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Tiku M, Zeru MA, Belay DB. Spatio-temporal distributions and determinants of diarrhea among under-five children in Ethiopia. Front Public Health 2024; 12:1369872. [PMID: 38835606 PMCID: PMC11149422 DOI: 10.3389/fpubh.2024.1369872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Accepted: 04/15/2024] [Indexed: 06/06/2024] Open
Abstract
Objective The purpose of this study was to evaluate the spatio-temporal pattern of Ethiopia's childhood diarrheal disease and identify its contributing factors. Methods We conducted analyses on secondary data from four Ethiopian Demographic and Health Surveys conducted between 2000 and 2016. Moran's I was used to determine spatial dependence and spatial models were used to evaluate variables associated with diarrhea in under-five children at the zonal level. Results Childhood diarrhea showed spatial clustering in Ethiopia (Moran's I; p < 0.05). The spatial regression model revealed significant factors at the zonal level: children born at home (e θ = 1.355, 95% CI: 1.052-1.544, p < 0.001), low birth weight (e θ = 1.18, 95% CI: 1.017-1.691, p < 0.05), and unimproved source of water (e θ = 0.8568, 95% CI: 0.671-1.086, p < 0.01). Conclusion The prevalence of diarrhea among under-five children varied over time by zone, with the Assosa, Hundene, and Dire Diwa zones having the highest rates. Home births and low birth weight contributed to the prevalence of childhood diarrhea. In high-risk zones of Ethiopia, reducing childhood diarrhea requires integrated child health interventions and raising awareness about the potential hazards associated with unimproved water sources.
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Affiliation(s)
- Meskerem Tiku
- Department of Statistics, Injibara University, Injibara, Ethiopia
| | - Melkamu A Zeru
- Department of Statistics, Bahir Dar University, Bahir Dar, Ethiopia
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Beggs PJ, Trueck S, Linnenluecke MK, Bambrick H, Capon AG, Hanigan IC, Arriagada NB, Cross TJ, Friel S, Green D, Heenan M, Jay O, Kennard H, Malik A, McMichael C, Stevenson M, Vardoulakis S, Dang TN, Garvey G, Lovett R, Matthews V, Phung D, Woodward AJ, Romanello MB, Zhang Y. The 2023 report of the MJA-Lancet Countdown on health and climate change: sustainability needed in Australia's health care sector. Med J Aust 2024; 220:282-303. [PMID: 38522009 DOI: 10.5694/mja2.52245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 12/06/2023] [Indexed: 03/25/2024]
Abstract
The MJA-Lancet Countdown on health and climate change in Australia was established in 2017 and produced its first national assessment in 2018 and annual updates in 2019, 2020, 2021 and 2022. It examines five broad domains: health hazards, exposures and impacts; adaptation, planning and resilience for health; mitigation actions and health co-benefits; economics and finance; and public and political engagement. In this, the sixth report of the MJA-Lancet Countdown, we track progress on an extensive suite of indicators across these five domains, accessing and presenting the latest data and further refining and developing our analyses. Our results highlight the health and economic costs of inaction on health and climate change. A series of major flood events across the four eastern states of Australia in 2022 was the main contributor to insured losses from climate-related catastrophes of $7.168 billion - the highest amount on record. The floods also directly caused 23 deaths and resulted in the displacement of tens of thousands of people. High red meat and processed meat consumption and insufficient consumption of fruit and vegetables accounted for about half of the 87 166 diet-related deaths in Australia in 2021. Correction of this imbalance would both save lives and reduce the heavy carbon footprint associated with meat production. We find signs of progress on health and climate change. Importantly, the Australian Government released Australia's first National Health and Climate Strategy, and the Government of Western Australia is preparing a Health Sector Adaptation Plan. We also find increasing action on, and engagement with, health and climate change at a community level, with the number of electric vehicle sales almost doubling in 2022 compared with 2021, and with a 65% increase in coverage of health and climate change in the media in 2022 compared with 2021. Overall, the urgency of substantial enhancements in Australia's mitigation and adaptation responses to the enormous health and climate change challenge cannot be overstated. Australia's energy system, and its health care sector, currently emit an unreasonable and unjust proportion of greenhouse gases into the atmosphere. As the Lancet Countdown enters its second and most critical phase in the leadup to 2030, the depth and breadth of our assessment of health and climate change will be augmented to increasingly examine Australia in its regional context, and to better measure and track key issues in Australia such as mental health and Aboriginal and Torres Strait Islander health and wellbeing.
