Impacts of Climate Change on Health & Wellbeing in South Africa Abstract Write an abstract of a reasearch paper A Proposed Method of Abstract Preparation

Impacts of Climate Change on Health & Wellbeing in South Africa Abstract Write an abstract of a reasearch paper

A Proposed Method of Abstract Preparation

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Cope, W.G., Bartsch, M.R., Rada, R.G., Balogh, S.J., Rupprecht, J.E., Young, R.D., Johnson, D.K., 1999. Bioassessment of mercury, cadmium, polychlorinated biphenyls, and pesticides in the upper Mississippi River with zebra mussels (Dreissena polymorpha). Environmental Science and Technology 33, 4385-4390.

The Upper Mississippi River has been contaminated with high levels of mercury (Hg), cadmium (Cd), and polychlorinated biphenyls (PCBs) by point and nonpoint sources resulting in elevated contaminant levels in fish and macroinvertebrates. This study investigated the zebra mussel (Dreissena polymorpha) as a sentinel species and assessed the bioavailability of Hg, Cd, and PCBs in the Mississippi River. Zebra mussels were collected on artificial substrates from 19 locks and dams from Minneapolis, MN to Muscatine, IA. Elevated levels of Hg, Cd, and PCBs were found in zebra muscle tissues after a 143-day exposure. Mercury levels ranged from 2.6 to 6.1 ng/g wet weight and cadmium from 76 to 213 ng/g wet weight. The composition of PCB congeners was similar throughout the river. This study suggests that zebras muscles are a sentinel species in the Mississippi River and may be important in trophic transfer of contaminants due to their increasing importance as a food source for certain fish and waterfowl. International Journal of
Environmental Research
and Public Health
Review
Impacts of Climate Change on Health and Wellbeing
in South Africa
Matthew F. Chersich 1, * ID , Caradee Y. Wright 2 , Francois Venter 1
and Barend Erasmus 3 ID
1
2
3
*
ID
, Helen Rees 1 , Fiona Scorgie 1
Wits Reproductive Health and HIV Institute, Faculty of Health Sciences, University of the Witwatersrand,
Johannesburg 2000, South Africa; FVenter@wrhi.ac.za (F.V.); hrees@wrhi.ac.za (H.R.);
FScorgie@wrhi.ac.za (F.S.)
Environment and Health Research Unit, South African Medical Research Council and Department of
Geography, Geoinformatics and Meteorology, University of Pretoria, Pretoria, Hatfield,
Private Bag X200028, South Africa; Caradee.Wright@mrc.ac.za
Global Change Institute, University of the Witwatersrand, Johannesburg 2000, South Africa;
Barend.Erasmus@wits.ac.za
Correspondence: mchersich@wrhi.ac.za; Tel.: +27-72-752-1123
Received: 10 July 2018; Accepted: 24 August 2018; Published: 31 August 2018

Abstract: Given its associated burden of disease, climate change in South Africa could be reframed as
predominately a health issue, one necessitating an urgent health-sector response. The growing impact
of climate change has major implications for South Africa, especially for the numerous vulnerable
groups in the country. We systematically reviewed the literature by searching PubMed and Web
of Science. Of the 820 papers screened, 34 were identified that assessed the impacts of climate
change on health in the country. Most papers covered effects of heat on health or on infectious
diseases (20/34; 59%). We found that extreme weather events are the most noticeable effects to date,
especially droughts in the Western Cape, but rises in vector-borne diseases are gaining prominence.
Climate aberration is also linked in myriad ways with outbreaks of food and waterborne diseases,
and possibly with the recent Listeria epidemic. The potential impacts of climate change on mental
health may compound the multiple social stressors that already beset the populace. Climate change
heightens the pre-existing vulnerabilities of women, fishing communities, rural subsistence farmers
and those living in informal settlements. Further gender disparities, eco-migration and social
disruptions may undermine the prevention—but also treatment—of HIV. Our findings suggest that
focused research and effective use of surveillance data are required to monitor climate change’s
impacts; traditional strengths of the country’s health sector. The health sector, hitherto a fringe
player, should assume a greater leadership role in promoting policies that protect the public’s health,
address inequities and advance the country’s commitments to climate change accords.
