Table 2.

Epidemiological evidence on the impacts of climate change on food- and water-borne diarrhea in HKH region.

Study region	Study period	Disease	Findings	References
Afghanistan	2010–2016	All cause diarrhea	For every 1°C increase in mean daily temperature incidence of diarrhea increased by 0.70% (95% CI: 0.67, 0.73%).	Anwar et al., 2019
Nepal (3 ecological belts including Himalayan region)	2002–2014	All cause diarrhea	For every 1°C increase in average temperature the risk of diarrhea incidence increased by 0.85–5.05% (highest impact felt in mountains). The overall effect for Nepal was found to be 4.39% (95% CI: 3.95–4.85).	Dhimal et al., 2016
Bhutan (national study including high mountains)	2003–2013	All cause diarrhea	For every 1°C increase in maximum temperature, incidence of diarrhea increased by 0.6% (95% CI: 0.5–0.6%).	Wangdi and Clements, 2017
South China (mountainous province)	2004–2010	Bacillary dysentery	Compared with the YLDs in 2010, increasing flood events may lead to a 4.0% increase in the YLDs for bacillary dysentery by 2020 and 8.0% increase by 2030 in Guangxi, China.	Liu et al., 2017
North India	Future projection	All cause diarrhea	A 1.8°C increase in future temperature in the Ganges basin is expected to increase the burden of diarrhea in north India by 10% by the 2040s.	Moors et al., 2013
Balochistan, Pakistan (mountainous region)		Cholera	Increase in temperature and flood has led to increase in the burden of cholera and other gastro-enteric infections causing diarrhea.	Malik et al., 2012