also, from a research point of view, evolving the trigger model once more data on the cholera risk factors becomes available.
How to cite: van den Homberg, M., Drooglever Fortuyn, M., Margutti, J., Duchemin, M., Drame, G., Ewane Ngando, C., Maillard, A.-L., and Crépey, P.: Co-creating a trigger model for cholera anticipatory action in Cameroon, EGU General Assembly 2025, Vienna, Austria, 27 Apr–2 May 2025, EGU25-19944, https://doi.org/10.5194/egusphere-egu25-19944, 2025.
The “Climate, Health and Equity Co-Benefits” project, funded by the Italian National Plan for Complementary Investments (PNC), promotes urban climate change adaptation and mitigation across Italian cities. ISPRA-(Italian Institute for Environmental Protection and Research) analyzed current (2010–2023) and projected (to 2030) gas emissions, focusing on key greenhouse gases (GHGs, including CO2, CH4, and N2O) and pollutants (NOx, PM10, and PM2.5) from vehicular traffic, which are known to have adverse health effects, in six major Italian cities: Turin, Milan, Bologna, Rome, Bari, and Palermo. Utilizing the EU-standard Copert software - a recognized and validated tool for vehicle emission calculations - the study estimated baseline emissions and modeled future trends based on detailed vehicle data, encompassing engine size, fuel type, and Euro standard classifications, obtained from ACI (Automobile Club Italia). To explore potential pathways for achieving significant emission reductions, various 2030 scenarios were developed, reflecting potential vehicle management policies aimed at substantial reductions in both GHG and pollutant emissions associated with urban mobility. These scenarios identify actionable strategies designed to minimize environmental impact and significantly enhance air quality within these urban areas, ultimately contributing to the development of more sustainable urban transport solutions.
Between 2010 and 2023, Turin, Milan, and Rome saw reductions in both the number of vehicles (-5.5%, -3.8%, and -6.2%, respectively) and emissions, including GHGs (e.g., up to -4% in CO₂ emissions) and particles (e.g., up to -27% for PM10 emissions). The other cities, Palermo, Bari and Bologna, have recorded an increase in the number of vehicles (+1.9%, +2.9%, and +7.7%, respectively), however, CO2 emissions do not grow proportionally to the number of vehicles. In addition, PM10 emissions have decreased (Palermo -13%, Bari -21%, and Bologna -20.4%). These findings suggest that, beyond reducing the size of the vehicle fleet, the transition to more efficient and technologically advanced vehicles (such as electric or hybrid) is crucial for mitigating climate change by reducing the emissions of health-damaging pollutants and enhancing the health co-benefits of proposed measures. The analyses of the other parameters considered lead to the same conclusions and observations.
Several scenarios were simulated for 2030: one of them assuming a 30% reduction in annual kilometers travelled, resulted in a corresponding 30% decrease in emissions across all cities and parameters. This outcome can be achieved through the implementation of an efficient local public transportation network that provides a proper alternative to private vehicle use. A similar magnitude of reduction can be achieved by considering the scenario that drastically reduces the number of Euro-standard 0-3 vehicles. In terms of CO₂, an average reduction of 24% was observed across all cities. Additionally, significant reductions can be achieved by introducing a substantial number of hybrid and electric vehicles to replace all the oldest vehicles in the 2023 fleet. In this case, we observed an average reduction of 8.5%, 25%, and 55% for CO₂, PM10, and NOx, respectively.
This research was carried out within the project “Co-benefits of health and equity to support climate change response plans in Italy” funded by PNC – CUP-MASTER-J55I22004450001, PREV-A-2022-12376994.
How to cite: Faticanti, M., Di Micco, L., Abati, S., Bultrini, M., and Lepore, A.: Emission analysis and sustainable mobility scenarios in Italian cities, EGU General Assembly 2025, Vienna, Austria, 27 Apr–2 May 2025, EGU25-3519, https://doi.org/10.5194/egusphere-egu25-3519, 2025.
Air quality is a critical environmental concern that poses significant health risks to populations worldwide. Therefore, the impact of air pollution on the cognitive health of older adults has gained attention as an urgent global concern. This study addresses a critical research gap by investigating the association between air pollution, specifically particulate matter PM10 and PM2.5, and cognitive functioning in older adults across various European regions.
Using data from the Survey of Health, Ageing, and Retirement in Europe (SHARE), a comprehensive panel study on health and aging as well as data from the European Environmental Agency (EEA) developed as part of EEA’s Air Quality Health Risk Assessments, this research employs multilevel modeling to explore the consequences of varying air quality on cognitive functioning such as episodic memory or verbal fluency. Older adults are particularly vulnerable subpopulations, and with their increasing representation in populations, understanding the factors influencing their cognitive health has never been more pertinent.
The study demonstrates that while individual factors (e.g. as education) and contextual factors, such as societal development and equality, are recognized as significant for episodic memory, the role of environmental factors remains underexplored. This research addresses this gap by examining the impact of air pollution on cognitive health, with a specific focus on how its effects vary by education. Our findings indicate that exposure to PM2.5 and PM10 significantly impairs cognitive performance in older adults. Additionally, the results highlight a pronounced educational gradient in the impact of pollution on cognitive health, particularly among women at advanced ages, whereas this pattern is not observed among men.