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Affiliation(s)
| | | | | | - Hilary Bambrick
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT
| | - Anthony G Capon
- Monash Sustainable Development Institute, Monash University, Melbourne, VIC
| | | | | | | | | | - Donna Green
- Climate Change Research Centre and ARC Centre of Excellence for Climate Extremes, UNSW, Sydney, NSW
| | - Maddie Heenan
- Australian Prevention Partnership Centre, Sax Institute, Sydney, NSW
- The George Institute for Global Health, Sydney, NSW
| | - Ollie Jay
- Thermal Ergonomics Laboratory, University of Sydney, Sydney, NSW
| | - Harry Kennard
- Center on Global Energy Policy, Columbia University, New York, NY, USA
| | | | | | - Mark Stevenson
- Transport, Health and Urban Design (THUD) Research Lab, University of Melbourne, Melbourne, VIC
| | - Sotiris Vardoulakis
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT
| | - Tran N Dang
- University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | | | - Raymond Lovett
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT
- Australian Institute of Aboriginal and Torres Strait Islander Studies, Canberra, ACT
| | - Veronica Matthews
- University Centre for Rural Health, University of Sydney, Sydney, NSW
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Lu Y, Zhu H, Hu Z, He F, Chen G. Epidemic Characteristics, Spatiotemporal Pattern, and Risk Factors of Other Infectious Diarrhea in Fujian Province From 2005 to 2021: Retrospective Analysis. JMIR Public Health Surveill 2023; 9:e45870. [PMID: 38032713 PMCID: PMC10722358 DOI: 10.2196/45870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 05/03/2023] [Accepted: 09/05/2023] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND Other infectious diarrhea (OID) continues to pose a significant public health threat to all age groups in Fujian Province. There is a need for an in-depth analysis to understand the epidemiological pattern of OID and its associated risk factors in the region. OBJECTIVE In this study, we aimed to describe the overall epidemic characteristics and spatiotemporal pattern of OID in Fujian Province from 2005 to 2021 and explore the linkage between sociodemographic and environmental factors and the occurrence of OID within the study area. METHODS Notification data for OID in Fujian were extracted from the China Information System for Disease Control and Prevention. The spatiotemporal pattern of OID was analyzed using Moran index and Kulldorff scan statistics. The seasonality of and short-term impact of meteorological factors on OID were examined using an additive decomposition model and a generalized additive model. Geographical weighted regression and generalized linear mixed model were used to identify potential risk factors. RESULTS A total of 388,636 OID cases were recorded in Fujian Province from January 2005 to December 2021, with an average annual incidence of 60.3 (SD 16.7) per 100,000 population. Children aged <2 years accounted for 50.7% (196,905/388,636) of all cases. There was a steady increase in OID from 2005 to 2017 and a clear seasonal shift in OID cases from autumn to winter and spring between 2005 and 2020. Higher maximum temperature, atmospheric pressure, humidity, and precipitation were linked to a higher number of deseasonalized OID cases. The spatial and temporal aggregations were concentrated in Zhangzhou City and Xiamen City for 17 study years. Furthermore, the clustered areas exhibited a dynamic spreading trend, expanding from the southernmost Fujian to the southeast and then southward over time. Factors such as densely populated areas with a large <1-year-old population, less economically developed areas, and higher pollution levels contributed to OID cases in Fujian Province. CONCLUSIONS This study revealed a distinct distribution of OID incidence across different population groups, seasons, and regions in Fujian Province. Zhangzhou City and Xiamen City were identified as the major hot spots for OID. Therefore, prevention and control efforts should prioritize these specific hot spots and highly susceptible groups.
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Affiliation(s)
- Yixiao Lu
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Shenzhen, China
| | - Hansong Zhu
- Fujian Provincial Center for Disease Control and Prevention, The Practice Base on the School of Public Health, Fujian Medical University, Fuzhou, China
| | - Zhijian Hu
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Fei He
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Guangmin Chen
- Fujian Provincial Center for Disease Control and Prevention, The Practice Base on the School of Public Health, Fujian Medical University, Fuzhou, China
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Linh Tran NQ, Cam Hong Le HT, Pham CT, Nguyen XH, Tran ND, Thi Tran TH, Nghiem S, Ly Luong TM, Bui V, Nguyen-Huy T, Doan VQ, Dang KA, Thuong Do TH, Thi Ngo HK, Nguyen TV, Nguyen NH, Do MC, Ton TN, Thu Dang TA, Nguyen K, Tran XB, Thai P, Phung D. Climate change and human health in Vietnam: a systematic review and additional analyses on current impacts, future risk, and adaptation. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2023; 40:100943. [PMID: 38116497 PMCID: PMC10730327 DOI: 10.1016/j.lanwpc.2023.100943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 09/29/2023] [Accepted: 10/09/2023] [Indexed: 12/21/2023]
Abstract
This study aims to investigate climate change's impact on health and adaptation in Vietnam through a systematic review and additional analyses of heat exposure, heat vulnerability, awareness and engagement, and projected health costs. Out of 127 reviewed studies, findings indicated the wider spread of infectious diseases, and increased mortality and hospitalisation risks associated with extreme heat, droughts, and floods. However, there are few studies addressing health cost, awareness, engagement, adaptation, and policy. Additional analyses showed rising heatwave exposure across Vietnam and global above-average vulnerability to heat. By 2050, climate change is projected to cost up to USD1-3B in healthcare costs, USD3-20B in premature deaths, and USD6-23B in work loss. Despite increased media focus on climate and health, a gap between public and government publications highlighted the need for more governmental engagement. Vietnam's climate policies have faced implementation challenges, including top-down approaches, lack of cooperation, low adaptive capacity, and limited resources.
