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Excess burden of non-communicable disease years of life lost from heat in rural Burkina Faso: a time series analysis of the years 2000–2010
  1. Aditi Bunker1,2,
  2. Maquins Odhiambo Sewe3,
  3. Ali Sié4,
  4. Joacim Rocklöv3,
  5. Rainer Sauerborn2
  1. 1 Network Aging Research, Heidelberg University, Heidelberg, Germany
  2. 2 Institute of Public Health, University of Heidelberg, Heidelberg, Germany
  3. 3 Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
  4. 4 Centre de Recherche en Santé de Nouna, Nouna, Burkina Faso
  1. Correspondence to Aditi Bunker; aditi.bunker{at}


Objectives Investigate the association of heat exposure on years of life lost (YLL) from non-communicable diseases (NCD) in Nouna, Burkina Faso, between 2000 and 2010.

Design Daily time series regression analysis using distributed lag non-linear models, assuming a quasi-Poisson distribution of YLL.

Setting Nouna Health and Demographic Surveillance System, Kossi Province, Rural Burkina Faso.

Participants 18 367 NCD-YLL corresponding to 790 NCD deaths recorded in the Nouna Health and Demographic Surveillance Site register over 11 years.

Main outcome measure Excess mean daily NCD-YLL were generated from the relative risk of maximum daily temperature on NCD-YLL, including effects delayed up to 14 days.

Results Daily average NCD-YLL were 4.6, 2.4 and 2.1 person-years for all ages, men and women, respectively. Moderate 4-day cumulative rise in maximum temperature from 36.4°C (50th percentile) to 41.4°C (90th percentile) resulted in 4.44 (95% CI 0.24 to 12.28) excess daily NCD-YLL for all ages, rising to 7.39 (95% CI 0.32 to 24.62) at extreme temperature (42.8°C; 99th percentile). The strongest health effects manifested on the day of heat exposure (lag 0), where 0.81 (95% CI 0.13 to 1.59) excess mean NCD-YLL occurred daily at 41.7°C compared with 36.4°C, diminishing in statistical significance after 4 days. At lag 0, daily excess mean NCD-YLL were higher for men, 0.58 (95% CI 0.11 to 1.15) compared with women, 0.15 (95% CI −0.25 to 9.63) at 41.7°C vs 36.4°C.

Conclusion Premature death from NCD was elevated significantly with moderate and extreme heat exposure. These findings have important implications for developing adaptation and mitigation strategies to reduce ambient heat exposure and preventive measures for limiting NCD in Africa.

  • heat
  • years of life lost
  • non-communicable disease
  • Sub-Saharan africa
  • time series

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  • Contributors AB and RS developed the research idea with input from JR. Data were provided by AS. AB, MOS, JR and RS developed the modelling strategy. AB conducted the analysis, which was verified by MOS and JR. AB wrote the manuscript. All authors contributed to revision of the manuscript.

  • Funding AB was funded by the Klaus-Tschira Stiftung gGmbH (00.128.2008).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement There is no additional unpublished work.

  • Correction notice This article has been corrected since it first published. The Acknowledgements have been added in.

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