This study provides critical evidence for shaping public health policies aimed at mitigating the adverse effects of air pollution on cognitive well-being in aging populations. Addressing the cognitive consequences of air pollution is crucial for supporting healthy aging and improving quality of life for older adults across diverse contexts, including European populations.
How to cite: Weber, D., Aktas, A., and Poblete Cazenave, M.: Breathing Clean Air, Remembering Better: A Cross-Regional Study of Air Quality and Episodic Memory in European Older Adults, EGU General Assembly 2025, Vienna, Austria, 27 Apr–2 May 2025, EGU25-17311, https://doi.org/10.5194/egusphere-egu25-17311, 2025.
Experiencing severe flooding tends to worsen mental health, e.g., increased incidence of anxiety, depression, or post-traumatic stress disorder, creating a significant public health issue to be addressed. Moreover, extreme events can co-occur, magnifying potential impacts. For example, in 2020, several countries suffered severe floods, including Vietnam, simultaneously with the COVID-19 pandemic. Understanding the combined mental health impacts of floods and COVID-19 is an existing research gap we seek to address by conducting 400 face-to-face surveys in October 2023 in two coastal communes in Hue City, where local people faced widespread severe flooding, COVID-19 restrictions and lockdowns.
The respondents' mental health was assessed using the Kessler psychological distress scale (K6). Results show that 20% of the respondents report they have mental health distress, and 80% report no mental health distress. Binary logistic regression models demonstrated that among twelve flood stressors, facing ‘livelihood difficulties’, ‘seeing dead human bodies’, and ‘being rescued’ relate significantly to mental distress. Meanwhile, ‘impacts on individual health’ and ‘interrupted education’ are the two significant stressors of COVID-19. When combined, these five factors stay significant, with ‘seeing dead human bodies’ and ‘interrupted education’ increasing their odds ratios (ORs), while the ORs of the other factors decreased. Additionally, the multivariable regression model revealed the combined effects of flood and COVID-19 when comparing the ORs of four groups ranging from ‘No flood stress & No Covid stress’ to ‘Flood stress & Covid stress’. Effect size is highest for those who experienced both flood and COVID-19 impacts in the same year with OR = 9.67 (p-value < 0.001), compared with those who suffered only flood impacts with OR = 5.47 (p-value < 0.001), or only COVID-19 impacts with OR =2.83 (p-value < 0.1).
These findings are insightful for addressing public health problems under the impacts of multiple risks instead of focusing on a single risk. This draws attention to systematic mental health assessment and care for vulnerable groups, which is still a significant gap in developing countries. Also, the results raise the need for supporting policies and action plans to reduce the psychological impacts of the coincidences of disasters and pandemics, like providing additional support to at-risk communities. Specifically, some interventions or solutions during and after disasters, like the management of human remains, rehearsed evacuation plans, prevention of school closure, and setting up public health infrastructure for psychological assistance, are needed.
How to cite: Pham, T. D. M., Hudson, P., Thieken, A. H., and Bubeck, P.: Understanding the combined mental health impacts of flooding and COVID-19 in Hue City, Central Vietnam, EGU General Assembly 2025, Vienna, Austria, 27 Apr–2 May 2025, EGU25-7349, https://doi.org/10.5194/egusphere-egu25-7349, 2025.
In the recent IPCC Report [1], Malawi has been designated as one of the most vulnerable countries to climate change. With many low-lying regions, unpaved roads, and poor building infrastructure, flooding and heavy precipitation, in particular, are considerable threats to population health. Between 1991 and 2020, more than 3.5 million people were exposed to flooding in Malawi, with 935 deaths due to flooding, mudslides, disease, and injury [2]. In addition to these direct impacts on individual health, precipitation events can severely disrupt access to and provision of medical care. In 2023, Cyclone Freddy affected the operation of 79 healthcare facilities [3], some of which were forced to close for months.
As there is no systematic data collection on the nature of these disruptions, the magnitude of their consequences is unknown. However, given that such extreme precipitation events are expected to become more common, that impact is expected to become worse in the coming decades. Using facility-specific data on antenatal care (ANC) service provision in Malawi [4], coupled with ERA5 reanalysis data [5], we use regression analyses to characterize the historic relationship between precipitation and healthcare access. We then use downscaled CMIP6 projections [6] to estimate the future impact. Under Shared Socio-economic Pathway 5.85, we estimate that 54,800 ANC appointments will be affected between 2025 and 2060, due to precipitation. That represents 0.2% of projected births in Malawi. However, this belies significant regional and temporal variation: in regions in the South or bordering Lake Malawi, up to 1 in 40 of all appointments could be affected annually. In a country with already-high maternal and neonatal mortality, such disruptions could increase barriers to care and worsen health outcomes.
1. Birkmann, E., et al. (2022). Poverty, livelihoods, and sustainable development. In H.-O. Pörtner et al. (Eds.), Climate Change 2022: Impacts, Adaptation, and Vulnerability, 1171–1274. Cambridge University Press.
