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Haque F, Lampe FC, Hajat S, Stavrianaki K, Hasan SMT, Faruque ASG, Ahmed T, Jubayer S, Kelman I. Is heat wave a predictor of diarrhoea in Dhaka, Bangladesh? A time-series analysis in a South Asian tropical monsoon climate. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003629. [PMID: 39226251 PMCID: PMC11371214 DOI: 10.1371/journal.pgph.0003629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 07/29/2024] [Indexed: 09/05/2024]
Abstract
While numerous studies have assessed the association between temperature and diarrhoea in various locations, evidence of relationship between heat wave and diarrhoea is scarce. We defined elevated daily mean and maximum temperature over the 95th and 99th percentiles lasting for at least one day between March to October 1981-2010 as TAV95 and TAV99 and D95 and D99 heat wave, respectively. We investigated the association between heat wave and daily counts of hospitalisations for all-cause diarrhoea in Dhaka, Bangladesh using time series regression analysis employing constrained distributed lag-linear models. Effects were assessed for all ages and children aged under 5 years of age. Diarrhoea hospitalisation increased by 6.7% (95% CI: 4.6%- 8.9%), 8.3% (3.7-13.1), 7.0 (4.8-9.3) and 7.4 (3.1-11.9) in all ages on a TAV95, TAV99, D95 and D99 heat wave day, respectively. These effects were more pronounced for under-5 children with an increase of 13.9% (95% CI: 8.3-19.9), 24.2% (11.3-38.7), 17.0 (11.0-23.5) and 19.5 (7.7-32.6) in diarrhoea hospitalisations on a TAV95, TAV99, D95 and D99 heat wave day, respectively. At lags of 3 days, we noticed a negative association indicating a 'harvesting' effect. Our findings suggest that heat wave was a significant risk factor for diarrhoea hospitalisation in Dhaka. Further research is needed to elucidate the causal pathways and identify the preventive measures necessary to mitigate the impacts of heat waves on diarrhoea. Given that no heat wave definitions exist for Dhaka, these results may help to define heat waves for Dhaka and trigger public health interventions including heat alerts to prevent heat-related morbidity in Dhaka, Bangladesh.
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Affiliation(s)
- Farhana Haque
- Institute for Global Health (IGH), University College London (UCL), London, United Kingdom
- UK Public Health Rapid Support Team (UK-PHRST), Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine (LSHTM), London, United Kingdom
| | - Fiona C. Lampe
- Institute for Global Health (IGH), University College London (UCL), London, United Kingdom
| | - Shakoor Hajat
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine (LSHTM), London, United Kingdom
| | - Katerina Stavrianaki
- Department of Statistical Science, Department of Risk and Disaster Reduction, University College London (UCL), London, United Kingdom
| | | | - A. S. G. Faruque
- Nutrition and Clinical Services Division, icddr,b, Dhaka, Bangladesh
| | - Tahmeed Ahmed
- Nutrition and Clinical Services Division, icddr,b, Dhaka, Bangladesh
| | - Shamim Jubayer
- National Heart Foundation Hospital and Research Institute (NHF&RI), Dhaka, Bangladesh
| | - Ilan Kelman
- Department of Risk and Disaster Reduction, Institute for Global Health (IGH), University College London (UCL), London, United Kingdom
- University of Agder, Kristiansand, Norway
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Grembi JA, Nguyen AT, Riviere M, Heitmann GB, Patil A, Athni TS, Djajadi S, Ercumen A, Lin A, Crider Y, Mertens A, Karim MA, Islam MO, Miah R, Famida SL, Hossen MS, Mutsuddi P, Ali S, Rahman MZ, Hussain Z, Shoab AK, Haque R, Rahman M, Unicomb L, Luby SP, Arnold BF, Bennett A, Benjamin-Chung J. Influence of hydrometeorological risk factors on child diarrhea and enteropathogens in rural Bangladesh. PLoS Negl Trop Dis 2024; 18:e0012157. [PMID: 38739632 PMCID: PMC11115220 DOI: 10.1371/journal.pntd.0012157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 05/23/2024] [Accepted: 04/18/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND A number of studies have detected relationships between weather and diarrhea. Few have investigated associations with specific enteric pathogens. Understanding pathogen-specific relationships with weather is crucial to inform public health in low-resource settings that are especially vulnerable to climate change. OBJECTIVES Our objectives were to identify weather and environmental risk factors associated with diarrhea and enteropathogen prevalence in young children in rural Bangladesh, a population with high diarrheal disease burden and vulnerability to weather shifts under climate change. METHODS We matched temperature, precipitation, surface water, and humidity data to observational longitudinal data from a cluster-randomized trial that measured diarrhea and enteropathogen prevalence in children 6 months-5.5 years from 2012-2016. We fit generalized additive mixed models with cubic regression splines and restricted maximum likelihood estimation for smoothing parameters. RESULTS Comparing weeks with 30°C versus 15°C average temperature, prevalence was 3.5% higher for diarrhea, 7.3% higher for Shiga toxin-producing Escherichia coli (STEC), 17.3% higher for enterotoxigenic E. coli (ETEC), and 8.0% higher for Cryptosporidium. Above-median weekly precipitation (median: 13mm; range: 0-396mm) was associated with 29% higher diarrhea (adjusted prevalence ratio 1.29, 95% CI 1.07, 1.55); higher Cryptosporidium, ETEC, STEC, Shigella, Campylobacter, Aeromonas, and adenovirus 40/41; and lower Giardia, sapovirus, and norovirus prevalence. Other associations were weak or null. DISCUSSION Higher temperatures and precipitation were associated with higher prevalence of diarrhea and multiple enteropathogens; higher precipitation was associated with lower prevalence of some enteric viruses. Our findings emphasize the heterogeneity of the relationships between hydrometeorological variables and specific enteropathogens, which can be masked when looking at composite measures like all-cause diarrhea. Our results suggest that preventive interventions targeted to reduce enteropathogens just before and during the rainy season may more effectively reduce child diarrhea and enteric pathogen carriage in rural Bangladesh and in settings with similar meteorological characteristics, infrastructure, and enteropathogen transmission.
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Affiliation(s)
- Jessica A. Grembi
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, School of Medicine, Stanford University, Stanford, California, United States of America
| | - Anna T. Nguyen
- Department of Epidemiology and Population Health, School of Medicine, Stanford University, Stanford, California, United States of America
| | - Marie Riviere
- Department of Epidemiology and Population Health, School of Medicine, Stanford University, Stanford, California, United States of America
| | - Gabriella Barratt Heitmann
- Department of Epidemiology and Population Health, School of Medicine, Stanford University, Stanford, California, United States of America
| | - Arusha Patil
- Department of Epidemiology and Population Health, School of Medicine, Stanford University, Stanford, California, United States of America
| | - Tejas S. Athni
- Harvard Medical School, Harvard University, Boston, Massachusetts, United States of America
| | - Stephanie Djajadi
- Division of Epidemiology, School of Public Health, University of California, Berkeley, Berkeley, California, United States of America
| | - Ayse Ercumen
- Department of Forestry and Environmental Resources, North Carolina State University, Raleigh, North Carolina, United States of America
| | - Audrie Lin
- Department of Microbiology and Environmental Toxicology, University of California, Santa Cruz, Santa Cruz, California, United States of America
| | - Yoshika Crider
- King Center on Global Development, Stanford University, Stanford, California, United States of America
| | - Andrew Mertens
- Harvard Medical School, Harvard University, Boston, Massachusetts, United States of America
| | - Md Abdul Karim
- Infectious Disease Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Md Ohedul Islam
- Infectious Disease Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Rana Miah
- Infectious Disease Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Syeda L. Famida
- Infectious Disease Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Md Saheen Hossen
- Infectious Disease Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Palash Mutsuddi
- Infectious Disease Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Shahjahan Ali
- Infectious Disease Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Md Ziaur Rahman
- Infectious Disease Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Zahir Hussain
- Infectious Disease Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Abul K. Shoab
- Infectious Disease Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Rashidul Haque
- Infectious Disease Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Mahbubur Rahman
- Infectious Disease Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Leanne Unicomb
- Infectious Disease Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Stephen P. Luby
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, School of Medicine, Stanford University, Stanford, California, United States of America
| | - Benjamin F. Arnold
- Francis I. Proctor Foundation and Department of Ophthalmology, University of California, San Francisco, San Francisco, California, United States of America
| | - Adam Bennett
- Malaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, California, United States of America
- PATH, Seattle, Washington, United States of America
| | - Jade Benjamin-Chung
- Department of Epidemiology and Population Health, School of Medicine, Stanford University, Stanford, California, United States of America
- Chan Zuckerberg Biohub, San Francisco, California, United States of America
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Khoo MS, Ahmad Azman AH, Ismail NAS, Abdul Wahab A, Ali A. Associations between meteorological variation and hospitalisations for rotavirus infections in Kuala Lumpur, Malaysia. Heliyon 2024; 10:e28574. [PMID: 38596105 PMCID: PMC11002053 DOI: 10.1016/j.heliyon.2024.e28574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 03/11/2024] [Accepted: 03/20/2024] [Indexed: 04/11/2024] Open
Abstract
Objectives Rotavirus (RoV) infections have emerged as a significant public health concern around the world. Understanding the relationship between climatic conditions and hospitalisations due to RoV infections can help engage effective prevention strategies. This study aims to investigate the potential associations between meteorological variability and RoV-related hospitalisations in Kuala Lumpur, Malaysia. Methods Hospitalization data from a tertiary teaching hospital in Kuala Lumpur over a twelve-year period were retrospectively collected. Concurrently, meteorological data were obtained from the Malaysian Meteorological Department (MetMalaysia) including variables of temperature, humidity, precipitation, and atmospheric pressure to further demonstrate relationship with RoV-associated hospitalisations. Results The results indicated positive correlations between increased rainfall, rainy days, humidity, and RoV-related hospitalisations, suggesting the influence of environmental factors on the transmission of RoV. Conclusions This study highlights positive associations between meteorological variations and hospitalizations for RoV infections in Kuala Lumpur, Malaysia. Further investigations, including national-level data, are needed to deepen our understanding of these associations, particularly within the context of Malaysia and to develop targeted interventions for disease prevention and control.
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Affiliation(s)
- Mohammad Shukri Khoo
- Department of Paediatrics, Faculty of Medicine, Universiti Kebangsaan Malaysia Specialist Children's Hospital, The National University of Malaysia, 56000, Kuala Lumpur, Malaysia
- Clinical Research Unit, Universiti Kebangsaan Malaysia Specialist Children's Hospital, The National University of Malaysia, 56000, Kuala Lumpur, Malaysia
| | - Ahmad Hathim Ahmad Azman
- Department of Paediatrics, Faculty of Medicine, Universiti Kebangsaan Malaysia Specialist Children's Hospital, The National University of Malaysia, 56000, Kuala Lumpur, Malaysia
| | - Noor Akmal Shareela Ismail
- Department of Biochemistry, Faculty of Medicine, The National University of Malaysia, 56000, Kuala Lumpur, Malaysia
| | - Asrul Abdul Wahab
- Department of Medical Microbiology & Immunology, Faculty of Medicine, The National University of Malaysia, 56000, Kuala Lumpur, Malaysia
| | - Adli Ali
- Department of Paediatrics, Faculty of Medicine, Universiti Kebangsaan Malaysia Specialist Children's Hospital, The National University of Malaysia, 56000, Kuala Lumpur, Malaysia
- Clinical Research Unit, Universiti Kebangsaan Malaysia Specialist Children's Hospital, The National University of Malaysia, 56000, Kuala Lumpur, Malaysia
- Institute of IR4.0, The National University of Malaysia, 43600, Bangi, Malaysia
- Infection and Immunology Health and Advanced Medicine Cluster, The National University of Malaysia, 56000, Kuala Lumpur, Malaysia
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Lee TT, Dalvie MA, Röösli M, Merten S, Kwiatkowski M, Mahomed H, Sweijd N, Cissé G. Understanding diarrhoeal diseases in response to climate variability and drought in Cape Town, South Africa: a mixed methods approach. Infect Dis Poverty 2023; 12:76. [PMID: 37596648 PMCID: PMC10436439 DOI: 10.1186/s40249-023-01127-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 08/03/2023] [Indexed: 08/20/2023] Open
Abstract
BACKGROUND The climate of southern Africa is expected to become hotter and drier with more frequent severe droughts and the incidence of diarrhoea to increase. From 2015 to 2018, Cape Town, South Africa, experienced a severe drought which resulted in extreme water conservation efforts. We aimed to gain a more holistic understanding of the relationship between diarrhoea in young children and climate variability in a system stressed by water scarcity. METHODS Using a mixed-methods approach, we explored diarrhoeal disease incidence in children under 5 years between 2010 to 2019 in Cape Town, primarily in the public health system through routinely collected diarrhoeal incidence and weather station data. We developed a negative binomial regression model to understand the relationship between temperature, precipitation, and relative humidity on incidence of diarrhoea with dehydration. We conducted in-depth interviews with stakeholders in the fields of health, environment, and human development on perceptions around diarrhoea and health-related interventions both prior to and over the drought, and analysed them through the framework method. RESULTS From diarrhoeal incidence data, the diarrhoea with dehydration incidence decreased over the decade studied, e.g. reduction of 64.7% in 2019 [95% confidence interval (CI): 5.5-7.2%] compared to 2010, with no increase during the severe drought period. Over the hot dry diarrhoeal season (November to May), the monthly diarrhoea with dehydration incidence increased by 7.4% (95% CI: 4.5-10.3%) per 1 °C increase in temperature and 2.6% (95% CI: 1.7-3.5%) per 1% increase in relative humidity in the unlagged model. Stakeholder interviews found that extensive and sustained diarrhoeal interventions were perceived to be responsible for the overall reduction in diarrhoeal incidence and mortality over the prior decade. During the drought, as diarrhoeal interventions were maintained, the expected increase in incidence in the public health sector did not occur. CONCLUSIONS We found that that diarrhoeal incidence has decreased over the last decade and that incidence is strongly influenced by local temperature and humidity, particularly over the hot dry season. While climate change and extreme weather events especially stress systems supporting vulnerable populations such as young children, maintaining strong and consistent public health interventions helps to reduce negative health impacts.
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Affiliation(s)
- Tristan Taylor Lee
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Mohamed Aqiel Dalvie
- Centre for Environmental and Occupational Health Research, School of Public Health, University of Cape Town, Cape Town, South Africa
| | - Martin Röösli
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Sonja Merten
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Marek Kwiatkowski
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Hassan Mahomed
- Metro Health Services, Western Cape Government: Health and Wellness, Western Cape, South Africa
- Division of Health Systems and Public Health, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Neville Sweijd
- Alliance for Collaboration on Climate and Earth Systems Science, Council for Scientific and Industrial Research, Pretoria, South Africa
| | - Guéladio Cissé
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland.
- University of Basel, Basel, Switzerland.
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5
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Garbern SC, Islam MT, Islam K, Ahmed SM, Brintz BJ, Khan AI, Taniuchi M, Platts-Mills JA, Qadri F, Leung DT. Derivation and External Validation of a Clinical Prediction Model for Viral Diarrhea Etiology in Bangladesh. Open Forum Infect Dis 2023; 10:ofad295. [PMID: 37404954 PMCID: PMC10316693 DOI: 10.1093/ofid/ofad295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 05/26/2023] [Indexed: 07/06/2023] Open
Abstract
Background Antibiotics are commonly overused for diarrheal illness in many low- and middle-income countries, partly due to a lack of diagnostics to identify viral cases, in which antibiotics are not beneficial. This study aimed to develop clinical prediction models to predict risk of viral-only diarrhea across all ages, using routinely collected demographic and clinical variables. Methods We used a derivation dataset from 10 hospitals across Bangladesh and a separate validation dataset from the icddr,b Dhaka Hospital. The primary outcome was viral-only etiology determined by stool quantitative polymerase chain reaction. Multivariable logistic regression models were fit and externally validated; discrimination was quantified using area under the receiver operating characteristic curve (AUC) and calibration assessed using calibration plots. Results Viral-only diarrhea was common in all age groups (<1 year, 41.4%; 18-55 years, 17.7%). A forward stepwise model had AUC of 0.82 (95% confidence interval [CI], .80-.84) while a simplified model with age, abdominal pain, and bloody stool had AUC of 0.81 (95% CI, .78-.82). In external validation, the models performed adequately although less robustly (AUC, 0.72 [95% CI, .70-.74]). Conclusions Prediction models consisting of 3 routinely collected variables can accurately predict viral-only diarrhea in patients of all ages in Bangladesh and may help support efforts to reduce inappropriate antibiotic use.
