A scoping review to map research gaps and opportunities relating to heat-related health hazards in countries surrounding Lake Victoria, Africa.

Oscar Brousse , Tobi E. Morakinyo, Clare Heaviside

Urban populations in sub-Saharan Africa are at rising risks of climate-related health hazards due to global climate change and uncontrolled rapid urbanization. Despite the increasing recognition of these challenges, the extent to which urban climates impact health outcomes in Africa remains poorly understood. East African countries surrounding the Lake Victoria Basin (Kenya, Uganda, Rwanda, Burundi and Tanzania) are no different, even though this region is one of the most densely populated areas in the world and a climatically unique part of the globe. In this scoping review focusing on urban climate and health-related impacts around the Lake Victoria Basin, we highlight how key research and knowledge gaps exist in the area and derive potential opportunities for future works aiming at preventing maladaptation. Using systematic search criteria over the Web of Knowledge and Scopus databases, we first selected 133 papers out of 878 that cover climate—particularly air temperature—in urban areas and related health outcomes. Following further selection criteria, we reviewed 24 papers focusing on East African cities neighboring the Lake Victoria Basin. Our bibliometric analysis shows that research on the topics of urban climate and urban health has increased since the 2010s. However, it remains limited in scope and is unevenly distributed geographically; most of the studies focus on the two large metropolises of the region, Nairobi (Kenya) and Kampala (Uganda), and other cities of the basin are underrepresented. We found an increase that explicitly examine the links between urban climate and health after 2019, with more recent studies incorporating more information on the intra-urban climate variability and the potential unequal exposures to climate hazards in cities, particularly in informal settlements. Key climate-driven health hazards in cities include heat- and cold-related mortality and morbidity, dangerous heat stress levels, exposure to critical air pollution, vector-borne diseases, water-borne diseases, and human-to-human infectious diseases. Nevertheless, major knowledge gaps on the influence of urban climate on these health hazards still remains in the area, mostly due to the characteristic climate and health data scarcity and a lack of longitudinal, intra-urban and transdisciplinary studies. We therefore argue that more integrated and interdisciplinary research should be done in the region, combining fields of urban climatology, public health, and social sciences. Data scarcity should be addressed, with a promising opportunity for the deployment of low-cost monitoring devices. This is essential to prevent potential maladaptation by expanding knowledge on how urban heterogeneity in the specific context of the Lake Victoria Basin influences unequal climate-health risks to local populations. Insights from East African countries in the region have broader relevance as similar climate-health challenges could emerge globally due to climate change and ongoing urbanization.