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Affiliation(s)
- Nu Quy Linh Tran
- Centre for Environment and Population Health, School of Medicine and Dentistry, Griffith University, Australia
| | - Huynh Thi Cam Hong Le
- Child Health Research Centre, Faculty of Medicine, University of Queensland, Australia
| | | | - Xuan Huong Nguyen
- Centre for Scientific Research and International Collaboration, Phan Chau Trinh University, Quang Nam, Vietnam
| | - Ngoc Dang Tran
- University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | | | - Son Nghiem
- Department of Health Economics, Wellbeing and Society, Australian National University, Australia
| | - Thi Mai Ly Luong
- Faculty of Environmental Sciences, Vietnam University of Science, Hanoi, Vietnam
| | - Vinh Bui
- Faculty of Science and Engineering, Southern Cross University, Australia
| | - Thong Nguyen-Huy
- Centre for Applied Climate Sciences, University of Southern Queensland, Australia
| | - Van Quang Doan
- Centre for Computational Sciences, University of Tsukuba, Japan
| | - Kim Anh Dang
- Queensland Alliance for Environmental Health Sciences, The University of Queensland, Australia
| | - Thi Hoai Thuong Do
- University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Hieu Kim Thi Ngo
- University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | | | - Ngoc Huy Nguyen
- Vietnam National University - Vietnam Japan University, Hanoi, Vietnam
| | - Manh Cuong Do
- Health Environment Management Agency, Ministry of Health, Vietnam
| | | | - Thi Anh Thu Dang
- Hue University of Medicine and Pharmacy, Hue University, Hue City, Vietnam
| | - Kien Nguyen
- Hue University of Economics, Hue University, Hue City, Vietnam
| | | | - Phong Thai
- Queensland Alliance for Environmental Health Sciences, The University of Queensland, Australia
| | - Dung Phung
- School of Public Health, The University of Queensland, Australia
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Sekarrini CE, Sumarmi, Bachri S, Taryana D, Giofandi EA. The application of geographic information system for dengue epidemic in Southeast Asia: A review on trends and opportunity. J Public Health Res 2022; 11:22799036221104170. [PMID: 35911430 PMCID: PMC9335475 DOI: 10.1177/22799036221104170] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 03/30/2022] [Indexed: 11/17/2022] Open
Abstract
The infectious disease dengue hemorrhagic fever remains an unresolved global problem, with climatic conditions and the location of areas located at the equator more often infected with dengue fever. Various modeling approaches have been employed for the development of a dengue risk map. The geographic information system approach was used as an instrument in applying mathematical algorithms to process field vector data into a preventive objective which is studied, then the application of remote sensing provides spatial-temporal data related to land use/land cover data sources as other variable categories. Map of hotspots for dengue fever cases is used to identify the risk of dengue fever areas by applying various complex methodologies, analysis, and visualization of advanced data are needed for its application in public health. In the last 10 years, the increase in the publication of dengue hemorrhagic fever in Southeast Asia in reputable international journals has increased significantly.
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Affiliation(s)
- Cipta Estri Sekarrini
- Program Doctoral of Geography Education, Faculty of Social Science, State University of Malang, Malang, East Java, Indonesia
| | - Sumarmi
- Department of Geography Education, Faculty of Social Science, State University of Malang, Malang, East Java, Indonesia
| | - Syamsul Bachri
- Department of Geography Education, Faculty of Social Science, State University of Malang, Malang, East Java, Indonesia
| | - Didik Taryana
- Department of Geography Education, Faculty of Social Science, State University of Malang, Malang, East Java, Indonesia
| | - Eggy Arya Giofandi
- Department of Geography, Faculty of Social Science, State University of Padang, Padang, West Sumatera, Indonesia
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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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Chen C, Guan Z, Huang C, Jiang D, Liu X, Zhou Y, Yan D, Zhang X, Zhou Y, Ding C, Lan L, Lin Y, Wu J, Li L, Yang S. Epidemiological Trends and Hotspots of Other Infectious Diarrhea (OID) in Mainland China: A Population-Based Surveillance Study From 2004 to 2017. Front Public Health 2021; 9:679853. [PMID: 34368054 PMCID: PMC8339203 DOI: 10.3389/fpubh.2021.679853] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 06/03/2021] [Indexed: 12/17/2022] Open
Abstract
Background: The incidence of other infectious diarrhea (OID) ranked second in class C notifiable disease in China. It has posed a great threat to public health of all age groups. The aim of this study was to investigate the epidemiological trends and hotspots of OID in mainland China. Materials and Methods: Incidence and mortality data for OID stratified by date, age and region from 2004 to 2017 was extracted from the data-center of China public health science. Joinpoint regression and space-time analyses were performed to explore the epidemiological trends and hotspots of OID. Results: The average annual incidence of OID was 60.64/100,000 and it showed an increased trend in the mainland China especially after 2006 (APC = 4.12, 95 CI%: 2.06-6.21). Children of 0-4 year age group accounts for 60.00% (5,820,897/11,414,247) of all cases and its incidence continuously increased though 2004-2017 (APC = 6.65, 95 CI%: 4.39-8.96). The first-level spatial and temporal aggregation areas were located in Beijing and Tianjin, with the gathering time from 2005/1/1 to 2011/12/31 (RR = 5.52, LLR = 572893.59, P < 0.001). The secondary spatial and temporal aggregation areas covered Guangdong, Guangxi, Hainan and Guizhou from 2011/1/1 to 2017/12/31 (RR = 1.98, LLR = 242292.72, P < 0.001). OID of Tianjin and Beijing presented a decreased trend since 2006. However, the incidence of OID in Guangdong, Guangxi, Hainan and Guizhou showed increased trends through 2004-2017. Conclusion: Our study showed that OID showed a constantly increasing trend and brought considerable burden in China especially in the 0-4 age group. The high-risk periods and clusters of regions for OID were identified, which will help government develop disease-specific and location-specific interventive measures.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | - Jie Wu
