{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T13:20:50Z","timestamp":1788355250170,"version":"build-2803163510"},"reference-count":30,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,2]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n                  <jats:p>A database of historic rainfall and temperature standardized anomalies was constructed for sub-Saharan Africa (SSA) over the period 2000 to 2020 and merged with the harmonized versions of 51 rounds of Demographic and Health Surveys for 19 countries in SSA. Multivariable logit models of the determinants of the probability of reported incidence of fever, diarrhea, and coughing among children under 5 years of age were estimated with explanatory variables, including the quintiles of rainfall and temperature anomalies experienced locally, and a variety of observable child, maternal, household, and environmental covariates. The highest marginal effect on the probability of fever was at the top quintile of rainfall anomalies, and the highest marginal effect of anomalous rainfall events on diarrhea was at the bottom quintile of rainfall anomalies. The marginal effects of rainfall on coughing were the highest at the bottom and top quintiles. Anomalously cold and hot conditions were associated with reductions in the incidence of fever, diarrhea, and cough in comparison with the incidence of the same illnesses at normal temperatures. Higher maternal education was associated with a lower probability of fever and diarrhea in the event of unusually wet events and unusually hot temperatures. However, higher maternal education did not have a greater protective effect on the reported incidence of child diarrhea than periods with normal rainfall. Also, improved toilets at home were associated with a significantly lower probability of child fever, diarrhea, and cough, especially during unusually dry and unusually wet weather, as well as during unusually high temperatures.<\/jats:p>","DOI":"10.4269\/ajtmh.25-0464","type":"journal-article","created":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T16:22:52Z","timestamp":1783009372000},"page":"625-636","source":"Crossref","is-referenced-by-count":0,"title":["The Weather\u2013Child Morbidity Link and the Modifying Effect of Maternal Education and Sanitation: Evidence from Sub-Saharan Africa"],"prefix":"10.4269","volume":"115","author":[{"given":"Emmanuel","family":"Skoufias","sequence":"first","affiliation":[{"name":"Lee Kuan Yew School of Public Policy, National University of Singapore, Singapore;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katja","family":"Vinha","sequence":"additional","affiliation":[{"name":"Independent Consultant, World Bank Group, Nashville, Tennessee, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Levels and Trends in Child Mortality: Report 2020, Estimates developed by the United Nations Interagency Group for Child Mortality Estimation","year":"2020"},{"issue":"11","key":"b2","series-title":"BMJ Open","first-page":"e065257","article-title":"Prevalence and associated factors of common childhood illnesses in sub-Saharan Africa from 2010 to 2020: A cross-sectional study","volume":"12","author":"Chilot","year":"2022"},{"issue":"1","key":"b3","series-title":"Sci Rep","first-page":"18796","article-title":"Characterizing the contribution of high temperatures to child undernourishment in sub-Saharan Africa","volume":"10","author":"Baker","year":"2020"},{"key":"b4","series-title":"Glob Environ Change","first-page":"102192","article-title":"Climate variability and child nutrition: Findings from sub-Saharan Africa","volume":"65","author":"Thiede","year":"2020"},{"issue":"35","key":"b5","series-title":"Proc Natl Acad Sci USA","first-page":"17219","article-title":"Mapping the effects of drought on child stunting","volume":"116","author":"Cooper","year":"2019"},{"issue":"7","key":"b6","series-title":"Int J Environ Res Public Health","first-page":"823","article-title":"Rainfall and temperature influences on childhood diarrhea and the effect modification role of water and sanitation conditions: A systematic review and meta-analysis","volume":"21","author":"Geremew","year":"2024"},{"issue":"3","key":"b7","series-title":"Am J Epidemiol","first-page":"344","article-title":"Heavy rainfall events and diarrhea incidence: The role of social and environmental factors","volume":"179","author":"Carlton","year":"2014"},{"issue":"4","key":"b8","series-title":"Int J Epidemiol","first-page":"816","article-title":"Multi-country analysis of the effects of diarrhoea on childhood stunting","volume":"37","author":"Checkley","year":"2008"},{"issue":"3","key":"b9","series-title":"Proc Natl Acad Sci USA","first-page":"e2119409120","article-title":"Uncovering social and environmental factors that increase the burden of climate-sensitive diarrheal infections on children","volume":"120","author":"Dimitrova","year":"2023"},{"issue":"3","key":"b10","series-title":"Am J Trop Med Hyg","first-page":"644","article-title":"Drought and illness among young children in Uganda, 2009\u20132012","volume":"102","author":"Epstein","year":"2020"},{"issue":"4","key":"b11","series-title":"J Econ Perspect","first-page":"33","article-title":"Quantifying economic damages from climate change","volume":"32","author":"Auffhammer","year":"2018"},{"issue":"2","key":"b12","series-title":"Lancet Planet Health","first-page":"e147","article-title":"Precipitation variability and risk of infectious disease in children under 5 years for 32 countries: A global analysis using Demographic and Health Survey data","volume":"6","author":"Dimitrova","year":"2022"},{"issue":"11","key":"b13","series-title":"JAMA Pediatr","first-page":"1206","article-title":"Floods and diarrhea risk in young children in low- and middle-income countries","volume":"177","author":"Wang","year":"2023"},{"key":"b14","article-title":"IPUMS\u2013Demographic and Health Surveys: Version 7.","author":"Boyle","year":"2019"},{"issue":"1","key":"b15","series-title":"PLoS One","first-page":"e0341218","article-title":"Community-level externalities in child health and nutrition: Evidence from sub-Saharan Africa","volume":"21","author":"Skoufias","year":"2026"},{"key":"b16","doi-asserted-by":"crossref","DOI":"10.1596\/1813-9450-10683","article-title":"The Welfare Cost of Drought in Sub-Saharan Africa.","author":"Gascoigne","year":"2024"},{"issue":"3","key":"b17","series-title":"J Econ Lit","first-page":"740","article-title":"What do we learn from the weather? 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