Impact of extreme weather events on Sub-Saharan African child and adolescent mental health: The implications of a systematic review of sparse research findings^✰

Introduction: Over the past 10–15 years there has been increasing attention to the potential impact of extreme weather events (EWE) on children's mental health. Because sub-Saharan Africa (SSA) is experiencing an increase in the frequency and severity of these events, we decided it was necessary to conduct a systematic review. The focus was to examine research findings on the direct and indirect impacts of EWE on the mental health of children and adolescents living in SSA to inform protective adaptation strategies and promote resilience. Materials and Methods: In 2020 we conducted a systematic review in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and a review of the grey literature. The systematic review and grey literature search identified 1342 studies. Results: The titles and abstracts of 858 articles and grey literature were assessed for eligibility (e.g., mental health outcomes for children and adolescents linked to exposure to an EWE in SSA) with 21 articles identified for full-text review. Of these, only two were eligible for full review. Both articles focused on extreme flooding events and associated psychological distress. Several protective factors were identified (e.g., age, sex, encouragement, and shared hardship) that ameliorated the psychological distress. Discussion: There is an alarming lack of research focusing specifically on the mental health of youth exposed to EWE in SSA, where EWE, especially extreme heat, flooding and droughts, continue to increase. The indication is that children and adolescents living in SSA are at risk of mental health impacts such as depression and post-traumatic stress disorder. With the severe shortage of SSA-specific research, SSA decision-makers, planners and adaptation strategy developers are not guided by local and regional evidence and may be missing areas of concern and opportunities for prevention.