2. World Bank. (2024). Malawi - Climate and Health Vulnerability Assessment. https://hdl.handle.net/10986/41847.
3. Lutala, P., & Makwero, M. (2023). Cyclone Freddy in Malawi: Reflections from a primary care perspective. Afr. J. Prim. Health Care Fam. Med., 15(1), 1–2
4. Malawi HMIS. (2022). Malawi Health Management Information System. https://dhis2.health.gov.mw/.
5. Hersbach, H., et al. (2020). The ERA5 global reanalysis. Q. J. R. Meteorol. Soc., 146(730), 1999–2049.
6. Gergel, D., et al (2022). ClimateImpactLab/DownscaleCMIP6: v1.0.0. https://doi.org/10.5281/zenodo.6403794.
How to cite: Murray-Watson, R. and the TLO Modelling Team: The effect of extreme precipitation on the use of maternal healthcare services in Malawi., EGU General Assembly 2025, Vienna, Austria, 27 Apr–2 May 2025, EGU25-6133, https://doi.org/10.5194/egusphere-egu25-6133, 2025.
Introduction
The effects of climatic shocks on access to routine health services are under-theorised. Evidence suggests significant and adverse impacts of climate hazard exposure on maternal and child health outcomes, including through reduced service access. However, prior work has predominantly focused on macro-level (national) health system dynamics for single hazards. There is limited understanding of how shock effects may overlap and interact in space and time and affect local level health care access. We applied qualitative system dynamics modelling to visualise cause-and-effect relationships linking exposure to floods and heatwaves to health service access at community level in a lower-middle income setting at significant, ongoing risk of exposure to heatwaves and flooding.
Methods
Group Model Building workshops were conducted in November 2024 in Senanga and Sinazongwe Districts of Zambia, with 70 community members, 10 facility-level healthcare practitioners, and 50 district-level decision-makers. Causal Loop Diagrams (CLDs) were generated to identify sources and pathways of vulnerability influencing access to maternal and child health services in response to heatwaves and flooding events in these communities. Discussions focused on event experiences during the 12 months preceding the workshops, and on access to antenatal care visits, health facility deliveries and routine childhood immunisation as outcomes. Draft CLDs from each workshop were edited and merged following a stepwise process, and then qualitatively analysed to identify relevant feedback loops and delays.
Results
We found common vulnerability pathways for health service access linked to heatwaves and flooding exposure. There was also evidence of cascading risk from district to household level influencing health service utilisation. Key demand-side vulnerabilities included impacts on household income arising from damage to crops in communities where livelihoods centred on agricultural production. This reduced care seeking as healthcare was de-prioritised relative to meeting basic needs, and transport costs to access care became less affordable. Lack of access to transport was an additional pathway (e.g. due to infrastructure damage in the case of flooding, or the perceived risk of heat-related illness in the context of heatwaves). On the supply side, there were vulnerabilities arising from disrupted power supplies and logistics (e.g. comprising vaccine cold chain integrity). Heat and flooding also affected healthcare worker delivery of outreach services, and productivity linked both to the effects of climatic stressors and and absenteeism due to challenges in accessing facilities themselves. There were also important trade-offs influencing both health service supply and demand in the context of heatwaves and flooding. Health care providers sometimes deprioritised delivery of routine maternal and child healthcare where demand linked to increases in water-borne disease, heat exhaustion and other hazard exposure impacts rose.
Conclusion
Results from this analysis suggest a key role for adaptation strategies addressing livelihoods, critical infrastructure and procurement to reduce disruption to routine maternal and child health care access during floods and heatwaves in Zambia. Future work should consider the generalisability of these findings to other contexts and evaluate the impact and cost-effectiveness of different adaptation interventions to support preparedness, response and recovery.
How to cite: Ismail, S., Bwalya, B., Chama-Chiliba, C., Bozzani, F., Simona, S., Chisola, M., Bwalya, R., Moonga, A., Mweemba, C., Sakic-Trogrlic, R., and Borghi, J.: Pathways of vulnerability and risk influencing access to maternal and child healthcare in the context of heatwaves and flooding in Zambia, EGU General Assembly 2025, Vienna, Austria, 27 Apr–2 May 2025, EGU25-8796, https://doi.org/10.5194/egusphere-egu25-8796, 2025.
Extreme weather events (floods and heatwaves) are becoming more frequent and intense due to climate change, posing significant risks to maternal and child health (MCH). These events interact in complex ways, occurring as compounding hazards (simultaneous or overlapping events), multiple hazards (independent but co-occurring risks), or cascading hazards (where one event triggers or exacerbates another). Understanding these interactions is critical for assessing their full health impacts and improving health system resilience. To date, health-related research has primarily focused on the effects of each hazard individually. This study employs an integrated framework that combines copula models, Bayesian networks, and machine learning approaches to analyse multi-hazard interactions, focusing on Zambia as a case study. Data, including daily rainfall and temperature, MCH-related datasets, utilisation data, and health system performance metrics – such as antenatal care (ANC), postnatal care (PNC), childhood immunisation, place and mode of delivery, and health service utilisation records – were obtained from Zambia through the REACH project. Daily rainfall was merged with TAMSAT and ERA5 reanalysis data (weather station data) to identify flood and heatwave events across Zambia from 1981 to 2023. Copula models were used to capture non-linear dependencies between heatwaves and floods; Bayesian networks uncovered causal pathways linking hazards with MCH and utilisation outcomes; and machine learning models (e.g., random forests and neural networks) predicted health impacts and identified critical patterns of hazard-MCH interactions. Intermediate variables, such as demand-side factors (e.g., education, wealth, age, etc.) and supply-side factors (e.g., facility density, health worker density, and healthcare financing), were incorporated to improve causal inference and identify actionable pathways. Marginal distributions for temperature and precipitation extremes were modelled using extreme value theory, while copulas quantified the joint probabilities of simultaneous extremes. Bayesian networks provided insights into cascading effects, such as how flooding damages healthcare infrastructure and exacerbates the impact of heatwaves on MCH services. Machine learning models were then trained to predict MCH outcomes (utilisation rates and counts) based on these multi-hazard interactions, leveraging their capacity to handle complex, non-linear relationships. Key results focus on estimating the level of ANC and PNC service disruption caused by compounding hazards, such as simultaneous floods and heatwaves. There is an urgent need for climate-resilient healthcare systems and targeted interventions to mitigate the risks of interacting with climate extremes on MCH. Such disruptions are anticipated to highlight important predictive factors, including increased rates of preterm births and maternal complications. This integrated approach, combining statistical, causal, and predictive tools, offers a holistic framework for analysing multi-hazard interactions and their impact on maternal and child health outcomes. By focusing on Zambia as a case study, this research aims to generate insights that are both contextually relevant and scalable for global application.
