Heatwave and risk of hospitalization: A multi-province study in Vietnam.

The effects of heatwaves on morbidity in developing and tropical countries have not been well explored. The purpose of this study was to examine the relationship between heatwaves and hospitalization and the potential influence of socio-economic factors on this relationship in Vietnam. Generalized Linear Models (GLM) with Poisson family and Distributed Lag Models (DLM) were applied to evaluate the effect of heatwaves for each province (province-level effect). A random-effects meta-analysis was applied to calculate the pooled estimates (country-level effects) for 'all causes', infectious, cardiovascular, and respiratory admissions queried by lag days, regions, sex, and ages. We used random-effects meta-regression to explore the potential influence of socio-economic factors on the relationship between heatwaves and hospitalization. The size of province-level effects varied across provinces. The pooled estimates show that heatwaves were significantly associated with a 2.5% (95%CI: 0.8-4.3) and 3.8% (95%CI, 1.5-6.2) increase in all causes and infectious admissions at lag 0. Cardiovascular and respiratory admissions (0.8%, 95%CI: -1.6-3.3; 2.2%, 95%CI: -0.7-5.2) were not significantly increased after a heatwave event. The risk of hospitalization due to heatwaves was higher in the North than in the South for all causes (5.4%, 95%CI: -0.1-11.5 versus 1.3%, 95%CI: 0.1-2.6), infectious (11.2%, 95%CI: 3.1-19.9 versus 3.2%, 95%CI: 0.7-5.7), cardiovascular (7.5%, 95%CI: 1.1-14.4 versus -1.2%, 95%CI: -2.6-2.3), and respiratory diseases (2.7%, 95%CI: -5.4-11.5 versus 2.1%, 95%CI: -0.8-1.2). A non-significant influence of socio-economic factors on the relationship between heatwave and hospitalization was observed. This study provides important evidence and suggests implications for the projected impacts of climate change related extreme weather. Climate change adaptation programs of the health sector should be developed to protect residents from the effects of extreme weather events such as heatwaves in Vietnam.