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Lanjuan Li
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Shigui Yang
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Faridah L, Mindra IGN, Putra RE, Fauziah N, Agustian D, Natalia YA, Watanabe K. Spatial and temporal analysis of hospitalized dengue patients in Bandung: demographics and risk. Trop Med Health 2021; 49:44. [PMID: 34039439 PMCID: PMC8152360 DOI: 10.1186/s41182-021-00329-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 05/03/2021] [Indexed: 01/02/2023] Open
Abstract
Background Bandung, the fourth largest city in Indonesia and capital of West Java province, has been considered a major endemic area of dengue, and studies show that the incidence in this city could increase and spread rapidly. At the same time, estimation of incidence could be inaccurate due to a lack of reliable surveillance systems. To provide strategic information for the dengue control program in the face of limited capacity, this study used spatial pattern analysis of a possible outbreak of dengue cases, through the Geographic Information System (GIS). To further enhance the information needed for effective policymaking, we also analyzed the demographic pattern of dengue cases. Methods Monthly reports of dengue cases from January 2014 to December 2016 from 16 hospitals in Bandung were collected as the database, which consisted of address, sex, age, and code to anonymize the patients. The address was then transformed into geocoding and used to estimate the relative risk of a particular area’s developing a cluster of dengue cases. We used the kernel density estimation method to analyze the dynamics of change of dengue cases. Results The model showed that the spatial cluster of the relative risk of dengue incidence was relatively unchanged for 3 years. Dengue high-risk areas predominated in the southern and southeastern parts of Bandung, while low-risk areas were found mostly in its western and northeastern regions. The kernel density estimation showed strong cluster groups of dengue cases in the city. Conclusions This study demonstrated a strong pattern of reported cases related to specific demographic groups (males and children). Furthermore, spatial analysis using GIS also visualized the dynamic development of the aggregation of disease incidence (hotspots) for dengue cases in Bandung. These data may provide strategic information for the planning and design of dengue control programs.
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Affiliation(s)
- Lia Faridah
- Parasitology Division, Department of Biomedical Science, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia. .,Foreign Visiting Researcher at Department of Civil and Environmental Engineering, Ehime University, Matsuyama, Japan.
| | | | - Ramadhani Eka Putra
- School of Life Science and Technology, Institut Teknologi Bandung, Jl. Ganeca 10, Bandung, West Java, 40132, Indonesia
| | - Nisa Fauziah
- Parasitology Division, Department of Biomedical Science, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | - Dwi Agustian
- Department of Public Health, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | - Yessika Adelwin Natalia
- Department of Public Health, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | - Kozo Watanabe
- Department of Civil and Environmental Engineering, Ehime University, Matsuyama, Japan
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9
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Tran DN, Doan VQ, Nguyen VT, Khan A, Thai PK, Cunrui H, Chu C, Schak E, Phung D. Spatial patterns of health vulnerability to heatwaves in Vietnam. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2020; 64:863-872. [PMID: 32086569 DOI: 10.1007/s00484-020-01876-2] [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: 09/06/2019] [Revised: 01/28/2020] [Accepted: 02/08/2020] [Indexed: 06/10/2023]
Abstract
The increasing frequency and intensity of heat events have weighty impacts on public health in Vietnam, but their effects vary across regions. In this study, we have applied a vulnerability assessment framework (VAF) to systematically assess the spatial pattern of health vulnerability to heatwaves in Vietnam. The VAF was computed as the function of three dimensions: exposure, sensitivity, and adaptive capacity, with the indicators for each dimension derived from the relevant literature, consultation with experts, and available data. An analytic hierarchy process (AHP) was used to determine the weight of indicators. Each province in Vietnam's vulnerability to the health impacts of heatwaves was evaluated by applying the vulnerability index, computed using 13 indicators (sensitivity index, 9; adaptive capacity index, 3; and exposure index, 1). As a result of this analysis, this study has identified heatwave vulnerability 'hotspots', primarily in the Southeast, Central Highlands, and South Central Coast of Vietnam. However, these hotspots are not necessarily the same as the area most vulnerable to climate change, because some areas that are more sensitive to heatwaves may have a higher capacity to adapt to them due to a host of factors including their population characteristics (e.g. rates of the elderly or children), socio-economic and geographical conditions, and the availability of air-conditioners. This kind of information, provided by the vulnerability index framework, allows policymakers to determine how to more efficiently allocate resources and devise appropriate interventions to minimise the impact of heatwaves with strategies tailored to each region of Vietnam.
