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Nepal is a country economically dependent on climate-sensitive industries. It is highly vulnerable to the environmental, social, economic and health impacts of climate change. The objective of this study is to explore community perceptions of climate variability and human health risks. In this letter, we present a cross sectional study conducted between August 2013 and July 2014 in the Tanahu district of Nepal. Our analysis is based on 258 face-to-face interviews with household heads utilizing structured questionnaires. Over half of the respondents (54.7%) had perceived a change in climate, 53.9% had perceived an increase in temperature in the summer and 49.2% had perceived an increase in rainfall during the rainy season. Half of the respondents perceived an increase in the number of diseases during the summer, 46.5% perceived an increase during the rainy season and 48.8% during winter. Only 8.9% of the respondents felt that the government was doing enough to prevent climate change and its impact on their community. Belonging to the Janajati (indigenous) ethnic group, living in a pakki, super-pakki house and belonging to poor or mid-level income were related to higher odds of perceiving climate variability. Illiterates were less likely to perceive climate variability. Respondents living in a pakki house, super-pakki, or those who were poor were more likely to perceive health risks. Illiterates were less likely to perceive health risks.
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Environ. Res. Lett. 10 (2015) 034007 doi:10.1088/1748-9326/10/3/034007
LETTER
Climate change and adverse health events: community perceptions
from the Tanahu district of Nepal
Shiva Raj Mishra
1
, Parash Mani Bhandari
2
, Rita Issa
3
, Dinesh Neupane
4
, Swadesh Gurung
5
and
Vishnu Khanal
1
1
Nepal Development Society, Chitwan, Nepal
2
Maharajgunj Medical Campus, Institute of Medicine, Kathmandu, Nepal
3
University College London, UK
4
Center for Global Health, Department of Public Health, Aarhus University, Aarhus, Denmark
5
Ipas, Kathmandu, Nepal
E-mail: shivarajmishra@gmail.com,parashmanibhandari@gmail.com,ritaissa88@gmail.com,neupane.dinesh@gmail.com,
grgswadesh@gmail.com and khanal.vishnu@gmail.com
Keywords: climate change, perception, health, Nepal, disease, variability
Abstract
Nepal is a country economically dependent on climate-sensitive industries. It is highly vulnerable to
the environmental, social, economic and health impacts of climate change. The objective of this study
is to explore community perceptions of climate variability and human health risks. In this letter, we
present a cross sectional study conducted between August 2013 and July 2014 in the Tanahu district of
Nepal. Our analysis is based on 258 face-to-face interviews with household heads utilizing structured
questionnaires. Over half of the respondents (54.7%) had perceived a change in climate, 53.9% had
perceived an increase in temperature in the summer and 49.2% had perceived an increase in rainfall
during the rainy season. Half of the respondents perceived an increase in the number of diseases
during the summer, 46.5% perceived an increase during the rainy season and 48.8% during winter.
Only 8.9% of the respondents felt that the government was doing enough to prevent climate change
and its impact on their community. Belonging to the Janajati (indigenous) ethnic group, living in a
pakki, super-pakki house and belonging to poor or mid-level income were related to higher odds of
perceiving climate variability. Illiterates were less likely to perceive climate variability. Respondents
living in a pakki house, super-pakki, or those who were poor were more likely to perceive health risks.
Illiterates were less likely to perceive health risks.
Introduction
Nepal is diverse in its geography, ecosystemand culture.
As a country economically dependent on climate-
sensitive industries such as agriculture, forestry and
ecotourism, it ranks 14th in the world when assessing
for vulnerability to climate change [1]. Since 1975, the
temperature of the country has risen 1.8 °C, with an
average annual increase of 0.06 °C [2]. This may have
detrimental effects [3]. The environmental, social and
economic impacts of climate change are rst and most
strongly felt by communities who live in ecologically
fragile areas [4]. Such communities often depend on
local natural resources for survival. Assessing these
communitiesperception and response to climate
variabilitysuch as short to medium term uctuations
in climate statecan identify early coping mechanisms
that are adopted to mitigate the worst of climate change.
Climate change is arguably the biggest current
threat to public health, contributing to the global bur-
den of disease and premature death [5]. Variant cli-
mate patterns and global warming will alter the
pattern and prevalence of infectious and vector-borne
diseases [6]. Disease burden may also increase as a
result of climate change related migration of reservoir
hosts [7]. Additionally, climate variability will lead to a
resurgence and increased endemicity of tropical dis-
eases [6]. Globally, an estimated 166 000 deaths result
from change in climate annually, relative to the aver-
age baseline measurements between 19611990 [8].
Diarrhea, the leading cause of under-ve deaths in
developing countries, is estimated to increase by 25%
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by 2020. Furthermore, annually, 5.5 million disability
adjusted life years (DALYs) can be attributed to cli-
mate change [9]. An earlier study reported ve cate-
gories of health outcomes which are most likely to be
affected by climate change: temperature-related mor-
bidity and mortality; health effects of extreme weather
events (storms, tornadoes, hurricanes, and precipita-
tion extremes); air-pollution-related health effects;
water-borne and food-borne diseases; and vector-
borne and rodent-borne diseases [10].
In Southeast Asia, including Nepal, there is a like-
lihood of increased epidemics of malaria, dengue,
other vector-borne diseases and climate-change
attributed diarrhea [1113]. As a result of rising global
temperatures, rainfall is predicted to increase, thereby
increasing the likelihood of ooding. Droughts and
ooding will result in declining crop yields and sub-
sequent malnutrition in this region [13]. Additionally,
Nepal is vulnerable to ooding, mudslides and glacier
lake outbursts secondary to the melting Himalayan
glaciers, which will lead to uctuations in the quality
and quantity of water, available land mass and envir-
onmental safety [14]. Few studies have explored the
spatial correlation between climate change and health
outcomes [1517]. Little is known about perceptions
of climate variability and subsequent health risks in
Nepal, particularly amongst the most at-risk commu-
nities. The following questions are explored in this
study:
(i) What are local perceptions of climate varia-
bility; what form does climate variability take? (ii) does
the local community perceive changes in patterns and
burden of disease?
Our ndings are useful to guide climate change
policy for at-risk communities. Utilizing local peoples
perception and coping strategies is essential if inter-
ventions are to be well targeted and well placed. Such
data gathered amongst the most vulnerable commu-
nities are useful for the implementation of wider
national and international policy and strategy.
