Climate Change Impacts on Waterborne Diseases: A Systematic Review of Mechanisms and Predictive Models

Global climate change significantly alters environmental and health dynamics, posing a major 21st-century public health threat. Waterborne diseases (diarrhea, cholera, skin infections, dysentery) influenced by both water and food are particularly sensitive to these changes. While numerous studies have investigated these impacts, a critical assessment of their methodologies is lacking. This systematic review synthesizes the impact of climate change on waterborne diseases, focusing on analytical methods and predictive models used to explain disease presence or abundance. We further evaluate the strengths and limitations of each approach, identifying key gaps for future research. We analyzed 88 indexed research articles published between 1996 and 2024. Our findings demonstrate that diverse climate-related extreme events, including precipitation, flooding, and drought, substantially impact waterborne disease incidence. Additionally, temperature, salinity, humidity, sunshine duration, wind patterns, and specific water quality parameters play significant roles, with regional variations observed. Sensitivity analysis methods (e.g., Pearson/Spearman correlations) and mathematical models (e.g., generalized additive, mixed, and regression models) are employed to assess sensitivities, quantify correlations, examine impacts, and predict risks. Based on these findings, we urge future research to prioritize elucidating mechanisms and developing models that leverage climate data to accurately and quantitatively predict disease presence or abundance. This enhanced predictive capacity will underpin tailored adaptation strategies for sustainable development.

Keywords: Climate change; water-borne disease; modeling; Impacts ; forecast