Quantifying disease burden among climate refugees using multidisciplinary approach: A case of Dhaka, Bangladesh

Abstract

The instability of climate and its human-induced change lead to relocation of affected people who become 'climate refugees'. Bangladesh, being one of the countries most vulnerable to climate change events, especially water-related climatic hazards (floods, droughts, cyclones, etc), is in the frontline of global warming-driven mass migrations. To study climate refugees in Dhaka, one of the largest, most densely populated and fastest-growing polluted megacities, we used a population-based integrated home visiting survey, interviews with mothers, home-based surveillance, and household environmental monitoring. Disability Adjusted Life Years (DALYs) lost due to diarrhea and asthma attacks among climate refugee and non-climate refugee children under 5. years of age were quantified. The results conclusively showed that, compared with the non-climate refugees community, climate refugees showed a substantial increase of diarrhea and asthma which lead to 18,697 and 1069-folds higher DALYs loss. Moreover, used as an input to an epidemiological analysis, DALYs lost due to diarrhea and asthma showed significant changes with Odds Ratio (OR) ranges of 4.6-9.5 and 3.4-5.8, respectively in the climate refugees community for some statistically selected predictors. It is concluded that household environmental exposure (water and indoor air quality) had significant adverse effects on children's health among climate refugees. This suggests that public health policies should be oriented not only towards reduction in environmental diseases, but also towards affecting elimination of exposure of children. © 2014 Elsevier Ltd.