{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:07:07Z","timestamp":1792022827554,"version":"4.4.0"},"reference-count":81,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2014,7,7]],"date-time":"2014-07-07T00:00:00Z","timestamp":1404691200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/3.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Cerebrospinal meningitis (CSM) is one of the infectious diseases likely to be affected by climate change. Although there are a few studies on the climate change-CSM nexus, none has considered perceptions of community members. However, understanding public perception in relation to a phenomenon is very significant for the design of effective communication and mitigation strategies as well as coping and adaptation strategies.  This paper uses focus group discussions (FGDs) to fill this knowledge lacuna. Results show that although a few elderly participants ascribed fatal causes (disobedience to gods, ancestors, and evil spirits) to CSM infections during FGDs, majority of participants rightly linked CSM infections to dry, very hot and dusty conditions experienced during the dry season. Finally, community members use a suite of adaptation options to curb future CSM epidemics.<\/jats:p>","DOI":"10.3390\/ijerph110706923","type":"journal-article","created":{"date-parts":[[2014,7,7]],"date-time":"2014-07-07T11:00:56Z","timestamp":1404730856000},"page":"6923-6939","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":43,"title":["Climate Change and Cerebrospinal Meningitis in the Ghanaian Meningitis Belt"],"prefix":"10.3390","volume":"11","author":[{"given":"Samuel","family":"Codjoe","sequence":"first","affiliation":[{"name":"Regional Institute for Population Studies, University of Ghana, P.O. Box LG 96, Legon, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vivian","family":"Nabie","sequence":"additional","affiliation":[{"name":"Regional Institute for Population Studies, University of Ghana, P.O. Box LG 96, Legon, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2014,7,7]]},"reference":[{"key":"ref_1","unstructured":"Field, C.B., Barros, V.R., Dokken, D.K., Mach, K.J., Mastrandrea, M.D., Bilir, T.E., Chatterjee, M., Ebi, K.L., Estrada, Y.O., and Genova, R.C. (2014). Contribution of Working Group II to the 5th Assessment Report of the Intergovernmental Panel on Climate Change, Cambridge University Press."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1038\/nature06937","article-title":"Attributing physical and biological impacts to anthropogenic climate change","volume":"453","author":"Rosenzweig","year":"2008","journal-title":"Nature"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1086\/650284","article-title":"Climate change and highland malaria: Fresh air for a hot debate","volume":"85","author":"Chaves","year":"2010","journal-title":"Quart. Rev. Biol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2104","DOI":"10.1016\/S0140-6736(09)61759-1","article-title":"Public health benefits of strategies to reduce greenhouse-gas emissions: Overview and implications for policy makers","volume":"374","author":"Haines","year":"2009","journal-title":"Lancet"},{"key":"ref_5","unstructured":"Parry, M.L., Canziani, O.F., Palutikof, J.P., van der Linden, P.J., and Hanson, C.E. (2007). Climate Change 2007: Impacts; Adaptation and Vulnerability. Contribution of Working Group II to the 4th Assessment Report of the Intergovernmental Panel on Climate Change, Cambridge University Press."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Broutin, H., Philippon, S., Constantin de Magny, G., Courel, F., Sultan, B., and Guegan, J.F. (2007). Comparative study of meningitis dynamics across nine African countries: A global perspective. Int. J. Health Geogr., 6.","DOI":"10.1186\/1476-072X-6-29"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1016\/j.vaccine.2007.04.034","article-title":"Risk mapping and early warning systems for the control of meningitis in Africa","volume":"25","author":"Cuevas","year":"2007","journal-title":"Vaccine"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1175\/WCAS-D-13-00004.1","article-title":"Climate influences on the interannual variability of meningitis incidence in northwest Nigeria","volume":"6","author":"Abdussalam","year":"2014","journal-title":"Weather Clim. Soc."