Keywords: Multiple hazards, maternal and child health, machine learning, copula models, Bayesian networks
Acknowledgements
This work was conducted under the framework of the Economic and Social Research Council grant: Building Resilience to Floods and Heat in the Maternal and Child Health Systems in Brazil and Zambia (REACH), Grant Number: ES/Y00258X/1
How to cite: Debele, S. E., Saulnier, D., Part, C., Chisola, M. N., Chama-Chiliba, C., Trogrlic, R. S., Ismail, S., Semwanga, A., Foss, A., and Borghi, J.: Modeling the impact of multiple hazards on the Maternal and Child Health System in Zambia , EGU General Assembly 2025, Vienna, Austria, 27 Apr–2 May 2025, EGU25-18902, https://doi.org/10.5194/egusphere-egu25-18902, 2025.
Posters on site: Thu, 1 May, 10:45–12:30 | Hall X3
The Sustainable Development Goal 3 commits to ending the malaria epidemic by 2030. Malaria poses a significant health threat in Sub-Saharan Africa and is a leading cause of child mortality. Additionally, climate change is disrupting the water cycle, likely increasing the frequency of floods and exposing more people to health risks. The stagnant flood water could serve as a breeding ground for mosquitoes. However, the relationship between flood risk and malaria dynamics in Sub-Saharan Africa remains poorly understood. In this study, we assess the impact of flood risk on children under five years old, revealing a 60-100% rate of the parasite Plasmodium falciparum within the demarcated flood zones in 49 Sub-Saharan African countries from 2000 to 2018. We utilised data on heavy rainfall, flood hazard maps derived from satellite imagery, and geospatial-temporal datasets concerning population and malaria rates to assess the number of children affected by floods and the burden of malaria in flood zones. Additionally, we incorporated socioeconomic vulnerability datasets. Vulnerability is categorised into four domains concerning children under five years: health, economy, health economy, and social factors.
The global method analyses trends over time for each country regarding the increased or decreased hazard, exposure, and vulnerability related to heavy rains and the burden of malaria in flood-prone areas. We aim to conduct a regression analysis to assess the relationship between these drivers and the malaria burden in flood zones. We also conducted a local analysis to identify potential deviations from the baseline by comparing the prevalence of Plasmodium falciparum in the flood zones to the prevalence at the national level. A linear regression was conducted to evaluate the possible relationship between malaria at the country level and within the flood zones in conjunction with the vulnerability.
We started the analyses for nine countries and observed that the proportion of male and female children exposed to floods in hazard zones is increasing globally and proportionally, alongside the number of children impacted by malaria in those zones. Although malaria cases among children aged 2 to 10 generally decreased, we observed some spikes in incidence in flood zones during the study period. Using Spearman's rank correlation coefficient, we observed a strong relationship between exposure to floods and the influence of malaria. However, there was no statistical significance regarding the impact of vulnerability and flood hazard on malaria dynamics. The regression analysis will give us more insight into the relationship between all the drivers. These findings underscore the complexity of the interactions involved, suggesting that the relationship is influenced by multiple factors rather than a single driving force.
How to cite: Eudaric, J., de Ruite, M. C., Sairam, N., Camero, A., Rafiezadeh Shahi, K., Zhu, X. X., Smith, M. W., and Kreibich, H.: The complex connection between flood risk and malaria dynamics in Sub-Saharan Africa, EGU General Assembly 2025, Vienna, Austria, 27 Apr–2 May 2025, EGU25-195, https://doi.org/10.5194/egusphere-egu25-195, 2025.
Flood risks pose increasing threats to societal every-day life and result in significant losses to economy. The monetary impacts related to infrastructure have been thoroughly studied and, although flood losses have been modelled, models for households are yet to be advanced. In addition, the increasing negative effects of floods on human health are often neglected or studied independently from risk assessments. Therefore, this contribution aims to fill the gap in risk research by providing a disaggregated study of economic and health losses in Can Tho city, a flood prone urban region located in the Mekong delta in South Vietnam. Quantitative survey data is analysed, including residential (n = 480) and commercial (shop-houses, n = 378) household interviews collected in 2013, as well as flood water and sewer samples for pathogen analysis, collected in 2016 after a flood event in the city. We present uni- and multivariable flood loss models for building, content, and sales decrease of households, based on water depth, building and content values, duration of closure of shop and the duration until full recovery. Water contamination models are developed to predict concentration and probability of infection. An expected result includes the development of complex interrelationships that can draw potential pathways towards flood risk adaptation. The models results will deliver a dynamic depiction of the diversity of risks in Can Tho city, providing critical insights for the flood-human-health system and risk management strategies.