Materials and methods
We performed a cross sectional study in the Tanahu
district of Nepal. This district is located in the central
hilly region of the country. It covers an area of
1546 km
2
and has a population of 323 228 [18]. The
district is at an elevation of 3402134 m above sea
level. The climate is tropical and sub-tropical, and the
temperature ranges from 5 °C to 48 °C [19].
This study was conducted in the Bhimad village
which was purposefully selected as a place where the
Terai plain meets the hills. The village is orientated to
commerce and tourism. This Village Development
Committee (VDC; the lowest administrative unit in
Nepal [20]) has a total of 2191 households and is
inhabited by 8414 people [18].
Study samples were drawn using proportionate
stratied random sampling. A comprehensive list of
households was obtained from the ofce of the VDC
and the existing administrative division of wards was
used to stratify the VDC into 9 strata. Samples were
selected in proportion to the population size of each
strata using systematic random sampling. Heads of
respective households were selected for face-to-face
interviews. If the head of the household was not pre-
sent at the time of the interview, the eldest person from
the same house was selected for the interview. We
selected 258 households, considering a 5 percent
allowable error. This is based on a similar study com-
pleted in Bangladesh, which found that 80% of
respondents perceived increased summer tempera-
tures, a decrease in rainfall and warmer winters (21).
The study questionnaire was prepared in considera-
tion with previous works for reference [2124]. Earlier
studies on perceptions of climate change have used a
ve point Likert scale, with a scale of 1 to 5 to denote
perceptions of climate variability. However, these did
not go so far as to measure what factors were attributed
to variability (22). In our study, we used a similar
approach with additional exposure variablese.g. per-
ception of climate variability, health riskmeasured
dichotomously (yesand no). By calculating such
variables, a new dimension is added to the existing lit-
erature. Prior to interviewing the 258 household heads,
the questionnaire was pre-tested among 20 household
heads in Nayapati VDC, Kathmandu, Nepal. The study
tool assessed an individuals: i) socio-demographic fac-
tors (age, sex, ethnicity, educational status, type of
family, type of house, main source of income and area
of cultivable land owned by the family) ii) perception of
climate variability over the past ve years, and iii) per-
ception of health risks. Demographic characteristics
were gathered through direct questioning and house-
hold observation. We further used classications from
the 2008 Household Budget Survey to identify house
types (25). A super-pakki house is dened as the house
in which both the walls and the roof are built in perma-
nent materials, such as cement, concrete and bricks. A
pakki house is a house where either wall or roof is built
in permanent materials and the other is built in tempor-
ary materials. A Kachhi house is one where both walls
and roof are built in temporary materials, such as mud,
straw, bamboo or plastic.
Respondents were asked whether they had experi-
enced, observed or witnessed given climate-change
related indicators. Three options provided to the
respondent were yes,noand do not know. Total
scores for climate variability and health risks were cal-
culated. Perception of climate variability was indicated
if the total score was greater than the median. The fol-
lowing questions were asked to the respondents to
measure the perception of climate variability:
1. Have you perceived a change in the degree of
hotness during the summer?
2
Environ. Res. Lett. 10 (2015) 034007 S R Mishra et al
2. Have you perceived a change in the degree of
coldness during the winter?
3. Have you perceived change in the amount of
rainfall during the rainy season?
We further tested whether respondents had a per-
ception of a change in disease occurrence. The per-
ceived human health risk was indicated if the
perceived health risk score was greater than the med-
ian. The following questions were asked to measure
the perception of health risks:
1. Have you perceived a change in the occurrence of
disease during the summer?
2. Have you perceived a change in the occurrence of
disease during the winter?
3. Have you perceived a change in the occurrence of
disease during the rainy season?
Data was entered into EpiData 3.1 and analyzed
using SPSS Version 17 (SPSS Inc., Chicago). We
considered all variables used in bivariate analysis for
multiple logistic regressions to control for confound-
ing [26].
This study was conducted from August 2013 to
July 2014 and the participantsenrollment was active
from March to May 2014. The study protocol was
approved by the Institutional Review Board (IRB) at
the Institute of Medicine, Tribhuvan University,
Nepal. Permission for conducting the study was also
obtained from the VDC ofce. We obtained written
informed consent from each household head after
explaining the rationale of the study. We ensured the
condentiality and anonymity of participants.
Respondents were informed of the right not to answer
any of the asked questions or leave the interview with-
out reason. A few of the respondents could not read or
write and provided verbal consent for interview.
Results
Characteristics of the respondents
Of the 258 participants, 74.4% were female and 86.8%
were aged 24 years or older. When asked about the size
of family, 53.9% reported to be living in nuclear
families. Agriculture was the main source of income
for 33.6% of the households questioned, followed by
foreign remittance at 28.3% of households. In terms of
economic status, 15.5% self-rated as poor, and 76%
as middle income. 27.1% percent were illiterate and
43.4% had a basic education (table not shown).
Perception of climate change and health risks
Over half of respondents had perceived a change in
climate (54.7%). A total of 53.9% perceived an
increase in hotness in the summer and 49.2% had
perceived an increase in rainfall during the rainy
season. Similarly, 50.0% had perceived an increase in
the number of diseases during the summer, 46.5%
perceived this increase during the rainy season and
48.8% during the winter (gure 1).
When asked about changes in local climate, 31.4%
noted an increase in wind velocity during the summer,
43.4% said rainfall during the summer was adequate,
though 5.8% had seen a spring dry up over the
preceding ve years (table not shown).
Household heads were asked for the necessity and
adequacy of both personal and government efforts in
mitigating climate change and its impact on the com-
munity. 3 in 10 respondents agreed that personal
effort was essential for climate change mitigation.
Only 8.9% felt that the government was doing enough
(gure 2).
Being a female (aOR = 1.780, 95% CI (0.991;
3.200)), belonging to the Janajati (indigenous) ethnic
group (aOR = 2.492, 95% CI (1.293; 4.801)), living in
apakki (aOR = 3.662, 95% CI (1.3889.663)), super-
pakki house (aOR = 5.862, 95% CI (2.119; 16.218)), or
belonging to poor (aOR = 9.187, 95% CI
(1.80846.675)) and those with mid-level income
(aOR = 5.193, 95% CI (1.34220.098)) were related to
higher odds of perceiving climate variability. The illit-
erate were less likely to perceive climate variability
(aOR = 0.410, 95% CI (0.1900.884)) (table 1).
