Baltimore, MD. (Aug. 19, 2026) – Researchers at the University of Maryland School of Medicine's Center for Vaccine Development and Global Health (CVD) have identified key social and environmental factors that influence how climate change affects childhood diarrheal diseases in sub-Saharan Africa. An August study published in Nature Communications found that while rising temperatures and changing rainfall patterns are likely to alter disease risks, factors such as vaccination, access to transportation, and other indicators of socioeconomic resilience can help reduce the impact of climate-related health threats. A second study that did an initial analysis of the data was published in the Journal of Infectious Diseases in June.
Diarrheal diseases are the third leading cause of death in children under age five worldwide and are the leading cause of malnutrition, according to the WHO . Climate change has led to the spread of these diseases as the pathogens that cause them – viruses, bacteria, and parasites – thrive in warmer humid climates. It is estimated that climate change-driven diarrheal disease will lead to an additional 48,000 deaths in children in 2030 primarily in sub-Saharan Africa and south Asia.
Researchers analyzed more than 9,300 cases of moderate-to-severe diarrhea among children under five years of age in Mali, Kenya, and The Gambia, drawing on data from the landmark Global Enteric Multicenter Study (GEMS) and its follow-up, Vaccine Impact on Diarrhea in Africa (VIDA) . They examined relationships between climate factors and four major diarrhea-causing pathogens: Cryptosporidium , Shigella , rotavirus, and enterotoxigenic Escherichia coli (ETEC).
Climate Drivers Vary by Locale
“Climate change does not affect all diarrheal diseases equally,” said Megan Kowalcyk , PhD, lead author of the studies and Research Associate at CVD “Our findings show that disease risk depends not only on temperature and rainfall patterns but also on factors that influence a family's ability to adapt and respond to environmental stressors.”
The researchers found that climate drivers varied substantially by pathogen and location. In Kenya, temperature was a key factor associated with the risk of Shigella , Cryptosporidium , and ETEC. However, rainfall-related variables were more influential for driving rotavirus, Cryptosporidium, and ETEC in Mali and The Gambia. Additionally, while temperature will rise drastically by 2055 the impact on precipitation and Cryptosporidium incidence is modest in all three study sites.
Importantly, the analyses demonstrated that adaptive capacity factors can modify climate-related disease risk. For example, children living in households with access to transportation, electricity, or television ownership generally experienced reduced climate-associated risks for certain pathogens compared with children lacking those resources. Similarly, if access to improved drinking water decreases it is projected that Cryptosporidium incidence will substantially increase under future climate scenarios in all sites. Likewise, increases in access to improved drinking water decreases Cryptosporidium incidence under future climate scenarios.
Certain Populations More Vulnerable
"This research highlights the importance of looking beyond environmental exposures alone," said Stefan Kappe PhD, CVD Director. "Building resilience to climate change will require a combination of public health interventions, infrastructure improvements, economic development, and expanded access to lifesaving vaccines."
These findings add to earlier research showing that climate change could significantly affect rates of diarrheal disease in low-resource communities, especially in sub-Saharan Africa. As temperatures rise and rainfall become less predictable, it is increasingly important to understand how social and economic challenges affect the spread of disease so that children most at risk can be better protected.
"This kind of modeling analysis gives public health planners something they rarely have: a site-by-site, pathogen-by-pathogen picture of what actually drives risk," said UMSOM Dean Mark T. Gladwin, MD. "It's notable that something like access to transportation showed up protective against climate change-driven disease. That tells us mobility and economic stability aren't peripheral to climate health strategy but may be essential to protect vulnerable populations while we address the root cause of climate change."
The GEMS and VIDA studies were funded by the Gates Foundation and led by Drs. Myron M. Levine and Karen L. Kotloff.
About the Center for Vaccine Development and Global Health
Founded in 1974, the University of Maryland School of Medicine’s Center for Vaccine Development and Global Health is internationally recognized for its research in vaccine development, infectious disease, and clinical trials that have paved the way for lifesaving interventions around the world. The CVD’s mission is to reduce the global burden of infectious diseases through research, training, and public health impact.
About the University of Maryland School of Medicine
The University of Maryland School of Medicine, established in 1807 as the first public medical school in the U.S., continues today as one of the fastest growing, top-tier biomedical research enterprises in the world. The School has nearly $500 million total research funding, 46 departments, centers, and institutes, more than 2,200 student trainees and over 3,000 faculty members, including notable members of the National Academy of Medicine. As the largest public medical school in the DC/MD/VA region, faculty-physicians are working to help patients manage chronic diseases like obesity, cancer, heart disease and addiction, while also working on cutting-edge research to address the most critical generational health challenges. In 2024, the School ranked #12 among public medical schools and #27 among all medical schools for R&D expenditures by the National Science Foundation. With a $1.3 billion total operating budget, the School partners with the University of Maryland Medical Center to serve nearly 2 million patients annually. The School's global reach extends around the world with research and treatment facilities in 33 countries. In Maryland, the School of Medicine is spearheading new initiatives in AI and health computing and partnering with the University of Maryland BioPark to develop new medical technologies and bioengineering ventures. For more information, visit medschool.umaryland.edu .
Nature Communications
People
Vulnerability to climate-driven pathogen-specific diarrheal diseases: secondary analysis from the Global Enteric Multicenter Study and Vaccine Impact on Diarrhea in Africa follow-up
6-Aug-2026
The authors declare no competing interests.