Is the effect of precipitation on acute gastrointestinal illness in southwestern Uganda different between Indigenous and non-Indigenous communities?

for the IHACC team, Johanna Busch, Lea Berrang-Ford*, Sierra Clark, Kaitlin Patterson, Emma Windfeld, Blanaid Donnelly, Shuaib Lwasa, Didacus Namanya, Sherilee L. Harper

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

8 Citations (Scopus)
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Acute gastrointestinal illness (AGI) is a global public health priority that often disproportionately effects Indigenous populations. While previous research examines the association between meteorological conditions and AGI, little is known about how socio-cultural factors may modify this relationship. This present study seeks to address this research gap by comparing AGI prevalence and determinants between an Indigenous and non-Indigenous population in Uganda. We estimate the 14-day self-reported prevalence of AGI among adults in an Indigenous Batwa population and their non-Indigenous neighbours using cross-sectional panel data collected over four periods spanning typically rainy and dry seasons (January 2013 to April 2014). The independent associations between Indigenous status, precipitation, and AGI are examined with multivariable multi-level logistic regression models, controlling for relative wealth status and clustering at the community level. Estimated prevalence of AGI among the Indigenous Batwa was greater than among the non-Indigenous Bakiga. Our models indicate that both Indigenous identity and decreased levels of precipitation in the weeks preceding the survey period were significantly associated with increased AGI, after adjusting for confounders. Multivariable models stratified by Indigenous identity suggest that Indigenous identity may not modify the association between precipitation and AGI in this context. Our results suggest that short-term changes in precipitation affect both Indigenous and non-Indigenous populations similarly, though from different baseline AGI preva-lences, maintaining rather than exacerbating this socially patterned health disparity. In the context of climate change, these results may challenge the assumption that changing weather patterns will necessarily exacerbate existing socially patterned health disparities.

Original languageEnglish
Article numbere0214116
JournalPLoS ONE
Issue number5
Publication statusPublished - May 2019
Externally publishedYes

Bibliographical note

Funding Information:
Funding was provided by the International Research Development Center (IDRC) Tri-Council Initiative on Adaptation to Climate Change, Indigenous Health Adaptation to Climate Change (IHACC), IDRC File nos. 106372-003, 004, 005. LBF and IHACC received the funding; Canadian Institutes for Health Research (CIHR) Open Operating Grant, Adaptation to the health effects of climate change among Indigenous peoples in the global south (IP-ADAPT), Application no. 298312. LBF and IHACC received the funding. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. We thank the 10 Batwa communities in Kanungu District that participated and collaborated in this study and all of the surveyors from Kanungu District, and other IHACC members (Mr. Jamen Kasumba, Mr. Martin Kigozi, Ms. Christine Nantongo and Ms. Fortunate Twebaze, Mr. Emmanuel Eloku from the Kanungu District Administration, and Mr. Hubert Nkabura from the Bwindi Community Hospital). We also thank Carlee Wright IHACC project manager for her assistance in preparing the manuscript for final submission. This research is part of an international project entitled the ‘Indigenous Health Adaptation to Climate Change’ (IHACC) project (, with parallel field study sites in the Canadian Arctic and Peru. The Indigenous Health Adaptation to Climate Change (IHACC) author group consists of Alejandro Llanos (Universidad Peruana Cayetano Heredia), Cesar Carcamo (Universidad Peruana Cayetano Heredia), Didacus Namanya (Public Health Uganda), James Ford (University of Leeds), Lea Berrang-Ford (University of Leeds), Sherilee Harper (University of Alberta), Shuaib Lwasa (Makerere University), and Victoria Edge (Public Health Agency of Canada).

Publisher Copyright:
© 2019 Busch et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


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