Respondents living in a pakki house (aOR = 2.907,
95% CI (1.1657.256)), super-pakki (aOR = 4.833,
95% CI (1.84412.672)), and being poor (aOR =
5.163, 95% CI (1.13823.416)) were more likely to
perceive health risks. The illiterate were less likely to
perceive health risks (aOR = 0.320, 95% CI
(0.1500.684)) (table 2).
Discussion and conclusions
Whilst this is the rst study to report community
perception of climate variability and health risks in
Nepal, a number of limitations need to be considered.
Firstly, all respondentsperception of climate varia-
bility and health risks were measured from proxy
indicators. Secondly, this study surveyed a large
number of households in a single village of a mid-hill
district of Nepal. Due to coverage of such a small study
area, extrapolation of the ndings to other parts of the
country may be limited. Finally, measuring perception
of climate variability and health risks is difcult. The
responses recorded through indicators may suffer
recall bias, and be subject to personal judgment [21].
Nevertheless, the ndings of this study reect the
communitiesview on climate change and health, and
will be important while launching programs to
mitigate future adverse events.
Data conrm that Nepal has experienced a mea-
surable change in climate, particularly in precipitation
patterns and heat stress [1517]. Our study ndings
3
Environ. Res. Lett. 10 (2015) 034007 S R Mishra et al
show these objective ndings are reected in sub-
jective measurements of climate change at a commu-
nity level. A signicant proportion of respondents
have a clear perception of climate variability, most
notably through increased summer temperatures,
higher wind velocity and increased rainfall during the
rainy season.
People falling under the Janajati (indigenous)
group were found to have higher odds of perceiving
climate variability. This observed association could be
accounted for their close relationship with and reli-
ance upon environmental resources for survival. An
earlier similar study conducted among indigenous
people in Nigeria [27]reects these ndings, stating
that over a few decades, 73% had experienced rising
temperatures, 83.5% had expressed a decrease in rain-
fall and 75% had said the environment is becoming
drier to the point of affecting human comfort. Our
study found association between economic level and
perception of climate variability and health risks.
Those with lower economic level depend on natural
resources such as forest, grassland and wetland [28],
thus they are supposed to perceive climate variability
and disease occurrence more compared to people of
higher economic level. Education was positively asso-
ciated with perception of climate variability and health
risks. Literacy of the effects of climate change can be
instrumental in achieving better adaptation at com-
munity level. Further research is needed to shed light
on our speculations.
Compared to a similar study in Bangladesh [21], a
smaller percentage of our research community per-
ceived climate variability. Such differences may be an
accurate perception due to oods and heat waves
being more common in Bangladesh than in Nepal. In
an another study in Nepal, 73.2% of people believed
that the weather was getting warmer, 67.2% believed
that the onset of summer and monsoon had advanced
during the last 10 years; furthermore, 46% believed
that there was less snow on mountains than before and
70% felt that water sources were drying up [29]. Again,
variation in results may be due to inherent differences
in the study location.
Table 1. Factors associated with perception of climate variability.
Variables OR (95% CI) aOR (95% CI)
Age 0.674
<20 years 1
2045 years 1.175 (0.4802.875)
>45 years 1.439 (0.5573.718)
Sex 0.054
Male 1
Female 1.780 (0.9913.200)
Ethnicity 0.000 0.000
Brahmin/
Chhetri
11
Janajati 2.476
a
(1.3384.580) 2.492
a
(1.2934.801)
Dalit 0.763 (0.3521.653) 0.608 (0.2611.414)
Type of family 0.577
Nuclear 1
Joint 0.817(0.4941.351)
Extended 1.562(0.3377.242)
Education 0.197 0.066
Educated 1 1
Literate 0.998 (0.5481.818) 0.725 (0.3701.422)
Illiterate 0.601 (0.3091.170) 0.410
a
(0.1900.884)
Source of
income
0.063
Agriculture 1
Skilled 1.863
a
(1.0843.202)
Labor 1.073 (0.3833.003)
House type 0.019 0.003
Kachha 11
Pakki 2.071 (0.9204.660) 3.662
a
(1.3889.663)
Super-pakki 2.950
a
(1.3686.362) 5.862
a
(2.11916.218)
Economic level 0.096 0.027
Poor 2.400 (0.5819.908) 9.187
a
(1.80846.675)
Mid-level
income
3.589 (0.98313.100) 5.193
a
(1.34220.098)
Rich 1 1
a
p < 0.05, statistically signicant at 95% CI.
Table 2. Factors associated with perception of health risks.
Variables OR (95% CI) aOR (95% CI)
Age 0.601
<20 years 1
20-45 years 1.336 (0.5463.266)
>45 years 1.596 (0.6184.124)
Sex 0.199
Male 1
Female 1.454 (0.8222.573)
Ethnicity 0.008 0.006
Brahmin/
Chhetri
11
Janajati 1.900
a
(1.0423.464) 1.805(0.950 3.430)
Dalit 0.750 (0.3571.574) 0.596 (0.2641.346)
Type of family 0.86
Nuclear 1
Joint 0.987 (0.5991.625)
Extended 1.518 (0.3287.035)
Educational
status
0.058 0.011
Educated 1 1
Literate 0.880 (0.4831.604) 0.651(0.335 1.264)
Illiterate 0.477
a
(0.2450.928) 0.320
a
(0.1500.684)
Source of
income
0.116
Agriculture 1
Skilled 1.662 (0.9752.832)
Labor 0.883 (0.3172.463)
Type of house 0.038 0.005
Kachha 11
Pakki 1.804 (0.8263.941) 2.907
a
(1.1657.256)
Super-pakki 2.560
a
(1.2235.359) 4.833
a
(1.84412.672)
Economic level 0.155 0.098
Poor 1.833 (0.4966.778) 5.163
a
(1.13823.416)
Mid-level
income
2.723 (0.8398.835) 3.384 (0.98211.655)
Rich 1 1
a
p < 0.05, statistically signicant at 95% CI.
