In a groundbreaking study published in JAMA Network Open, researchers from Hokkaido University have unveiled a critical link between temperature fluctuations and the incidence of gastroenteritis among Rohingya refugees residing in Bangladesh’s overcrowded camps. This study, the first of its kind to investigate the climatic influences on gastrointestinal diseases in displaced populations, highlights the urgent need for climate-adaptive health interventions in refugee settings. The findings shed light on how colder temperatures, in particular, elevate the risk of diarrheal diseases—signaling a pressing public health challenge heightened by climate variability.
Gastroenteritis, an inflammation of the stomach and intestines often caused by viral or bacterial infections, results in symptoms such as diarrhea, vomiting, and abdominal pain. The disease burden in refugee camps, especially among the Rohingya population, is exacerbated due to poor sanitation, contaminated water sources, and densely packed living conditions. The Rohingya, a stateless Muslim minority, now number nearly 919,000 in 34 refugee camps in Cox’s Bazar, Bangladesh, with unprecedented population densities exceeding 60,000 individuals per square kilometer, making disease control particularly difficult.
The research team conducted an extensive analysis of over 64,000 gastroenteritis cases recorded at clinics operated by the United Nations High Commissioner for Refugees (UNHCR) between 2019 and 2021. Using rigorous statistical methods, the study identified a nonlinear relationship between air temperature and gastroenteritis incidence. Specifically, in Kutupalong camp, the risk of gastroenteritis increased when temperatures deviated from an optimum reference point of 26°C, rising with both colder and hotter extremes. Meanwhile, Nayapara camp exhibited a steady increase in disease risk exclusively linked to decreasing temperatures, revealing nuanced differences in how temperature impacts health outcomes in neighboring but distinct settings.
One of the most compelling observations is the delayed onset of gastroenteritis cases following exposure to cold weather. The researchers found a lag of approximately 18 days between a drop in temperature and a subsequent spike in disease incidence. This suggests a temporal window during which cold conditions promote viral propagation or weaken host defenses, culminating in a surge of infections nearly two and a half weeks later. This delayed effect poses unique challenges for health surveillance and intervention planning, requiring anticipatory actions based on climatic forecasts rather than solely on immediate case counts.
Associate Professor Xerxes Seposo, the study’s corresponding author, elaborates on the underlying mechanisms driving these seasonal trends. Viral pathogens such as norovirus and rotavirus, which are predominant causes of gastroenteritis in colder months, can survive longer in low temperatures and facilitate prolonged outbreaks lasting up to two weeks. Conversely, warmer temperatures tend to favor bacterial pathogens including Salmonella and Campylobacter, which cause shorter-term illnesses. This distinct temperature-pathogen interplay underscores the complexity of disease ecology and the importance of tailored public health responses suited to the prevailing climatic conditions.
The Rohingya camps’ environmental context amplifies these temperature-driven risks. With sanitation infrastructures often inadequate and water supplies reliant on shallow wells prone to contamination, residents face continual exposure to pathogenic agents. Dry seasons exacerbate water scarcity, compelling reliance on unsafe sources, thereby compounding the vulnerability to gastrointestinal infections. These intersecting factors form a perfect storm where climatic variability interacts with infrastructural fragilities to escalate disease burdens among refugees.
This study arrives amid growing global concerns about climate change and its multifaceted impacts on human health, especially in marginalized populations. Refugee camps exemplify environments where climate-sensitive health issues intersect with socio-political vulnerabilities. Rising global temperatures are projected to increase the frequency of extreme weather events, including heatwaves and cold spells, further destabilizing fragile health systems in displacement contexts. The enhanced understanding of temperature-disease dynamics provided by this research offers a foundation for integrating climate considerations into humanitarian health planning.
Moreover, the findings advocate for proactive public health strategies that incorporate meteorological data to predict and mitigate outbreaks. Early warning systems leveraging temperature forecasts could enable timely deployment of medical resources and public education campaigns, potentially curbing the escalation of gastroenteritis cases. Strengthening sanitation, ensuring reliable access to clean water, and improving healthcare infrastructure remain foundational to reducing disease susceptibility under changing climatic conditions.
Takuya Takata, co-first author and collaborator in the Department of Hygiene at Hokkaido University, emphasizes the importance of building climate resilience in refugee healthcare services. “As displacement crises become increasingly prolonged due to conflict and environmental stressors, fostering adaptive capacity in healthcare delivery is not just a necessity but a moral imperative,” Takata asserts. This entails investment in infrastructure capable of withstanding weather variability and enhanced training for healthcare workers on climate-related health risks.
The projected growth of the Rohingya refugee population further heightens the urgency for integrated climate-health responses. Policymakers and humanitarian organizations must consider environmental determinants as central components of health initiatives. Ignoring these factors risks perpetuating cycles of illness that erode community well-being and overburden limited medical capacities. The study’s comprehensive approach serves as a model for similar analyses in other displacement settings worldwide.
In conclusion, this pivotal research presents compelling evidence that colder temperatures significantly heighten gastroenteritis risk among Rohingya refugees, with impacts lagging weeks behind temperature drops. It elucidates the intricate relationships between climate, pathogens, and human vulnerability in extreme humanitarian contexts. As climate change continues to reshape disease landscapes, incorporating environmental data into health strategy development offers a pathway to more effective and equitable care for some of the world’s most vulnerable populations.
Subject of Research: People
Article Title: Air Temperature and Gastroenteritis Among Rohingya Populations in Bangladesh Refugee Camps
News Publication Date: 18-Apr-2025
Web References: http://dx.doi.org/10.1001/jamanetworkopen.2025.5768
Image Credits: Takuya Takata
Keywords: Rohingya refugees, gastroenteritis, temperature, climate change, diarrhea, public health, refugee camps, Bangladesh, viral infections, bacterial infections, climate resilience, disease risk