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Affiliation(s)
- Dang Ngoc Tran
- The Institute of Research and Development, Duy Tan University, Da Nang, Vietnam
- Department of Environmental Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh, Vietnam
| | - Van Quang Doan
- Centre for Computational Sciences, the University of Tsukuba, Tsukuba, Ibaraki, 305-8577, Japan
| | - Vien Truong Nguyen
- Department of Environmental Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh, Vietnam
| | - Ansar Khan
- Department of Geography, Lalbaba College, Howrah, India
| | - Phong K Thai
- Queensland Alliance for Environmental Health Sciences, The University of Queensland, Brisbane, QLD, 4102, Australia
| | - Huang Cunrui
- Health Management and Policy, School of Public Health, Sun Yat-Sen University, Guangzhou, Guangdong Province, China
| | - Cordia Chu
- Centre for Environment and Population Health, School of Medicine, Griffith University, Brisbane, Australia
| | - Elena Schak
- Centre for Environment and Population Health, School of Medicine, Griffith University, Brisbane, Australia
| | - Dung Phung
- Centre for Environment and Population Health, School of Medicine, Griffith University, Brisbane, Australia.
- School of Medicine, Griffith University, Gold Coast campus, Parklands Drive, Southport, QLD, 4222, Australia.
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10
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Hao Y, Zhang N, Wu J, Su B, Gong L, Ma W, Hou S, Zhang J, Song D, Liao W, Zhong S, Yang L, Huang C. Identifying Infectious Diarrhea Hot spots and Associated Socioeconomic Factors in Anhui Province, China. Am J Trop Med Hyg 2020; 101:549-554. [PMID: 31333151 DOI: 10.4269/ajtmh.19-0161] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Infectious diarrhea cases have increased during the past years in the Anhui Province of China, but little is known about its spatial cluster pattern and associated socioeconomic factors. We obtained county-level total cases of infectious diarrhea in 105 counties of Anhui in 2016 and computed age-adjusted rates. Socioeconomic factors were collected from the Statistical Yearbook. Hot spot analysis was used to identify hot and cold spot counties for infectious diarrhea incidence. We then applied binary logistic regression models to determine the association between socioeconomic factors and hot spot or cold spot clustering risk. Hot spot analysis indicated there were both significant hot spot (29 counties) and cold spot (18 counties) clustering areas for infectious diarrhea in Anhui (P < 0.10). Multivariate binary logistic regression results showed that infectious diarrhea hot spots were positively associated with per capita gross domestic product (GDP), with an adjusted odds ratio (AOR): 3.51, 95% CI: 2.09-5.91, whereas cold spots clustering were positively associated with the number of medical staffs (AOR: 1.18, 95% CI: 1.08-1.29) and negatively associated with the number of public health physicians (AOR: 0.27, 95% CI: 0.09-0.86). We identified locations for hot and cold spot clusters of infectious diarrhea incidence in Anhui, and the clustering risks were significantly associated with health workforce resources and the regional economic development. Targeted interventions should be carried out with considerations of regional socioeconomic conditions.