4
Environ. Res. Lett. 10 (2015) 034007 S R Mishra et al
At present, there are few studies reporting a cor-
relation between climate change and diseases occur-
rence in Nepal. An earlier study reported a 1 °C
increase in minimum and mean temperatures and
increased malaria incidence by 27% [30]. Public per-
ception of climate change is not new to literature
[2124]; however, further analysis exploring pre-
dictors of climate variability and health risks have not
been reported before. Our study format and ndings
can benet further research in the eld to link sub-
jective and objective measures of climate change.
Furthermore, our study pointed out strong evidence
to support climate variability in Nepal. Perception of
climate variability and diseases occurrence were pre-
dicted by a number of factors, including socio-demo-
graphic (ethnicity, education, house type) and
economic level. The literature states that voluntary
mitigation and adaptation is often the result of per-
ception of climate variability [31]. In the light of this
evidence, better awareness activities about climate
variability and associated human health risks can
yield better adaptation and mitigation practices in
Nepal. Our ndings can particularly be of higher
importance to the National Adaptation Program of
Actions 2010(32) and the Local Adaptation Plan of
Action National Framework 2011launched by the
Ministry of Science, Technology and Environment
[33]. These two frameworks are keys to successfully
adapting to and mitigating climate change in Nepal.
As measures to address and mitigate climate change
receive increasing priority, our data outcomes are
valuable: to assist policy makers in mapping commu-
nity vulnerability to climate change and adverse
health outcomes, and to better direct the design of
community based mitigation and adaptation strate-
gies in Nepal and beyond.
Data accessibility
Data will be made available upon the approval from
Institutional Review Board of Institute of Medicine.
Figure 1. Perception of climate variability and disease occurrence.
Figure 2. Attitude towards climate change.
5
Environ. Res. Lett. 10 (2015) 034007 S R Mishra et al
Acknowledgments
The authors wish to thank the study participants for
contributing their valuable support, time and
responses. We appreciate the help of the Community
Health Diagnosis-Bhimad team. The authors thank
Department of Community Medicine and Public
Health, the Institute of Medicine Nepal, and the
Bhimad Village Development Committee ofce for
their support during the research.
Competing Interest
The authors declare no competing interests.
Authors Contribution
SRM conceived the research work. PMB coordi-
nated the eld level data collection. SRM and SG car-
ried out the data analysis. SRM wrote the draft of the
manuscript. VK, RI and DN contributed in the litera-
ture review, interpretation of results and manuscript
revision. All the authors contributed in the revision of
the paper and agreed on the nal manuscript.
References
[1] Kreft S and Eckstein D 2014 Global Climate Risk Index 2014
(Bonn: Germanwatch e.V.) http://germanwatch.org/en/
download/8551.pdf
[2] Shrestha A, Budhathoki K, Shrestha R and Adhikari R 2004
Bathymetric survey of Tsho Rolpa Glacier Lake2002 Hydrol-
ogy J. SOHAM 1135
[3] Kim K H, Kabir E and Ara Jahan S 2014 A review of the
consequences of global climate change on human health
J. Environ. Sci. Health C32 299318
[4] Lama S and Devkota B 2009 Vulnerability of mountain
communities to climate change and adaptation strategies
J. Agric. Environ. 10 7683
[5] IPCC Climate Change 2007 Synthesis Report. Contribution of
Working Groups I, II and III to the Fourth Assessment Report of
the Intergovernmental Panel on Climate Change (Cambridge:
Cambridge University Press)
[6] Haines A, Kovats R S, Campbell-Lendrum D and Corvalan C
2006 Climate change and human health: impacts, vulnerability
and public health Public Health 120 58596
[7] Hales S, Kovats S and Woodward A 2000 What El Niño can tell
us about human health and global climate change Glob.
Change Human Health 16677
[8] McMichael A J, Campbell-Lendrum D, Kovats R S,
Edwards S and Wilkinson P 2004 Comparative Quantication
of Health Risks: Global and Regional Burden of Disease due to
Selected Major Risk Factors (Geneva: World Health
Organization)
[9] World Health Organization 2002 The World Health Report
2002: Reducing Risks, Promoting Healthy Life (Geneva: World
Health Organization)
[10] Patz J A et al 2001 The potential health impacts of climate
variability and change for the United States. Executive
summary of the report of the health sector of the US National
Assessment J. Environ. Health 64 208
[11] Martens P et al 1999 Climate change and future populations at
risk of malaria Glob. Environ. Change 9S89107
[12] Bai L, Morton L C and Liu Q 2013 Climate change and
mosquito-borne diseases in China: a review Glob. Health 9:10
doi:10.1186/1744-8603-9-10
[13] Parry M L 2007 Climate change 2007: impacts Adaptation and
Vulnerability: Working Group II Contribution to the Fourth
Assessment Report of the IPCC Intergovernmental Panel on
Climate Change (Cambridge: Cambridge University Press)
[14] Barnett T P, Adam J C and Lettenmaier D P 2005 Potential
impacts of a warming climate on water availability in snow-
dominated regions Nature 438 3039
[15] Marahatta S, Dangol B S and Gurung G B 2009 Temporal and
Spatial Variability of Climate Change over Nepal (19762005)
(Kathmandu: Practical Action Nepal Ofce) http://
practicalaction.org/le/region_nepal/ClimateChange1976-
2005.pdf
[16] Bhandari G P, Gurung S, Dhimal M and Bhusal C L 2012
Climate change and occurrence of diarrheal diseases: evolving
facts from Nepal J. Nepal Health Res. Council 10 1816
[17] Pradhan B, Shrestha S, Shrestha R, Pradhanang S,
Kayastha B and Pradhan P 2013 Assessing climate change and
heat stress responses in the Tarai region of Nepal Indust. Health
51 10112
[18] Central Bureau of Statistics. National Population and Housing
Census. Kathmandu (Nepal): Central Bereau of Statistics 2011
[19] Central Bureau of Statistics 2012 District Pro le Tanahu
(Kathmandu: CBS)
[20] Poudel J P (ed) 2013 Demographic Pro le of Nepal, 2013/2014:
VDC and Municipality Population, Household and Population
by Sex: Ward Level (Kathmandu: Mega Research Centre and
Publication)
[21] Haque M A, Yamamoto S S, Malik A A and Sauerborn R 2012
Householdsperception of climate change and human health
risks: a community perspective Environmental Health: A
Global Access Science Source 11 1
[22] Devkota R P 2014 Climate change: trends and peoples
perception in Nepal J. Environ. Protection 2014 25565
[23] Akerlof K et al 2010 Public perceptions of climate change as a
human health risk: surveys of the United States, Canada and
