We assessed the association between childhood diarrhoeal incidence and climatic factors in rural and urban settings in the health district of Mbour in western Senegal. We used monthly diarrhoeal case records among children under five years registered in 24 health facilities over a four-year period (2011–2014). Climatic data (i.e., daily temperature, night temperature and rainfall) for the same four-year period were obtained. We performed a negative binomial regression model to establish the relationship between monthly diarrhoeal incidence and climatic factors of the same and the previous month. There were two annual peaks in diarrhoeal incidence: one during the cold dry season and one during the rainy season. We observed a positive association between diarrhoeal incidence and high average temperature of 36 °C and above and high cumulative monthly rainfall at 57 mm and above. The association between diarrhoeal incidence and temperature was stronger in rural compared to urban settings, while higher rainfall was associated with higher diarrhoeal incidence in the urban settings. Concluding, this study identified significant health–climate interactions and calls for effective preventive measures in the health district of Mbour. Particular attention should be paid to urban settings where diarrhoea was most common in order to reduce the high incidence in the context of climatic variability, which is expected to increase in urban areas in the face of global warming.

Diarrhoeal diseases remain a major public health problem, causing more than half a million child deaths every year, particularly in low- and middle-income countries (LMICs). Despite existing knowledge on the aetiologies and causes of diarrhoeal diseases, relatively little is known about its spatial patterns in LMICs, including Senegal. In the present study, data from a cross-sectional survey carried out in 2016 were analysed to describe the spatial pattern of diarrhoeal prevalence in children under the age of 5 years in the secondary city of Mbour in the south-western part of Senegal. Bayesian conditional autoregressive (CAR) models with spatially varying coefficients were employed to determine the effect of sociodemographic, economic and climate parameters on diarrhoeal prevalence. We observed substantial spatial heterogeneities in diarrhoea prevalence. Risk maps, stratified by age group, showed that diarrhoeal prevalence was higher in children aged 25-59 months compared to their younger counterparts with the highest risk observed in the north and south peripheral neighbourhoods, especially in Grand Mbour, Médine, Liberté and Zone Sonatel. The posterior relative risk estimate obtained from the Bayesian CAR model indicated that a unit increase in the proportion of people with untreated stored drinking water was associated with a 29% higher risk of diarrhoea. A unit increase in rainfall was also associated with an increase in diarrhoea risk. Our findings suggest that public health officials should integrate disease mapping and cluster analyses and consider the varying effects of sociodemographic factors in developing and implementing areaspecific interventions for reducing diarrhoea.

Rapid urbanisation, particularly in secondary cities in Africa, brings along specific challenges for global health, including the prevention and control of infectious diseases such as diarrhoea. Our purpose was to visualise urbanisation trends and its effect on risk factors associated with childhood diarrhoea, e.g. water supply, sanitation, wastewater and solid waste management in Mbour, a secondary city in south-western Senegal. Our visualisation is facilitated by epidemiological and geographical surveys carried out in 2016. A deeper spatial and visual understanding of the urbanisation trends and the disparities of diarrhoea-associated risk factors might lead to the implementation of suitable health interventions and preventive measures. Our visualisation is aimed to serve as a basis for discussion and as a decision support tool for policymakers, municipal officials and local communities to prioritise interventions related to water, sanitation and waste management with a view to reduce the environmental and health risks in the rapidly growing city of Mbour, which is set as an example for other similar secondary cities across low- and middle-income countries in Africa.

The uneven spatial distribution of basic facilities within urban areas is a major problem for developing countries like Senegal due to the emphasis of accessibility disparities and the use of this services. The efforts to quantify the problem and its consequences on people are constrained by the lack of satisfactory data and methods. The study seeks to examine the spatial accessibility to basic services (access to water, health, education, economic infrastructure and transportation services) in a very heterogeneous urban system and to highlight inequalities in access for improving the geographical accessibility and to ensure equity. The article explore the use of spatial analysis method (Closest Facility) to measure the potential accessibility to services and facilities in the city of Mbour. The analyses uses all the inhabited houses of the city as the potential demand. Results emphasis unequal access to basic urban services in the city and a center-periphery model with a high concentration of services around the city. The study demonstrates the utility of this method for the identification of disadvantaged areas, decision making and planning of basic services. It also provides paths for improving accessibility in urban areas with a high density of population.