Understanding the impact of extreme weather events on non-communicable diseases in sub-Saharan Africa: a scoping review

Introduction: Sub-Saharan Africa (sSA) is undergoing an epidemiological transition, with non-communicable chronic diseases (NCDs) rapidly becoming the leading cause of morbidity and mortality. Simultaneously, climate change is exacerbating the frequency, intensity and duration of extreme weather events, disproportionately affecting sSA. Extreme weather events strain healthcare, disrupting routine care for persons living with NCDs. The objective of this scoping review is to summarise the current evidence on the association of climate-related extreme weather events and NCDs in sSA. Methods: PubMed, Cochrane, Embase, PsycINFO (EBSCO), Web of Science, Global Health (CABI) and Scopus (Elsevier) were searched to identify peer-reviewed publications from 1995 to 2023, examining the effects of extreme weather events, including floods, droughts, cyclones, mud or landslides and extreme temperatures, on NCDs such as cardiovascular diseases, diabetes, respiratory conditions, cancer and mental health in sSA. Three reviewers conducted abstract screening of 903 articles, full-text screening of 108 articles and data extraction of 31 articles. Results: Of the 31 included articles, 27 reported on the mental health burden associated with floods and droughts. Few studies reported the impact of cyclones (4), extreme temperatures (3) and mud or landslides (2) on NCDs. Furthermore, we found a lack of geographic diversity among cited countries, with only 16 sSA countries represented in the literature. Conclusions: There is an urgent need for comprehensive research in under-represented sSA countries impacted by extreme weather events. Research needs to encompass a wider range of NCD outcomes, extreme weather events and countries. Lessons from other regions of the world can inform the development of cost-effective and climate-resilient strategies to reduce the impact of extreme weather events on NCD management in sSA.