Malta. International J. Environ. Res. Public Health 7
2559-606
[24] Semenza J C, Hall D E, Wilson D J, Bontempo B D,
Sailor D J and George L A 2008 Public perception of climate
change voluntary mitigation and barriers to behavior change
Am J. Preventive Med. 35 47987
[25] Nepal Rastra Bank 2008 Types of House (Dwelling Units)
(Kathmandu: Nepal Rastra Bank)
[26] Bursac Z, Gauss C H, Williams D K and Hosmer D W 2008
Purposeful selection of variables in logistic regression Source
Code for Biology and Medicine 317
[27] Ishaya S and Abaje I 2008 Indigenous peoples perception on
climate change and adaptation strategies in Jemaa local
government area of Kaduna State, Nigeria J. Geography Regio-
nal Planning 113843
[28] International Fund for Agricultural Development 2011 Rural
Poverty Report 2011 (Rome: IFAD)
[29] Chaudhary P and Bawa K S 2011 Local perceptions of climate
change validated by scientic evidence in the Himalayas
Biology Lett. 776770
[30] Dhimal M, OHara R B, Karki R, Thakur G D, Kuch U and
Ahrens B 2014 Spatio-temporal distribution of malaria and its
association with climatic factors and vector-control interven-
tions in two high-risk districts of Nepal Malaria J. 13 457
[31] Semenza J C, Ploubidis G B and George L A 2011 Climate
change and climate variability: personal motivation for
adaptation and mitigation Environ. Health 10 46
[32] Ministry of Science Technology and Environment 2010
National Adaptation Programmes of Action (NAPA)
(Kathmandu: Ministry of Environment)
[33] Ministry of Science Technology & Environment 2011 Local
Adaptation Plan of Action National Framework (LAPA) (Kath-
mandu: Government of Nepal)
6
Environ. Res. Lett. 10 (2015) 034007 S R Mishra et al
... A study among vulnerable communities -defined as prone to climate change hazards like cyclone and flood -in Bangladesh found that 54.2% of respondents had some knowledge about climate change, and that people with higher educational level or who live near a school were more knowledgeable about climate change and its impact on health [15]. A Nepalese study performed in a district located in the central hilly region of the country reported 54.7% of respondents had perceived a change in climate, that poverty increased the likelihood of perceiving health risks while illiteracy decreased the likelihood of perceiving health risks [16]. A Tanzanian study found that rural communities have little knowledge on climate change and its impacts on e.g., malaria, and only one in four understood the Swahili term for climate change. ...
... A main finding of this study is that the residents in the informal settlement Mukuru, Nairobi, Kenya are aware of climate change and its effects, experience climate change affects their community, and are concerned about both climate change and climate change related health impacts [7,11,14,16,18,27]. This high degree of knowledge is consistent with recent studies e.g. in South African informal settlements [28] and a qualitative study conducted in Mukuru [18] where health care workers, community leaders and volunteers living in Mukuru were all conscious of a link between climate change and health [18] which correlates with the findings of our study. ...
... In this study all participants consider themselves and their families at risk of respiratory, water-and vectorborne diseases; all diseases which have also been associated with climate change induced weather in previous studies [7,11,14,16,18,27,29,30]. Other studies and reports have stated that over the last 10 years air pollution, a decrease in general health, poorer water quality, droughts and heat waves were the most experienced impacts of climate change on Mukuru informal settlements [18,20,31]. ...
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Background Residents of informal settlements in Sub-Sahara Africa (SSA) are vulnerable to the health impacts of climate change. Little is known about the knowledge, attitudes and practices (KAP) of inhabitants of informal settlements in SSA regarding climate change and its health impacts. The aim of this study was to investigate how inhabitants of an informal settlement in SSA experience climate change and its health impacts and assess related knowledge, attitudes and practices. The study was conducted in Mukuru informal settlement in Nairobi City County, Kenya. Methods A cross-sectional study was conducted in September 2021 using a structured, semi-closed KAP questionnaire. Inclusion criteria were ≥ 18 years of age and living in one of the three main sections in Mukuru: Kwa Njenga, Kwa Reuben or Viwandani. By spinning a pen at the geographic centre of each section, a random direction was selected. Then, in every second household one individual was interviewed, creating a representative mix of ages and genders of the local community. To assess participant characteristics associated with climate change knowledge multivariable logistic regression was used. Thematic content analysis was performed for qualitative responses. Results Out of 402 study participants, 76.4% (n = 307) had heard of climate change before the interview, 90.8% (n = 365) reported that climate change was affecting their community, and 92.6% (n = 372) were concerned with the health-related impact of climate change. Having lived in Mukuru for more than 10 years and living in a dwelling close to the riverside were factors significantly associated with having heard of climate change before (aOR 3.1, 95%CI 1.7 – 5.8 and aOR 2.6, 95%CI 1.1 – 6.1, respectively) and experiencing a climate change related impact on the community (aOR 10.7, 95%CI 4.0 – 28.4 and aOR 7.7; 95%CI 1.7 – 34.0, respectively). Chronic respiratory conditions, vector-borne diseases, including infectious diarrhoea, malnutrition and cardiovascular diseases were identified by respondents as climate related health risks. Conclusions Most respondents were knowledgeable about climate change and were experiencing its (health-related) impact on their community. This study provides insights which may prove useful for policy makers, intervention planners and researchers to work on locally adapted mitigation and adaption strategies.
... " Comparing surveys from the US, Canada, and Malta, Akerlof et al. [7] found that despite the majority of people across all three countries viewing climate change as a health risk, "climate change appears to lack salience as a health issue" based on the limited depth of answers to open-ended questions. Studies in other parts of the world such as Nepal [8], Bangladesh [9], and Hong Kong [10] have found high levels of awareness of climate change, but varying degrees of awareness around public health impacts depending on factors such as education and income. ...