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Affiliation(s)
- Stephanie Chow Garbern
- Department of Emergency Medicine, Alpert Medical School, Brown University, Providence, Rhode Island, USA
| | | | - Kamrul Islam
- Infectious Diseases Division, icddr,b, Dhaka, Bangladesh
| | - Sharia M Ahmed
- Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Ben J Brintz
- Division of Epidemiology, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | | | - Mami Taniuchi
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, Virginia, USA
| | - James A Platts-Mills
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, Virginia, USA
| | - Firdausi Qadri
- Infectious Diseases Division, icddr,b, Dhaka, Bangladesh
| | - Daniel T Leung
- Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City, Utah, USA
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Powers JE, Mureithi M, Mboya J, Campolo J, Swarthout JM, Pajka J, Null C, Pickering AJ. Effects of High Temperature and Heavy Precipitation on Drinking Water Quality and Child Hand Contamination Levels in Rural Kenya. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2023; 57:6975-6988. [PMID: 37071701 PMCID: PMC10157894 DOI: 10.1021/acs.est.2c07284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Climate change may impact human health through the influence of weather on environmental transmission of diarrhea. Previous studies have found that high temperatures and heavy precipitation are associated with increased diarrhea prevalence, but the underlying causal mechanisms have not been tested and validated. We linked measurements of Escherichia coli in source water (n = 1673), stored drinking water (n = 9692), and hand rinses from children <2 years old (n = 2634) with publicly available gridded temperature and precipitation data (at ≤0.2 degree spatial resolution and daily temporal resolution) by the GPS coordinates and date of sample collection. Measurements were collected over a 3-year period across a 2500 km2 area in rural Kenya. In drinking water sources, high 7-day temperature was associated with a 0.16 increase in log10 E. coli levels (p < 0.001, 95% CI: 0.07, 0.24), while heavy 7-day total precipitation was associated with a 0.29 increase in log10 E. coli levels (p < 0.001, 95% CI: 0.13, 0.44). In household stored drinking water, heavy 7-day precipitation was associated with a 0.079 increase in log10 E. coli levels (p = 0.042, 95% CI: 0.07, 0.24). Heavy precipitation did not increase E. coli levels among respondents who treated their water, suggesting that water treatment can mitigate effects on water quality. On child hands, high 7-day temperature was associated with a 0.39 decrease in log10 E. coli levels (p < 0.001, 95% CI: -0.52, -0.27). Our findings provide insight on how climate change could impact environmental transmission of bacterial pathogens in Kenya. We suggest water treatment is especially important after heavy precipitation (particularly when preceded by dry periods) and high temperatures.
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Affiliation(s)
- Julie E Powers
- University of California, Berkeley, Berkeley, California 94704, United States
| | - Maryanne Mureithi
- Innovations for Poverty Action, Sandalwood Lane, Nairobi 00500, Kenya
| | - John Mboya
- Innovations for Poverty Action, Sandalwood Lane, Nairobi 00500, Kenya
| | - Jake Campolo
- Farmers Business Network, San Carlos, California 94070, United States
| | | | - Joseph Pajka
- Tufts University, Medford, Massachusetts 02155, United States
| | - Clair Null
- Mathematica, Washington, D.C. 20002, United States
| | - Amy J Pickering
- University of California, Berkeley, Berkeley, California 94704, United States
- Chan Zuckerberg Biohub, San Francisco, California 94158, United States
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Asare EO, Al-Mamun MA, Sarmin M, Faruque ASG, Ahmed T, Pitzer VE. The influence of demographic and meteorological factors on temporal patterns of rotavirus infection in Dhaka, Bangladesh. Proc Biol Sci 2022; 289:20212727. [PMID: 35673869 PMCID: PMC9174722 DOI: 10.1098/rspb.2021.2727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
To quantify the potential impact of rotavirus vaccines and identify strategies to improve vaccine performance in Bangladesh, a better understanding of the drivers of pre-vaccination rotavirus patterns is required. We developed and fitted mathematical models to 23 years (1990-2012) of weekly rotavirus surveillance data from Dhaka with and without incorporating long-term and seasonal variation in the birth rate and meteorological factors. We performed external model validation using data between 2013 and 2019 from the regions of Dhaka and Matlab. The models showed good agreement with the observed age distribution of rotavirus cases and captured the observed shift in seasonal patterns of rotavirus hospitalizations from biannual to annual peaks. The declining long-term trend in the birth rate in Bangladesh was the key driver of the observed shift from biannual to annual winter rotavirus patterns. Meteorological indices were also important: a 1°C, 1% and 1 mm increase in diurnal temperature range, surface water presence and degree of wetness were associated with a 19%, 3.9% and 0.6% increase in the transmission rate, respectively. The model demonstrated reasonable predictions for both Dhaka and Matlab, and can be used to evaluate the impact of rotavirus vaccination in Bangladesh against changing patterns of disease incidence.
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Affiliation(s)
- Ernest O. Asare
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, Yale University, New Haven, CT, USA
| | - Mohammad A. Al-Mamun
- Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, USA
| | - Monira Sarmin
- Nutrition and Clinical Services Division (NCSD), International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - A. S. G. Faruque
- Nutrition and Clinical Services Division (NCSD), International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Tahmeed Ahmed
- Nutrition and Clinical Services Division (NCSD), International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Virginia E. Pitzer
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, Yale University, New Haven, CT, USA
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Hao Q, Gao Q, Zhao R, Wang H, Li H, Jiang B. The effect and attributable risk of daily temperature on category C infectious diarrhea in Guangdong Province, China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:23963-23974. [PMID: 34817816 DOI: 10.1007/s11356-021-17132-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 10/17/2021] [Indexed: 05/16/2023]
Abstract
Previous studies have explored the effect between ambient temperature and infectious diarrhea (ID) mostly using relative risk, which provides limited information in practical applications. Few studies have focused on the disease burden of ID caused by temperature, especially for different subgroups and cities in a multi-city setting. This study aims to estimate the effects and attributable risks of temperature on category C ID and explore potential modifiers among various cities in Guangdong. First, distributed lag non-linear models (DLNMs) were used to explore city-specific associations between daily mean temperature and category C ID from 2014 to 2016 in Guangdong and pooled by applying multivariate meta-analysis. Then, multivariate meta-regression was implemented to analyze the potential heterogeneity among various cities. Finally, we assessed the attributable burden of category C ID due to temperature, low (below the 5th percentile of temperature) and high temperature (above the 95th percentile of temperature) for each city and subgroup population. Compared with the 50th percentile of daily mean temperature, adverse effects on category C ID were found when the temperature was lower than 12.27 ℃ in Guangdong Province. Some city-specific factors (longitude, urbanization rate, population density, disposable income per capita, and the number of medical technicians and beds per thousand persons) could modify the relationship of temperature-category C ID. During the study period, there were 60,505 category C ID cases (17.14% of total cases) attributable to the exposure of temperature, with the attributable fraction (AF) of low temperature (4.23%, 95% empirical confidence interval (eCI): 1.79-5.71%) higher than high temperature (1.34%, 95% eCI: 0.86-1.64%). Males, people under 5 years, and workers appeared to be more vulnerable to temperature, with AFs of 29.40%, 19.25%, and 21.49%, respectively. The AF varied substantially at the city level, with the largest AF of low temperature occurring in Shaoguan (9.58%, 95% eCI: 8.36-10.09%), and that of high temperature occurring in Shenzhen (3.16%, 95% eCI: 2.70-3.51%). Low temperature was an important risk factor for category C ID in Guangdong Province, China. The exposure-response relationship could be modified by city-specific characteristics. Considering the whole population, the attributable risk of low temperature was much higher than that of high temperature, and males, people under 5 years, and workers were vulnerable populations.
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Affiliation(s)
- Qiang Hao
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, No.44 Wenhuaxi Road, Lixia District, Jinan, 250012, Shandong Province, People's Republic of China
- Shandong University Climate Change and Health Center, Jinan, 250012, Shandong Province, People's Republic of China
| | - Qi Gao
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong Province, People's Republic of China
| | - Ran Zhao
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, No.44 Wenhuaxi Road, Lixia District, Jinan, 250012, Shandong Province, People's Republic of China
- Shandong University Climate Change and Health Center, Jinan, 250012, Shandong Province, People's Republic of China
| | - Haitao Wang
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, No.44 Wenhuaxi Road, Lixia District, Jinan, 250012, Shandong Province, People's Republic of China
| | - Hao Li
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, No.44 Wenhuaxi Road, Lixia District, Jinan, 250012, Shandong Province, People's Republic of China
- Shandong University Climate Change and Health Center, Jinan, 250012, Shandong Province, People's Republic of China
| | - Baofa Jiang
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, No.44 Wenhuaxi Road, Lixia District, Jinan, 250012, Shandong Province, People's Republic of China.
- Shandong University Climate Change and Health Center, Jinan, 250012, Shandong Province, People's Republic of China.
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9
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Chua PLC, Ng CFS, Tobias A, Seposo XT, Hashizume M. Associations between ambient temperature and enteric infections by pathogen: a systematic review and meta-analysis. Lancet Planet Health 2022; 6:e202-e218. [PMID: 35278387 DOI: 10.1016/s2542-5196(22)00003-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 01/04/2022] [Accepted: 01/05/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Numerous studies have quantified the associations between ambient temperature and enteric infections, particularly all-cause enteric infections. However, the temperature sensitivity of enteric infections might be pathogen dependent. Here, we sought to identify pathogen-specific associations between ambient temperature and enteric infections. METHODS We did a systematic review and meta-analysis by searching PubMed, Web of Science, and Scopus for peer-reviewed research articles published from Jan 1, 2000, to Dec 31, 2019, and also hand searched reference lists of included articles and excluded reviews. We included studies that quantified the effects of ambient temperature increases on common pathogen-specific enteric infections in humans. We excluded studies that expressed ambient temperature as a categorical or diurnal range, or in a standardised format. Two authors screened the search results, one author extracted data from eligible studies, and four authors verified the data. We obtained the overall risks by pooling the relative risks of enteric infection by pathogen for each 1°C temperature rise using random-effects modelling and robust variance estimation for the correlated effect estimates. Between-study heterogeneity was measured using I2, τ2, and Q-statistic. Publication bias was determined using funnel plot asymmetry and the trim-and-fill method. Differences among pathogen-specific pooled estimates were determined using subgroup analysis of taxa-specific meta-analysis. The study protocol was not registered but followed the PRISMA guidelines. FINDINGS We identified 2981 articles via database searches and 57 articles from scanning reference lists of excluded reviews and included articles, of which 40 were eligible for pathogen-specific meta-analyses. The overall increased risks of incidence per 1°C temperature rise, expressed as relative risks, were 1·05 (95% CI 1·04-1·07; I2 97%) for salmonellosis, 1·07 (1·04-1·10; I2 99%) for shigellosis, 1·02 (1·01-1·04; I2 98%) for campylobacteriosis, 1·05 (1·04-1·07; I2 36%) for cholera, 1·04 (1·01-1·07; I2 98%) for Escherichia coli enteritis, and 1·15 (1·07-1·24; I2 0%) for typhoid. Reduced risks per 1°C temperature increase were 0·96 (95% CI 0·90-1·02; I2 97%) for rotaviral enteritis and 0·89 (0·81-0·99; I2 96%) for noroviral enteritis. There was evidence of between-pathogen differences in risk for bacterial infections but not for viral infections. INTERPRETATION Temperature sensitivity of enteric infections can vary according to the enteropathogen causing the infection, particularly for bacteria. Thus, we encourage a pathogen-specific health adaptation approach, such as vaccination, given the possibility of increasingly warm temperatures in the future. FUNDING Japan Society for the Promotion of Science (Kakenhi) Grant-in-Aid for Scientific Research.
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Affiliation(s)
- Paul L C Chua
- Department of Global Health Policy, Graduate School of Medicine, University of Tokyo, Bunkyo-ku, Tokyo, Japan; Department of Global Health, School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan.
| | - Chris Fook Sheng Ng
- Department of Global Health Policy, Graduate School of Medicine, University of Tokyo, Bunkyo-ku, Tokyo, Japan; Department of Global Health, School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Aurelio Tobias
- Department of Global Health, School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan; Institute of Environmental Assessment and Water Research, Spanish Council for Scientific Research, Barcelona, Spain
| | - Xerxes T Seposo
- Department of Global Health, School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Masahiro Hashizume
- Department of Global Health Policy, Graduate School of Medicine, University of Tokyo, Bunkyo-ku, Tokyo, Japan
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10
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Talukder MR, Chu C, Rutherford S, Huang C, Phung D. The effect of high temperatures on risk of hospitalization in northern Vietnam. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:12128-12135. [PMID: 34561800 DOI: 10.1007/s11356-021-16601-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 09/14/2021] [Indexed: 06/13/2023]
Abstract
Vietnam is one Southeast Asian country most vulnerable to climate change. By the end of the twenty-first century, temperature could rise above 5°C across Vietnam according to the IPCC highest emission pathway scenario. However, research on the temperature-health effects from the geographically diverse sub-tropical northern region of Vietnam is limited making location specific health system preparedness difficult. This study examines the elevated temperature-hospitalization relationship for the seven provinces in northern Vietnam by using generalized linear and distributed lag models. A random-effect meta-analysis was used to estimate the pooled temperature hospitalizations risks for all causes, and for infectious, cardiovascular, and respiratory diseases. The pooled estimates show a significant effect of high temperature on hospitalizations for the same day (lag 0), when a 1°C increase in temperature above 24°C was significantly associated with 1.1% (95% CI, 0.9-1.4%) increased risk for all-cause hospital admissions, 2.4% (95% CI, 1.9-2.9%) increased risk for infectious disease admissions, 0.5% (95% CI, 0.1-0.9%) increased risk for cardiovascular disease admissions, and 1.3% (95% CI, 0.9-1.6%) increased risk for respiratory disease admissions. This research adds to the scant evidence examining heat and health morbidity effects in sub-tropical climates and has important implications for better understanding and preparing for the future impacts of climate change related temperature on Vietnam residents.
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Affiliation(s)
- Mohammad Radwanur Talukder
- Menzies School of Health Research, Royal Darwin Hospital, Darwin, NT, Australia.
- Baker Heart and Diabetes Institute, Alice Springs Hospital, Alice Springs, NT, Australia.
| | - Cordia Chu
- Centre for Environment and Population Health, School of Medicine and Dentistry, Griffith University, Brisbane, Australia
| | - Shannon Rutherford
- School of Medicine and Dentistry, Griffith University, Gold Coast, Australia
| | | | - Dung Phung
- Centre for Environment and Population Health, School of Medicine and Dentistry, Griffith University, Brisbane, Australia.
- School of Medicine and Dentistry, Griffith University, Gold Coast, Australia.
