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Characterizing the Impact of Extreme Heat on Mortality, Karachi, Pakistan, June 2015

Published online by Cambridge University Press:  05 April 2016

Usman Ghumman  and
Jennifer Horney
Usman Ghumman
Affiliation:
Department of Epidemiology and Biostatistics, Texas A&M School of Public Health, College Station, Texas USA
Jennifer Horney*
Affiliation:
Department of Epidemiology and Biostatistics, Texas A&M School of Public Health, College Station, Texas USA
*
Correspondence: Jennifer Horney, PhD, MPH Department of Epidemiology andBiostatistics Texas A&M School of Public Health1266 TAMU College Station, Texas 77843 USA E-mail: horney@sph.tamhsc.edu
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Abstract

Introduction

Karachi, Pakistan was affected by a heat wave in June 2015 during the Muslim holy month of Ramadan. Many media reports attributed the excess deaths in part to the practice of daylight fasting during Ramadan. As much of the published research reports on heat-related mortality in Europe and the United States, an exploration of the effects of extreme heat on residents of a South Asian mega-city address a gap in current disaster research.

Hypothesis/Problem

This report investigated potential risk factors for excess mortality associated with the June 2015 heat wave in Karachi, Pakistan.

Methods

Data were obtained through manual review of death certificates at public hospitals and private clinics in Karachi, Pakistan, conducted from July 1 through July 31, 2015 by a trained physician. Demographic data for any deaths with a primary cause of death of heat-related illness were recorded in Microsoft Excel (Microsoft Corp.; Redmond, Washington USA). EpiSheet (2012; Rothman. Modern Epidemiology. Lippincott Williams & Wilkins; Philadelphia, Pennsylvania USA) was used to calculate risk differences (RD), rate ratios (RR), and 95% confidence intervals (95% CI).

Results

Overall, residents of Karachi were approximately 17 times as likely to die of a heat-related cause of death during June 2015 (RR=17.68; 95% CI, 13.87-22.53) when compared with the reference period of June 2014. Residents with a monthly income lower than 20,000 Pakistani Rupees (US $196; RD=0.03; 95% CI, 0.01-0.05) and those with less than a fifth grade education (RD=0.03; 95% CI, 0.00-0.05) were at significantly higher risk of death during the 2015 heat wave compared to the reference period.

Conclusion

Fasting during Ramadan was not a significant risk factor for mortality from heat-related causes during the Karachi heat wave of June 2015. A large number of excess deaths were reported across all demographic groups, which due to the burden of record keeping in an under-resourced health system during a public health emergency, are almost certainly an underestimate.

GhummanU , HorneyJ . Characterizing the Impact of Extreme Heat on Mortality, Karachi, Pakistan, June 2015. Prehosp Disaster Med. 2016;31(3):263–266.

Keywords

disastersglobal healthhot temperaturemortality
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 31 , Issue 3 , June 2016 , pp. 263 - 266
Copyright
© World Association for Disaster and Emergency Medicine 2016 

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