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

Abstract

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 prevalences, 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.

Health gender gap in Uganda: do weather effects and water play a role?

“…Other common symptoms such as fever, weakness, coughing, abdominal pain and diarrhea were prevalent in both men and women. Some of the abovementioned symptoms are major signs of acute gastrointestinal illness linked to decreased water availability and quality due to precipitation shortfalls in Uganda [ 61 ]. Furthermore, Epstein et al [ 59 ] highlighted water availability as one of the hypothesized mechanisms through which drought or reduced precipitation affects illness in Uganda, especially diarrhea.…”

Place, displacement, and health-seeking behaviour among the Ugandan Batwa: A qualitative study

“…From June 1 to July 31, 2014, qualitative data were collected as part of a larger study on the burden of acute gastrointestinal illness in Kanungu District, Uganda [ 30 , 31 , 41 ] (see discussion guides in S1 and S2 Files ). Twenty focus group discussions were conducted in ten Batwa settlements.…”

Assessing dietary adequacy and temporal variability in the context of Covid-19 among Indigenous and rural communities in Kanungu District, Uganda: a mixed-methods study

“…The Batwa are likely to be more vulnerable due to their socioeconomic position, lack of agricultural knowledge and infertile land [30]. In this region, malaria is seasonal with peaks in January and February [31], and gastrointestinal illnesses are more prevalent in the dry season [32]. Also, the link between seasonality, precipitation and food security is well documented in the region, with families being more food insecure in the dry season [30].…”