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1016\/S0035-9203(02)90089-1","article-title":"Where is the meningitis belt? Defining an area at risk of epidemic meningitis in Africa","volume":"96","author":"Molesworth","year":"2002","journal-title":"Trans. Roy. Soc. Trop. Med. Hyg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"781","DOI":"10.1111\/j.1365-3156.2006.01630.x","article-title":"Potential of environmental models to predict meningitis epidemics in Africa","volume":"11","author":"Thomson","year":"2006","journal-title":"Trop. Med. Int. Health"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Yaka, P., Sultan, B., Broutin, H., Janicot, S., Philippon, S., and Fourquet, N. (2008). Relationship between climate and year to year variability in meningitis outbreaks: A case study in Burkina Faso and Niger. Int. J. Health Geogr., 7.","DOI":"10.1186\/1476-072X-7-34"},{"key":"ref_12","first-page":"1","article-title":"Weather variables and climatic influence on the epidemiology of cerebrospinal or meningococcal meningitis","volume":"3","author":"Obiakor","year":"2011","journal-title":"Asian J. Med. Pharm. Res."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Palmgren, H. (2009). Meningococcal disease and climate. Glob. Health Action, 2.","DOI":"10.3402\/gha.v2i0.2061"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1047","DOI":"10.1017\/S0950268806005929","article-title":"Evaluation of the meningitis epidemics risk model in Africa","volume":"134","author":"Savory","year":"2006","journal-title":"Epidemiol. Infect."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1093\/clinids\/17.1.126","article-title":"Forty years of meningococcal disease in Israel: 1951\u20131990","volume":"17","author":"Block","year":"1993","journal-title":"Clin. Infect. Dis."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1007\/BF01208730","article-title":"Weather conditions prior to major outbreaks of meningococcal meningitis in the United Kingdom","volume":"36","author":"Collier","year":"1992","journal-title":"Int. J. Biometeorol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1146\/annurev.publhealth.28.021406.144128","article-title":"Seasonality of infectious diseases","volume":"28","author":"Fisman","year":"2007","journal-title":"Annu. Rev. Public Health"},{"key":"ref_18","first-page":"226","article-title":"Seasonal variation in meningococcal disease in Denmark: Relation to age and meningococcal phenotype","volume":"35","author":"Jensen","year":"2003","journal-title":"Scand. J. Infect. Dis."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"588","DOI":"10.1093\/aje\/kwn383","article-title":"Environmental exposures and invasive meningococcal disease: An evaluation of effects on varying time scales","volume":"169","author":"Kinlin","year":"2009","journal-title":"Amer. J. Epidemiol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1111\/j.1467-842X.2002.tb00676.x","article-title":"Meningococcal disease and meteorological conditions in Auckland, New Zealand","volume":"26","author":"Lindsay","year":"2002","journal-title":"Aust. N. Z. J. Public Health"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1007\/s10654-006-9013-1","article-title":"Do environmental factors influence the occurrence of acute meningitis in industrialized countries? An epidemic of varying aetiology in northern Italy","volume":"21","author":"Michele","year":"2006","journal-title":"Eur. J. Epidemiol."},{"key":"ref_22","unstructured":"Millon, C. (1983). When and Where are We at Risk? The Geographical Distribution of Meningococcal Meningitis in England and Wales. [Bachelor Thesis, School of Geography, University of Oxford]."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"664","DOI":"10.1016\/S0035-9203(00)90224-4","article-title":"Meningitis seasonal pattern in Africa and detection of epidemics: A retrospective study in Niger; 1990\u20131998","volume":"94","author":"Djingarey","year":"2000","journal-title":"Trans. Roy. Soc. Trop. Med. Hyg."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"829","DOI":"10.1016\/S0140-6736(85)90812-8","article-title":"Meningococcal disease and season in sub-Saharan Africa","volume":"2","author":"Greenwood","year":"1985","journal-title":"Lancet"},{"key":"ref_25","first-page":"3","article-title":"La m\u00e9ningite c\u00e9r\u00e9bro-spinale en Afrique","volume":"2","author":"Lapeyssonnie","year":"1963","journal-title":"Bull. World Health Organ."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1711","DOI":"10.1128\/jcm.28.8.1711-1719.1990","article-title":"Characterization of epidemic and non-epidemic Neisseria meningitidis serogroup A strains from Sudan and Sweden","volume":"28","author":"Salih","year":"1990","journal-title":"J. Clin. Microbiol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1017\/S0950268800051931","article-title":"Meningococcal meningitis and carriage in western Zaire. A hypoendemic zone related to climate?","volume":"114","author":"Cheesbrough","year":"1995","journal-title":"Epidemiol. Infect."