12047_doi_deposit 20221130060000 assa nadiag@assaf.org.za assa South African Journal of Science S. Afr. J. Sci 1996-7489 11302022 118 11/12 Albert E. Manyuchi Global Change Institute, University of the Witwatersrand, Johannesburg, South Africa https://orcid.org/0000-0001-7189-6201 Matthew Chersich Wits Reproductive Health and HIV Institute, University of the Witwatersrand, Johannesburg, South Africa https://orcid.org/0000-0002-4320-9168 Coleen Vogel Global Change Institute, University of the Witwatersrand, Johannesburg, South Africa https://orcid.org/0000-0002-3842-8489 Caradee Y. Wright Environmental and Health Research Unit, South African Medical Research Council, Pretoria, South Africa Department of Geography, Geoinformatics and Meteorology, University of Pretoria, Pretoria, South Africa https://orcid.org/0000-0001-9608-818X Ruwadzano Matsika Global Change Institute, University of the Witwatersrand, Johannesburg, South Africa https://orcid.org/0000-0002-1343-5527 Barend Erasmus Office of the Dean, Faculty of Natural and Agricultural Sciences, University of Pretoria, Pretoria, South Africa https://orcid.org/0000-0003-1869-8091 Temperature extremes vary across Africa. A continent-wide examination of the impacts of heat on health in Africa, and a synthesis of Africa-informed evidence is, however, lacking. A systematic review of articles published in peer-reviewed journals between January 1992 and April 2019 was conducted. To be eligible, articles had to be Africa-specific, in English, and focused on how heatwaves and high ambient temperatures affect morbidity and mortality. A secondary systematic analysis on policies and interventions comprising 17 studies was also conducted, and the findings synthesised together with those of the 20 primary studies. Eleven studies showed that high ambient temperatures and heat waves are linked with increased mortality rates in Africa. These linkages are characterised by complex, linear and non-linear (J or U) relationships. Eight of the nine primary studies of morbidity outcome reported that an increase in temperature was accompanied by raised disease incidence. Children and the elderly were the population groups most vulnerable to extreme heat exposure. Location-specific interventions and policy suggestions include developing early warning systems, creating heat-health plans, changing housing conditions and implementing heat-health awareness campaigns. In summary, this review demonstrates that, while heat-health relationships in Africa are complex, extreme temperatures are associated with high mortality and morbidity, especially amongst vulnerable populations. As temperatures increase across Africa, there is an urgent need to develop heat-health plans and implement interventions. Future studies must document intervention effectiveness and quantify the costs of action and inaction on extreme heatrelated mortality and morbidity. 11302022 1 10.17159/sajs.2016/crossmark sajs.co.za false 2021-08-20 2022-09-21 2022-11-30 University of the Witwatersrand, Johannesburg http://dx.doi.org/10.13039/100009467 https://creativecommons.org/licenses/by/4.0/ 10.17159/sajs.2022/12047 20221130060000 https://sajs.co.za/article/view/12047 https://sajs.co.za/article/view/12047/19452 https://sajs.co.za/article/view/12047/19452 https://sajs.co.za/article/view/12047/19452 https://sajs.co.za/article/view/12047/19452 https://sajs.co.za/article/view/12047/19452 https://sajs.co.za/article/view/12047/19452 https://sajs.co.za/article/view/12047/19452