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Background Understanding public perceptions of the health risks of climate change is critical to inform risk communication and support the adoption of adaptive behaviours. In Canada, very few studies have explored public understandings and perceptions of climate impacts on health. The objective of this study was to address this gap by exploring perceptions of the link between climate change and health. Methods We conducted a survey of Canadians (n = 3,014) to address this objective. The 116-question survey measured prior consideration of the link between climate change and health, affective assessment of climate health impacts, unprompted knowledge of climate health impacts, and concern about a range of impacts. ANOVA tests were used to assess differences among sociodemographic groups. Results Overall, Canadian’s have a similar level of concern about health impacts of climate change compared with concern about other impacts (e.g. biophysical, economic, and national security). Among health-related impacts, respondents were more concerned about impacts on water, food and air quality, compared with impacts on mental health, infectious diseases and heat-related illnesses. There were differences among sociodemographic groups; women were significantly more concerned than men about all of the health-related impacts; respondents with a high school level of education were significantly less concerned about all health-related impacts compared with respondents with more education; and respondents on the political left were more concerned with those in the political centre, who were more concerned than those on the political right. Conclusion There is emerging literature suggesting that framing communication around climate change in terms of the health risks it poses may increase perceptions of the proximity of the risks. These results suggest that it is important to be specific in the types of health risks that are communicated, and to consider the concerns of the target sociodemographic groups. The differential knowledge, awareness, and concern of climate health impacts across segments of the Canadian population can inform targeted communication and engagement to build broader support for adaptation and mitigation measures.
... Similar studies are being conducted inside the country and globally. For example, in Ethiopia (Debela et al., 2015) ( (Mishra et al., 2015) and Kaski and Chitwan districts of Nepal (Khanal and Kattel 2017). However, the understanding of district level key stakeholders and forest users are largely lacking from rural mid hills district of Nepal. ...
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Climate change is regarded as one of the most fundamental threats to sustainable livelihood and global development. There is growing a global concern in linking community-managed forests as potential climate change mitigation projects. This study was conducted to explore the local people's perception on climate change and the role of community forestry (CF) to combat climate change impacts. Two active community forest user groups (CFUGs) from Rukum West District in Nepal were selected as study sites, and various participatory tools were applied to collect primary data. Although most of the respondents were aware about the words "Climate Change" in study sites, they were more familiar with the irregularities in rainfall season and other weather extremities. The study focuses on perceptions of, and on adaptations to climate change by Community Forest User Groups. Information was collected from both primary and secondary data sources. Climate data were analyzed through trend analysis. Results show that most community forest users perceive climate change acutely and respond to it, based on their own indigenous knowledge and experiences, through both agricultural and non-agricultural adaptations at an individual level. 70% of the respondents had the idea that, due to increase in precipitation, there is a frequent occurrence of erosion, floods and landslide. Around 78% of the people agreed that community forests help in stabilizing soil, reducing the natural hazards like erosion, landslide. Biogas as an alternative source of cooking energy, and changes in crops and their varieties are the common adaptation measures that local people start practicing in both CFUGs in Nepal.
... Half of the respondents perceived an increase in the number of diseases during the summer, 46.5% perceived an increase during the rainy season and 48.8% during winter. [30]. ...
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Climate change, sometimes called global warming, is the observed century-scale rise in the average temperatures of the earth's climate systems and its related effects. There are both natural and anthropogenic contributors to climate change. For example, volcanic eruptions are natural contributors and the burning of fossil fuels with the consequent release of greenhouse gases, such as water vapor, carbon dioxide, and methane. This is the largest human influence on global warming. This study attempted to assess the knowledge, contributory community practices, and perceived effects of climate change in a characteristic suburban community in Africa, where the majority of people are expected to have poor knowledge about the phenomenon. It was a cross-sectional study. The study population comprised townies in the Okada community, excluding students of Igbinedion University. Pre-tested structured questionnaires were the tools for data collection. Data analysis was done with IBM SPSS Version 21 and the level of statistical significance was set at p<0.05. A total of 274 respondents participated. 82.1% of respondents had knowledge of climate change with TV/radio (51.1%) being the most widely reported source of information. More than half of the respondents recognized human activities and natural variability as responsible factors. Bush burning (33.3%), burning of fossil fuels (15.3%) [especially cooking gas] and deforestation (12.4%) were recognized anthropogenic contributors to climate change in Okada. Burning (70.1%) was the predominant method of waste disposal among respondents. Of the perceived effects, poor harvest and crop yield (77%) were the most feared effects of climate change to respondents.
... A review of the literature from 2020 on health implications of climate change found just seven studies on climate change and health in LMICs [20]. The review identified studies reporting on food insecurity [21][22][23], water insecurity [22,23], illness [23][24][25], mental health [23], injuries from extreme weather events [22], and heat-exposure [26] related to climate change. All these risks were also reported by the participants in this study. ...
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Sub-Saharan Africa has been identified as one of the most vulnerable regions to climate change. The objective of this study was to explore knowledge and perspectives on climate change and health-related issues, with a particular focus on non-communicable diseases, in the informal settlement (urban slum) of Mukuru in Nairobi, Kenya. Three focus group discussions and five in-depth interviews were conducted with total of 28 participants representing local community leaders, health care workers, volunteers, policy makers and academia. Data were collected using semi-structured interview guides and analyzed using grounded theory. Seven main themes emerged: climate change related diseases, nutrition and access to clean water, environmental risk factors, urban planning and public infrastructure, economic risk factors, vulnerable groups, and adaptation strategies. All participants were conscious of a link between climate change and health. This is the first qualitative study on climate change and health in an informal settlement in Africa. The study provides important information on perceived health risks, risk factors and adaptation strategies related to climate change. This can inform policy making, urban planning and health care, and guide future research. One important strategy to adapt to climate change-associated health risks is to provide training of local communities, thus ensuring adaptation strategies and climate change advocacy.
... A study from Bangladesh demonstrated that subjects with a sufficient level of education were more aware of climate change [32]. Other studies from the Philippines, Nepal, and China have reported similar results [37][38][39]. Therefore, increasing knowledge about climate change among students is a valuable strategy that can be used to enhance awareness of climate change. Furthermore, the results of this study indicate that a higher income is associated with a greater concern about climate change. ...