How to cite: Villafani, Y., Sairam, N., and Cominola, A.: Flood resilience disparities: The intersection between economic and health risks in Can Tho, Vietnam, EGU General Assembly 2025, Vienna, Austria, 27 Apr–2 May 2025, EGU25-1071, https://doi.org/10.5194/egusphere-egu25-1071, 2025.
In 2019, cyclones Idai and Kenneth hit Mozambique’s coast only six weeks apart. A state of emergency was declared by the World Health Organisation (WHO) due to the outbreak of cholera and other infectious diseases. This was exacerbated by a lack of sanitation and access to clean drinking water, especially in densely populated, poorer regions. After Idai, financial resources were already strained, impairing the response to the impacts of subsequent cyclone Kenneth. The continued displacement of people and ongoing disruption of basic services after Kenneth contributed to another cholera outbreak.
In recent years, society faced immense challenges resulting from the increasing complexity of disaster risk. As the example demonstrates, the impacts of consecutive disasters are often exacerbated by the consecutive nature of the hazards themselves. Several recent international agreements have called upon the disaster risk science community to move away from assessing the risk from hazards one-by-one and to improve our understanding of temporal dynamics of disaster risk. Subsequently, in past years, we have seen a rise in multi-(hazard) risk studies trying to understand some of these complexities conceptually and statistically. However, these studies do not consider the consecutive occurrence of disease outbreaks following hazards.
In this research, we use the Myriad-HESA database (Claassen et al., 2023) to link historic disasters caused by natural hazards with historic waterborne diseases outbreaks. We develop spatiotemporal footprints of disease outbreaks based on open-source databases of historic disease outbreaks. We then apply Myriad-HESA using the eleven single hazards already included in the database and overlay them with the disaster outbreaks data. This allows us to map hotspots of overlapping events but also to assess events with a time window (allowing for a temporal lag between disasters and subsequent disease outbreaks). Our findings allow practitioners to respond more accurately and promptly depending on the local situation.
How to cite: de Ruiter, M. and Jäger, W.: Global hotspots of disasters and waterborne disease outbreaks, EGU General Assembly 2025, Vienna, Austria, 27 Apr–2 May 2025, EGU25-3517, https://doi.org/10.5194/egusphere-egu25-3517, 2025.
Severe flood events significantly impact the mental health of affected people, leading to an increased prevalence of mental disorders such as posttraumatic stress disorder (PTSD). However, there is a lack of knowledge and understanding of the long-term mental health effects of severe flooding, the recovery process and the influencing factors. We address this knowledge gap using the particularly devastating flood event that occurred in July 2021 in Germany as an example. The event caused an overall damage of €33 billion and resulted in 190 fatalities, over 750 injured, and many others struggling with their experiences. We conducted quantitative online surveys in highly affected regions in Germany 12 to 36 months after the flood event. The surveys used a short clinically validated epidemiological screening scale to detect indications of PTSD. Through statistical modelling, we assessed the changes in PTSD indications over time and identified subgroups of individuals with different PTSD symptoms. We also examined potential influencing variables, focusing on personal (e.g., resilience) and social (e.g., support network, offers of assistance) factors. In the severely impacted district of Ahrweiler in the federal state of Rhineland-Palatinate, the PTSD prevalence shows a reduction over time: 28% of individuals showed indications of PTSD around 12 months post-flooding, 24% 18 months after the flood, and 17% 36 months after the event. The proposed modelling will offer deeper insights into the long-term dynamics of mental health recovery at the individual level. With this research, we aim to tailor the development of targeted interventions to support individuals and communities affected by disasters.
How to cite: Zenker, M.-L., Bubeck, P., and Thieken, A. H.: From trauma to recovery: dynamics of long-term mental health after the 2021 German floods , EGU General Assembly 2025, Vienna, Austria, 27 Apr–2 May 2025, EGU25-9164, https://doi.org/10.5194/egusphere-egu25-9164, 2025.
In early September 2023, the Thessaly Region (central Greece) was devastated by the Daniel storm, which brought extreme precipitation. The resulting embankment failures in the Pineios catchment caused flooding up to 4 m deep, submerging many rural areas for days. This event claimed 17 lives and caused extensive damage to structures and infrastructure, including roads, bridges, lifelines, residences, agricultural land, livestock facilities, industrial and tourist infrastructure.
The above weather conditions in the Region of Thessaly, the subsequent floods and their impacts had the potential to affect public health and in particular to cause sporadic cases, outbreaks and epidemics of infectious diseases in the affected area, as has been shown by similar examples of floods and other hydro-meteorological hazards, not only in developing, but also in developed countries worldwide.
The aim of this research is to highlight all the risk factors that favor the occurrence of infectious diseases in the area affected by the Daniel storm and the subsequent flooding. This is achieved not only by taking into account the significant results of the existing relevant research on the effects of hydrometeorological events in the affected areas, but also by mainly presenting field data obtained from field surveys during and after the event.
Adverse conditions from these extreme events fostered public health risks contributing to incidence increase of rodent- and water-borne diseases, and respiratory infections.
