A retrospective study on potential waterborne diseases recorded in health facilities in and around Buhoma, Bwindi Impenetrable National Park, Uganda (2015-2024)

Abstract

Communities adjacent to wildlife protected areas face elevated waterborne disease risks due to poor WASH infrastructure, and human–wildlife interactions. At Buhoma, Bwindi Impenetrable National Park (BINP), Uganda, shared water sources between humans, livestock, and endangered mountain gorillas may facilitate pathogen transmission, yet disease trends remain poorly documented. This study aimed to establish the distribution, trends and establish the impact of weather changes on waterborne diseases recorded at health facilities in and around Buhoma, BINP, from 2015 to 2024. A retrospective cross – sectional study was conducted at Kayonza Health Center III, Buhoma, reviewing 1,789 waterborne disease records from July 2017 to September 2024. Patient demographics and diagnoses were analyzed using descriptive statistics. Quarterly case counts were subjected to time series decomposition, ARIMA modeling and Granger causality tests. Secondary climate data (rainfall, and temperature) were obtained from Ruhija Meteorological Station. Patients had a median age of 3.8 years (IQR [1.3 – 13.0]). Helminths were the most prevalent (48.5%), followed by chronic diarrhea (33.6%) and acute diarrhea (13.9%). Chronic and acute diarrhea constitutes 47.5% of the cases, while protozoal infections were rarely diagnosed (<1%). Time series decomposition revealed strong seasonality and an upward trend in cases. ARIMA (0,1,2) forecasting projected persistent instability. Rainfall showed a near – significant effect on disease occurrence (Granger causality: F=4.39, p-value=0.06); temperature had no significant effect. Waterborne infections, particularly diarrheal diseases, pose a substantial burden in this wildlife – adjacent community, disproportionately affecting young children. Seasonal patterns and potential rainfall linkages suggest climate vulnerability. Low protozoal detection likely reflects diagnostic gaps. Targeted WASH interventions for children, strengthened surveillance, mass deworming, and multisectoral approaches are urgently needed.