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Climate change poses a global threat to public health. This study investigated the understanding of, and concern over, climate change in Saudi Arabia and examined the associations with sociodemographic characteristics and dietary choices. This cross-sectional study consisted of 280 participants recruited via an online survey. Of the study participants, 45% demonstrated a sufficient understanding of climate change, and 56% were highly concerned about climate change. Male sex, medium-high monthly income, high education, and governmental employees were determinants of sufficient understanding of and great concern over climate change. Participants who exhibited a high understanding of climate change score demonstrated significantly higher consumption of vegetables (3.47 ± 0.98) and vegetable oils (3.26 ± 1.07) than participants with a low understanding score (3.31 ± 0.96 and 3.00 ± 1.01, respectively) (p ≤ 0.01). Additionally, participants with higher concern of climate change scores exhibited lower consumption of red meat (p = 0.0001), poultry (p = 0.003), margarine (p = 0.02), and soy products (p = 0.04). The study revealed a poor understanding of, but great concern over, climate change. The intake of non-climate-friendly food was typically higher than that of climate-friendly food. These findings are critical for developing strategies to enhance awareness of climate change and encourage people to consume climate-friendly food to mitigate climate change and improve public health.
... However, studies conducted in countries Asia and Africa indicate people being aware of the health impacts of climate change such as injuries, heat risk, stress, illness, food and water insecurity, which is in contrast to our findings. [34][35][36] The perceptual understanding of climate change is largely localized in nature and is related with the variations as well as extreme events observed in weather. It appears that people do not perceive that climate change has a bearing on climate-influenced diseases. ...
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Background: In the climate change discourse, a body of scholarship focusing on how people perceive climate change and its impact is increasing. However, in the Indian context, such scholarship is limited. Objective: This paper aims to describe the perceptions of people on climate change and its health impacts, which were captured as part of a larger study. Methodology: A cross-sectional study was conducted in randomly selected 983 households in four districts spread across Madhya Pradesh and Jammu and Kashmir. A semi-structured questionnaire was used to collect the data. Results: For 72% of respondents, the perception was not related to climate change per se. Their perceptions were contextual and were based on the anomalies which are observed in the immediate weather conditions. The health impacts of climate change were also not understood at the first place, but with probing 64% of respondents were able to report seasonal diseases. Conclusion: Perceptions of the people regarding climate change are more linked to their own experiences with their local weather conditions rather than the overall concept. This also explains their lack of comprehension about the health impact of climate change, but a sound understanding of seasonal diseases.
... During the FGDs and KII, most of the farmers informed us that climate change had negative impacts on human health with climate change induced disease becoming more common in their communities in recent years. Farmers reported being more susceptible in recent years to diseases such as viral influenza, kala-zar, diarrhea, typhoid, and dengue fever, diseases that have also been the subject of human health studies linked to climate change [51,52]. ...
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The impact of climate change on farmers’ livelihoods has been observed in various forms at the local and regional scales. It is well known that the Himalayas region is affected by climate change, as reflected in the basic knowledge of farmers in the region. A questionnaire-based survey involving a total of 747 households was conducted to gather information on climate change and its impact, where the survey addressed four physiographic regions of the trans-boundary Koshi River Basin (KRB). Moreover, climatic data were used to calculate climatic trends between 1980 and 2018. The Mann–Kendall trend test was performed and the Sen’s slope calculated to analyze the inter-annual climatic trends over time. The survey noted that, for the basin, there was an increase in temperature, climate-induced diseases of crops, an increase in the frequency of pests as well as drought and floods and a decrease in rainfall, all which are strong indicators of climate change. It was perceived that these indicators had adverse impacts on crop production (89.4%), human health (82.5%), livestock (68.7%) and vegetation (52.1%). The observed climatic trends for all the physiographic regions included an increasing temperature trend and a decreasing rainfall trend. The rate of change varied according to each region, hence strongly supporting the farmers’ local knowledge of climate change. The highest increasing trend of temperature noted in the hill region at 0.0975 °C/a (p = 0.0002) and sharpest decreasing trend of rainfall in the mountain region by −10.424 mm/a (p = 0.016) between 1980 and 2018. Formulation of suitable adaptation strategies according to physiographic region can minimize the impact of climate change. New adaptation strategies proposed include the introduction of infrastructure for irrigation systems, the development of crop seeds that are more tolerant to drought, pests and disease tolerance, and the construction of local hospitals for the benefit of farming communities.
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The species composition of bumblebees (Bombus species) across the elevation gradients in Chitwan-Annapurna Landscape (CHAL) was studied from April to November 2019. We performed opportunistic surveys to collect the bumblebee specimens. The walking transects were followed in the accessible places along the Kaligandaki, Marshyandi, and Budhigandaki river basins in different habitats (e.g., agricultural, forest, grassland and home garden). We identified 16 Bombus species from the sampling areas. The highest relative abundance was of B. haemorrhoidalis (20%), followed by B. festivus (20%) and B. eximius (19%). The least abundant species were B. branickii, B. miniatus, B. novus, and B. pressus with 1% relative abundance of each. We examined the effects of elevation on bumblebee richness and found a significant relationship. The Highest species richness was detected in the mid-elevation. Likewise, the highest species richness and diversity were found in the forest habitat in Gorkha site (n = 12, Shannon index H’ = 2.18) followed by the grassland habitat of the Mustang site (n = 11, Shannon index H’ = 2.10). Whereas, comparatively, species diversity was higher in habitats of the Gorkha site comparing Manang and Mustang. The elevation gradients create immense variations in microclimatic conditions and vegetation dynamics, which influence bumblebee abundance, species richness and diversities in different habitats in the study area. The mid-elevation range (2000–3000 m asl) of CHAL exhibited the highest species richness probably due to the higher availability of pollinator-dependent flowering plants in this range. The landcover composition and anthropogenic activities along the elevation gradient is the governing factor for the species composition, distribution and diversity of bumblebees in CHAL. We recommend to decision-makers for formulating their conservation strategies under a socio-ecological framework.
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Background At a time of intersecting public health crises of COVID-19 and climate change, understanding public perceptions of the health risks of climate change is critical to inform risk communication and support the adoption of adaptive behaviours. In Canada, very few studies have explored public understandings and perceptions of climate impacts on health. Methods This study addresses this gap through a nationally-representative survey of Canadians (n=3,014) to explore public perceptions and awareness regarding the link between climate change and health in Canada. The 116-question survey measured awareness of the link between climate change and health, affective assessment of climate health impacts, unprompted knowledge of climate health impacts, and concern about a range of impacts. Kruskal-Wallis tests were used to test for differences in median values among sociodemographic groups. The survey also measured baseline climate opinion, which was used to segment the public into different audiences through a latent class analysis. Results Three climate opinion classes were identified in the sample (disengaged, concerned, and alarmed) and perceptions of climate health impacts were compared across these classes and other sociodemographic variables. Approximately half (53%) of respondents have considerable awareness of the link between climate change and health, and even more (61%) perceive climate change as bad for health. The majority of respondents (58%) can name one or more health impact without prompting. Concern about health impacts of climate change is highest among the alarmed and lowest among the disengaged, as compared to concerns about other categories of climate impacts such as economic. Across the survey, knowledge and concern are highest for water- and food-related health impacts. Conclusions The differential knowledge, awareness, and concern of climate health impacts across segments of the Canadian population can inform targeted communication and engagement to build broader support for adaptation and mitigation measures.