Keywords: South Africa; climate change; HIV; eco-migration; extreme weather events; health
1. Introduction
The question of how to tackle the ecological determinants of health is poised to become the
signature public health issue of the coming decade in South Africa, in much the same way that HIV
took centre stage in the preceding decades. Rapid environmental changes are creating observable
effects in multiple domains, from air quality, temperature and weather patterns, to food security and
disease burden [1]. Ambient air pollution is estimated to have been responsible for 4% of deaths in
South Africa in 2015 [2]. Even though there is some spatial variation in the warming signal, most of
South Africa has experienced upward trends in temperature during the last half of the 20th century [3,4].
Int. J. Environ. Res. Public Health 2018, 15, 1884; doi:10.3390/ijerph15091884
www.mdpi.com/journal/ijerph
Int. J. Environ. Res. Public Health 2018, 15, 1884
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Food security is also under threat, with, for example, crop yields likely to decline in many parts of
the country,
accompanied
by2018,
livestock
losses [5]. Furthermore, it is now possible to detect changes
in
Int. J. Environ.
Res. Public Health
15, x
2 of 16
response to climate change in most terrestrial, freshwater and marine ecosystems in the country [6–8].
[3,4].
security
is also under
threat, with, forand
example,
crop yields likely
to decline
in many is
parts
Species
areFood
changing
genetically,
physiologically
morphologically,
and their
distribution
shifting,
of the country, accompanied by livestock losses [5]. Furthermore, it is now possible to detect changes
which affects food webs, and foments transmission of infectious diseases [9].
in response to climate change in most terrestrial, freshwater and marine ecosystems in the country
In South Africa, despite policies promoting an ambitious renewable energy programme,
[6–8]. Species are changing genetically, physiologically and morphologically, and their distribution
the country’s
to climate
change
has been
hamperedofbyinfectious
policy uncertainty
is shifting,response
which affects
food webs,
and foments
transmission
diseases [9]. and corruption,
especiallyIninSouth
the energy
transport
andanitsambitious
health systems
areenergy
ill-prepared
for thethe
effects
Africa, and
despite
policiessectors,
promoting
renewable
programme,
of climate
aberration
The new
National
Climate
Change
which
is currently
for public
country’s
response[10].
to climate
change
has been
hampered
byBill,
policy
uncertainty
and open
corruption,
comment
shows
promise,
however.
Itssectors,
provisions
coordination
different
especially
in the
energy and
transport
and itsfor
health
systems areamong
ill-prepared
for thegovernment
effects
of
climate
aberration
[10].
The
new
National
Climate
Change
Bill,
which
is
currently
open
for
public
departments have the potential to remove policy uncertainty, and align related policies [11].
comment
shows
promise,
however.
Its
provisions
for
coordination
among
different
government
This article summarises evidence of the impact of climate change on health in South Africa and
departments
have
the potential
to remove
policy uncertainty,
and align
related
policiesimpacts
[11]. on health
highlights
specific
effects
on vulnerable
populations.
The review
covers
the direct
This article summarises evidence of the impact of climate change on health in South Africa and
through extreme events and temperature increases, but also the more indirect impacts mediated
highlights specific effects on vulnerable populations. The review covers the direct impacts on health
through natural systems (for example infectious diseases) and through social vulnerabilities [12].
through extreme events and temperature increases, but also the more indirect impacts mediated
Whilethrough
severalnatural
narrative
reviews
have summed
impacts
climatesocial
change
on health [12].
in South
systems
(for example
infectiousthe
diseases)
andofthrough
vulnerabilities
Africa
[13–16],
there
is
a
need
to
review
more
up
to
date
literature
and
to
collate
evidence
While several narrative reviews have summed the impacts of climate change on health in South in a
systematic
Africa manner.
[13–16], there is a need to review more up to date literature and to collate evidence in a
systematic manner.