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11
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Colston JM, Zaitchik BF, Badr HS, Burnett E, Ali SA, Rayamajhi A, Satter SM, Eibach D, Krumkamp R, May J, Chilengi R, Howard LM, Sow SO, Jahangir Hossain M, Saha D, Imran Nisar M, Zaidi AKM, Kanungo S, Mandomando I, Faruque ASG, Kotloff KL, Levine MM, Breiman RF, Omore R, Page N, Platts‐Mills JA, Ashorn U, Fan Y, Shrestha PS, Ahmed T, Mduma E, Yori PP, Bhutta Z, Bessong P, Olortegui MP, Lima AAM, Kang G, Humphrey J, Prendergast AJ, Ntozini R, Okada K, Wongboot W, Gaensbauer J, Melgar MT, Pelkonen T, Freitas CM, Kosek MN. Associations Between Eight Earth Observation-Derived Climate Variables and Enteropathogen Infection: An Independent Participant Data Meta-Analysis of Surveillance Studies With Broad Spectrum Nucleic Acid Diagnostics. GEOHEALTH 2022; 6:e2021GH000452. [PMID: 35024531 PMCID: PMC8729196 DOI: 10.1029/2021gh000452] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 10/12/2021] [Accepted: 11/18/2021] [Indexed: 05/10/2023]
Abstract
Diarrheal disease, still a major cause of childhood illness, is caused by numerous, diverse infectious microorganisms, which are differentially sensitive to environmental conditions. Enteropathogen-specific impacts of climate remain underexplored. Results from 15 studies that diagnosed enteropathogens in 64,788 stool samples from 20,760 children in 19 countries were combined. Infection status for 10 common enteropathogens-adenovirus, astrovirus, norovirus, rotavirus, sapovirus, Campylobacter, ETEC, Shigella, Cryptosporidium and Giardia-was matched by date with hydrometeorological variables from a global Earth observation dataset-precipitation and runoff volume, humidity, soil moisture, solar radiation, air pressure, temperature, and wind speed. Models were fitted for each pathogen, accounting for lags, nonlinearity, confounders, and threshold effects. Different variables showed complex, non-linear associations with infection risk varying in magnitude and direction depending on pathogen species. Rotavirus infection decreased markedly following increasing 7-day average temperatures-a relative risk of 0.76 (95% confidence interval: 0.69-0.85) above 28°C-while ETEC risk increased by almost half, 1.43 (1.36-1.50), in the 20-35°C range. Risk for all pathogens was highest following soil moistures in the upper range. Humidity was associated with increases in bacterial infections and decreases in most viral infections. Several virus species' risk increased following lower-than-average rainfall, while rotavirus and ETEC increased with heavier runoff. Temperature, soil moisture, and humidity are particularly influential parameters across all enteropathogens, likely impacting pathogen survival outside the host. Precipitation and runoff have divergent associations with different enteric viruses. These effects may engender shifts in the relative burden of diarrhea-causing agents as the global climate changes.
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12
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Thwiny HT, Alsalih NJ, Saeed ZF, Al-Yasari AMR, Al-Saadawe MAA, Alsaadawi MAE. Prevalence and seasonal pattern of enteric viruses among hospitalized children with acute gastroenteritis in Samawah, Iraq. J Med Life 2022; 15:52-57. [PMID: 35186136 PMCID: PMC8852632 DOI: 10.25122/jml-2021-0158] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 10/27/2021] [Indexed: 11/09/2022] Open
Abstract
Almost all of the deaths happening under the age of 5 occur in the developed countries of Africa and Asia. This study included children admitted to the surgical care, aged 6 months to 5 years, who suffered from acute gastroenteritis and received treatment at Samawah, Iraq, from December 2018 to December 2019. Test results detected different types of rotaviruses, adenoviruses, astroviruses using ELISA. 56.6% of the infections were attributed to a viral pathogen. The main cause was attributed to rotavirus and adenovirus. The causative agents of diarrheal diseases in 28.1% of cases are rotaviruses, in 17.05% – adenoviruses, in 11.43% – astroviruses. Viral mono-infections are detected more often than mixed infections. Viral intestinal infections are characterized by seasonality and rise in the cold season, with a peak incidence of rotavirus infection in April, adenovirus infection in November, and astrovirus infection in December.
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Affiliation(s)
| | - Nawar Jasim Alsalih
- Division of Microbiology, College of Veterinary Medicine, Al-Muthanna University, Samawah, Iraq
| | - Zeayd Fadhil Saeed
- Nursing Department, Al Furat Al Awsat Technical University, Samawah, Iraq
| | | | | | - Mohenned Abd ElHussein Alsaadawi
- Department of Parasitology, College of Veterinary Medicine, Al-Muthanna University, Samawah, Iraq,Corresponding Author: Mohenned Abd ElHussein Alsaadawi, Department of Parasitology, College of Veterinary Medicine, Al-Muthanna University, Samawah, Iraq. E-mail:
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13
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Liang M, Ding X, Wu Y, Sun Y. Temperature and risk of infectious diarrhea: a systematic review and meta-analysis. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:68144-68154. [PMID: 34268683 DOI: 10.1007/s11356-021-15395-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 07/07/2021] [Indexed: 06/13/2023]
Abstract
Infectious diarrhea (ID) is an intestinal infectious disease including cholera, typhoid and paratyphoid fever, bacterial and amebic dysentery, and other infectious diarrhea. There are many studies that have explored the relationship between ambient temperature and the spread of infectious diarrhea, but the results are inconsistent. It is necessary to systematically evaluate the impact of temperature on the incidence of ID. This study was based on the PRISMA statement to report this systematic review. We conducted literature searches from CNKI, VIP databases, CBM, PubMed, Web of Science, Cochrane Library, and other databases. The number registered in PROSPERO is CRD42021225472. After searching a total of 4915 articles in the database and references, 27 studies were included. The number of people involved exceeded 7.07 million. The overall result demonstrated when the temperature rises, the risk of infectious diarrhea increases significantly (RRcumulative=1.42, 95%CI: 1.07-1.88, RRsingle-day=1.08, 95%CI: 1.03-1.14). Subgroup analysis found the effect of temperature on the bacillary dysentery group (RRcumulative=1.85, 95%CI: 1.48-2.30) and unclassified diarrhea groups (RRcumulative=1.18, 95%CI: 0.59-2.34). The result of the single-day effect subgroup analysis was similar to the result of the cumulative effect. And the sensitivity analysis proved that the results were robust. This systematic review and meta-analysis support that temperature will increase the risk of ID, which is helpful for ID prediction and early warning in the future.
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Affiliation(s)
- Mingming Liang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China
| | - Xiuxiu Ding
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China
| | - Yile Wu
- Department of Hospital Infection Prevention and Control, The Second Affiliated Hospital of Anhui Medical University, No. 678 Furong Road, Hefei, 230601, Anhui, People's Republic of China
| | - Yehuan Sun
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China.
- Center for Evidence-Based Practice, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China.
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14
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Smith DW, Islam M, Furst KE, Mustaree S, Crider YS, Akter N, Islam SA, Sultana S, Mahmud ZH, Rahman M, Mitch WA, Davis J. Chlorine taste can increase simulated exposure to both fecal contamination and disinfection byproducts in water supplies. WATER RESEARCH 2021; 207:117806. [PMID: 34768105 DOI: 10.1016/j.watres.2021.117806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 08/21/2021] [Accepted: 10/21/2021] [Indexed: 06/13/2023]
Abstract
Expanding drinking water chlorination could substantially reduce the burden of disease in low- and middle-income countries, but the taste of chlorinated water often impedes adoption. We developed a Monte Carlo simulation to estimate the effect of people's choice to accept or reject drinking water based on chlorine taste and their subsequent exposure to E. coli and trihalomethanes, a class of disinfection byproduct (DBP). The simulation used empirical data from Dhaka, Bangladesh, a megacity with endemic waterborne disease. We drew on published taste acceptability thresholds from Dhaka residents, measured residual chlorine and thermotolerant E. coli inactivation following the addition of six chlorine doses (0.25-3.0 mg/L as Cl2) to untreated piped water samples from 100 locations, and analyzed trihalomethane formation in 54 samples. A dose of 0.5 mg/L, 75% lower than the 2 mg/L dose typically recommended for household chlorination of low-turbidity waters, minimized overall exposure to E. coli. Doses of 1-2 mg/L maximized overall exposure to trihalomethanes. Accounting for chlorine taste aversion indicates that microbiological exposure increases and DBP exposure decreases above certain doses as a higher proportion of people reject chlorinated water in favor of untreated water. Taken together with findings from other modeling analyses, empirical studies, and field trials, our results suggest that taste acceptability should be a critical consideration in establishing chlorination dosing guidelines. Particularly when chlorination is first implemented in water supplies with low chlorine demand, lower doses than those generally recommended for household water treatment can help avoid taste-related objections while still meaningfully reducing contaminant exposure.
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Affiliation(s)
- Daniel W Smith
- Civil & Environmental Engineering, Stanford University, 473 Via Ortega, Y2E2 Building, Stanford, CA 94305, USA.
| | - Mahfuza Islam
- Environmental Interventions Unit, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka 1212, Bangladesh
| | - Kirin E Furst
- Civil & Environmental Engineering, Stanford University, 473 Via Ortega, Y2E2 Building, Stanford, CA 94305, USA
| | - Shobnom Mustaree
- Environmental Microbiology Laboratory, icddr,b, 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka 1212, Bangladesh
| | - Yoshika S Crider
- Energy & Resources Group and Division of Epidemiology & Biostatistics, University of California Berkeley, 310 Barrows Hall, Berkeley, CA 94720, USA
| | - Nazrin Akter
- Environmental Interventions Unit, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka 1212, Bangladesh
| | - Syed Anjerul Islam
- Environmental Interventions Unit, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka 1212, Bangladesh
| | - Sonia Sultana
- Environmental Interventions Unit, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka 1212, Bangladesh
| | - Zahid H Mahmud
- Environmental Microbiology Laboratory, icddr,b, 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka 1212, Bangladesh
| | - Mahbubur Rahman
- Environmental Interventions Unit, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka 1212, Bangladesh
| | - William A Mitch
- Civil & Environmental Engineering, Stanford University, 473 Via Ortega, Y2E2 Building, Stanford, CA 94305, USA
| | - Jennifer Davis
- Civil & Environmental Engineering, Stanford University, 473 Via Ortega, Y2E2 Building, Stanford, CA 94305, USA; Stanford Woods Institute for the Environment, Stanford University, 473 Via Ortega, Y2E2 Building, Stanford, CA 94305, USA
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15
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Childhood Rotavirus Infection Associated with Temperature and Particulate Matter 2.5 µm: A Retrospective Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312570. [PMID: 34886295 PMCID: PMC8656776 DOI: 10.3390/ijerph182312570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 11/22/2021] [Accepted: 11/24/2021] [Indexed: 11/18/2022]
Abstract
No study has ever investigated how ambient temperature and PM2.5 mediate rotavirus infection (RvI) in children. We used insurance claims data from Taiwan in 2006–2012 to evaluate the RvI characteristics in children aged ≤ 9. The RvI incidence rates were higher in colder months, reaching the highest in March (117.0/100 days), and then declining to the lowest in July (29.2/100 days). The age–sex-specific average incident cases were all higher in boys than in girls. Stratified analysis by temperature (<20, 20–24, and ≥25 °C) and PM2.5 (<17.5, 17.5–31.4, 31.5–41.9, and ≥42.0 μg/m3) showed that the highest incidence was 16.4/100 days at average temperatures of <20 °C and PM2.5 of 31.5–41.9 μg/m3, with Poisson regression analysis estimating an adjusted relative risk (aRR) of 1.26 (95% confidence interval (CI) = 1.11–1.43), compared to the incidence at the reference condition (<20 °C and PM2.5 < 17.5 μg/m3). As the temperature increased, the incident RvI cases reduced to 4.84 cases/100 days (aRR = 0.40, 95% CI = 0.35–0.45) when it was >25 °C with PM2.5 < 17.5 μg/m3, or to 9.84/100 days (aRR = 0.81, 95% CI = 0.77–0.93) when it was >25 °C with PM2.5 > 42 μg/m3. The seasonal RvI is associated with frequent indoor personal contact among children in the cold months. The association with PM2.5 could be an alternative assessment due to temperature inversion.
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16
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Singh N, Mall RK, Banerjee T, Gupta A. Association between climate and infectious diseases among children in Varanasi city, India: A prospective cohort study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 796:148769. [PMID: 34274660 DOI: 10.1016/j.scitotenv.2021.148769] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 06/25/2021] [Accepted: 06/27/2021] [Indexed: 06/13/2023]
Abstract
The effects of climate on infectious diseases could influence the health impacts, particularly in children in countries with the unfair socioeconomic conditions. In a prospective cohort of 461 children under 16-years-of-age in Varanasi city, India, the association of maximum-temperature (Tmax), relative humidity (RH), absolute humidity (AH), rainfall (RF), wind-speed (WS), and solar radiation (SLR) with prevalent infectious diseases (Diarrhea, Common cold and flu, Pneumonia, Skin-disease and Malaria, and Dengue) was examined using binomial-regression, adjusting for confounders and effect modifiers (socioeconomic-status; SES and child anthropometry), from January 2017 to January 2020. Attributable-fraction (AFx) was calculated due to each climate variable for each infectious disease. The result showed that each unit (1 °C) rise in Tmax was associated with an increase in diarrhea and skin-disease cases by 3.97% (95% CI: 2.92, 5.02) and 3.94% (95% CI: 1.67, 6.22), respectively, whereas, a unit decline in Tmax was associated with an increase in cold and flu cases by 3.87% (95% CI: 2.97, 4.76). Rise in humidity (RH) was associated with increase in cases of cold and flu by 0.73% (95% CI: 0.38, 1.08) and malaria (AH) by 7.19% (95% CI: 1.51, 12.87) while each unit (1 g/m3) decrease in humidity (AH) observed increase in pneumonia cases by 3.02% (95% CI: 0.75, 5.3). WS was positively associated with diarrhea (14.16%; 95% CI: 6.52, 21.80) and negatively with dengue (17.40%; 12.32, 22.48) cases for each unit change (kmph). RF showed marginal association while SLR showed no association at all. The combined AFx due to climatic factors ranged from 9 to 18%. SES and anthropometric parameters modified the climate-morbidity association in children with a high proportion of children found suffering from stunting, wasting, and underweight conditions. Findings from this study draw the attention of government and policymakers to prioritize effective measures for child health as the present association may increase disease burden in the future under climate-change scenarios in already malnourished paediatric population through multiple pathways.
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Affiliation(s)
- Nidhi Singh
- DST-Mahamana Centre of Excellence in Climate Change Research, Institute of Environment and Sustainable Development, Banaras Hindu University, Varanasi, India
| | - R K Mall
- DST-Mahamana Centre of Excellence in Climate Change Research, Institute of Environment and Sustainable Development, Banaras Hindu University, Varanasi, India.
| | - T Banerjee
- DST-Mahamana Centre of Excellence in Climate Change Research, Institute of Environment and Sustainable Development, Banaras Hindu University, Varanasi, India
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17
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Short-Term Impacts of Meteorology, Air Pollution, and Internet Search Data on Viral Diarrhea Infection among Children in Jilin Province, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111615. [PMID: 34770125 PMCID: PMC8582928 DOI: 10.3390/ijerph182111615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 10/29/2021] [Accepted: 11/03/2021] [Indexed: 01/08/2023]
Abstract
The influence of natural environmental factors and social factors on children’s viral diarrhea remains inconclusive. This study aimed to evaluate the short-term effects of temperature, precipitation, air quality, and social attention on children’s viral diarrhea in temperate regions of China by using the distribution lag nonlinear model (DLNM). We found that low temperature affected the increase in children’s viral diarrhea infection for about 1 week, while high temperature and heavy precipitation affected the increase in children’s viral diarrhea infection risk for at least 3 weeks. As the increase of the air pollution index may change the daily life of the public, the infection of children’s viral diarrhea can be restrained within 10 days, but the risk of infection will increase after 2 weeks. The extreme network search may reflect the local outbreak of viral diarrhea, which will significantly improve the infection risk. The above factors can help the departments of epidemic prevention and control create early warnings of high-risk outbreaks in time and assist the public to deal with the outbreak of children’s viral diarrhea.