From September 5 to December 31, 2023, 296 patients from the affected areas were evaluated for suspected leptospirosis at Thessaly hospitals, with 45 cases (15.3%) confirmed, according to the newsletters of the National Public Health Organization on May 30, 2024.
Damage to water supply and irrigation systems in Thessaly led to shortage of clean water after the storm. Clusters of gastroenteritis cases were reported in affected areas, alongside increased respiratory infections due to influenza virus and SARS-CoV-2.
Receding floodwaters can create mosquito breeding grounds, increasing the risk of mosquito-borne disease emergence. However, heavy rainfall and flooding may reduce mosquito density by diluting organic matter and washing away habitats. Combined with colder weather and preventive measures against mosquitoes, no West Nile virus cases were reported in Thessaly after mid-October.
A high injury rate during disasters and low tetanus vaccination coverage can lead to outbreaks. However, Greece's successful national vaccination program and prompt vaccination of individuals with uncertain or incomplete immunization status in flood-affected areas prevented any tetanus cases or outbreaks.
The conditions that emerged resulted in the mobilization of the Civil Protection and Public Health authorities not only to deal with the impact of the storm and the subsequent flooding, but also to prevent and manage indirect public health impacts. The instructions and guidelines to affected residents, health professionals and Civil Protection staff were in line with international good practices and lessons learned from recent examples of complex and compound disasters around the world.
Amid the climate change, hydrometeorological hazards are increasing, disrupting activities across many sectors. To address emerging infectious diseases, robust disaster preparedness is crucial, including resilient infrastructure, effective disease surveillance, and comprehensive environmental planning.
How to cite: Mavrouli, M., Mavroulis, S., Lekkas, E., and Tsakris, A.: Environmental and structural impacts of the 2023 Daniel storm and subsequent floods in the Thessaly Region (Central Greece) and factors controlling infectious disease emergence in flooded areas, EGU General Assembly 2025, Vienna, Austria, 27 Apr–2 May 2025, EGU25-12921, https://doi.org/10.5194/egusphere-egu25-12921, 2025.
Climate change is a pressing global challenge with adverse effects on human health and well-being. Like many sub-Saharan African countries, Zambia faces the dual burden of extreme weather events and health challenges, particularly in maternal and child health (MCH). We employed a multiple-evidence approach and conducted nine focus group discussions (FGDs), 75 key informant interviews (KIIs) and a structured document review of blended sources of evidence (scientific articles, governmental and non-governmental reports, national communications, and newspapers). We examined the impacts and risks of heatwaves and floods on MCH systems in Zambia. The FGDs and KIIs constituted community, health facility and district-level participants from Senanga and Sinazongwe Districts of Southern Zambia. Both districts have almost perennial occurrences of floods and heat waves. We explored the lived experiences of community members and health practitioners by examining the effects of floods and heatwaves on daily life and MCH service provision, access, quality, and related health outcomes. Further, we assessed the preparedness, risk reduction, mitigation, coping and adaptation strategies implemented by community, health facility and district-level stakeholders in response to the two climate hazards. Our study results show pathways through which heatwaves and floods impact MCH, including limiting access to healthcare and increasing the prevalence of infectious diseases. Additionally, the results highlight coping and adaptation measures instituted, such as external support from state and non-state actors, collaboration, and resource allocation to enhance or maintain MCH service delivery during these extreme weather events. Furthermore, the results showcase healthcare decision-making structures and how information is shared across stakeholders before and during disaster events. The results reveal innovative solutions at district, community, facility, and household levels adopted and desired by stakeholders within the MCH system to strengthen resilience to future extreme weather events. We recommend future research to better understand community challenges in accessing MCH services and for health facilities to provide such services during extreme weather events. This will streamline policy strategies to enhance community resilience and ensure the sustainability of MCH systems amidst the growing threats posed by climate change.
How to cite: Bwalya, B., Simona, S., Chama- Chiliba, C., Sakic Trogrlic, R., Chisola, M., Bwalya, R., Moonga, A., Mweemba, C., Bozzani, F., Ismail, S., Borghi, J., and Saulnier, D.: Impacts and Risks of Heatwaves and Floods on Maternal and Child Health Systems in Zambia; A multi evidence approach , EGU General Assembly 2025, Vienna, Austria, 27 Apr–2 May 2025, EGU25-13957, https://doi.org/10.5194/egusphere-egu25-13957, 2025.
Disasters associated with natural hazards often coincide with other types of threats and risks including health emergencies resulting in compounding impacts in a multi-hazard context. In Germany as well as many countries, the co-occurrence of the COVID-19 pandemic and disaster events has posed a complex challenge in recent years, testing its capacity for crisis management and long-term resilience. While disasters associated with natural hazards resulted in immediate and visible costs such as structural damage, expenditures for emergency response and economic disruptions, the COVID-19 pandemic also introduced ongoing economic impacts arising from long-term post-viral conditions such as Long COVID and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS).
Using data from 2020 to 2024, this analysis compares direct disaster-related costs with the national burden of Long COVID and ME/CFS in Germany. Disaster events and direct disaster-related costs for Germany were extracted from various data and information sources, including CATDAT, scientific literature, reports, official press releases, and news reports. Among these events, the July 2021 flood, which occurred during the COVID-19 pandemic, caused severe damage to buildings, infrastructure, and industry, with a direct and indirect economic impact of more than 40 billion euros across various sectors.