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1016\/S0163-4453(87)92052-4","article-title":"Factors influencing susceptibility to meningococcal disease during an epidemic in the Gambia, west Africa","volume":"14","author":"Greenwood","year":"1987","journal-title":"J. Infect."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1543","DOI":"10.1111\/j.1365-3156.2008.02165.x","article-title":"Association of respiratory tract infection symptoms and air humidity with meningococcal carriage in Burkina Faso","volume":"13","author":"Mueller","year":"2008","journal-title":"Trop. Med. Int. Health"},{"key":"ref_30","first-page":"329","article-title":"Correlation between rainfall and meningococcal meningitis in Niger","volume":"65","author":"Michel","year":"2005","journal-title":"Med. Trop."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"807","DOI":"10.1023\/A:1007365919013","article-title":"Weather conditions and cerebrospinal meningitis in Benin (Gulf of Guinea, west Africa)","volume":"13","author":"Besancenot","year":"1997","journal-title":"Eur. J. Epidemiol."},{"key":"ref_32","unstructured":"Molineaux, L. (1969). Climate and Meningococcal Disease. [Ph.D. Thesis, University of Berkeley]."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1093\/clinids\/14.2.515","article-title":"Meningococcal meningitis in sub-Saharan Africa: A model for the epidemic process","volume":"14","author":"Moore","year":"1992","journal-title":"Clin. Infect. Dis."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Sultan, B., Labadi, K., Gue\u2019gan, J.F., and Janicot, S. (2005). Climate drives the meningitis epidemics onset in west Africa. PLoS Med., 2.","DOI":"10.1371\/journal.pmed.0020006"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1016\/j.landusepol.2008.05.008","article-title":"Local stakeholders\u2019 perception of muddy flood risk and implications for management approaches: A case study in Alsace (France)","volume":"26","author":"Heitz","year":"2009","journal-title":"Land Use Policy"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"635","DOI":"10.1111\/j.1539-6924.2008.01040.x","article-title":"How do disaster characteristics influence risk perception?","volume":"28","author":"Ho","year":"2008","journal-title":"Risk Anal."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1080\/08941920903357782","article-title":"Environmental perceptions of rural South African residents: The complex nature of environmental concern","volume":"24","author":"Hunter","year":"2010","journal-title":"Soc. Nat. Resour."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1007\/s10584-006-9059-9","article-title":"Climate change risk perception and policy preferences: The role of affect, imagery and values","volume":"77","author":"Leiserowitz","year":"2006","journal-title":"Climatic Change"},{"key":"ref_39","unstructured":"(1998). Guidelines on the Control of Epidemic Meningococcal Disease, WHO. [2nd ed.]."},{"key":"ref_40","unstructured":"WHO Meningococcal Meningitis. Fact Sheet. Available online:http:\/\/www.who.int\/mediacentre\/factsheets&gt;\/2003\/fs141\/en\/indexhtml."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"773","DOI":"10.1111\/j.1365-3156.2006.01639.x","article-title":"100 years of epidemic meningitis in west Africa\u2014Has anything changed?","volume":"11","author":"Greenwood","year":"2006","journal-title":"Trop. Med. Int. Health"},{"key":"ref_42","unstructured":"Ministry of Health (2010). Recorded Cerebrospinal Meningitis Cases in Ghana, 1985\u20132008."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1136\/adc.83.2.111","article-title":"Twelve year outcomes following bacterial meningitis: Further evidence for persisting effects","volume":"83","author":"Grimwood","year":"2000","journal-title":"Arch. Dis. Child."},{"key":"ref_44","first-page":"543","article-title":"Epidemiologic features of pneumococcal meningitis in Africa. Clinical and serotypical aspects","volume":"27","author":"Mar","year":"1979","journal-title":"Pathol. Biol."},{"key":"ref_45","unstructured":"Kumanda, V. (1983). Changing Pattern of Incidence of Meningococcal Meningitis as Seen in Ahmadu Bello University, Teaching Hospital, Zaria (1979\u20131982), Department of Community Medicine, Ahmadu Bello University."