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18
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Climate Change and Enteric Infections in the Canadian Arctic: Do We Know What’s on the Horizon? GASTROINTESTINAL DISORDERS 2021. [DOI: 10.3390/gidisord3030012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The Canadian Arctic has a long history with diarrheal disease, including outbreaks of campylobacteriosis, giardiasis, and salmonellosis. Due to climate change, the Canadian Arctic is experiencing rapid environmental transformation, which not only threatens the livelihood of local Indigenous Peoples, but also supports the spread, frequency, and intensity of enteric pathogen outbreaks. Advances in diagnostic testing and detection have brought to attention the current burden of disease due to Cryptosporidium, Campylobacter, and Helicobacter pylori. As climate change is known to influence pathogen transmission (e.g., food and water), Arctic communities need support in developing prevention and surveillance strategies that are culturally appropriate. This review aims to provide an overview of how climate change is currently and is expected to impact enteric pathogens in the Canadian Arctic.
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19
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Gopalkrishna V, Joshi MS, Chavan NA, Shinde MS, Walimbe AM, Sawant PM, Kalrao VR, Dhongade RK, Bavdekar AR. Prevalence and genetic diversity of gastroenteritis viruses in hospitalized children < 5 years of age in Maharashtra state, Western India, 2017-2019. J Med Virol 2021; 93:4805-4816. [PMID: 33990988 DOI: 10.1002/jmv.27085] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 04/07/2021] [Accepted: 05/11/2021] [Indexed: 12/16/2022]
Abstract
Four gastroenteritis viruses were responsible for 54% of the acute gastroenteritis (AGE) cases in children hospitalized between May 2017 and December 2019 in Pune city of Maharashtra state, Western India. The majority (79%) of the children were <2 years of age. The prevalence of Rotavirus A (RVA) was 30.5% followed by 14.3% for norovirus, 8.4% for adenovirus, and 5.5% for astrovirus. The severity of the disease was highest in patients with coinfections compared with the patients with a single infection or negative for all (p = 0.024). Genotyping analysis showed that the majority of the RVA-positive samples (66%) could be typed as G3P[8], 63.6% of the norovirus as GII.4 Sydney [P16], 44% of the adenovirus as type 41%, and 56.2% of the astrovirus as astrovirus type 1. The almost equivalent prevalence of rotavirus and nonrotaviruses and acute gastroenteritis (AGE) cases without known etiology in around 46% of the cases was noted in the present study. Our data highlight that after the recent inclusion of rotavirus vaccines as a part of the National Immunization schedule in India, conducting extensive AGE surveillance in children should include nonrotaviruses such as norovirus.
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Affiliation(s)
| | - Madhuri S Joshi
- Enteric Viruses Group, ICMR-National Institute of Virology, Pune, India
| | - Nutan A Chavan
- Enteric Viruses Group, ICMR-National Institute of Virology, Pune, India
| | - Manohar S Shinde
- Enteric Viruses Group, ICMR-National Institute of Virology, Pune, India
| | - Atul M Walimbe
- Bioinformatics Group, ICMR-National Institute of Virology, Pune, India
| | - Pradeep M Sawant
- Enteric Viruses Group, ICMR-National Institute of Virology, Pune, India
| | - Vijay R Kalrao
- Bharati Vidyapeeth Medical College and Hospital, Pune, India
| | - Ram K Dhongade
- Sant Dnyaneshwar Medical Foundation & Research Centre's Shaishav Clinic, Pune, India
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Bhandari D, Bi P, Dhimal M, Sherchand JB, Hanson-Easey S. Non-linear effect of temperature variation on childhood rotavirus infection: A time series study from Kathmandu, Nepal. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 748:141376. [PMID: 32798872 DOI: 10.1016/j.scitotenv.2020.141376] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 07/07/2020] [Accepted: 07/28/2020] [Indexed: 06/11/2023]
Abstract
INTRODUCTION This study aimed to investigate the effects of temperature variability on rotavirus infections among children under 5 years of age in Kathmandu, Nepal. Findings may inform infection control planning, especially in relation to the role of environmental factors in the transmission of rotavirus infection. METHODS Generalized linear Poisson regression equations with distributed lag non-linear model were fitted to estimate the effect of temperature (maximum, mean and minimum) variation on weekly counts of rotavirus infections among children under 5 years of age living in Kathmandu, Nepal, over the study period (2013 to 2016). Seasonality and long-term effects were adjusted in the model using Fourier terms up to the seventh harmonic and a time function, respectively. We further adjusted the model for the confounding effects of rainfall and relative humidity. RESULTS During the study period, a total of 733 cases of rotavirus infection were recorded, with a mean of 3 cases per week. We detected an inverse non-linear association between rotavirus infection and average weekly mean temperature, with increased risk (RR: 1.52; 95% CI: 1.08-2.15) at the lower quantile (10th percentile) and decreased risk (RR: 0.64; 95% CI: 0.43-0.95) at the higher quantile (75th percentile). Similarly, we detected an increased risk [(RR: 1.93; 95% CI: 1.40-2.65) and (RR: 1.42; 95% CI: 1.04-1.95)] of rotavirus infection for both maximum and minimum temperature at their lower quantile (10th percentile). We estimated that 344 (47.01%) cases of rotavirus diarrhoea among the children under 5 years of age were attributable to minimum temperature. The significant effect of temperature on rotavirus infection was not observed beyond lag zero week. CONCLUSION An inverse non-linear association was estimated between rotavirus incidence and all three indices of temperature, indicating a higher risk of infection during the cooler times of the year, and suggesting that transmission of rotavirus in Kathmandu, Nepal may be influenced by temperature.
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Affiliation(s)
- Dinesh Bhandari
- The University of Adelaide, School of Public Health, Adelaide, South Australia, Australia.
| | - Peng Bi
- The University of Adelaide, School of Public Health, Adelaide, South Australia, Australia.
| | | | | | - Scott Hanson-Easey
- The University of Adelaide, School of Public Health, Adelaide, South Australia, Australia.
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Msolo L, Iweriebor BC, Okoh AI. Rotavirus and Cryptosporidium pathogens as etiological proxies of gastroenteritis in some pastoral communities of the Amathole District Municipality, Eastern Cape, South Africa. BMC Res Notes 2020; 13:187. [PMID: 32228662 PMCID: PMC7106725 DOI: 10.1186/s13104-020-05024-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 03/17/2020] [Indexed: 01/04/2023] Open
Abstract
Objective Cryptosporidium and Rotavirus agents have been associated with severe diarrheal illnesses and remain as one of the worst human health burdens in most developing regions. In the present study, we evaluated the incidences of Cryptosporidium and Rotavirus in diarrheal stool specimens of patients in some rural settlements of the Amathole District Municipality in the Eastern Cape Province, South Africa. Stool specimens from diarrheal children and elderly individuals were collected from clinics and hospitals within the rural communities of the region over a period of 21 months (February 2017–November 2018). Commercial enzyme-immuno-assays were used for the detection of Rotavirus and Cryptosporidium pathogens from processed diarrheal stool specimens. Results A total of 53 fresh stool samples from diarrheal patients were screened and 36% of the diarrheagenic stool specimens tested positive for Group A Rotavirus antigens, while 5.7% tested positive for Cryptosporidium antigens. Our findings reveal Rotavirus and Cryptosporidium pathogens as important etiological agents associated with diarrheal illnesses in children, among the rural hinterlands of the Amathole District Municipality.
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Affiliation(s)
- Luyanda Msolo
- SA-MRC Microbial Water Quality Monitoring Centre, University of Fort Hare, Private Bag X1314, Alice, 5700, Eastern Cape, South Africa. .,Applied and Environmental Microbiology Research Group, Department of Biochemistry and Microbiology, University of Fort Hare, Alice, 5700, Eastern Cape, South Africa.
| | - Benson C Iweriebor
- Sefako Makgatho Health Sciences University, Ga-Rankuwa, Pretoria, Gauteng, South Africa
| | - Anthony I Okoh
- SA-MRC Microbial Water Quality Monitoring Centre, University of Fort Hare, Private Bag X1314, Alice, 5700, Eastern Cape, South Africa.,Applied and Environmental Microbiology Research Group, Department of Biochemistry and Microbiology, University of Fort Hare, Alice, 5700, Eastern Cape, South Africa
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Martinez PP, Mahmud AS, Yunus M, Faruque ASG, Ahmed T, Pascual M, Buckee CO. Tube Well Use as Protection Against Rotavirus Infection During the Monsoons in an Urban Setting. J Infect Dis 2020; 221:238-242. [PMID: 31776559 PMCID: PMC6936003 DOI: 10.1093/infdis/jiz436] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 08/21/2019] [Indexed: 11/25/2022] Open
Abstract
Rotavirus, a diarrheal pathogen spread via fecal-oral transmission, is typically characterized by a winter incidence peak in most countries. Unlike for cholera and other waterborne infections, the role of sanitation and socioeconomic factors on the spatial variation of rotavirus seasonality remains unclear. In the current study, we analyzed their association with rotavirus seasonality, specifically the odds of monsoon cases, across 46 locations from 2001 to 2012 in Dhaka. Drinking water from tube wells, compared to other sources, has a clear protective effect against cases during the monsoon, when flooding and water contamination are more likely. This finding supports a significant environmental component of transmission.
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Affiliation(s)
- Pamela P Martinez
- Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Ayesha S Mahmud
- Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
- Planetary Health Alliance, Harvard University, Cambridge, Massachusetts, USA
- Department of Demography, University of California, Berkeley, Berkeley, California, USA
| | - Mohammad Yunus
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - A S G Faruque
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Tahmeed Ahmed
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Mercedes Pascual
- Department of Ecology and Evolution, University of Chicago, Chicago, Illinois, USA
| | - Caroline O Buckee
- Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
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Wang H, Di B, Zhang T, Lu Y, Chen C, Wang D, Li T, Zhang Z, Yang Z. Association of meteorological factors with infectious diarrhea incidence in Guangzhou, southern China: A time-series study (2006-2017). THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 672:7-15. [PMID: 30954825 DOI: 10.1016/j.scitotenv.2019.03.330] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 03/10/2019] [Accepted: 03/21/2019] [Indexed: 05/13/2023]
Abstract
BACKGROUND Infectious diarrhea (ID) has exerted a severe disease burden on the world. The seasonal ID patterns suggest that meteorological factors (MFs) may influence ID incidence. The aim of this study was to evaluate the effect of MFs on ID, and to provide scientific evidence to the relevant health authorities for disease control and prevention. METHODS Data from ID cases and daily MFs (including mean temperature, diurnal temperature range, relative humidity, precipitation, atmospheric pressure, and wind velocity) in Guangzhou, Southern China from 2006 to 2017 were collected. Using a distributed lag non-linear model approach, we assessed the relationship between MFs and ID incidence. RESULTS Compared with the lowest ID risk values, low mean temperature, relative humidity, and precipitation were associated with an increased risk for ID, while higher diurnal temperature range and atmospheric pressure were also associated with increased risk. Maximum atmospheric pressure and minimum relative humidity had larger cumulative effects within 21 lag days, yielding relative risks of 133.11 (95% CI: 61.29-289.09) and 18.17 (14.42-22.89), respectively. The cumulative effect within 21 lag days of minimum temperature was higher than that from maximum temperature in all sub-populations. The cumulative effects of minimum temperature for men, teenagers, and young adults (10-29 years) were higher than those for other populations. CONCLUSIONS MFs should be considered when developing prevention and surveillance programs for ID. Special attention should be paid to vulnerable populations, such as teenagers and young adults.
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Affiliation(s)
- Hui Wang
- Guangzhou Centre for Disease Control and Prevention, Guangzhou, China
| | - Biao Di
- Guangzhou Centre for Disease Control and Prevention, Guangzhou, China
| | - TieJun Zhang
- Department of Nuclear Medicine, The first Affiliated Hospital of Baotou Medical College, Baotou 014010, China
| | - Yin Lu
- Guangzhou Centre for Disease Control and Prevention, Guangzhou, China
| | - Chun Chen
- Guangzhou Centre for Disease Control and Prevention, Guangzhou, China
| | - Dahu Wang
- Guangzhou Centre for Disease Control and Prevention, Guangzhou, China
| | - Tiegang Li
- Guangzhou Centre for Disease Control and Prevention, Guangzhou, China.
| | - Zhoubin Zhang
- Guangzhou Centre for Disease Control and Prevention, Guangzhou, China
| | - Zhicong Yang
- Guangzhou Centre for Disease Control and Prevention, Guangzhou, China
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Colston JM, Zaitchik B, Kang G, Peñataro Yori P, Ahmed T, Lima A, Turab A, Mduma E, Sunder Shrestha P, Bessong P, Peng RD, Black RE, Moulton LH, Kosek MN. Use of earth observation-derived hydrometeorological variables to model and predict rotavirus infection (MAL-ED): a multisite cohort study. Lancet Planet Health 2019; 3:e248-e258. [PMID: 31229000 PMCID: PMC6650544 DOI: 10.1016/s2542-5196(19)30084-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 04/08/2019] [Accepted: 04/09/2019] [Indexed: 05/25/2023]
Abstract
BACKGROUND Climate change threatens to undermine recent progress in reducing global deaths from diarrhoeal disease in children. However, the scarcity of evidence about how individual environmental factors affect transmission of specific pathogens makes prediction of trends under different climate scenarios challenging. We aimed to model associations between daily estimates of a suite of hydrometeorological variables and rotavirus infection status ascertained through community-based surveillance. METHODS For this analysis of multisite cohort data, rotavirus infection status was ascertained through community-based surveillance of infants in the eight-site MAL-ED cohort study, and matched by date with earth observation estimates of nine hydrometeorological variables from the Global Land Data Assimilation System: daily total precipitation volume (mm), daily total surface runoff (mm), surface pressure (mbar), wind speed (m/s), relative humidity (%), soil moisture (%), solar radiation (W/m2), specific humidity (kg/kg), and average daily temperatures (°C). Lag relationships, independent effects, and interactions were characterised by use of modified Poisson models and compared with and without adjustment for seasonality and between-site variation. Final models were created with stepwise selection of main effects and interactions and their validity assessed by excluding each site in turn and calculating Tjur's Coefficients of Determination. FINDINGS All nine hydrometeorological variables were significantly associated with rotavirus infection after adjusting for seasonality and between-site variation over multiple consecutive or non-consecutive lags, showing complex, often non-linear associations that differed by symptom status and showed considerable mutual interaction. The final models explained 5·9% to 6·2% of the variability in rotavirus infection in the pooled data and their predictions explained between 0·0% and 14·1% of the variability at individual study sites. INTERPRETATION These results suggest that the effect of climate on rotavirus transmission was mediated by four independent mechanisms: waterborne dispersal, airborne dispersal, virus survival on soil and surfaces, and host factors. Earth observation data products available at a global scale and at subdaily resolution can be combined with longitudinal surveillance data to test hypotheses about routes and drivers of transmission but showed little potential for making predictions in this setting. FUNDING Bill & Melinda Gates Foundation; Foundation for the National Institutes of Health, National Institutes of Health, Fogarty International Center; Sherrilyn and Ken Fisher Center for Environmental Infectious Diseases, Johns Hopkins School of Medicine; and NASA's Group on Earth Observations Work Programme.
