Health Impacts of Extreme Heat Events in Disadvantaged Urban Communities Across Africa: A Systematic Review

Extreme heat events are associated with increased morbidity and mortality, disproportionately affecting vulnerable populations. However, evidence from disadvantaged urban settings in Africa remains scarce. This systematic review aimed to synthesize existing research on the health impacts of extreme heat in Africa’s disadvantaged urban communities. A systematic literature search was conducted in accordance with PRISMA guidelines across eleven databases (PubMed, Cochrane, VHL, Google Scholar, ScienceDirect, Research4Life, DOAJ, Emerald, Taylor & Francis, Annual Reviews, and IRIS), carried out over two search periods (December 2023–March 2024 and December 2024–February 2025). Eligible studies were published between 2010 and 2024 in English, French, or Portuguese, and examined direct or indirect heat-health effects in disadvantaged urban settings. Screening of 96,608 titles and 59 abstracts yielded 21 eligible studies. Geographically, the evidence was concentrated in South Africa (n = 7), Kenya (n = 6), and Tanzania (n = 4), with single studies from Cameroon, Egypt, Nigeria, and Ghana. Heat-related morbidity was examined in 17 studies and mortality in four. Commonly reported conditions included dehydration, heat exhaustion, skin rashes, heatstroke, and cardiovascular and respiratory diseases. Extreme heat was further associated with mortality from non-communicable diseases, pneumonia, and acute respiratory infections. Children, older adults, and the most economically deprived communities exhibited heightened vulnerability, driven by adverse socioeconomic and environmental conditions. The available evidence confirms substantial heat-health impacts on disadvantaged urban populations across Africa, while revealing a notable research gap in French- and Portuguese-language literature. These findings underscore the urgent need for expanded, geographically and linguistically diverse research to inform climate adaptation strategies and health protection policies.