Assessing vulnerability of diarrheal diseases associated with climate variability effects in four coastal districts of Bangladesh.
Climate change has intensified public health challenges in coastal Bangladesh, particularly increasing the prevalence of diarrheal diseases. This study assesses the vulnerability to diarrheal diseases in four coastal districts-Satkhira, Jhalakathi, Barguna, and Gopalganj-by examining the relationship between climate variability and disease occurrences. A mixed-methods approach was used, integrating hospital admission records (n = 46,741 diarrheal cases identified from 361,265 patients) from five government health facilities between January 2017 and December 2022 with meteorological data from the Bangladesh Meteorological Department. Key Informant Interviews (KIIs) and Focus Group Discussions (FGDs) were conducted in all four districts. A total of 28 KIIs and 9 FGDs were conducted across the selected upazilas to collect field-level information. Findings indicate a significant positive correlation between maximum temperature and diarrheal incidence (r = 0.228, p = 0.0012). Diarrhea cases were more prevalent at maximum temperatures of 30-35 °C. In contrast, rainfall showed no statistically significant association with diarrheal trends (r = 0.094, p = 0.235), although descriptively fewer cases were observed at rainfall levels above 60 mm. Seasonal analysis revealed peak diarrheal cases between March and May, coinciding with the hottest months of the year. Age-specific analysis showed that children aged 0-3 years accounted for 37.6% of total cases, and females represented 52.7% of reported cases (χ2 test, p < 0.001). Qualitative findings from KIIs and FGDs highlighted salinity intrusion, flooding, waterlogging, inadequate sanitation, and limited healthcare resources as key drivers of vulnerability in the study districts. Vulnerable groups, including children under five and women, are disproportionately affected due to exposure to contaminated water and healthcare access constraints. To mitigate climate-induced diarrheal diseases, the study recommends improvements in water and sanitation infrastructure, enhanced healthcare services, and community-based awareness programs. Integrating climate resilience into public health policies is essential to reducing disease vulnerability in coastal regions.Findings indicate a significant positive correlation between maximum temperature and diarrheal incidence (r = 0.228, p = 0.0012). Diarrhea cases were more prevalent at maximum temperatures of 30-35 °C. In contrast, rainfall showed no statistically significant association with diarrheal trends (r = 0.094, p = 0.235), although descriptively fewer cases were observed at rainfall levels above 60 mm. Seasonal analysis revealed peak diarrheal cases between March and May, coinciding with the hottest months of the year. Age-specific analysis showed that children aged 0-3 years accounted for 37.6% of total cases, and females represented 52.7% of reported cases (χ2 test, p < 0.001). Qualitative findings from KIIs and FGDs highlighted salinity intrusion, flooding, waterlogging, inadequate sanitation, and limited healthcare resources as key drivers of vulnerability in the study districts. Vulnerable groups, including children under five and women, are disproportionately affected due to exposure to contaminated water and healthcare access constraints. To mitigate climate-induced diarrheal diseases, the study recommends improvements in water and sanitation infrastructure, enhanced healthcare services, and community-based awareness programs. Integrating climate resilience into public health policies is essential to reducing disease vulnerability in coastal regions.