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Affiliation(s)
- Josh M Colston
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Benjamin Zaitchik
- Department of Earth and Planetary Sciences, Johns Hopkins Krieger School of Arts and Sciences, Baltimore, MD, USA
| | | | - Pablo Peñataro Yori
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Tahmeed Ahmed
- Nutrition & Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Aldo Lima
- Federal University of Ceará, Fortaleza, Brazil
| | - Ali Turab
- Interactive Research and Development, Maternal and Child Health (MCH) Program, Karachi, Pakistan
| | - Esto Mduma
- Haydom Global Health Institute, Haydom, Tanzania
| | | | | | - Roger D Peng
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Robert E Black
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Lawrence H Moulton
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Margaret N Kosek
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
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Mertens A, Balakrishnan K, Ramaswamy P, Rajkumar P, Ramaprabha P, Durairaj N, Hubbard AE, Khush R, Colford JM, Arnold BF. Associations between High Temperature, Heavy Rainfall, and Diarrhea among Young Children in Rural Tamil Nadu, India: A Prospective Cohort Study. ENVIRONMENTAL HEALTH PERSPECTIVES 2019; 127:47004. [PMID: 30986088 PMCID: PMC6785227 DOI: 10.1289/ehp3711] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 02/21/2019] [Accepted: 03/19/2019] [Indexed: 05/19/2023]
Abstract
BACKGROUND The effects of weather on diarrhea could influence the health impacts of climate change. Children have the highest diarrhea incidence, especially in India, where many lack safe water and sanitation. OBJECTIVES In a prospective cohort of 1,284 children under 5 y of age from 900 households across 25 villages in rural Tamil Nadu, India, we examined whether high temperature and heavy rainfall was associated with increased all-cause diarrhea and water contamination. METHODS Seven-day prevalence of diarrhea was assessed monthly for up to 12 visits from January 2008 to April 2009, and hydrogen sulfide ([Formula: see text]) presence in drinking water, a fecal contamination indicator, was tested in a subset of households. We estimated associations between temperature and rainfall exposures and diarrhea and [Formula: see text] using binomial regressions, adjusting for potential confounders, random effects for village, and autoregressive-1 error terms for study week. RESULTS There were 259 cases of diarrhea. The prevalence of diarrhea during the 7 d before visits was 2.95 times higher (95% CI: 1.99, 4.39) when mean temperature in the week before the 7-d recall was in the hottest versus the coolest quartile of weekly mean temperature during 1 December 2007 to 15 April 2009. Diarrhea prevalence was 1.50 times higher when the 3 weeks before the diarrhea recall period included [Formula: see text] (vs. 0 d) with rainfall of [Formula: see text] (95% CI: 1.12, 2.02), and 2.60 times higher (95% CI: 1.55, 4.36) for heavy rain weeks following a 60-d dry period. The [Formula: see text] prevalence in household water was not associated with heavy rain prior to sample collection. CONCLUSIONS The results suggest that, in rural Tamil Nadu, heavy rainfall may wash pathogens that accumulate during dry weather into child contact. Higher temperatures were positively associated with diarrhea 1-3 weeks later. Our findings suggest that diarrhea morbidity could worsen under climate change without interventions to reduce enteric pathogen transmission through multiple pathways. https://doi.org/10.1289/EHP3711.
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Affiliation(s)
- Andrew Mertens
- 1 School of Public Health, University of California , Berkeley, California, USA
| | - Kalpana Balakrishnan
- 2 Department of Environmental and Health Engineering, Sri Ramachandra Medical College and Research Institute , Porur, Chennai, Tamil Nadu, India
| | - Padmavathi Ramaswamy
- 2 Department of Environmental and Health Engineering, Sri Ramachandra Medical College and Research Institute , Porur, Chennai, Tamil Nadu, India
| | - Paramasivan Rajkumar
- 2 Department of Environmental and Health Engineering, Sri Ramachandra Medical College and Research Institute , Porur, Chennai, Tamil Nadu, India
| | - Prabhakar Ramaprabha
- 2 Department of Environmental and Health Engineering, Sri Ramachandra Medical College and Research Institute , Porur, Chennai, Tamil Nadu, India
| | - Natesan Durairaj
- 2 Department of Environmental and Health Engineering, Sri Ramachandra Medical College and Research Institute , Porur, Chennai, Tamil Nadu, India
| | - Alan E Hubbard
- 1 School of Public Health, University of California , Berkeley, California, USA
| | - Ranjiv Khush
- 3 Aquaya Institute , San Francisco, California, USA
| | - John M Colford
- 1 School of Public Health, University of California , Berkeley, California, USA
| | - Benjamin F Arnold
- 1 School of Public Health, University of California , Berkeley, California, USA
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Godsmark CN, Irlam J, van der Merwe F, New M, Rother HA. Priority focus areas for a sub-national response to climate change and health: A South African provincial case study. ENVIRONMENT INTERNATIONAL 2019; 122:31-51. [PMID: 30573189 DOI: 10.1016/j.envint.2018.11.035] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 10/26/2018] [Accepted: 11/14/2018] [Indexed: 06/09/2023]
Abstract
INTRODUCTION The intersection of health and climate change is often absent or under-represented in sub-national government strategies. This analysis of the literature, using a new methodological framework, highlights priority focus areas for a sub-national government response to health and climate change, using the Western Cape (WC) province of South Africa as a case study. METHODS A methodological framework was created to conduct a review of priority focus areas relevant for sub-national governments. The framework encompassed the establishment of a Project Steering Group consisting of relevant, sub-national stakeholders (e.g. provincial officials, public and environmental health specialists and academics); an analysis of local climatic projections as well as an analysis of global, national and sub-national health risk factors and impacts. RESULTS Globally, the discussion of health and climate change adaptation strategies in sub-national, or provincial government is often limited. For the case study presented, multiple health risk factors were identified. WC climatic projections include a warmer and potentially drier future with an increased frequency and intensity of extreme weather events. WC government priority focus areas requiring further research on health risk factors include: population migration and environmental refugees, land use change, violence and human conflict and vulnerable groups. WC government priority focus areas for further research on health impacts include: mental ill-health, non-communicable diseases, injuries, poisonings (e.g. pesticides), food and nutrition insecurity-related diseases, water- and food-borne diseases and reproductive health. These areas are currently under-addressed, or not addressed at all, in the current provincial climate change strategy. CONCLUSIONS Sub-national government adaptation strategies often display limited discussion on the health and climate change intersect. The methodological framework presented in this case study can be globally utilized by other sub-national governments for decision-making and development of climate change and health adaptation strategies. Additionally, due to the broad range of sectoral issues identified, a primary recommendation from this study is that sub-national governments internationally should consider a "health and climate change in all policies" approach when developing adaptation and mitigation strategies to address climate change.
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Affiliation(s)
- Christie Nicole Godsmark
- Division of Environmental Health, School of Public Health and Family Medicine, University of Cape Town, South Africa
| | - James Irlam
- Division of Environmental Health, School of Public Health and Family Medicine, University of Cape Town, South Africa; Primary Health Care Directorate, University of Cape Town, South Africa
| | - Frances van der Merwe
- Department of Environmental Affairs and Development Planning, Western Cape Government, South Africa
| | - Mark New
- African Climate and Development Initiative, University of Cape Town, Cape Town, South Africa; School of International Development, University of East Anglia, Norwich, UK
| | - Hanna-Andrea Rother
- Division of Environmental Health, School of Public Health and Family Medicine, University of Cape Town, South Africa.
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Experience and Future Perceived Risk of Floods and Diarrheal Disease in Urban Poor Communities in Accra, Ghana. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15122830. [PMID: 30545071 PMCID: PMC6313637 DOI: 10.3390/ijerph15122830] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 11/28/2018] [Accepted: 12/04/2018] [Indexed: 01/05/2023]
Abstract
Diarrheal disease is a critical health condition in urban areas of developing countries due to increasing urbanization and its associated problems of sanitation and poor access to good drinking water. Increasing floods in cities have been linked to the risk of diarrheal disease. There are few studies that specifically link flooding with diarrhea diseases. This may be due to the fact that secondary data mainly hospital recorded cases, and not individual cases at the household level are used. Furthermore, of the few papers that consider the flood-diarrheal diseases nexus, none have considered risk perceptions in general, and more specifically, whether households that have experienced floods which resulted in a reported case of diarrhea, have higher perceived risks of future occurrences of the two phenomena compared to households that had different experiences. Yet, this is critical for the development of interventions that seek to increase protective behaviors and reduce the risk of contracting diarrhea. We surveyed 401 households in some selected urban poor communities in Accra, the capital of Ghana. Results show that households that experienced floods which resulted in a reported case of diarrhea, have higher perceived risk of future occurrence of the two phenomena compared to other households. We recommend public education that reduces the risk of exposure to flood and diarrhea through flood mitigation measures, including the construction of drains in communities and educating communities on good sanitation.
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Sadiq A, Bostan N, Yinda KC, Naseem S, Sattar S. Rotavirus: Genetics, pathogenesis and vaccine advances. Rev Med Virol 2018; 28:e2003. [PMID: 30156344 DOI: 10.1002/rmv.2003] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 07/02/2018] [Accepted: 07/07/2018] [Indexed: 01/27/2023]
Abstract
Since its discovery 40 years ago, rotavirus (RV) is considered to be a major cause of infant and childhood morbidity and mortality particularly in developing countries. Nearly every child in the world under 5 years of age is at the risk of RV infection. It is estimated that 90% of RV-associated mortalities occur in developing countries of Africa and Asia. Two live oral vaccines, RotaTeq (RV5, Merck) and Rotarix (RV1, GlaxoSmithKline) have been successfully deployed to scale down the disease burden in Europe and America, but they are less effective in Africa and Asia. In April 2009, the World Health Organization recommended the inclusion of RV vaccination in national immunization programs of all countries with great emphasis in developing countries. To date, 86 countries have included RV vaccines into their national immunization programs including 41 Global Alliance for Vaccines and Immunization eligible countries. The predominant RV genotypes circulating all over the world are G1P[8], G2P[4], G3P[8], G4P[8], and G9P[8], while G12[P6] and G12[P8] are emerging genotypes. On account of the segmented genome, RV shows an enormous genetic diversity that leads to the evolution of new genotypes that can influence the efficacy of current vaccines. The current need is for a global RV surveillance program to monitor the prevalence and antigenic variability of new genotypes to formulate future vaccine development planning. In this review, we will summarize the previous and recent insights into RV structure, classification, and epidemiology and current status of RV vaccination around the globe and will also cover the status of RV research and vaccine policy in Pakistan.
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Affiliation(s)
- Asma Sadiq
- Department of Biosciences, COMSATS University Islamabad, Islamabad, Pakistan
| | - Nazish Bostan
- Department of Biosciences, COMSATS University Islamabad, Islamabad, Pakistan
| | - Kwe Claude Yinda
- Rega Institute, Laboratory of Clinical and Epidemiological Virology, University of Leuven, Leuven, Belgium
| | - Saadia Naseem
- Department of Biosciences, COMSATS University Islamabad, Islamabad, Pakistan
| | - Sadia Sattar
- Department of Biosciences, COMSATS University Islamabad, Islamabad, Pakistan
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Colston JM, Ahmed T, Mahopo C, Kang G, Kosek M, de Sousa Junior F, Shrestha PS, Svensen E, Turab A, Zaitchik B. Evaluating meteorological data from weather stations, and from satellites and global models for a multi-site epidemiological study. ENVIRONMENTAL RESEARCH 2018; 165:91-109. [PMID: 29684739 PMCID: PMC6024078 DOI: 10.1016/j.envres.2018.02.027] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Revised: 02/07/2018] [Accepted: 02/19/2018] [Indexed: 05/03/2023]
Abstract
BACKGROUND Longitudinal and time series analyses are needed to characterize the associations between hydrometeorological parameters and health outcomes. Earth Observation (EO) climate data products derived from satellites and global model-based reanalysis have the potential to be used as surrogates in situations and locations where weather-station based observations are inadequate or incomplete. However, these products often lack direct evaluation at specific sites of epidemiological interest. METHODS Standard evaluation metrics of correlation, agreement, bias and error were applied to a set of ten hydrometeorological variables extracted from two quasi-global, commonly used climate data products - the Global Land Data Assimilation System (GLDAS) and Climate Hazards Group InfraRed Precipitation with Stations (CHIRPS) - to evaluate their performance relative to weather-station derived estimates at the specific geographic locations of the eight sites in a multi-site cohort study. These metrics were calculated for both daily estimates and 7-day averages and for a rotavirus-peak-season subset. Then the variables from the two sources were each used as predictors in longitudinal regression models to test their association with rotavirus infection in the cohort after adjusting for covariates. RESULTS The availability and completeness of station-based validation data varied depending on the variable and study site. The performance of the two gridded climate models varied considerably within the same location and for the same variable across locations, according to different evaluation criteria and for the peak-season compared to the full dataset in ways that showed no obvious pattern. They also differed in the statistical significance of their association with the rotavirus outcome. For some variables, the station-based records showed a strong association while the EO-derived estimates showed none, while for others, the opposite was true. CONCLUSION Researchers wishing to utilize publicly available climate data - whether EO-derived or station based - are advised to recognize their specific limitations both in the analysis and the interpretation of the results. Epidemiologists engaged in prospective research into environmentally driven diseases should install their own weather monitoring stations at their study sites whenever possible, in order to circumvent the constraints of choosing between distant or incomplete station data or unverified EO estimates.
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Affiliation(s)
- Josh M Colston
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Tahmeed Ahmed
- Nutrition & Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), Dhaka, Bangladesh.
| | - Cloupas Mahopo
- Department of Nutrition, University of Venda, South Africa.
| | | | - Margaret Kosek
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | | | - Prakash Sunder Shrestha
- Department of Child Health, Institute of Medicine of Tribhuvan University, Kathmandu, Nepal.
| | | | - Ali Turab
- Research and Development, Maternal and Child Health (MCH) Program, Karachi, Pakistan.
| | - Benjamin Zaitchik
- Department of Earth and Planetary Sciences, Johns Hopkins Krieger School of Arts and Sciences, Baltimore, MD, USA.
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Beyene H, Deressa W, Kumie A, Grace D. Spatial, temporal, and spatiotemporal analysis of under-five diarrhea in Southern Ethiopia. Trop Med Health 2018; 46:18. [PMID: 29991924 PMCID: PMC5987573 DOI: 10.1186/s41182-018-0101-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Accepted: 05/24/2018] [Indexed: 11/10/2022] Open
Abstract
Background Despite improvements in prevention efforts, childhood diarrhea remains a public health concern. However, there may be substantial variation influenced by place, time, and season. Description of diarrheal clusters in time and space and understanding seasonal patterns can improve surveillance and management. The present study investigated the spatial and seasonal distribution and purely spatial, purely temporal, and space-time clusters of childhood diarrhea in Southern Ethiopia. Methods The study was a retrospective analysis of data from the Health Management Information System (HMIS) under-five diarrheal morbidity reports from July 2011 to June 2017 in Sidama Zone. Annual diarrhea incidence at district level was calculated. Incidence rate calculation and seasonal trend analysis were performed. The Kulldorff SaTScan software with a discrete Poisson model was used to identify statistically significant special, temporal, and space-time diarrhea clusters. ArcGIS 10.1 was used to plot the maps. Results A total of 202,406 under-five diarrheal cases with an annual case of 5822 per 100,000 under-five population were reported. An increasing trend of diarrhea incidence was observed over the 6 years with seasonal variation picking between February and May. The highest incidence rate (135.8/1000) was observed in the year 2016/17 in Boricha district. One statistically significant most likely spatial cluster (Boricha district) and six secondary clusters (Malga, Hulla, Aleta Wondo, Shebedino, Loka Abaya, Dale, and Wondogenet) were identified. One statistically significant temporal cluster (LLR = 2109.93, p < 0.001) during December 2013 to May 2015 was observed in all districts. Statistically significant spatiotemporal primary hotspot was observed in December 2012 to January 2015 in Malga district with a likelihood ratio of 1214.67 and a relative risk of 2.03. First, second, third, and fourth secondary hotspots occurred from January 2012 to May 2012 in Loka Abaya, December 2011 in Bursa, from March to April 2014 in Gorchie, and March 2012 in Wonsho districts. Conclusion Childhood diarrhea was not distributed randomly over space and time and showed an overall increasing trend of seasonal variation peaking between February and May. The health department and other stakeholders at various levels need to plan targeted interventional activities at hotspot seasons and areas to reduce morbidity and mortality.