2. Review Methods
2. Review Methods
Medline (PubMed) and Web of Science were searched on 8 August 2018 (Supplementary File 1:
Medline (PubMed)
and Web
of Science
searched
ontext
8 August
File 1:
review protocol).
The PubMed
search
strategywere
included
free
terms2018
and (Supplementary
MeSH codes, specifically:
review
protocol).
The
PubMed
search
strategy
included
free
text
terms
and
MeSH
codes,
specifically:
(((((“South Africa”[MeSH]) OR (“South Africa”[Title/Abstract]) OR (“Southern Africa*“[Title/Abstract])))
(((((“South
Africa”[MeSH])
OR
(“South
Africa”[Title/Abstract])
OR
(“Southern
AND “last 10 years”[PDat])) AND (((“global warming”[Title/Abstract] OR “global warming”[MeSH]
Africa*“[Title/Abstract]))) AND “last 10 years”[PDat])) AND (((“global warming”[Title/Abstract] OR
OR climatic*[Title/Abstract] OR “climate change”[Title/Abstract] OR “climate change”[MeSH] OR
“global warming”[MeSH] OR climatic*[Title/Abstract] OR “climate change”[Title/Abstract] OR
“Desert
Climate”[MeSH]
OR
Nino-Southern
Oscillation”[MeSH]
OR Oscillation”[MeSH]
Microclimate[MeSH]
“climate
change”[MeSH]
OR“El
“Desert
Climate”[MeSH]
OR “El Nino-Southern
OR OR
“Tropical
Climate”[MeSH])).
A
total
of
820
titles
and
abstracts
were
screened
by
a
single
reviewer
Microclimate[MeSH] OR “Tropical Climate”[MeSH])). A total of 820 titles and abstracts were screened after
removal
34 duplicate
items
(Figure
1).duplicate items (Figure 1).
by a of
single
reviewer after
removal
of 34
Figure 1. PRISMA Flow diagram for review of articles on impact of climate change in South Africa [17].
Int. J. Environ. Res. Public Health 2018, 15, 1884
3 of 14
To be included, articles had to describe the impact of climate change on health in South Africa.
All study designs were eligible, including modelling studies, narrative and systematic reviews,
case studies, case series and qualitative research. We excluded articles that were not in English
(n = 3), only covered animals or plants (n = 343), were not on South Africa (n = 270), were unrelated to
health (n = 47) or climate change (n = 55), or were on climate change adaptation (n = 38) or mitigation
(n = 30). We then screened full text articles for eligibility (n = 86), of which 34 were included. We then
extracted data on the characteristics of the included articles (Table 1). The findings presented in each
included article were used to draft the text of the review. We also included additional articles located
through searches of article references or through targeted internet searches for policy documents,
for example.
Table 1. Characteristics of studies included in the review.
No
Article Title
Country(ies)
of Research
Study Setting
Study Design
Study Population
Study Aim
Study Outcome Data
1
The HIV/AIDS epidemic in
South Africa: Convergence
with tuberculosis,
socio-ecological
vulnerability, and climate
change patterns [18]
South Africa
Whole country
Review
Persons living with HIV
or TB, as well as the
general population
Review intersections between
HIV, tuberculosis and
climate change
N/A
Modelling
study
Anopheles arabiensis
mosquitos
To apply a climate-based,
ordinary-differential-equation
model to analyse the
influence of ambient
temperature on the
development and the
mortality rate of
Anopheles arabiensis
The seasonality of An.
arabiensis and the
influence of climatic
factors on the vector
population dynamics
Modelling
study
General population
living in the four cities
To examine the impacts of
climate change on extreme
precipitation events under
different climate scenarios
Number of extreme
precipitation events,
number of wet days
and dry spells
Patients with malaria
To examine the dynamics of
the disease’s transmission
and its persistence, by
investigating the relationship
between climate and the
occurrence of malaria
Monthly climatic
variables and
monthly malaria
cases using data over
19 years. Time lag
between climate
variation and
malaria incidence
Whole population,
but focus on vulnerable
groups
To illustrate the complexity of
achieving greater equity,
drawing on experiences in
Canada and South Africa.
