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This study examined the relationship between ECEs and respiratory health outcomes over a 12-year period (2008\u20132019). A total of 48 ECEs were analyzed, of which 28 occurred in regions reporting more than 100 medical insurance claims for respiratory diseases. These events included storms, heatwaves, cold waves, floods, and tornadoes. Using a two-week lag period, we assessed their short-term association with respiratory claims. The findings revealed both increases and decreases in claims following ECEs, yet seasonal epidemiological trends exerted a more consistent and pronounced influence on respiratory health than individual extreme events. Percentage variations for statistically significant events ranged from approximately\u2009+\u200916% to +\u2009121%, while decreases ranged from \u2212\u20095% to \u2212\u2009178%. Although certain events displayed notable impacts, no distinct clustering was observed across seasons or years. These results underscore the importance of strengthening seasonal preparedness measures alongside climate-sensitive surveillance systems. Integrated approaches that address both seasonal and extreme climate risks are vital to safeguard vulnerable populations amid increasing climate variability in South Africa.<\/jats:p>","DOI":"10.1007\/s00484-025-03062-8","type":"journal-article","created":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T14:16:28Z","timestamp":1768227388000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Exploring the role of extreme climate events (ECEs) in the incidence of respiratory disease in South Africa"],"prefix":"10.1007","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2939-4296","authenticated-orcid":false,"given":"Ogone","family":"Motlogeloa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0854-1720","authenticated-orcid":false,"given":"Jennifer M.","family":"Fitchett","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neville","family":"Sweijd","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,1,12]]},"reference":[{"key":"3062_CR1","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1016\/B978-0-12-809665-9.09754\u2026","volume":"2","author":"RW Abrams","year":"2018","unstructured":"Abrams RW, Abrams JF, Abrams AL (2018) Climate change challenges for Africa. 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