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Affiliation(s)
- Hunachew Beyene
- 1College of Health Sciences, Hawassa University, P.O. Box 1560, Hawassa, Ethiopia.,2School of Public Health, Addis Ababa University, P.O. Box 1176, Addis Ababa, Ethiopia
| | - Wakgari Deressa
- 2School of Public Health, Addis Ababa University, P.O. Box 1176, Addis Ababa, Ethiopia
| | - Abera Kumie
- 2School of Public Health, Addis Ababa University, P.O. Box 1176, Addis Ababa, Ethiopia
| | - Delia Grace
- 3International Livestock Research Institute, Box 30709, Nairobi, Kenya
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Hasan MA, Mouw C, Jutla A, Akanda AS. Quantification of Rotavirus Diarrheal Risk Due to Hydroclimatic Extremes Over South Asia: Prospects of Satellite-Based Observations in Detecting Outbreaks. GEOHEALTH 2018; 2:70-86. [PMID: 32159010 PMCID: PMC7007079 DOI: 10.1002/2017gh000101] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 12/03/2017] [Accepted: 12/05/2017] [Indexed: 05/25/2023]
Abstract
Rotavirus is the most common cause of diarrheal disease among children under 5. Especially in South Asia, rotavirus remains the leading cause of mortality in children due to diarrhea. As climatic extremes and safe water availability significantly influence diarrheal disease impacts in human populations, hydroclimatic information can be a potential tool for disease preparedness. In this study, we conducted a multivariate temporal and spatial assessment of 34 climate indices calculated from ground and satellite Earth observations to examine the role of temperature and rainfall extremes on the seasonality of rotavirus transmission in Bangladesh. We extracted rainfall data from the Global Precipitation Measurement and temperature data from the Moderate Resolution Imaging Spectroradiometer sensors to validate the analyses and explore the potential of a satellite-based seasonal forecasting model. Our analyses found that the number of rainy days and nighttime temperature range from 16°C to 21°C are particularly influential on the winter transmission cycle of rotavirus. The lower number of wet days with suitable cold temperatures for an extended time accelerates the onset and intensity of the outbreaks. Temporal analysis over Dhaka also suggested that water logging during monsoon precipitation influences rotavirus outbreaks during a summer transmission cycle. The proposed model shows lag components, which allowed us to forecast the disease outbreaks 1 to 2 months in advance. The satellite data-driven forecasts also effectively captured the increased vulnerability of dry-cold regions of the country, compared to the wet-warm regions.
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Affiliation(s)
- M. Alfi Hasan
- Civil and Environmental EngineeringUniversity of Rhode IslandKingstonRIUSA
| | - Colleen Mouw
- Graduate School of OceanographyUniversity of Rhode IslandNarragansettRIUSA
| | - Antarpreet Jutla
- Civil and Environmental EngineeringWest Virginia UniversityMorgantownWVUSA
| | - Ali S. Akanda
- Civil and Environmental EngineeringUniversity of Rhode IslandKingstonRIUSA
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Viral Gastroenteritis. PRINCIPLES AND PRACTICE OF PEDIATRIC INFECTIOUS DISEASES 2018. [PMCID: PMC7151782 DOI: 10.1016/b978-0-323-40181-4.00056-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Das SK, Chisti MJ, Sarker MHR, Das J, Ahmed S, Shahunja KM, Nahar S, Gibbons N, Ahmed T, Faruque ASG, Rahman M, J Fuchs G, Al Mamun A, John Baker P. Long-term impact of changing childhood malnutrition on rotavirus diarrhoea: Two decades of adjusted association with climate and socio-demographic factors from urban Bangladesh. PLoS One 2017; 12:e0179418. [PMID: 28877163 PMCID: PMC5587254 DOI: 10.1371/journal.pone.0179418] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Accepted: 05/30/2017] [Indexed: 12/29/2022] Open
Abstract
Background There is strong association between childhood rotavirus, diarrhoea, climate factors and malnutrition. Conversely, a significant nutritional transition (reduced under-nutrition) with a concurrent increasing trend of rotavirus infection in last decade was also observed among under 5 children, especially in developing countries including Bangladesh. Considering the pathophysiology of rotavirus, there might be an interaction of this nutrition transition which plays a pivotal role in increasing rotavirus infection in addition to climate and other man-made factors in urban areas such as Dhaka, Bangladesh. Methods Relevant monthly data from 1993–2012 were extracted from the archive of the Diarrhoeal Disease Surveillance System of icddr, b and linked with data collected from the Dhaka station of the Bangladesh Meteorological Department (mean temperature, rainfall, sea level pressure and humidity). Seasonal autoregressive integrated moving average time series models were deployed to determine the association between the monthly proportion of rotavirus infection and underweight, stunting and wasting adjusting for climate, socio-demographic and sanitation factors. Finding The proportion of rotavirus cases among all causes diarrhoea increased from 20% in 1993 to 43% in 2012 (Chi squared for trend p = 0.010). In contrast, underweight, stunting and wasting decreased from 59%-29% (p<0.001); 53%-21% (p<0.001) and 32%-22% (p<0.001) respectively over the same period. Mean ambient temperature increased from 25.76°C-26.62°C (p = 0.07); mean rainfall, sea level pressure and mean humidity decreased from 234.92–111.75 mm (p = 0.5), 1008.30–1006.61 mm of hg (p = 0.02) and 76.63%-70.26% (p<0.001), respectively. In the adjusted model, a decrease in monthly proportion of underweight [coef.: -0.189 (95% CI:-0.376, -0.003)] and wasting [-0.265 (-0.455, -0.075)] were significantly and inversely associated with rotavirus infection. However, an inverse but insignificant association was observed for stunting [-0.070 (-0.249, 0.109)]. Interpretation The reduction of acute childhood malnutrition is significantly associated with increasing rotavirus diarrhoea among under-5 children. Thus mass vaccination in addition to interventions directed at man-made modifiable predictors for prevention and control is warranted.
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Affiliation(s)
- Sumon Kumar Das
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
- Institute for Social Science Research, The University of Queensland, Brisbane, Australia
- * E-mail: ,
| | - Mohammod Jobayer Chisti
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | | | - Jui Das
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Shawnawaz Ahmed
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - K. M. Shahunja
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | | | - Nora Gibbons
- University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States of America
| | - Tahmeed Ahmed
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Abu Syed Golam Faruque
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Mustafizur Rahman
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - George J Fuchs
- University of Kentucky College of Medicine, Lexington, United States of America
| | - Abdullah Al Mamun
- Institute for Social Science Research, The University of Queensland, Brisbane, Australia
| | - Peter John Baker
- School of Public Health, The University of Queensland, Brisbane, Australia
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Ouedraogo N, Ngangas SMT, Bonkoungou IJO, Tiendrebeogo AB, Traore KA, Sanou I, Traore AS, Barro N. Temporal distribution of gastroenteritis viruses in Ouagadougou, Burkina Faso: seasonality of rotavirus. BMC Public Health 2017; 17:274. [PMID: 28327111 PMCID: PMC5359802 DOI: 10.1186/s12889-017-4161-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Accepted: 03/02/2017] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Acute gastroenteritis is one of the most common diseases among children and adults, and continues to cause a major problem of public health in Burkina Faso. The temporal pattern of rotavirus, norovirus, sapovirus, astrovirus, adenovirus and Aichivirus A was studied by examining prevalence of gastroenteritis viruses in association with meteorological variables in Ouagadougou, Burkina Faso. METHODS Stool samples from 263 children under 5 years of age and 170 older children patients, adolescent and adults with gastroenteritis were collected in Ouagadougou, Burkina Faso from November 2011 to September 2012. Enteric viruses were detected using real-time or end-point (RT-) PCR. Temperature, humidity and monthly rainfall were recorded from the National Meteorological Direction. Categorical data were compared by Chi-square tests and the effect of weather variables and monthly prevalence were analyzed using Pearson Correlation Coefficient test. RESULTS The prevalence of rotavirus infections was significantly higher in the dry season (Season S1) compared to the wet season (season S2) (p = 0.03) among the population of children under 5 years of age. No statistically significant difference was observed regarding other gastroenteritis viruses comparing the dry season and the wet season. Positive cases of rotavirus, norovirus, adenovirus and sapovirus in children under 5 years of age were correlated with temperature (r = -0.68, p = 0.01; r = -0.74, p < 0.001; r = -0.68, p = 0.01; r = -0.65, p = 0.02, respectively) and only rotavirus, adenovirus and astrovirus were correlated with relative humidity (r = -0.61, p = 0.04; r = -0.54, p = 0.08; r = -0.51, p = 0.1 respectively). No correlation was observed with rainfall. In older children, adolescent and adults patients, rotavirus and norovirus correlated with relative humidity (r = -0.58, p = 0.05; r = 0.54, p = 0.08 respectively), but, no correlation was observed between the temperature and the rainfall. CONCLUSION This study extends knowledge on the monthly fluctuations on the prevalence of viral gastroenteritis. These results can provide valuable information necessary to alert health care providers when a period of infection in the community is likely to occur. The transmission of these viruses in Burkina Faso could depends on multiple factors including climatic variables.
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Affiliation(s)
- Nafissatou Ouedraogo
- Laboratoire de Biologie Moléculaire, d'Epidémiologie et de Surveillance des Bactéries et Virus Transmis par les Aliments, Centre de Recherche en Sciences Biologiques Alimentaires et Nutritionnelles (CRSBAN), Université Ouaga I Joseph KI-ZERBO, Ouagadougou, Burkina Faso.
| | - Stephanie Moustapha Tomba Ngangas
- Laboratoire de Biologie Moléculaire, d'Epidémiologie et de Surveillance des Bactéries et Virus Transmis par les Aliments, Centre de Recherche en Sciences Biologiques Alimentaires et Nutritionnelles (CRSBAN), Université Ouaga I Joseph KI-ZERBO, Ouagadougou, Burkina Faso
| | - Isidore Juste Ouindguèta Bonkoungou
- Laboratoire de Biologie Moléculaire, d'Epidémiologie et de Surveillance des Bactéries et Virus Transmis par les Aliments, Centre de Recherche en Sciences Biologiques Alimentaires et Nutritionnelles (CRSBAN), Université Ouaga I Joseph KI-ZERBO, Ouagadougou, Burkina Faso.,Laboratoire National de Santé Publique, Direction de la Biologie médicale (DBM), Ouagadougou, Burkina Faso
| | - Aissatou Bénéwendé Tiendrebeogo
- Laboratoire de Biologie Moléculaire, d'Epidémiologie et de Surveillance des Bactéries et Virus Transmis par les Aliments, Centre de Recherche en Sciences Biologiques Alimentaires et Nutritionnelles (CRSBAN), Université Ouaga I Joseph KI-ZERBO, Ouagadougou, Burkina Faso
| | - Kuan Abdoulaye Traore
- Laboratoire de Biologie Moléculaire, d'Epidémiologie et de Surveillance des Bactéries et Virus Transmis par les Aliments, Centre de Recherche en Sciences Biologiques Alimentaires et Nutritionnelles (CRSBAN), Université Ouaga I Joseph KI-ZERBO, Ouagadougou, Burkina Faso
| | - Idrissa Sanou
- Laboratoire de Bactériologie-Virologie de l'Hôpital National BLAISE COMPAORE, Ouagadougou, Burkina Faso.,UFR Sciences de la Santé, Université Ouaga I Joseph KI ZERBO, Ouagadougou, Burkina Faso
| | - Alfred Sababénédjo Traore
- Laboratoire de Biologie Moléculaire, d'Epidémiologie et de Surveillance des Bactéries et Virus Transmis par les Aliments, Centre de Recherche en Sciences Biologiques Alimentaires et Nutritionnelles (CRSBAN), Université Ouaga I Joseph KI-ZERBO, Ouagadougou, Burkina Faso
| | - Nicolas Barro
- Laboratoire de Biologie Moléculaire, d'Epidémiologie et de Surveillance des Bactéries et Virus Transmis par les Aliments, Centre de Recherche en Sciences Biologiques Alimentaires et Nutritionnelles (CRSBAN), Université Ouaga I Joseph KI-ZERBO, Ouagadougou, Burkina Faso
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Phung D, Chu C, Rutherford S, Nguyen HLT, Luong MA, Do CM, Huang C. Heavy rainfall and risk of infectious intestinal diseases in the most populous city in Vietnam. THE SCIENCE OF THE TOTAL ENVIRONMENT 2017; 580:805-812. [PMID: 28012659 DOI: 10.1016/j.scitotenv.2016.12.027] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Revised: 11/13/2016] [Accepted: 12/03/2016] [Indexed: 05/13/2023]
Abstract
The association between heavy rainfall and infectious intestinal diseases (IID) has not been well described and little research has been conducted in developing countries. This study examines the association between heavy rainfall and hospital admissions for IID in Ho Chi Minh City, the most populous city in Vietnam. An interrupted time-series method was used to examine the effect of each individual heavy rainfall event (HRE) on IID. The percentage changes in post-HRE level and trends of IID were estimated for 30days following each HRE. Then a random-effect meta-analysis was used to quantify the pooled estimate of effect sizes of all HREs on IID. The pooled estimates were calculated over a 21day lag period. The effects of a HRE on IID varied across individual HREs. The pooled estimates indicate that the levels of IID following a HRE increased from 7.3% to 13.5% for lags from 0 to 21days, however statistically significant increases were only observed for lags from 4 to 6days (13.5%, 95%CI: 1.4-25.4; 13.3%, 95%CI: 1.5-25.0; and 12.9%, 95%CI: 1.6-24.1 respectively). An average decrease of 0.11% (95%CI: -0.55-0.33) per day was observed for the post-HRE trend. This finding has important implications for the projected impacts on residents living in this city which is highly vulnerable to increased heavy rainfall associated with climate change. Adaptation and intervention programs should be developed to prevent this additional burden of disease and to protect residents from the adverse impacts of extreme weather events.
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Affiliation(s)
- Dung Phung
- Centre for Environment and Population Health, Griffith University, Australia; School of Public Health, Sun Yat-sen University, China.
| | - Cordia Chu
- Centre for Environment and Population Health, Griffith University, Australia
| | - Shannon Rutherford
- Centre for Environment and Population Health, Griffith University, Australia
| | | | - Mai Anh Luong
- Health Environment Management Agency, Vietnam Ministry of Health, Viet Nam
| | - Cuong Manh Do
- Health Environment Management Agency, Vietnam Ministry of Health, Viet Nam
| | - Cunrui Huang
- School of Public Health, Sun Yat-sen University, China; Centre for Environment and Population Health, Griffith University, Australia.
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Boithias L, Choisy M, Souliyaseng N, Jourdren M, Quet F, Buisson Y, Thammahacksa C, Silvera N, Latsachack K, Sengtaheuanghoung O, Pierret A, Rochelle-Newall E, Becerra S, Ribolzi O. Hydrological Regime and Water Shortage as Drivers of the Seasonal Incidence of Diarrheal Diseases in a Tropical Montane Environment. PLoS Negl Trop Dis 2016; 10:e0005195. [PMID: 27935960 PMCID: PMC5147807 DOI: 10.1371/journal.pntd.0005195] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Accepted: 11/17/2016] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND The global burden of diarrhea is a leading cause of morbidity and mortality worldwide. In montane areas of South-East Asia such as northern Laos, recent changes in land use have induced increased runoff, soil erosion and in-stream suspended sediment loads, and potential pathogen dissemination. To our knowledge, few studies have related diarrhea incidences to catchment scale hydrological factors such as river discharge, and loads of suspended sediment and of Fecal Indicator Bacteria (FIB) such as Escherichia coli, together with sociological factors such as hygiene practices. We hypothesized that climate factors combined with human behavior control diarrhea incidence, either because higher rainfall, leading to higher stream discharges, suspended sediment loads and FIB counts, are associated with higher numbers of reported diarrhea cases during the rainy season, or because water shortage leads to the use of less safe water sources during the dry season. Using E. coli as a FIB, the objectives of this study were thus (1) to characterize the epidemiological dynamics of diarrhea in Northern Laos, and (2) to identify which hydro-meteorological and sociological risk factors were associated with diarrhea epidemics. METHODS Considering two unconnected river catchments of 22 and 7,448 km2, respectively, we conducted a retrospective time series analysis of meteorological variables (rainfall, air temperature), hydrological variables (discharge, suspended sediments, FIB counts, water temperature), and the number of diarrheal disease cases reported at 6 health centers located in the 5 southern districts of the Luang Prabang Province, Lao PDR. We also examined the socio-demographic factors potentially affecting vulnerability to the effect of the climate factors, such as drinking water sources, hygiene habits, and recreational water exposure. RESULTS Using thus a mixed methods approach, we found E. coli to be present all year long (100-1,000 Most Probable Number or MPN 100 mL-1) indicating that fecal contamination is ubiquitous and constant. We found that populations switch their water supply from wells to surface water during drought periods, the latter of which appear to be at higher risk of bacterial contamination than municipal water fountains. We thus found that water shortage in the Luang Prabang area triggers diarrhea peaks during the dry and hot season and that rainfall and aquifer refill ends the epidemic during the wet season. The temporal trends of reported daily diarrhea cases were generally bimodal with hospital admissions peaking in February-March and later in May-July. Annual incidence rates were higher in more densely populated areas and mostly concerned the 0-4 age group and male patients. CONCLUSIONS We found that anthropogenic drivers, such as hygiene practices, were at least as important as environmental drivers in determining the seasonal pattern of a diarrhea epidemic. For diarrheal disease risk monitoring, discharge or groundwater level can be considered as relevant proxies. These variables should be monitored in the framework of an early warning system provided that a tradeoff is found between the size of the monitored catchment and the frequency of the measurement.
