Background: This study aims to investigate the current impacts of extreme temperature and heatwaves on human health in terms of both mortality and morbidity. This systematic review analyzed the impact of heatwaves on mortality, morbidity, and the associated vulnerability factors, focusing on the sensitivity component. Methods: This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 flow checklist. Four databases (Scopus, Web of Science, EBSCOhost, PubMed) were searched for articles published from 2012 to 2022. Those eligible were evaluated using the Navigation Guide Systematic Review framework. Results: A total of 32 articles were included in the systematic review. Heatwave events increased mortality and morbidity incidence. Sociodemographic (elderly, children, male, female, low socioeconomic, low education), medical conditions (cardiopulmonary diseases, renal disease, diabetes, mental disease), and rural areas were crucial vulnerability factors. Conclusions: While mortality and morbidity are critical aspects for measuring the impact of heatwaves on human health, the sensitivity in the context of sociodemographic, medical conditions, and locality posed a higher vulnerability to certain groups. Therefore, further research on climate change and health impacts on vulnerability may help stakeholders strategize effective plans to reduce the effect of heatwaves.

Leptospirosis is a neglected emerging zoonotic disease with a profound public health impact worldwide with higher burden of disease in resource-poor countries. The environmental and occupational exposures contribute to human and animal transmission, but the interaction was less explored. A deeper understanding of the critical environmental and occupational drivers in different contexts will provide useful information for disease control and prevention measures. This review aimed to summarize the potential environmental and occupational risk factors associated with leptospirosis infection. Four databases (Scopus, Web of Science, Ovid MEDLINE, EBSCOhost) were searched for articles published from 2012 to 2021. Eligible articles were assessed using a checklist for assessing the quality of the studies. The quality of the articles was assessed based on the laboratory diagnosis approach and statistical analysis method. A total of 32 studies were included in this systematic review. Water-related risk factors such as natural water as the primary water source (AOR 1.8-18.28), water-related recreational activities (AOR 2.36-10.45), flood exposure (AOR 1.54-6.04), contact with mud (AOR 1.57-4.58) and stagnant water (AOR 2.79-6.42) were associated with increased risk of leptospirosis. Infrastructural deficiencies such as un-plastered house walls and thatched houses presented a higher risk (AOR 2.71-5.17). Living in low-lying areas (AOR 1.58-3.74), on clay loam soil (OR 2.72), agricultural land (OR 2.09), and near rubber tree plantations (AOR 11.65) is associated with higher risk of leptospirosis. Contact with rats (AOR 1.4-3.5), livestock (AOR 1.3-10.4), and pigs (AOR 1.54-7.9) is associated with an increased risk of leptospirosis. Outdoor workers (AOR 1.95-3.95) and slaughterhouse workers (AOR 5.1-7.5) have higher risk of leptospirosis. The environmental and occupational components related to water, infrastructure, landscape, agriculture, and exposed animals play an essential role in leptospirosis transmission. The magnitude of those risk factors differs with geographical region, climate factor, urbanization and population growth, and the country's socioeconomic status.

Ambient air pollution remains one of the most important risk factors for health outcomes. In recent years, there has been a growing number of research linking particulate matter (PM) exposure with adverse health effects, especially on cardiovascular and respiratory systems. The objective of this review is to examine the range and nature of studies on time series analysis of health outcomes affected by PM_2.5 across a broad research area. A literature search was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping review framework through a strategic search of PubMed and ScienceDirect online databases for articles from January 2016 to January 2021. Articles were first screened by their titles and abstracts. Then two reviewers independently reviewed and evaluated the full text of the remaining articles for eligibility. Of the 407 potentially relevant studies, 138 articles were included for final analysis. There was an increasing trend in publications from 2016 to 2019 but a decreasing trend in the year 2020. Most studies were conducted in Eastern and South-Eastern Asia (69.6%), Europe and Northern America (14.5%) and Latin America and the Caribbean (8.7%), with the majority coming from high- and upper-middle-income countries (95.6%). The main methodology used was Generalized Additive Model (GAM) with Poisson distribution (74.6%). Morbidity was the most common health outcome studied (60.1%), with vulnerable groups (64.5%) often included. The association between PM_2.5 and health effects was stronger for respiratory diseases compared to cardiovascular diseases. In short-term studies (less than 7 years), respiratory diseases showed higher risks compared to cardiovascular. However, in long-term studies (7 years and more), cardiovascular showed higher risks.