Also to Identify bi-directional
lessons relevant both to
countries and globally
concerning health care
funding approaches and other
means of reducing health
inequities, including those
related to climate change
N/A
Self-completed
heat-health log and
questionnaire, and
indoor temperature
and relative humidity
measured in
classrooms
2
Modelling the influence of
temperature and rainfall on
the population dynamics of
Anopheles arabiensis [19]
South Africa
Dondotha
village,
northeast part of
KwaZulu-Natal
Province
3
Potential impacts of climate
change on extreme
precipitation over four
African coastal cities [20]
Egypt,
Mozambique,
Nigeria,
South Africa
Cape Town,
Western Cape
4
Climatic Variables and
Malaria Morbidity in
Mutale Local Municipality,
South Africa: A 19-Year
Data Analysis [21]
South Africa
Mutale
municipality,
Limpopo
province
Time-series
analysis
5
Why equity in health and
in access to health care are
elusive: Insights from
Canada and
South Africa [22]
6
Students’ Perceived
Heat-Health Symptoms
Increased with Warmer
Classroom
Temperatures [23]
South Africa
City of Joburg,
Gauteng
Province
Cross-sectional
study
School children aged
14–18 years at 8 schools
in City of Johannesburg
To assess school children‘s
perceived heat-health
symptoms during school
hours in the classroom
7
How climate change can
fuel listeriosis outbreaks in
South Africa [24]
South Africa
Whole country
Editorial
General population
To consider the relationship
between listeriosis outbreaks
and climate change
N/A
8
Ecological niche and
potential distribution of
Anopheles arabiensis in
Africa in 2050 [25]
Anopheles arabiensis
mosquitos
To map the future potential
distribution of Anopheles
arabiensis in Africa
Distribution of
Anopheles arabiensis
under three climate
change scenarios,
comparing baseline
and projected changes
9
Environmental Change,
Migration, and Conflict in
Africa: A Critical
Examination of the
Interconnections [26]
People who are
migrants, or in conflict
areas
To examine interconnections
between environmental
change, migration and conflict
in Africa, analysing evidence
for migration as an
intermediary and
bidirectional causal variable in
the climate-conflict interaction
N/A
Canada,
South Africa
All of Africa
All of
sub-Saharan
Africa
Whole country
Whole country
Migrants in the
country
Narrative
review
Modelling
study
Narrative
review
Int. J. Environ. Res. Public Health 2018, 15, 1884
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Table 1. Cont.
Country(ies)
of Research
Study Setting
South Africa
No
Article Title
Study Design
Study Population
Study Aim
Study Outcome Data
10
The health implications of
wastewater reuse in
vegetable irrigation: a case
study from Malamulele,
South Africa [27]
Malamulele,
Limpopo
province
Cross-sectional
survey
Farmers, children, farm
workers, vegetable
consumers and
environmental samples
To investigate the health and
socio-economic implications
of irrigation of vegetables
with wastewater
Number and type of
helminth eggs in
wastewater and
vegetable wash water,
prevalence of
gastroenteritis
11
Seasonally lagged effects of
climatic factors on malaria
incidence in South Africa
[28]
South Africa
Limpopo
Spatial and
temporal
mapping, with
self-organizing
maps
Malaria cases
To analyse the relationship
between local climatic effects
and remote atmospheric
teleconnections on the
incidence of malaria,
including lag effects
Association between
malaria incidence and
local and regional
climate factors
12
Effect of temperature on
the Bulinus
globosus—Schistosoma
haematobium system [29]
South Africa
uMkhanyakude
and Verulam,
KwaZulu-Natal
Province
Prospective
study
Bulinus globosus and
Schistosoma
haematobium
To assess the effect of
temperature on snail
fecundity, growth, survival
and parasite development
Snail fecundity and
growth., and parasite
development
13
Current and Potential
Future Seasonal Trends of
Indoor Dwelling
Temperature and Likely
Health Risks in Rural
Southern Africa [30]
Households in rural
setting in north-eastern
part of South Africa
To consider the relationship
between temperatures in
indoor and outdoor
environments in a rural
residential setting in a
current climate and warmer
predicted future climate
Temperature and
humidity
measurements
collected hourly in
406 homes in summer
and spring and at