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Affiliation(s)
- Laurie Boithias
- Géosciences Environnement Toulouse, Université de Toulouse, CNES, CNRS, IRD, UPS, Toulouse, France
| | - Marc Choisy
- MIVEGEC (UMR CNRS-IRD-University of Montpellier), Montpellier, France
- Oxford University Clinical Research Unit, Hanoi, Vietnam
| | - Noy Souliyaseng
- Institut de la Francophonie pour la Médecine Tropicale (IFMT), Vientiane, Lao PDR
| | | | - Fabrice Quet
- Institut de la Francophonie pour la Médecine Tropicale (IFMT), Vientiane, Lao PDR
| | - Yves Buisson
- Institut de la Francophonie pour la Médecine Tropicale (IFMT), Vientiane, Lao PDR
| | - Chanthamousone Thammahacksa
- IRD, Department of Agricultural Land Management (DALaM), Ban Nogviengkham, Xaythany District, Vientiane, Lao PDR
| | - Norbert Silvera
- IRD-iEES-Paris, Department of Agricultural Land Management (DALaM), Ban Nogviengkham, Xaythany District, Vientiane, Lao PDR
- iEES-Paris (IRD-Sorbonne Universités-UPMC-CNRS-INRA-UDD-UPEC), Université Pierre et Marie Curie (UPMC), 4 place Jussieu, Paris, France
| | - Keooudone Latsachack
- IRD, Department of Agricultural Land Management (DALaM), Ban Nogviengkham, Xaythany District, Vientiane, Lao PDR
| | - Oloth Sengtaheuanghoung
- Department of Agricultural Land Management (DALaM), Ban Nogviengkham, Xaythany District, Vientiane, Lao PDR
| | - Alain Pierret
- IRD-iEES-Paris, Department of Agricultural Land Management (DALaM), Ban Nogviengkham, Xaythany District, Vientiane, Lao PDR
- iEES-Paris (IRD-Sorbonne Universités-UPMC-CNRS-INRA-UDD-UPEC), Université Pierre et Marie Curie (UPMC), 4 place Jussieu, Paris, France
| | - Emma Rochelle-Newall
- iEES-Paris (IRD-Sorbonne Universités-UPMC-CNRS-INRA-UDD-UPEC), Université Pierre et Marie Curie (UPMC), 4 place Jussieu, Paris, France
| | - Sylvia Becerra
- Géosciences Environnement Toulouse, Université de Toulouse, CNES, CNRS, IRD, UPS, Toulouse, France
| | - Olivier Ribolzi
- Géosciences Environnement Toulouse, Université de Toulouse, CNES, CNRS, IRD, UPS, Toulouse, France
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Temperature Variability and Occurrence of Diarrhoea in Children under Five-Years-Old in Cape Town Metropolitan Sub-Districts. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13090859. [PMID: 27589772 PMCID: PMC5036692 DOI: 10.3390/ijerph13090859] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Revised: 08/10/2016] [Accepted: 08/17/2016] [Indexed: 01/15/2023]
Abstract
This paper describes the relationship between temperature change and diarrhoea in under five-year-old children in the Cape Town Metropolitan Area (CTMA) of South Africa. The study used climatic and aggregated surveillance diarrhoea incidence data of two peak periods of seven months each over two consecutive years. A Poisson regression model and a lagged Poisson model with autocorrelation was performed to test the relationship between climatic parameters (minimum and maximum temperature) and incidence of diarrhoea. In total, 58,617 cases of diarrhoea occurred in the CTMA, which is equivalent to 8.60 cases per 100 population under five years old for the study period. The mixed effect overdispersed Poisson model showed that a cluster adjusted effect of an increase of 5 °C in minimum and maximum temperature results in a 40% (Incidence risk ratio IRR: 1.39, 95% CI 1.31–1.48) and 32% (IRR: 1.32, 95% CI: 1.22–1.41) increase in incident cases of diarrhoea, respectively, for the two periods studied. Autocorrelation of one-week lag (Autocorrelation AC 1) indicated that a 5 °C increase in minimum and maximum temperature led to 15% (IRR: 1.46, 95% CI: 1.09–1.20) and 6% (IRR: 1.06, 95% CI: 1.01–1.12) increase in diarrhoea cases, respectively. In conclusion, there was an association between an increase in minimum and maximum temperature, and the rate at which diarrhoea affected children under the age of five years old in the Cape Town Metropolitan Area. This finding may have implications for the effects of global warming and requires further investigation.
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Phung D, Guo Y, Nguyen HTL, Rutherford S, Baum S, Chu C. High temperature and risk of hospitalizations, and effect modifying potential of socio-economic conditions: A multi-province study in the tropical Mekong Delta Region. ENVIRONMENT INTERNATIONAL 2016; 92-93:77-86. [PMID: 27060418 DOI: 10.1016/j.envint.2016.03.034] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2015] [Revised: 03/01/2016] [Accepted: 03/25/2016] [Indexed: 05/22/2023]
Abstract
The Mekong Delta Region (MDR) in Vietnam is highly vulnerable to extreme weather related to climate change. However there have been hardly any studies on temperature-hospitalization relationships. The objectives of this study were to examine temperature-hospitalization relationship and to evaluate the effects of socio-economic factors on the risk of hospitalizations due to high temperature in the MDR. The Generalized Linear and Distributed Lag Models were used to examine hospitalizations for extreme temperature for each of the 13 provinces in the MDR. A random-effects meta-analysis was used to estimate the pooled risk for all causes, and for infectious, cardiovascular, and respiratory diseases sorted by sex and age groups. Random-effects meta-regression was used to evaluate the effect of socio-economic factors on the temperature-hospitalization association. For 1°C increase in average temperature, the risk of hospital admissions increased by 1.3% (95% CI, 0.9-1.8) for all causes, 2.2% (95% CI, 1.4-3.1) for infectious diseases, and 1.1% (95% CI, 0.5-1.7) for respiratory diseases. However the result was inconsistent for cardiovascular diseases. Meta-regression showed population density, poverty rate, and illiteracy rate increased the risk of hospitalization due to high temperature, while higher household income, houses using safe water, and houses using hygienic toilets reduced this risk. In the MDR, high temperatures have a significant impact on hospitalizations for infectious and respiratory diseases. Our findings have important implications for better understanding the future impacts of climate change on residents of the MDR. Adaptation programs that consider the risk and protective factors should be developed to protect residents from extreme temperature conditions.
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Affiliation(s)
- Dung Phung
- Centre for Environment and Population Health, Griffith University, Australia.
| | - Yuming Guo
- Division of Epidemiology and Biostatistics, School of Public Health, University of Queensland, Australia
| | - Huong T L Nguyen
- Health Environment Management Agency, Ministry of Health, Viet Nam
| | - Shannon Rutherford
- Centre for Environment and Population Health, Griffith University, Australia
| | - Scott Baum
- Centre for Environment and Population Health, Griffith University, Australia
| | - Cordia Chu
- Centre for Environment and Population Health, Griffith University, Australia
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Levy K, Woster AP, Goldstein RS, Carlton EJ. Untangling the Impacts of Climate Change on Waterborne Diseases: a Systematic Review of Relationships between Diarrheal Diseases and Temperature, Rainfall, Flooding, and Drought. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2016; 50:4905-22. [PMID: 27058059 PMCID: PMC5468171 DOI: 10.1021/acs.est.5b06186] [Citation(s) in RCA: 195] [Impact Index Per Article: 24.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
Global climate change is expected to affect waterborne enteric diseases, yet to date there has been no comprehensive, systematic review of the epidemiological literature examining the relationship between meteorological conditions and diarrheal diseases. We searched PubMed, Embase, Web of Science, and the Cochrane Collection for studies describing the relationship between diarrheal diseases and four meteorological conditions that are expected to increase with climate change: ambient temperature, heavy rainfall, drought, and flooding. We synthesized key areas of agreement and evaluated the biological plausibility of these findings, drawing from a diverse, multidisciplinary evidence base. We identified 141 articles that met our inclusion criteria. Key areas of agreement include a positive association between ambient temperature and diarrheal diseases, with the exception of viral diarrhea and an increase in diarrheal disease following heavy rainfall and flooding events. Insufficient evidence was available to evaluate the effects of drought on diarrhea. There is evidence to support the biological plausibility of these associations, but publication bias is an ongoing concern. Future research evaluating whether interventions, such as improved water and sanitation access, modify risk would further our understanding of the potential impacts of climate change on diarrheal diseases and aid in the prioritization of adaptation measures.
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Affiliation(s)
- Karen Levy
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
- Address correspondence to: Karen Levy, Department of Environmental Health, Emory University Rollins School of Public Health, 1518 Clifton Road NE, Atlanta, GA 30322. Telephone: 404.727.4502. Fax: 404.727.8744.
| | - Andrew P. Woster
- Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado, Aurora, Colorado, USA
| | - Rebecca S. Goldstein
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Elizabeth J. Carlton
- Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado, Aurora, Colorado, USA
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Burkart K, Kinney P. Is precipitation a predictor of mortality in Bangladesh? A multi-stratified analysis in a South Asian monsoon climate. THE SCIENCE OF THE TOTAL ENVIRONMENT 2016; 553:458-465. [PMID: 26933968 DOI: 10.1016/j.scitotenv.2016.01.206] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Revised: 01/29/2016] [Accepted: 01/29/2016] [Indexed: 06/05/2023]
Abstract
While numerous studies have assessed the association between temperature and mortality in various locations, few have addressed the relationship between precipitation and mortality. Given the high amounts of rainfall in many tropical monsoon areas and the often seasonally pronounced differences, there might be a potentially strong impact on health outcomes and death. In this study, we investigated the association between precipitation and daily death counts in Bangladesh from 2003 to 2007 using regression models with a quasipoisson distribution adjusting for long-term time and seasonal trends, day of the month, age and perceived temperature. Effects were assessed for all ages, the elderly and by gender. During the dry season a sharp increase in death risk was found at very high precipitation amounts which are most likely to be cyclone-related. This cyclone effect was most pronounced for females at the immediate day with an increase of 18.7% (3.8-35.6%) in non-external cause mortality per mm precipitation above 5mm. At longer lags we found a negative association between precipitation and mortality indicating some kind of dry effect which was more pronounced for the elderly with a mortality increase of 4.4% (2.6-6.2%) per mm decrease in precipitation. During the rainy season, we observed a protective effect of rainfall which was strongest during periods of seasonally high equivalent temperatures with a decrease in mortality of 4.0% (2.3-5.6%) per mm increase in precipitation on the immediate day. The observed associations between precipitation and mortality differed by season, age and gender. Generally, a strong short-term increase in mortality was associated with cyclonic activity during the dry season, while ongoing low rainfall seemed to have an adverse impact at higher lags. During the rainy season, precipitation seemed to mitigate heat effects.
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Affiliation(s)
- Katrin Burkart
- Department of Environmental Health Science, Mailman School of Public Health, Columbia University in the City of New York, NY, USA.
| | - Patrick Kinney
- Department of Environmental Health Science, Mailman School of Public Health, Columbia University in the City of New York, NY, USA
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Kabir MI, Rahman MB, Smith W, Lusha MAF, Milton AH. Climate change and health in Bangladesh: a baseline cross-sectional survey. Glob Health Action 2016; 9:29609. [PMID: 27049012 PMCID: PMC4821870 DOI: 10.3402/gha.v9.29609] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Revised: 02/21/2016] [Accepted: 03/02/2016] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Bangladesh is facing the unavoidable challenge of adaptation to climate change. However, very little is known in relation to climate change and health. This article provides information on potential climate change impact on health, magnitude of climate-sensitive diseases, and baseline scenarios of health systems to climate variability and change. DESIGN A cross-sectional study using multistage cluster sampling framework was conducted in 2012 among 6,720 households of 224 rural villages in seven vulnerable districts of Bangladesh. Information was obtained from head of the households using a pretested, interviewer-administered, structured questionnaire. A total of 6,720 individuals participated in the study with written, informed consent. RESULTS The majority of the respondents were from the low-income vulnerable group (60% farmers or day labourers) with an average of 30 years' stay in their locality. Most of them (96%) had faced extreme weather events, 45% of people had become homeless and displaced for a mean duration of 38 days in the past 10 years. Almost all of the respondents (97.8%) believe that health care expenditure increased after the extreme weather events. Mean annual total health care expenditure was 6,555 Bangladeshi Taka (BDT) (1 USD=77 BDT in 2015) and exclusively out of pocket of the respondents. Incidence of dengue was 1.29 (95% CI 0.65-2.56) and malaria 13.86 (95% CI 6.00-32.01) per 1,000 adult population for 12 months preceding the data collection. Incidence of diarrhoea and pneumonia among under-five children of the households for the preceding month was 10.3% (95% CI 9.16-11.66) and 7.3% (95% CI 6.35-8.46), respectively. CONCLUSIONS The findings of this survey indicate that climate change has a potential adverse impact on human health in Bangladesh. The magnitude of malaria, dengue, childhood diarrhoea, and pneumonia was high among the vulnerable communities. Community-based adaptation strategy for health could be beneficial to minimise climate change attributed health burden of Bangladesh.
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Affiliation(s)
- Md Iqbal Kabir
- Centre for Clinical Epidemiology and Biostatistics, School of Medicine and Public Health, Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW, Australia
- National Institute of Preventive and Social Medicine, NIPSOM, Dhaka, Bangladesh
- Climate Change and Health Promotion Unit, Ministry of Health and Family Welfare, Dhaka, Bangladesh;
| | - Md Bayzidur Rahman
- School of Public Health and Community Medicine, Faculty of Medicine, UNSW, Sydney, Australia
| | - Wayne Smith
- Centre for Clinical Epidemiology and Biostatistics, School of Medicine and Public Health, Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW, Australia
| | | | - Abul Hasnat Milton
- Centre for Clinical Epidemiology and Biostatistics, School of Medicine and Public Health, Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW, Australia
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Differential and enhanced response to climate forcing in diarrheal disease due to rotavirus across a megacity of the developing world. Proc Natl Acad Sci U S A 2016; 113:4092-7. [PMID: 27035949 DOI: 10.1073/pnas.1518977113] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The role of climate forcing in the population dynamics of infectious diseases has typically been revealed via retrospective analyses of incidence records aggregated across space and, in particular, over whole cities. Here, we focus on the transmission dynamics of rotavirus, the main diarrheal disease in infants and young children, within the megacity of Dhaka, Bangladesh. We identify two zones, the densely urbanized core and the more rural periphery, that respond differentially to flooding. Moreover, disease seasonality differs substantially between these regions, spanning variation comparable to the variation from tropical to temperate regions. By combining process-based models with an extensive disease surveillance record, we show that the response to climate forcing is mainly seasonal in the core, where a more endemic transmission resulting from an asymptomatic reservoir facilitates the response to the monsoons. The force of infection in this monsoon peak can be an order of magnitude larger than the force of infection in the more epidemic periphery, which exhibits little or no postmonsoon outbreak in a pattern typical of nearby rural areas. A typically smaller peak during the monsoon season nevertheless shows sensitivity to interannual variability in flooding. High human density in the core is one explanation for enhanced transmission during troughs and an associated seasonal monsoon response in this diarrheal disease, which unlike cholera, has not been widely viewed as climate-sensitive. Spatial demographic, socioeconomic, and environmental heterogeneity can create reservoirs of infection and enhance the sensitivity of disease systems to climate forcing, especially in the populated cities of the developing world.