Severe floods increase the risk of leptospirosis outbreaks in endemic areas. This study determines the spatial-temporal distribution of leptospirosis in relation to environmental factors after a major flooding event in Kelantan, Malaysia. We conducted an observational ecological study involving incident leptospirosis cases, from the 3 months before, during, and three months after flood, in reference to the severe 2014 Kelantan flooding event. Geographical information system was used to determine the spatial distribution while climatic factors that influenced the cases were also analyzed. A total of 1,229 leptospirosis cases were notified within the three study periods where incidence doubled in the postflood period. Twelve of 66 subdistricts recorded incidence rates of over 100 per 100,000 population in the postflood period, in comparison with only four subdistricts in the preflooding period. Average nearest neighborhood analysis indicated that the cases were more clustered in the postflood period as compared with the preflood period, with observed mean distance of 1,139 meters and 1,666 meters, respectively (both at P < 0.01). Global Moran’s I was higher in the postflood period (0.19; P < 0.01) as compared with the preflood period (0.06; P < 0.01). Geographic weighted regression showed that living close to water bodies increased the risk of contracting the disease. Postflooding hotspots were concentrated in areas where garbage cleanup occurred and the incidence was significantly associated with temperature, humidity, rainfall, and river levels. Postflooding leptospirosis outbreak was associated with several factors. Understanding the spatial distribution and associated factors of leptospirosis can help improve future disease outbreak management after the floods.

Background: Heat waves significantly impact ecosystems and human health, especially that of vulnerable populations, and are associated with increased morbidity and mortality. Besides being directly related to climate-sensitive health outcomes, heat waves have indirectly increased the burden on our health care systems. Although the existing literature examines the impact of heat waves and morbidity, past research has mostly been conducted in high-income countries (HICs), and studies on the impact of heat waves on morbidity in low- or middle-income countries (LMICs) are still scarce. Objective: This paper presents the protocol for a systematic review that aims to provide evidence of the impact of heat waves on health care services in LMICs. Methods: We will identify peer-reviewed studies from 3 online databases, including the Web of Science, PubMed, and SCOPUS, published from January 2002 to April 2023, using the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines. Quality assessment will be conducted using the Navigation Guide checklist. Key search terms include heatwaves, extreme heat, hospitalization, outpatient visit, burden, health services, and morbidity. Results: This systematic review will provide insight into the impact of heat waves on health care services in LMICs, especially on emergency department visits, ambulance call-outs, hospital admissions, outpatient department visits, in-hospital mortality, and health care operational costs. Conclusions: The results of this review are anticipated to help policymakers and key stakeholders obtain a better understanding of the impact of heat waves on health care services and prioritize investments to mitigate the effects of heat waves in LMICs. This entails creating a comprehensive heat wave plan and ensuring that adequate infrastructure, capacity, and human resources are allocated in the health care sector. These measures will undoubtedly contribute to the development of resilience in health care systems and hence protect the health and well-being of individuals and communities. Trial Registration: PROSPERO CRD42022365471; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=365471 International Registered Report Identifier (IRRID): DERR1-10.2196/44702

Purpose: The Sendai Framework for Disaster Risk Reduction 2015–2030 calls for a reduction in disaster mortality, yet measuring mortality remains a challenge due to varying definitions of disaster mortality, the quality, availability and diversity of data sources, generating mortality estimates, and how mortality data are interpreted.Design/methodology/approach: This paper uses five case studies to provide details around some of the complexities involved with measuring disaster mortality and to demonstrate the clear need for accurate disaster mortality data.Findings: The findings highlight the benefits of combining multiple data sources for accurate mortality estimates, access to interoperable and readily available global, national, regional and local data sets, and creating standardized definitions for direct and indirect mortality for easier attribution of causes of death.Originality/value: Countries should find a method of measuring mortality that works for them and their resources, and for the hazards they face. Combining accurate mortality data and estimates and leadership at all levels can inform policy and actions to reduce disaster mortality, and ultimately strengthen disaster risk reduction in countries for all citizens.