On top of that, the COVID-19 pandemic resulted in tens of millions of infections per year causing growing numbers of citizens affected by post-viral conditions, namely Long COVID and ME/CFS, with increasing economic, medical and social costs for German society. These costs are currently being modelled in a collaborative project whose aim is to shape public policy towards improving outcomes for Long COVID and ME/CFS patients, communities, and society at large. The modelling effort encompasses the progression of Long COVID and ME/CFS cases over time within the German population and different economic costing methods. Initial modelling results indicate that the economic costs of Long COVID and ME/CFS amount to several tens of billion euros per year per type, reflecting the significant burden these chronic illnesses place on healthcare systems, workforce productivity, and social welfare programs.
Preliminary findings of the comparison show that while disasters associated with natural hazards incurred significant one-time costs, the long-term economic burden of Long COVID and ME/CFS is in the same order of magnitude or even surpasses these figures over the years due to the sustained impact on labor markets and healthcare systems. This emphasizes the need for policy making such as increases in funding for basic and clinical research into Long COVID and ME/CFS as well as new therapeutic approaches and health care infrastructures. The results for Germany complement existing work done in other countries such as Australia examining the costs.
The integrated and multi-hazard nature of disasters across natural, biological, conflict and other man-made disasters needs to be accounted for adequate policy planning in the disaster and loss space which integrates well with work within the MYRIAD-EU project on multi-hazard and multi-risk scenarios across different sectors.
How to cite: Brand, J., Daniell, J., McLennan, A., Paessler, D., Schoening, S., and Heydecke, J.: Comparing Disaster Costs with the Long-term Economic Impact of Chronic Illness Stemming from COVID-19 in Germany, EGU General Assembly 2025, Vienna, Austria, 27 Apr–2 May 2025, EGU25-15292, https://doi.org/10.5194/egusphere-egu25-15292, 2025.
Background: Climate hazards represent a substantial risk to health systems and financing, especially when they compound. Building resilient and sustainable health systems requires intersectoral or co-financing arrangements that jointly support health and climate goals. However, it is unclear what opportunities exist for co-financing, across which financing functions, and at which health system scales. We propose a framework for studying co-financing for health and climate goals which considers the degree of integration between sector funding, and whether arrangements are ‘passive’, when cross-sectoral goals are indirectly affected, or ‘strategic’, when they are pre-emptively supported to build resilience and sustainability. Using this framework, we describe the range of co-financing arrangements that have been used to support climate and health goals based on a rigorous evidence review. We also summarize evidence on enablers and barriers to implementation, and research gaps and future priorities.
Methods: We undertook a rigorous narrative review. We identified key terms pertaining to financing and to health systems and climate goals to guide the review. We then searched the international literature using Pubmed and Web of Science from 2013-2023, the websites of key health and climate agencies for grey literature and consultation with stakeholders. We synthesized evidence according to our co-financing framework describing arrangements together with enablers and barriers to implementation.
Results: A total of 97 studies were included in the review. More than half were from low-and middle-income countries, with 36 focusing on health financing for climate goals and 39 on climate finance for health goals (promotive). Studies mostly addressed passive co-financing, assessing the consequences of climate inaction, including the impact on government health expenditure, health insurance and out of pocket payments. There was limited evidence of strategic co-financing or integrative co-financing. Several lessons emerged for designing effective co-financing mechanisms for health and climate needs including: 1) involving staff with climate and health sector knowledge in the design and implementation of co-financing arrangements; 2) the alignment and/or linkage of information systems across sectors; 3) clear communication and consistency of entitlements, and facilitating access to climate finance, to ensure funds target needs; and 4) flexibility in the use and allocation of funds to meet emerging needs.
Conclusion: Co-financing is critical to filling the financing gap for health sector adaptation and achieving recent COP29 funding pledges. Our study highlights issues to consider in the design and implementation of these schemes to maximise their benefit for health systems; and draws attention to some of the limitations of specific arrangements, identifying areas for further research.
How to cite: Borghi, J., Cuevas, S., Anton, B., Iaia, D., Gasparri, G., Hanson, M., Soucat, A., Bustreo, F., and Langlois, E.: Reconfiguring financing arrangements to build health system resilience to disasters and multi-hazards: a framework and evidence review of co-financing arrangements. , EGU General Assembly 2025, Vienna, Austria, 27 Apr–2 May 2025, EGU25-15716, https://doi.org/10.5194/egusphere-egu25-15716, 2025.
Changing climate and increasing urbanization have significantly amplified the frequency and intensity of extreme weather events. These events trigger cascading, multidimensional impacts, including physical destruction, financial losses, social disruptions, and both short- and long-term consequences for the health and well-being of affected populations. International efforts, such as the Lancet Countdown on Health and Climate Change, have highlighted the profound effects of climate events on human health. Despite consistent progress by the multi-hazards community in developing methods to assess the co-occurrence of disasters and the cascading impacts of multi-hazards, the susceptibility of populations to compounding multi-hazards remains underexplored in the context of health and community resilience. Our study addresses this gap by analyzing global data on extreme weather hazards from 2003 to 2021 at a 0.25° resolution, alongside the characteristics and resilience of exposed populations, using tools such as the Flood Resilience Measurement for Communities (FRMC) and the World Risk Poll Resilience Index.
