title: Water-borne diseases and extreme weather events in Cambodia: review of impacts and implications of climate change.
abstract: Cambodia is prone to extreme weather events, especially floods, droughts and typhoons. Climate change is predicted to increase the frequency and intensity of such events. The Cambodian population is highly vulnerable to the impacts of these events due to poverty; malnutrition; agricultural dependence; settlements in flood-prone areas, and public health, governance and technological limitations. Yet little is known about the health impacts of extreme weather events in Cambodia. Given the extremely low adaptive capacity of the population, this is a crucial knowledge gap. A literature review of the health impacts of floods, droughts and typhoons in Cambodia was conducted, with regional and global information reviewed where Cambodia-specific literature was lacking. Water-borne diseases are of particular concern in Cambodia, in the face of extreme weather events and climate change, due to, inter alia, a high pre-existing burden of diseases such as diarrhoeal illness and a lack of improved sanitation infrastructure in rural areas. A time-series analysis under quasi-Poisson distribution was used to evaluate the association between floods and diarrhoeal disease incidence in Cambodian children between 2001 and 2012 in 16 Cambodian provinces. Floods were significantly associated with increased diarrhoeal disease in two provinces, while the analysis conducted suggested a possible protective effect from toilets and piped water. Addressing the specific, local pre-existing vulnerabilities is vital to promoting population health resilience and strengthening adaptive capacity to extreme weather events and climate change in Cambodia.
authors.affiliation: Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria 3800, Australia. gidav2@student.monash.edu.
authors.forename: Grace I
authors.initials: GI
authors.lastname: Davies
authors.affiliation: National Centre for Epidemiology and Population Health, Australian National University, Canberra, A.C.T. 2601, Australia. lachlan.mciver@gmail.com.
authors.forename: Lachlan
authors.initials: L
authors.lastname: McIver
authors.affiliation: Institute of Tropical Medicine, Nagasaki University, Nagasaki 852-8523, Japan. yoonhee@nagasaki-u.ac.jp.
authors.forename: Yoonhee
authors.initials: Y
authors.lastname: Kim
authors.affiliation: Institute of Tropical Medicine, Nagasaki University, Nagasaki 852-8523, Japan. hashizum@nagasaki-u.ac.jp.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Hashizume
authors.affiliation: World Health Organization, Cambodia Country Office, Phnom Penh, Cambodia. iddingss@wpro.who.int.
authors.forename: Steven
authors.initials: S
authors.lastname: Iddings
authors.affiliation: World Health Organization, Cambodia Country Office, Phnom Penh, Cambodia. chanv@wpro.who.int.
authors.forename: Vibol
authors.initials: V
authors.lastname: Chan
mesh_terms: D000293:Adolescent; D002160:Cambodia / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D057231:Climate Change; D003141:Communicable Diseases / Q000453:epidemiology*; D055867:Cyclonic Storms; D003967:Diarrhea / Q000453:epidemiology*; D060766:Drinking Water / Q000009:adverse effects; D005260:Female; D055868:Floods; D006801:Humans; D007223:Infant; D008297:Male; D014038:Toilet Facilities / Q000706:statistics & numerical data; D014887:Weather
chemical_list: D060766:Drinking Water