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Affiliation(s)
- Yanbin Hao
- Department of Preventive Medicine, Gannan Medical University, Ganzhou, China.,Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, Guangzhou, China.,Shanghai Key Laboratory of Meteorology and Health, Shanghai Meteorological Service, Shanghai, China
| | - Na Zhang
- Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Jiabing Wu
- Anhui Provincial Center for Disease Control and Prevention, Hefei, China
| | - Bin Su
- Anhui Provincial Center for Disease Control and Prevention, Hefei, China
| | - Lei Gong
- Anhui Provincial Center for Disease Control and Prevention, Hefei, China
| | - Wanwan Ma
- Anhui Provincial Center for Disease Control and Prevention, Hefei, China
| | - Sai Hou
- Anhui Provincial Center for Disease Control and Prevention, Hefei, China
| | - Jin Zhang
- Anhui Provincial Center for Disease Control and Prevention, Hefei, China
| | - Dandan Song
- Anhui Provincial Center for Disease Control and Prevention, Hefei, China
| | - Wenmin Liao
- Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Shuang Zhong
- Center for Chinese Public Administration Research, School of Government, Sun Yat-sen University, Guangzhou, China
| | - Lianping Yang
- Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Cunrui Huang
- Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, Guangzhou, China.,Shanghai Key Laboratory of Meteorology and Health, Shanghai Meteorological Service, Shanghai, China
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11
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Green H, Bailey J, Schwarz L, Vanos J, Ebi K, Benmarhnia T. Impact of heat on mortality and morbidity in low and middle income countries: A review of the epidemiological evidence and considerations for future research. ENVIRONMENTAL RESEARCH 2019; 171:80-91. [PMID: 30660921 DOI: 10.1016/j.envres.2019.01.010] [Citation(s) in RCA: 75] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 01/04/2019] [Accepted: 01/04/2019] [Indexed: 05/13/2023]
Abstract
Heat waves and high air temperature are associated with increased morbidity and mortality. However, the majority of research conducted on this topic is focused on high income areas of the world. Although heat waves have the most severe impacts on vulnerable populations, relatively few studies have studied their impacts in low and middle income countries (LMICs). The aim of this paper is to review the existing evidence in the literature on the impact of heat on human health in LMICs. We identified peer-reviewed epidemiologic studies published in English between January 1980 and August 2018 investigating potential associations between high ambient temperature or heat waves and mortality or morbidity. We selected studies according to the following criteria: quantitative studies that used primary and/or secondary data and report effect estimates where ambient temperature or heat waves are the main exposure of interest in relation to human morbidity or mortality within LMICs. Of the total 146 studies selected, eighty-two were conducted in China, nine in other countries of East Asia and the Pacific, twelve in South Asia, ten in Sub-Saharan Africa, eight in the Middle East and North Africa, and seven in each of Latin America and Europe. The majority of studies (92.9%) found positive associations between heat and human morbidity/mortality. Additionally, while outcome variables and study design differed greatly, most utilized a time-series study design and examined overall heath related morbidity/mortality impacts in an entire population, although it is notable that the selected studies generally found that the elderly, women, and individuals within the low socioeconomic brackets were the most vulnerable to the effects of high temperature. By highlighting the existing evidence on the impact of extreme heat on health in LMICs, we hope to determine data needs and help direct future studies in addressing this knowledge gap. The focus on LMICs is justified by the lack of studies and data studying the health burden of higher temperatures in these regions even though LMICs have a lower capacity to adapt to high temperatures and thus an increased risk.
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Affiliation(s)
- Hunter Green
- Department of Family Medicine and Public Health, University of California, San Diego, 9500 Gilman Drive, La Jolla, 92093 CA, USA
| | - Jennifer Bailey
- Scripps Institution of Oceanography, University of California, San Diego, CA, USA
| | - Lara Schwarz
- Department of Family Medicine and Public Health, University of California, San Diego, 9500 Gilman Drive, La Jolla, 92093 CA, USA; Scripps Institution of Oceanography, University of California, San Diego, CA, USA
| | - Jennifer Vanos
- Department of Family Medicine and Public Health, University of California, San Diego, 9500 Gilman Drive, La Jolla, 92093 CA, USA; Scripps Institution of Oceanography, University of California, San Diego, CA, USA
| | - Kristie Ebi
- Center for Health and the Global Environment, University of Washington, Seattle, WA, USA
| | - Tarik Benmarhnia
- Department of Family Medicine and Public Health, University of California, San Diego, 9500 Gilman Drive, La Jolla, 92093 CA, USA; Scripps Institution of Oceanography, University of California, San Diego, CA, USA.
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12
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Luong LMT, Phung D, Sly PD, Dang TN, Morawska L, Thai PK. Effects of temperature on hospitalisation among pre-school children in Hanoi, Vietnam. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2019; 26:2603-2612. [PMID: 30474814 DOI: 10.1007/s11356-018-3737-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2018] [Accepted: 11/12/2018] [Indexed: 06/09/2023]
Abstract
This study examined the effect of short-term changes in ambient temperature on hospital admissions among children aged less than 5 years old in Hanoi, Vietnam. Data on daily hospital admissions from January 2010 to June 2014 were collected from two hospitals. Daily meteorological data were obtained for the same period. We applied time series analysis to evaluate the risk of hospitalisation related to hot and cold weather by age and causes. We found that a 1 °C decrease in minimum temperature during the cold weather months was associated with 2.2% increase in hospital admission for respiratory infection among children 3-5 years old. A 1 °C increase in diurnal temperature range (DTR) in cold weather was associated with an increase of 1.9% and 1.7% in hospitalisation for all causes and respiratory infection, respectively, among children < 3 years old and an increase of 1.8% and 3.4% in hospitalisation for all causes and respiratory infection, respectively, among children of 3-5 years old. Negative associations between hot weather and hospital admissions were demonstrated. These findings suggested that low temperature and DTRs in winter are important risk factors for hospital admissions among children aged < 5 years old in Hanoi. Other factors may have modified the effect of high temperature on hospital admissions of children in Hanoi.