},{"key":"ref_46","first-page":"154","article-title":"Perception and attitude to outbreak of Meningitis","volume":"7","author":"Akande","year":"1998","journal-title":"Niger. J. Med."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1689","DOI":"10.3201\/eid1211.060682","article-title":"Spatiotemporal analysis of invasive meningococcal disease, Germany","volume":"12","author":"Elias","year":"2006","journal-title":"Emerg. Infect. Dis."},{"key":"ref_48","unstructured":"Hastenrath, S. (1995). Climate Dynamics of the Tropics, Kluwer Academic."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1128\/CMR.13.1.144","article-title":"Update on meningococcal disease with emphasis on pathogenesis and clinical management","volume":"13","author":"Brandtzaeg","year":"2000","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_50","unstructured":"WHO (1999). Pneumococcal vaccines. Wkly. Epidemiol. Rec., 74, 177\u2013183."},{"key":"ref_51","unstructured":"WHO (2000). Detecting meningococcal meningitis epidemics in highly-endemic African countries. Wkly. Epidemiol. Rec., 75, 305\u2013312."},{"key":"ref_52","unstructured":"WHO (2005). Enhanced surveillance of epidemic meningococcal meningitis in Africa. Wkly. Epidemiol. Rec., 80, 313\u2013320."},{"key":"ref_53","unstructured":"Forgor, A.A. (2007). Meningococcal and Pneumococcal Meningitis in Northern Ghana, Faculty of Philosophy and Natural Science, University of Basel."},{"key":"ref_54","first-page":"179","article-title":"African epidemic cerebrospinal meningitis","volume":"60","author":"Waddy","year":"1957","journal-title":"J. Trop. Med. Hyg."},{"key":"ref_55","first-page":"358","article-title":"Report on an investigation of cerebrospinal fever in the northern territories of the Gold Coast","volume":"11","author":"Horn","year":"1908","journal-title":"J. Trop. Med. Hyg."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"748","DOI":"10.4269\/ajtmh.1977.26.748","article-title":"Meningococcal meningitis in northern Ghana: Epidemiology and control measures","volume":"26","author":"Belcher","year":"1977","journal-title":"Amer. J. Trop. Med. Hyg."},{"key":"ref_57","first-page":"3","article-title":"Forty-seven cases of pyogenic meningitis in adults in Korle Bu Hospital, Accra","volume":"10","author":"Haddock","year":"1971","journal-title":"Ghana Med. J."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1016\/0035-9203(54)90039-5","article-title":"A cycle of Cerebro-spinal Meningitis in the Gold Coast","volume":"48","author":"Greene","year":"1954","journal-title":"Trans. Roy. Soc. Trop. Med. Hyg."},{"key":"ref_59","unstructured":"Browne, M.P. Report on the First 7000 Cases of Cerebrospinal Meningitis in the Western Northern Territories\u20141st January to 21st March 1945, PRAAD."},{"key":"ref_60","unstructured":"Enos, K. (1997). Cerebrospinal Meningitis in Northern Ghana: The Experience of the War Memorial Hospital, Navrongo, Ministry of Health."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1080\/02724936.1992.11747559","article-title":"A study of bacterial meningitis in Kumasi, Ghana","volume":"12","author":"Mackie","year":"1992","journal-title":"Ann. Trop. Paediatr."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1016\/S0140-6736(99)03366-8","article-title":"Emergency vaccination against epidemic meningitis in Ghana: Implications for the control of meningococcal disease in west Africa","volume":"355","author":"Woods","year":"2000","journal-title":"Lancet"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1016\/S0035-9203(01)90007-0","article-title":"Risk factors for meningococcal meningitis in northern Ghana","volume":"95","author":"Hodgson","year":"2001","journal-title":"Trans. Roy. Soc. Trop. Med. Hyg."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"1440","DOI":"10.1093\/ije\/30.6.1440","article-title":"Survival and sequelae of meningococcal meningitis in Ghana","volume":"30","author":"Hodgson","year":"2001","journal-title":"Int. J. Epidemiol."},{"key":"ref_65","unstructured":"Hodgson, A., Smith, T., Gagneux, S., Enos, K.E., Adjuik, M., Pluschke, G., Binka, F., and Genton, B. (2002). Meningococcal Meningitis in Northern Ghana: Epidemiological and Clinical Features, Risk Factors, Survival and Sequelae, University of Basel."