How to cite: Sairam, N., Stalhandske, Z., Hyun, J. H., and de Ruiter, M.: Assessing Health and Community Resilience to Compounding Multi-Hazards, EGU General Assembly 2025, Vienna, Austria, 27 Apr–2 May 2025, EGU25-16666, https://doi.org/10.5194/egusphere-egu25-16666, 2025.
The increasing frequency and intensity of climate extremes, such as floods and heatwaves, pose significant challenges to Maternal and Child Health (MCH) systems, disrupting the delivery and access to essential health services. Mothers and children, due to their heightened health vulnerabilities, are disproportionately affected, particularly in accessing preventive care such as antenatal services and immunizations. Understanding the drivers of climate vulnerability within health systems and their evolution under future climate extremes is critical for designing effective adaptation strategies. However, existing research has predominantly focused on static or qualitative frameworks, leaving a notable gap in quantitative, dynamic, and integrative modeling approaches capable of analysing feedback mechanisms and cascading impacts over time. This research addresses this gap by developing a conceptual and theoretical System Dynamics Modeling (SDM) framework. Informed by evidence-based Causal Loop Diagrams (CLDs) and local stakeholder engagement, the framework highlights critical feedback loops and leverage points influencing MCH system resilience during climate events. Specifically, the study presents findings on how supply-side components – such as service delivery, workforce availability, infrastructure functionality, and resource flows – interact under climate stressors like floods and heatwaves. Designed using Stella Architect and calibrated with real-world data from the REACH project in Zambia, the SDM framework incorporates climate variables (e.g., flood intensity, duration, and frequency; heatwave patterns) and MCH performance metrics (e.g., household health surveys and service utilization records). Key findings reveal pathways through which climate extremes impact system performance, such as infrastructure disruptions caused by flooding that reduce service delivery or prolonged heatwaves that impair workforce productivity, creating cascading system-wide effects. Furthermore, stakeholder engagement identified critical vulnerabilities, including transportation challenges, supply chain delays, and power outages, which informed potential intervention strategies. These strategies include implementing early warning systems to improve preparedness, investing in climate-resilient infrastructure to protect health facilities and road networks, and adopting adaptive governance frameworks for effective resource allocation and coordination during crises. While this study presents a foundation by identifying critical system dynamics and exploring preliminary intervention strategies, the SDM framework is designed to support future applications. It can be used to simulate diverse scenarios, evaluate the long-term impacts of interventions, and guide adaptive strategies to enhance the sustainability and resilience of MCH systems. By advancing from a qualitative CLD to a robust SDM, this research equips policymakers and planners with a dynamic tool for evidence-based decision-making. Ultimately, it contributes to global efforts to build resilient health systems capable of adapting to the escalating challenges of climate change, laying the groundwork for applications across diverse contexts.
Keywords: Maternal and Child Health Systems, Climate Extremes, System Dynamics Modeling, Resilient Health Systems, Climate Change Adaptation
Acknowledgments
This work was conducted under the framework of the Economic and Social Research Council grant: Building Resilience to Floods and Heat in the Maternal and Child Health Systems in Brazil and Zambia (REACH), Grant Number: ES/Y00258X/1.
How to cite: Rwashana Semwanga, A., Debele, S., Silva, I., Simona, S., Bozzani, F., Ismail, S., Strelkon, N., Foss, A., Chiliba, C., Kovats, S., and Borghi, J.: Developing a System Dynamics framework to model the complex feedback between climate extremes and health systems , EGU General Assembly 2025, Vienna, Austria, 27 Apr–2 May 2025, EGU25-18064, https://doi.org/10.5194/egusphere-egu25-18064, 2025.
Posters virtual: Wed, 30 Apr, 14:00–15:45 | vPoster spot 3
EGU25-454 | ECS | Posters virtual | VPS13
Perception of the 2021 floods and their mental health, and social well-being among older adults in the Ahr Valley, GermanyWed, 30 Apr, 14:00–15:45 (CEST) | vP3.9
Protecting human health is a fundamental priority in contemporary society. According to the World Health Organization (WHO) Constitution, "Health is a state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity." While the physical health of older adults often receives considerable attention after flooding events, their mental and social well-being remains underexplored.
The 2021 floods in the Ahr Valley, Germany, had a devastating impact on local communities, particularly on older adults who are more vulnerable to the aftermath of natural disasters. This study explores the perceptions of floods among individuals aged 65 and older, focusing on their mental health and social well-being. Using a mixed-methods approach, we conducted surveys and in-depth interviews to collect first-hand data on their experiences and coping mechanisms. Our findings highlight the multifaceted challenges faced by this population, including heightened psychological distress, disruption of social networks, and concerns over long-term recovery.
This research underscores the need for targeted interventions to address the mental and social health needs of older adults in disaster-affected areas. By enhancing scientific understanding of the complex interplay between natural disasters and public health, the study aims to inform policymakers, healthcare providers, and social workers, ultimately improving the quality and effectiveness of post-disaster health services for older adults.
How to cite: Song, C., Atun, F., Blanford, J., and Anthonj, C.: Perception of the 2021 floods and their mental health, and social well-being among older adults in the Ahr Valley, Germany, EGU General Assembly 2025, Vienna, Austria, 27 Apr–2 May 2025, EGU25-454, https://doi.org/10.5194/egusphere-egu25-454, 2025.