two-hour intervals in
98 homes in winter
South Africa
14
A socio-economic approach
to One Health policy
research in
Southern Africa [31]
N/A
15
Climate change and
occupational health:
A South African
perspective [32]
16
Long-run relative
importance of temperature
as the main driver to
malaria transmission in
Limpopo Province,
South Africa: a simple
econometric approach [33]
17
Spatially and Temporally
Varying Associations
between Temporary
Outmigration and Natural
Resource Availability in
Resource-Dependent Rural
Communities in
South Africa: A Modeling
Framework [34]
South Africa
18
Mind the gap: institutional
considerations for
gender-inclusive climate
change policy in
Sub-Saharan Africa [35]
All of
sub-Saharan
Africa
Whole country
South Africa
Giyani,
Limpopo
Province
Cross-sectional
study
All countries
in Southern
Africa
Whole country
Narrative
review
General population
To identify which factors
affect the burden of disease
and how the burden could
affect socio-economic
well-being, including
climate change
South Africa
Whole country
Narrative
review
People in the workplace
To review the impacts of
climate change on
occupational health and
possible prevention and
control measures
N/A
South Africa
Limpopo
Province
Econometrics
People with malaria
To examine the distribution
of malaria, determine
direction and strength of the
relationship and causality
between malaria and
meteorological variables
Malaria correlation
with temperature
and rainfall
Rural areas
Modelling
study
Agincourt, rural area of
Mpumalanga province
To methodologically assess
the robustness of migration
environment associations
and to explore the effects of
inherent spatial variation of
these associations
Spatial variability in
migration-environment
associations.
Indicators of natural
resource availability.
Narrative
review
General population,
vulnerable groups
of women
To elucidate why women
should be placed at the heart
of climate change
interventions and establish
connections between gender
and climate change
N/A
Johannesburg,
Gauteng
Province and
Upington,
Northern
Province
Qualitative
study
People working in
sun-exposed
environment, including
grave diggers, street
sweepers, roadside
construction workers,
sewage and sanitary
workers and
horticultural workers.
To investigate the
perceptions of outdoor
workers regarding their work
environment in hot weather
and how this affected their
health and productivity
Heat-related effects,
including sunburn,
sleeplessness,
irritability, and
exhaustion. Also
work levels, outputs
and adaptation
measures
General population
To examine the impacts of
climate change on the
achievement of SDG 2
N/A
Children under five
with diarrhoea
To describe the relationship
between temperature change
and diarrhoea in under
five-year-old children
Incident cases of
diarrhoea and
associations with
temperature
19
Climate change impacts on
working people (the
HOTHAPS initiative):
findings of the South
African pilot study [36]
20
Climate change: A threat
towards achieving
‘Sustainable Development
Goal number two’
(end hunger, achieve food
security and improved
nutrition and promote
sustainable agriculture) in
South Africa [5]
South Africa
Whole country
Narrative
review using
snowball
sampling to
select sources
and discourse
analysis
21
Temperature Variability
and Occurrence of
Diarrhoea in Children
under Five-Years-Old in
Cape Town Metropolitan
Sub-Districts [37]
South Africa
Cape Town,
Western Cape
Surveillance
data
longitudinal
analysis
Int. J. Environ. Res. Public Health 2018, 15, 1884
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Table 1. Cont.
No
Article Title
22
Responding to climate
change in southern
Africa—the role of
research [38]
23
A public health approach
to the impact of climate
change on health in
southern
Africa—identifying priority
modifiable risks [14]
Country(ies)
of Research
Southern
Africa
Study Setting
Study Design
Whole country
Study Population
Study Aim
Study Outcome Data
Academic researchers
and funders
To highlight need for
collecting locally relevant
information on
climate change
N/A
Editorial
General population
To describe a conceptual
model for analysing
climate-related health risks
ranging from distal and
infrastructural, to proximal
and behav…
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