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"1229","DOI":"10.1111\/j.1365-3156.2005.01520.x","article-title":"Emergence of W135 meningococcal meningitis in Ghana","volume":"10","author":"Forgor","year":"2005","journal-title":"Trop. Med. Int. Health"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1046\/j.1365-3156.2000.00550.x","article-title":"Microheterogeneity of serogroup A (subgroup III) Neisseria meningitidis during an outbreak in northern Ghana","volume":"5","author":"Gagneux","year":"2000","journal-title":"Trop. Med. Int. Health"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"618","DOI":"10.1086\/339010","article-title":"Prospective study of a serogroup X Neisseria meningitidis outbreak in northern Ghana","volume":"185","author":"Gagneux","year":"2002","journal-title":"J. Infect. Dis."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1086\/431151","article-title":"An outbreak of serotype 1 Streptococcus pneumoniae meningitis in northern Ghana with features that are characteristic of Neisseria meningitidis meningitis epidemics","volume":"192","author":"Leimkugel","year":"2005","journal-title":"J. Infect. Dis."},{"key":"ref_70","doi-asserted-by":"crossref","unstructured":"Leimkugel, J., Hodgson, A., Forgor, A.A., Pfl\u00fcger, V., Dangy, J.P., Smith, T., Achtman, M., Gagneux, S., and Pluschke, G. (2007). Clonal waves of Neisseria colonisation and disease in the African meningitis belt: Eight-year longitudinal study in northern Ghana. PLoS Med., 4.","DOI":"10.1371\/journal.pmed.0040101"},{"key":"ref_71","doi-asserted-by":"crossref","unstructured":"Taha, M.K., Achtman, M., Alonso, J.M., Greenwood, B., Ramsay, M., Fox, A., Gray, S., and Kaczmarski, E. (2000). Serogroup W135 meningococcal disease in Hajj pilgrims. Lancet, 356.","DOI":"10.1016\/S0140-6736(00)03502-9"},{"key":"ref_72","first-page":"113","article-title":"Bacterial meningitis in children in southern Ghana","volume":"71","author":"Commey","year":"1994","journal-title":"East Afr. Med. J."},{"key":"ref_73","doi-asserted-by":"crossref","unstructured":"Owusu, M., Nguah, S.B., Boaitey, Y.A., Badu-Boateng, E., Abubakr, A.R., Lartey, R.A., and Adu-Sarkodie, Y. (2012). Aetiological agents of cerebrospinal meningitis: A retrospective study from a teaching hospital in Ghana. Ann. Clin. Microbiol. Antimicrob., 11.","DOI":"10.1186\/1476-0711-11-28"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"265","DOI":"10.4269\/ajtmh.12-0515","article-title":"Knowledge, attitudes, and practices related to Meningitis in northern Ghana","volume":"89","author":"Hayden","year":"2013","journal-title":"Amer. J. Trop. Med. Hyg."},{"key":"ref_75","doi-asserted-by":"crossref","unstructured":"Akweongo, P., Dalaba, M.A., Hayden, M.H., Awine, T., Nyaaba, G.N., Anaseba, D., Hodgson, A., Forgor, A.A., and Pandya, R. (2013). The economic burden of Meningitis to households in Kassena-Nankana district of northern Ghana. PLoS One, 8.","DOI":"10.1371\/journal.pone.0079880"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1007\/s13253-012-0095-9","article-title":"The role of weather in Meningitis outbreaks in Navrongo, Ghana: A generalized additive modeling approach","volume":"17","author":"Dukic","year":"2012","journal-title":"J. Agric. Biol. Environ. Stat."},{"key":"ref_77","unstructured":"Ghana Statistical Service (2012). 2010 Population and Housing Census. Summary Report of Final Results, Sakoa Press."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1007\/s10584-009-9776-y","article-title":"Floods in the Sahel: An analysis of anomalies, memory and anticipatory learning","volume":"103","author":"Tschakert","year":"2010","journal-title":"Climatic Change"},{"key":"ref_79","unstructured":"Parry, M.L., Canziani, O.F., Palutikof, J.P., van der Linden, P.J., and Handson, C.E. (2007). Contribution of Working Group II to the 4th Assessment Report of the Intergovernmental Panel on Climate Change, Cambridge University Press."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1023\/A:1005661622966","article-title":"An anatomy of adaptation to climate change and vairability","volume":"45","author":"Smit","year":"1999","journal-title":"Climatic Change"},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1016\/S0921-8009(98)00117-7","article-title":"Weathering climate change: Some simple rules to guide adaptation decisions","volume":"30","author":"Frankhauser","year":"1999","journal-title":"Ecol. Econ."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/11\/7\/6923\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T21:13:20Z","timestamp":1760217200000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/11\/7\/6923"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,7,7]]},"references-count":81,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2014,7]]}},"alternative-id":["ijerph110706923"],"URL":"https:\/\/doi.org\/10.3390\/ijerph110706923","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,7,7]]}}}