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Affiliation(s)
- Ly M T Luong
- Faculty of Medicine, The University of Queensland, Brisbane, Australia
- Children's Health and Environment Program, The University of Queensland, Brisbane, Australia
- Faculty of Environmental Sciences, VNU University of Science, Hanoi, Vietnam
| | - Dung Phung
- Centre for Environment and Population Health, Griffith University, Brisbane, Australia.
| | - Peter D Sly
- Children's Health and Environment Program, The University of Queensland, Brisbane, Australia
| | - Tran Ngoc Dang
- Department of Environmental Health, University of Medicine and Pharmacy, Ho Chi Minh, Vietnam
- The Institute of Research and Development, Duy Tan University, Da Nang City, Vietnam
| | - Lidia Morawska
- International Laboratory for Air Quality & Health, Queensland University of Technology, Brisbane, Australia
| | - Phong K Thai
- International Laboratory for Air Quality & Health, Queensland University of Technology, Brisbane, Australia.
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13
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Phung D, Chu C, Tran DN, Huang C. Spatial variation of heat-related morbidity: A hierarchical Bayesian analysis in multiple districts of the Mekong Delta Region. THE SCIENCE OF THE TOTAL ENVIRONMENT 2018; 637-638:1559-1565. [PMID: 29801249 DOI: 10.1016/j.scitotenv.2018.05.131] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 05/10/2018] [Accepted: 05/10/2018] [Indexed: 06/08/2023]
Abstract
This study examined spatial variability of heat-related morbidity in multiple districts of the Mekong Delta Region (MDR), Vietnam. It was conducted in 132 district/cities of the MDR. We used a series of hierarchical Bayesian models to examine the region-wide and district-specific association between temperatures and hospitalizations during the period of 2010-2013. The potential effects of seasonality, long-term trends, day of the week and holidays were controlled in the models. We also examined influences of socio-demographic factors on the temperature-hospitalization relationship. The results indicate that an increase of 5 °C in average temperature was associated with a 6.1% increase (95%CI: 5.9, 6.2) in region-wide hospital admissions. However, the district-level risks ranged from a 55.2% decrease {95%CI: (-54), (-56)} to a 24.4% increase (24.3-24.6) in admissions per 5 °C increase in average temperature. This reflects the heterogeneous magnitudes of temperature-hospitalization risk across districts. The results also indicate that temperature-hospitalization risk increased by 1.3% (95%CI: 1.2-1.4), for each increase of 1000 persons/km2 in population density, 2.1% (95%CI: 2.04-2.11) for each 1% increase in percent of females, and 2.7% (95%CI: 2.6-2.8) for each 1% increase in percent of pre-school students. In contrast, the temperature-related hospitalization risk decreased up to 6.8% {(95%CI: (-6.6)-(-6.9)} for each 1% increase in rural population. Public health intervention measures for both short-term and long-term effects of heat-related health risk should be developed with consideration of the use of city/district scale for the factors rather than the province scale. The province scale of factors does not accurately represent the variability of health risk due to exposure to high temperatures.
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Affiliation(s)
- Dung Phung
- Department of Health Policy & Management, School of Public Health, Sun Yat-sen University, Guangzhou, China.
| | - Cordia Chu
- Centre for Environment and Population Health, Griffith University, Queensland, Australia
| | - Dang Ngoc Tran
- Faculty of Public Health, University of Medicine and Pharmacy, Ho Chi Minh City, Viet Nam
| | - Cunrui Huang
- Department of Health Policy & Management, School of Public Health, Sun Yat-sen University, Guangzhou, China.
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14
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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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15
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Phung D, Nguyen HX, Nguyen HLT, Luong AM, Do CM, Tran QD, Chu C. The effects of socioecological factors on variation of communicable diseases: A multiple-disease study at the national scale of Vietnam. PLoS One 2018; 13:e0193246. [PMID: 29494623 PMCID: PMC5832231 DOI: 10.1371/journal.pone.0193246] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 02/07/2018] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE To examine the effects of socioecological factors on multiple communicable diseases across Vietnam. METHODS We used the Moran's I tests to evaluate spatial clusters of diseases and applied multilevel negative binomial regression models using the Bayesian framework to analyse the association between socioecological factors and the diseases queried by oral, airborne, vector-borne, and animal transmission diseases. RESULTS AND SIGNIFICANCE The study found that oral-transmission diseases were spatially distributed across the country; whereas, the airborne-transmission diseases were more clustered in the Northwest and vector-borne transmission diseases were more clustered in the South. Most of diseases were sensitive with climatic factors. For instance, a 1°C increase in average temperature is significantly associated with 0.4% (95CI, 0.3-0.5), 2.5% (95%CI, 1.4-3.6), 0.9% (95%CI, 0.6-1.4), 1.1% (95%CI), 5% (95%CI, 3-.7.4), 0.4% (95%CI, 0.2-0.7), and 2% (95%CI, 1.5-2.8) increase in risk of diarrhoea, shigellosis, mumps, influenza, dengue, malaria, and rabies respectively. The influences of socio-economic factors on risk of communicable diseases are varied by factors with the biggest influence of population density. The research findings reflect an important implication for the climate change adaptation strategies of health sectors. A development of weather-based early warning systems should be considered to strengthen communicable disease prevention in Vietnam.
