article · PLoS Medicine
Tropical cyclones pose a significant and growing danger to child survival in low- and middle-income nations. An observational sibling-matched case-control study analysed data covering over 100,000 under-five deaths alongside more than 247,000 controls across 34 countries between 1993 and 2021. The results reveal that cyclone exposure during the three months preceding a child's death significantly increases mortality risk. The greatest vulnerability occurs within the first month immediately following an event, with risks tapering over the subsequent two months. Historical estimates suggest that cyclone exposure within thirty days of death contributed to roughly 850,000 child fatalities between 2000 and 2020 in affected nations. These findings underscore the urgent requirement for focused interventions, particularly investments in community infrastructure, clean water access, and improved sanitation, to protect young children from the worsening impacts of extreme weather events.
Extreme weather events are increasing in frequency and intensity because of climate change. By linking cyclone occurrences directly to heightened child mortality in developing regions, this research illustrates the immediate human toll on the most vulnerable. It provides crucial evidence for public health leaders and development agencies seeking to design timely post-disaster responses and build long-term local resilience.
The abstract does not indicate a commercial application pathway, as it focuses on epidemiological analysis and public health policy recommendations such as improving water and sanitation infrastructure.
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BACKGROUND: Climate change has exacerbated the frequency, intensity, and impacts of extreme weather events (EWEs), such as tropical cyclones. However, the increasing impact of tropical cyclones on child mortality, especially in low- and middle-income countries (LMICs), remains understudied. METHODS AND FINDINGS: Utilizing individual-level data from the Demographic and Health Surveys, we conducted a sibling-matched case-control study to assess the impact of cyclone exposure over the past 3 months on under-five mortality. The study included 100,798 under-five deaths and 247,445 controls across 34 LMICs from 1993 to 2021. After adjusting for key meteorological and temporal confounders and maternal age, significant positive associations were observed between under-five deaths and cyclone exposure over the past 3 months before death (odds ratio [OR]: 1.038, 95% confidence interval [CI]: 1.002, 1.075; p = 0.041). Specifically, the strongest effects were observed in the first month before death (OR: 1.101, 95% CI: 1.039, 1.166; p < 0.001), diminishing in the second and third months before death. We estimated that cyclone exposure 0-30 days before death may have caused 0.85 million under-five deaths (95% CI: 0.35 million, 1.32 million) in countries exposed to cyclones from 2000 to 2020. As an observational study, its use of self-reported data and dichotomous exposure assessment may introduce recall bias and exposure misclassification, limiting accuracy and representativeness. CONCLUSIONS: This global analysis demonstrates the substantial under-five mortality risk from cyclones, emphasizing the importance of targeted strategies to enhance community resilience against the growing threat of EWEs on children, such as improving access to water sources and sanitation facilities.
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DOI: 10.1371/journal.pmed.1004735
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