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Tracking Cholera through Surveillance of Oral Rehydration Solution Sales at Pharmacies: Insights from Urban Bangladesh. PLoS Negl Trop Dis 2015; 9:e0004230. [PMID: 26641649 PMCID: PMC4671575 DOI: 10.1371/journal.pntd.0004230] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Accepted: 10/22/2015] [Indexed: 01/04/2023] Open
Abstract
Background In Bangladesh, pharmacy-purchased oral rehydration solution (ORS) is often used to treat diarrhea, including cholera. Over-the-counter sales have been used for epidemiologic surveillance in the past, but rarely, if ever, in low-income countries. With few early indicators for cholera outbreaks in endemic areas, diarrhea-related product sales may serve as a useful surveillance tool. Methodology/Principal Findings We tracked daily ORS sales at 50 pharmacies and drug-sellers in an urban Bangladesh community of 129,000 for 6-months while simultaneously conducting surveillance for diarrhea hospitalizations among residents. We developed a mobile phone based system to track the sales of ORS and deployed it in parallel with a paper-based system. Our objectives were to determine if the mobile phone system was practical and acceptable to pharmacists and drug sellers, whether data were reported accurately compared to a paper-based system, and whether ORS sales were associated with future incidence of cholera hospitalizations within the community. We recorded 47,215 customers purchasing ORS, and 315 hospitalized diarrhea cases, 22% of which had culture-confirmed cholera. ORS sales and diarrhea incidence were independently associated with the mean daily temperature; therefore both unadjusted and adjusted models were explored. Through unadjusted cross-correlation statistics and generalized linear models, we found increases in ORS sales were significantly associated with increases in hospitalized diarrhea cases up to 9-days later and hospitalized cholera cases up to one day later. After adjusting for mean daily temperature, ORS was significantly associated with hospitalized diarrhea two days later and hospitalized cholera one day later. Conclusions/Significance Pharmacy sales data may serve as a feasible and useful surveillance tool. Given the relatively short lagged correlation between ORS sales and diarrhea, rapid and accurate sales data are key. More work is needed in creating actionable algorithms that make use of this data and in understanding the generalizability of our findings to other settings. In Bangladesh, people often purchase oral rehydration solution (ORS) at their neighborhood pharmacy to treat diarrhea, including cholera. Over-the-counter sales have been used for epidemiologic surveillance, but rarely in low-income countries. With few early indicators for cholera outbreaks in endemic areas, diarrhea-related product sales may be a useful surveillance tool. We tracked daily ORS sales at pharmacies and drug-sellers in an urban Bangladesh community with both a mobile phone and paper-based system while conducting surveillance for diarrhea hospitalizations among residents. We found that increases in ORS sales were significantly associated increases in hospitalized diarrhea cases up to two days later and hospitalized cholera cases up to one day later. Our findings suggest that surveillance systems based on over-the-counter product sales may be a feasible and useful way to detect outbreaks in low-income settings and that mobile technology may make it even easier to collect implement.
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Carlton EJ, Woster AP, DeWitt P, Goldstein RS, Levy K. A systematic review and meta-analysis of ambient temperature and diarrhoeal diseases. Int J Epidemiol 2015; 45:117-30. [PMID: 26567313 DOI: 10.1093/ije/dyv296] [Citation(s) in RCA: 88] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/07/2015] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Global climate change is expected to increase the risk of diarrhoeal diseases, a leading cause of childhood mortality. However, there is considerable uncertainty about the magnitude of these effects and which populations bear the greatest risks. METHODS We conducted a systematic review using defined search terms across four major databases and, additionally, examined the references of 54 review articles captured by the search. We evaluated sources of heterogeneity by pathogen taxon, exposure measure, study quality, country income level and regional climate, and estimated pooled effect estimates for the subgroups identified in the heterogeneity analysis, using meta-analysis methods. RESULTS We identified 26 studies with 49 estimates. Pathogen taxa were a source of heterogeneity. There was a positive association between ambient temperature and all-cause diarrhoea (incidence rate ratio (IRR) 1.07; 95% confidence interval (CI) 1.03, 1.10) and bacterial diarrhoea (IRR 1.07; 95% CI 1.04, 1.10), but not viral diarrhoea (IRR 0.96; 95% CI 0.82, 1.11). These associations were observed in low-, middle- and high-income countries. Only one study of protozoan diarrhoea was identified. CONCLUSIONS Changes in temperature due to global climate change can and may already be affecting diarrhoeal disease incidence. The vulnerability of populations may depend, in part, on local pathogen distribution. However, evidence of publication bias and the uneven geographical distribution of studies limit the precision and generalizability of the pooled estimates.
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Affiliation(s)
- Elizabeth J Carlton
- Department of Environmental and Occupational Health, University of Colorado, Aurora, CO, USA,
| | - Andrew P Woster
- Department of Environmental and Occupational Health, University of Colorado, Aurora, CO, USA
| | - Peter DeWitt
- Department of Biostatistics, University of Colorado, Aurora, CO, USA and
| | | | - Karen Levy
- Department of Environmental Health, Emory University, Atlanta, GA, USA
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Prasetyo D, Ermaya Y, Martiza I, Yati S. Correlation between climate variations and rotavirus diarrhea in under-five children in Bandung. ASIAN PACIFIC JOURNAL OF TROPICAL DISEASE 2015. [DOI: 10.1016/s2222-1808(15)60955-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Beier D, Brzoska P, Khan MMH. Indirect consequences of extreme weather and climate events and their associations with physical health in coastal Bangladesh: a cross-sectional study. Glob Health Action 2015; 8:29016. [PMID: 26477878 PMCID: PMC4609650 DOI: 10.3402/gha.v8.29016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Revised: 09/11/2015] [Accepted: 09/13/2015] [Indexed: 11/29/2022] Open
Abstract
Background Bangladesh is one of the countries in the world which is most prone to natural disasters. The overall situation is expected to worsen, since extreme weather and climate events (EWCE) are likely to increase in both frequency and intensity. Indirect consequences caused in the events’ aftermath widen the range of possible adverse health outcomes. Objective To assess the association of indirect consequences of EWCE and physical health. Design We used recent cross-sectional self-reported data from 16 coastal villages in Bangladesh. A total of 980 households were surveyed using a structured questionnaire. The outcome of physical health was categorized into three groups, reflecting the severity of reported diseases by the respective source of treatment as a proxy variable (hospital/clinic for severe disease, other source/no treatment for moderate disease, and no disease). The final statistical analysis was conducted using multinomial logistic regression. Results Severe diseases were significantly associated with drinking water from open sources [odds ratio (OR): 4.26, 95% confidence interval (CI): 2.25–8.09] and tube wells (OR: 2.39, 95% CI: 1.43–4.01), moderate harm by river erosion (OR: 6.24, 95% CI: 2.76–14.11), food scarcity (OR: 1.98, 95% CI: 1.16–3.40), and the perception of increased employment problems (OR: 2.19, 95% CI: 1.18–4.07). Moderate diseases were significantly associated with moderate harm by river erosion (OR: 2.65, 95% CI: 1.28–5.48) and fully experienced food scarcity (OR: 1.75, 95% CI: 1.16–2.63). For both categories, women and the elderly had higher chances for diseases. Conclusions Indirect consequences of EWCE were found to be associated with adverse health outcomes. Basic needs such as drinking water, food production, and employment opportunities are particularly likely to become threatened by EWCE and, thus, may lead to a higher likelihood of ill-health. Intervention strategies should concentrate on protection and provision of basic needs such as safe drinking water and food in the aftermath of an event.
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Affiliation(s)
- Dominik Beier
- Department of Anesthesiology and Surgical Intensive Care Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Patrick Brzoska
- Unit of Epidemiology, Institute of Sociology, Faculty of Behavioral and Social Sciences, Chemnitz University of Technology, Chemnitz, Germany
| | - Md Mobarak Hossain Khan
- Department of Public Health Medicine, School of Public Health, Bielefeld University, Bielefeld, Germany;
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Phung D, Huang C, Rutherford S, Chu C, Wang X, Nguyen M, Nguyen NH, Manh CD, Nguyen TH. Association between climate factors and diarrhoea in a Mekong Delta area. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2015; 59:1321-31. [PMID: 25472927 DOI: 10.1007/s00484-014-0942-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Revised: 10/29/2014] [Accepted: 11/24/2014] [Indexed: 05/13/2023]
Abstract
The Mekong Delta is vulnerable to changes in climate and hydrological events which alter environmental conditions, resulting in increased risk of waterborne diseases. Research exploring the association between climate factors and diarrhoea, the most frequent waterborne disease in Mekong Delta region, is sparse. This study evaluated the climate-diarrhoea association in Can Tho city, a typical Mekong Delta area in Vietnam. Climate data (temperature, relative humidity, and rainfall) were obtained from the Southern Regional Hydro-Meteorological Centre, and weekly counts of diarrhoea visits were obtained from Can Tho Preventive Medicine Centre from 2004 to 2011. Analysis of climate and health variables was carried out using spline function to adjust for seasonal and long-term trends of variables. A distributed lag model was used to investigate possible delayed effects of climate variables on diarrhoea (considering 0-4 week lag periods), then the multivariate Poisson regression was used to examine any potential association between climate factors and diarrhoea. The results indicated that the diarrhoea incidence peaked within the period August-October annually. Significant positive associations were found between increased diarrhoea and high temperature at 4 weeks prior to the date of hospital visits (IRR = 1.07; 95 % CI = 1.04-1.08), high relative humidity (IRR = 1.13; 95 % CI = 1.12-1.15) and high (>90th percentile) cumulative rainfall (IRR = 1.05; 95 % CI = 1.05-1.08). The association between climate factors and diarrhoea was stronger in rural than urban areas. These findings in the context of the projected changes of climate conditions suggest that climate change will have important implications for residential health in Mekong Delta region.
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Affiliation(s)
- Dung Phung
- Centre for Environment and Population Health (CEPH), Nathan Campus, Griffith University, 179 Kessels Road, Nathan, Brisbane, Queensland, 4111, Australia,
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Ahmad SS, Aziz N, Butt A, Shabbir R, Erum S. Spatio-temporal surveillance of water based infectious disease (malaria) in Rawalpindi, Pakistan using geostatistical modeling techniques. ENVIRONMENTAL MONITORING AND ASSESSMENT 2015; 187:555. [PMID: 26245853 DOI: 10.1007/s10661-015-4779-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Accepted: 07/28/2015] [Indexed: 05/20/2023]
Abstract
One of the features of medical geography that has made it so useful in health research is statistical spatial analysis, which enables the quantification and qualification of health events. The main objective of this research was to study the spatial distribution patterns of malaria in Rawalpindi district using spatial statistical techniques to identify the hot spots and the possible risk factor. Spatial statistical analyses were done in ArcGIS, and satellite images for land use classification were processed in ERDAS Imagine. Four hundred and fifty water samples were also collected from the study area to identify the presence or absence of any microbial contamination. The results of this study indicated that malaria incidence varied according to geographical location, with eco-climatic condition and showing significant positive spatial autocorrelation. Hotspots or location of clusters were identified using Getis-Ord Gi* statistic. Significant clustering of malaria incidence occurred in rural central part of the study area including Gujar Khan, Kaller Syedan, and some part of Kahuta and Rawalpindi Tehsil. Ordinary least square (OLS) regression analysis was conducted to analyze the relationship of risk factors with the disease cases. Relationship of different land cover with the disease cases indicated that malaria was more related with agriculture, low vegetation, and water class. Temporal variation of malaria cases showed significant positive association with the meteorological variables including average monthly rainfall and temperature. The results of the study further suggested that water supply and sewage system and solid waste collection system needs a serious attention to prevent any outbreak in the study area.
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Affiliation(s)
- Sheikh Saeed Ahmad
- Department of Environmental Sciences, Fatima Jinnah Women University, Rawalpindi, Pakistan,
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Onozuka D, Hagihara A. Nationwide variation in the effects of temperature on infectious gastroenteritis incidence in Japan. Sci Rep 2015; 5:12932. [PMID: 26255569 PMCID: PMC4530438 DOI: 10.1038/srep12932] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Accepted: 07/15/2015] [Indexed: 11/12/2022] Open
Abstract
Although several studies have investigated the effects of temperature on the incidence of infectious gastrointestinal disease in a single city or region, few have investigated variations in this association using nationwide data. We obtained weekly data, gathered between 2000 and 2012, pertaining to infectious gastroenteritis cases and weather variability in all 47 Japanese prefectures. A two-stage analysis was used to assess the nonlinear and delayed relationship between temperature and morbidity. In the first stage, a Poisson regression allowing for overdispersion in a distributed lag nonlinear model was used to estimate the prefecture-specific effects of temperature on morbidity. In the second stage, a multivariate meta-analysis was applied to pool estimates at the national level. The pooled overall relative risk (RR) was highest in the 59.9th percentile of temperature (RR, 1.08; 95% CI: 1.01, 1.15). Meta-analysis results also indicated that the estimated pooled RR at lower temperatures (25th percentile) began immediately but did not persist, whereas an identical estimate at a higher temperature (75th percentile) was delayed but persisted for several weeks. Our results suggest that public health strategies aimed at controlling temperature-related infectious gastroenteritis may be more effective when tailored according to region-specific weather conditions.
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Affiliation(s)
- Daisuke Onozuka
- Department of Health Communication, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Akihito Hagihara
- Department of Health Communication, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
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Celik C, Gozel MG, Turkay H, Bakici MZ, Güven AS, Elaldi N. Rotavirus and adenovirus gastroenteritis: time series analysis. Pediatr Int 2015; 57:590-6. [PMID: 25625610 DOI: 10.1111/ped.12592] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Revised: 01/07/2015] [Accepted: 01/19/2015] [Indexed: 02/06/2023]
Abstract
BACKGROUND This study investigated the effects of changes in weather conditions (monthly average temperature, monthly minimum temperature, monthly average humidity) on rotavirus and adenovirus gastroenteritis frequency and whether there was a seasonal correlation. METHODS Between 2006 and 2012, 4702 fecal samples were taken from patients ≤ 5 years of age with acute gastroenteritis; these samples were analyzed in terms of rotavirus group A and adenovirus serotype 40-41 antigens using time-series and negative binomial regression analysis. RESULTS Rotavirus antigens were found in 797 samples (17.0%), adenovirus antigens in 113 samples (2.4%), and rotavirus and adenovirus antigens together in 16 samples (0.3%). There was a seasonal change in rotavirus gastroenteritis (P < 0.001), and a 1°C decrease in average temperature increased the ratio of rotavirus cases in those with diarrhea by 0.523%. In addition, compared with data from other years, the number of patients was lower in the first month of 2008 and in the second month of 2012, when the temperature was below -20°C (monthly minimum temperature). There was no statistically significant relationship between adenovirus infection and change in weather conditions. CONCLUSION Various factors such as change in weather conditions, as well as the population's sensitivity and associated changes in activity, play a role in the spread of rotavirus infection.
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Affiliation(s)
- Cem Celik
- Department of Medical Microbiology, Faculty of Medicine, Cumhuriyet University, Sivas, Turkey
| | - Mustafa Gokhan Gozel
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Cumhuriyet University, Sivas, Turkey
| | - Hakan Turkay
- Department of Econometrics, Faculty of Economics and Administrative Sciences, Cumhuriyet University, Sivas, Turkey
| | - Mustafa Zahir Bakici
- Department of Medical Microbiology, Faculty of Medicine, Cumhuriyet University, Sivas, Turkey
| | - Ahmet Sami Güven
- Department of Pediatrics, Faculty of Medicine, Cumhuriyet University, Sivas, Turkey
| | - Nazif Elaldi
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Cumhuriyet University, Sivas, Turkey
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