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Affiliation(s)
- Dung Phung
- Centre for Environment and Population Health, Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
| | - Huong Xuan Nguyen
- Da Nang University of Medical Technology and Pharmacy, Da Nang, Vietnam
| | | | - Anh Mai Luong
- Health Environment Management Agency, Ministry of Health, Hanoi, Vietnam
| | - Cuong Manh Do
- Health Environment Management Agency, Ministry of Health, Hanoi, Vietnam
| | - Quang Dai Tran
- General Department of Preventive Medicine, Ministry of Health, Hanoi, Vietnam
| | - Cordia Chu
- Centre for Environment and Population Health, Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
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16
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Azage M, Kumie A, Worku A, C. Bagtzoglou A, Anagnostou E. Effect of climatic variability on childhood diarrhea and its high risk periods in northwestern parts of Ethiopia. PLoS One 2017; 12:e0186933. [PMID: 29073259 PMCID: PMC5658103 DOI: 10.1371/journal.pone.0186933] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Accepted: 10/10/2017] [Indexed: 12/11/2022] Open
Abstract
Background Increasing climate variability as a result of climate change will be one of the public health challenges to control infectious diseases in the future, particularly in sub-Saharan Africa including Ethiopia. Objective To investigate the effect of climate variability on childhood diarrhea (CDD) and identify high risk periods of diarrheal diseases. Methods The study was conducted in all districts located in three Zones (Awi, West and East Gojjam) of Amhara Region in northwestern parts of Ethiopia. Monthly CDD cases for 24 months (from July 2013 to June 2015) reported to each district health office from the routine surveillance system were used for the study. Temperature, rainfall and humidity data for each district were extracted from satellite precipitation estimates and global atmospheric reanalysis. The space-time permutation scan statistic was used to identify high risk periods of CDD. A negative binomial regression was used to investigate the relationship between cases of CDD and climate variables. Statistical analyses were conducted using SaTScan program and StataSE v. 12. Results The monthly average incidence rate of CDD was 11.4 per 1000 (95%CI 10.8–12.0) with significant variation between males [12.5 per 1000 (95%CI 11.9 to 13.2)] and females [10.2 per 1000 (95%CI 9.6 to 10.8)]. The space-time permutation scan statistic identified the most likely high risk period of CDD between March and June 2014 located in Huletej Enese district of East Gojjam Zone. Monthly average temperature and monthly average rainfall were positively associated with the rate of CDD, whereas the relative humidity was negatively associated with the rate of CDD. Conclusions This study found that the most likely high risk period is in the beginning of the dry season. Climatic factors have an association with the occurrence of CDD. Therefore, CDD prevention and control strategy should consider local weather variations to improve programs on CDD.
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Affiliation(s)
- Muluken Azage
- School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
- Ethiopian Institute of Water Resources, Addis Ababa University, Addis Ababa, Ethiopia
- * E-mail:
| | - Abera Kumie
- School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Alemayehu Worku
- School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Amvrossios C. Bagtzoglou
- Department of Civil and Environmental Engineering, School of Engineering, University of Connecticut, Storrs, CT, United States of America
| | - Emmanouil Anagnostou
- Department of Civil and Environmental Engineering, School of Engineering, University of Connecticut, Storrs, CT, United States of America
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17
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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: 34] [Impact Index Per Article: 4.3] [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. Aiming to identify the most critical drivers of diarrhea epidemics in montane areas of South-East Asia, we conducted a retrospective time series analysis of diarrhea reported cases and of hydro-meteorological variables measured in two contrasted river basins in northern Laos, together with socio-behavioral practices. We found that during drought periods, the population switches its water supply from wells to surface water where we measured numbers of fecal indicator bacteria (E. coli) of 100–1,000 MPN 100 mL-1 (the World Health Organization recommendation is 0 MPN 100 mL-1 in drinking water supply sources). We found that water shortages trigger diarrhea peaks during the dry and hot seasons and that rainfall and subsequent aquifer refill ends the epidemic during the wet season. As E. coli counts in surface water are high all year long, E. coli may not be a relevant indicator of the fecal risk in this area. Conversely, stream discharge and aquifer water level appear to be relevant proxies to predict diarrheal risk. Mitigating both environmental and anthropogenic drivers of fecal bacteria dissemination in developing countries is critical in the context of global change: more intense rainfall combined to the extension of run-off prone land uses (e.g. tree plantation without understorey) may decrease both the aquifer recharge and the contaminant retention ecosystem service, and thus threaten the availability of safe water resource for the population.
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Affiliation(s)
- Laurie Boithias
- Géosciences Environnement Toulouse, Université de Toulouse, CNES, CNRS, IRD, UPS, Toulouse, France
- * E-mail:
| | - 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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