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Mitigating global climate change requires not only government action but also cooperation from consumers. Population-based, cross-sectional surveys were conducted among 1202 respondents in Portland OR and Houston TX between June and September 2007 regarding awareness, concern, and behavior change related to climate change. The data were subjected to both quantitative and qualitative analyses. Awareness about climate change is virtually universal (98% in Portland and 92% in Houston) with the vast majority reporting some level of concern (90% in Portland and 82% in Houston). A multivariate analysis revealed significant predictors of behavior change: individuals with heightened concern about climate change (p<0.001); respondents with higher level of education (p= 0.03); younger compared with older individuals (p<0.001); and Portlanders more likely to change behavior compared with Houstonians (p<0.001). Of those who changed behavior, 43% reported having reduced their energy usage at home, 39% had reduced gasoline consumption, and 26% engaged in other behaviors, largely recycling. Qualitative data indicate a number of cognitive, behavioral, and structural obstacles to voluntary mitigation. Although consumers are interested in global climate change-mitigation strategies and willing to act accordingly, considerable impediments remain. Government policy must eliminate economic, structural, and social barriers to change and advance accessible and economical alternatives. Individual-level mitigation can be a policy option under favorable contextual conditions, as these results indicate, but must be accompanied by mitigation efforts from industry, commerce, and government.
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Background Over the last decade, the incidence of confirmed malaria has declined significantly in Nepal. The aim of this paper is to assess the spatio-temporal distribution of malaria and its association with climatic factors and vector control interventions in two high-risk districts of Nepal. Methods Hotspot analysis was used to visualize the spatio-temporal variation of malaria incidence over the years at village level and generalized additive mixed models were fitted to assess the association of malaria incidence with climatic variables and vector control interventions. Results Opposing trends of malaria incidence were observed in two high-risk malaria districts of eastern and far-western Nepal after the introduction of long-lasting insecticidal nets (LLINs). The confirmed malaria incidence was reduced from 2.24 per 10,000 in 2007 to 0.31 per 10,000 population in 2011 in Morang district but increased from 3.38 to 8.29 per 10,000 population in Kailali district. Malaria hotspots persisted mostly in the same villages of Kailali district, whereas in Morang district malaria hotspots shifted to new villages after the introduction of LLINs. A 1[degree sign] C increase in minimum and mean temperatures increased malaria incidence by 27% (RR =1.27, 95% CI =1.12-1.45) and 25% (RR =1.25, 95% CI =1.11-1.43), respectively. The reduction in malaria incidence was 25% per one unit increase of LLINs (RR =0.75, 95% CI =0.62-0.92). The incidence of malaria was 82% lower in Morang than in Kailali district (RR =0.18, 95% CI =0.11-0.33). Conclusions The study findings suggest that LLIN coverage should be scaled up to entire districts rather than high-incidence foci only. Climatic factors should be considered for malaria micro-stratification, mosquito repellents should be prescribed for those living in forests, forest fringe and foothills and have regular visits to forests, and imported cases should be controlled by establishing fever check posts at border crossings.
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The impact of climate change has been significant enough to endanger human health both directly and indirectly via heat stress, degraded air quality, rising sea levels, food and water security, extreme weather events (e.g., floods, droughts, earthquakes, volcano eruptions, tsunamis, hurricanes, etc.), vulnerable shelter, and population migration. The deterioration of environmental conditions may facilitate the transmission of diarrhea, vector-borne and infectious diseases, cardiovascular and respiratory illnesses, malnutrition, etc. Indirect effects of climate change such as mental health problems due to stress, loss of homes, economic instability, and forced migration are also unignorably important. Children, the elderly, and communities living in poverty are among the most vulnerable of the harmful effects due to climate change. In this article, we have reviewed the scientific evidence for the human health impact of climate change and analyzed the various diseases in association with changes in the atmospheric environment and climate conditions.
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For policymakers -- Technical summary -- Assessment of observed changes and responses in natural and managed systems -- New assessment methods and the characterisation of future conditions -- Fresh water resources and their management -- Ecosystems, their properties, goods and services -- Food, fibre, and forest products -- Coastal systems and low-lying areas -- Industry, settlement and society -- Human health -- Africa -- Asia -- Australia and New Zealand -- Europe -- Latin America -- North America -- Polar regions (Arctic and Antarctic) -- Small islands -- Assessment of adaptation practices, options, constraints and capacity -- Inter-relationships between adaptation and mitigation -- Assessing key vulnerabilities and the risk from climate change -- Perspectives on climate change and sustainability -- Cross-chapter case studies.
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Global estimates of the potential impact of climate change on malaria transmission were calculated based on future climate scenarios produced by the HadCM2 and the more recent HadCM3 global climate models developed by the UK Hadley Centre. This assessment uses an improved version of the MIASMA malaria model, which incorporates knowledge about the current distributions and characteristics of the main mosquito species of malaria.The greatest proportional changes in potential transmission are forecast to occur in temperate zones, in areas where vectors are present but it is currently too cold for transmission. Within the current vector distribution limits, only a limited expansion of areas suitable for malaria transmission is forecast, such areas include: central Asia, North America and northern Europe. On a global level, the numbers of additional people at risk of malaria in 2080 due to climate change is estimated to be 300 and 150 million for P. falciparum and P. vivax types of malaria, respectively, under the HadCM3 climate change scenario. Under the HadCM2 ensemble projections, estimates of additional people at risk in 2080 range from 260 to 320 million for P. falciparum and from 100 to 200 million for P. vivax. Climate change will have an important impact on the length of the transmission season in many areas, and this has implications for the burden of disease. Possible decreases in rainfall indicate some areas that currently experience year-round transmission may experience only seasonal transmission in the future. Estimates of future populations at risk of malaria differ significantly between regions and between climate scenarios.