Health Professionals’ Perceptions of Dengue Fever, Malaria and Haemorrhagic Fever with Renal Syndrome in the Face of Climate Change in China

Abstract

Background Dengue fever, malaria and Hemorrhagic Fever with Renal Syndrome (HFRS) are common infectious diseases in China. The impact of climate change on infectious diseases has been studied extensively. An association between climatic factors and these emerging and re-emerging vector/rodent-borne diseases has been demonstrated in China. However, health professionals’ perceptions of climate change and infectious diseases, and China’s capacity to manage the challenge of these climate-sensitive diseases are still not clear. This study aimed to investigate health professionals’ perceptions, and to explore the adaptive capacity of China’s health system to deal with these diseases in the context of climate change. Methods With dengue, malaria and HFRS as case study diseases, questionnaire surveys were conducted to gauge health professionals’ perceptions of climate change and infectious disease control and prevention, and to explore the current capacity of the health system to manage emerging and re-emerging infectious diseases in China, in the context of climate change. The study can be broadly divided into two parts. In the first part of the study, a questionnaire survey was conducted among public health professionals in the Chinese Centers for Disease Control and Prevention (CDC) at national, provincial, prefectural and county levels. The second part of the study was conducted among clinical health professionals in hospitals. Data analysis was undertaken using descriptive methods and logistic regression. Results Most health professionals were concerned about climate change, and agreed with the statement that the weather was becoming warmer. More than 80% of health professionals agreed that climate change would affect population health, and indicated that climate change would influence infectious disease transmission, especially vector-borne diseases such as dengue and malaria. Nearly all perceived that dengue had emerged or re-emerged, and indicated that there had been a geographic expansion of the disease. Roughly half indicated that malaria had re-emerged in some parts of China, especially in southwest China. More than half perceived that HFRS had re-emerged, especially in northeast China. Most health professionals indicated that the capacity of the health system to detect infectious disease outbreaks/epidemics was excellent, and was well prepared for the challenge that emerging infectious diseases may pose. Conclusions The findings showed that health professionals were concerned about climate change and believed that it would affect infectious disease transmission. This research has identified some of the significant factors contributing to the transmission of infectious diseases, such as climate variation, migrant population, increasing vector/rodent density, imported cases, lack of health awareness and poor environmental conditions. For dengue control, reducing and controlling the density of mosquito vectors would be most important. For malaria control, regional cooperation and information sharing were urgently needed to curb re-emergence. For HFRS control, rodent control measures and health awareness of HFRS risks should be strengthened. Most health professionals believed that the capacity of the health system to manage infectious diseases was excellent. However, to increase adaptive capacity, the results show there is a strong need to increase funding for disease surveillance and control, improve the capacity of lower-level CDCs and rural health care, and strengthen logistical support in hospitals.