Joel Aik1, Janet Ong2, Lee-Ching Ng3. 1. Environmental Health Institute, National Environment Agency, 40 Scotts Road, Environment Building, #13-00, 228231, Singapore; School of Public Health and Community Medicine, Faculty of Medicine, University of New South Wales, New South Wales, Australia. Electronic address: joel_aik@nea.gov.sg. 2. Environmental Health Institute, National Environment Agency, 40 Scotts Road, Environment Building, #13-00, 228231, Singapore. Electronic address: janet_ong@nea.gov.sg. 3. Environmental Health Institute, National Environment Agency, 40 Scotts Road, Environment Building, #13-00, 228231, Singapore. Electronic address: NG_Lee_Ching@nea.gov.sg.
Abstract
BACKGROUND: Diarrhoeal disease is common and imposes substantial health and economic burdens across the globe, especially in the African and Southeast Asian regions. Besides causing high mortality and morbidity, diarrhoeal disease has also been associated with growth and cognitive shortfalls in children in low-resource settings. Extreme weather events brought about by climate change may increase diarrhoeal disease and impact vulnerable populations in countries regardless of levels of development. We examined the seasonal and climatic influences of acute diarrhoeal disease reports in Singapore, a city-state located in Southeast Asia. METHODS: We used a time-series analysis, adjusting for time-varying potential confounders in a negative binomial regression model and fitting fractional polynomials to investigate the relationship between climatic factors (temperature, relative humidity and rainfall) and reported diarrhoeal disease. RESULTS: We included 1,798,198 reports of diarrhoeal disease from 2005 to 2018. We observed annual trimodal peaks in the number of reports. Every 10% increase in relative humidity in the present week was positively associated with an increase in reports one week later [Incidence Rate Ratio (IRR): 1.030, 95% CI 1.004-1.057] and negatively associated with a decrease in reports six weeks later (IRR: 0.979, 95% CI 0.961-0.997). We observed effect modification of relative humidity on the risk of diarrhoeal disease in the first calendar quarter (January to March). There was weak evidence of a delayed effect of ambient air temperature on reports of diarrhoeal disease one week later (IRR: 1.013, 95% CI 0.998-1.027). No threshold effects of climatic factors were observed. Each week of school holidays was associated with a 14.4% reduction in diarrhoeal disease reports (IRR: 0.856, 95% CI: 0.840 to 0.871). Public holidays were associated with a reduction in reports in the same week and an increase a week later. CONCLUSIONS: Diarrhoeal disease is highly seasonal and is associated with climate variability. Food safety and primary healthcare resource mitigation could be timed in anticipation of seasonal and climate driven increases in disease reports.
BACKGROUND:Diarrhoeal disease is common and imposes substantial health and economic burdens across the globe, especially in the African and Southeast Asian regions. Besides causing high mortality and morbidity, diarrhoeal disease has also been associated with growth and cognitive shortfalls in children in low-resource settings. Extreme weather events brought about by climate change may increase diarrhoeal disease and impact vulnerable populations in countries regardless of levels of development. We examined the seasonal and climatic influences of acute diarrhoeal disease reports in Singapore, a city-state located in Southeast Asia. METHODS: We used a time-series analysis, adjusting for time-varying potential confounders in a negative binomial regression model and fitting fractional polynomials to investigate the relationship between climatic factors (temperature, relative humidity and rainfall) and reported diarrhoeal disease. RESULTS: We included 1,798,198 reports of diarrhoeal disease from 2005 to 2018. We observed annual trimodal peaks in the number of reports. Every 10% increase in relative humidity in the present week was positively associated with an increase in reports one week later [Incidence Rate Ratio (IRR): 1.030, 95% CI 1.004-1.057] and negatively associated with a decrease in reports six weeks later (IRR: 0.979, 95% CI 0.961-0.997). We observed effect modification of relative humidity on the risk of diarrhoeal disease in the first calendar quarter (January to March). There was weak evidence of a delayed effect of ambient air temperature on reports of diarrhoeal disease one week later (IRR: 1.013, 95% CI 0.998-1.027). No threshold effects of climatic factors were observed. Each week of school holidays was associated with a 14.4% reduction in diarrhoeal disease reports (IRR: 0.856, 95% CI: 0.840 to 0.871). Public holidays were associated with a reduction in reports in the same week and an increase a week later. CONCLUSIONS:Diarrhoeal disease is highly seasonal and is associated with climate variability. Food safety and primary healthcare resource mitigation could be timed in anticipation of seasonal and climate driven increases in disease reports.
Authors: Meghnath Dhimal; Dinesh Bhandari; Khem B Karki; Srijan Lal Shrestha; Mukti Khanal; Raja Ram Pote Shrestha; Sushma Dahal; Bihungum Bista; Kristie L Ebi; Guéladio Cissé; Amir Sapkota; David A Groneberg Journal: Int J Environ Res Public Health Date: 2022-05-18 Impact factor: 4.614
Authors: Josh M Colston; Benjamin F Zaitchik; Hamada S Badr; Eleanor Burnett; Syed Asad Ali; Ajit Rayamajhi; Syed M Satter; Daniel Eibach; Ralf Krumkamp; Jürgen May; Roma Chilengi; Leigh M Howard; Samba O Sow; M Jahangir Hossain; Debasish Saha; M Imran Nisar; Anita K M Zaidi; Suman Kanungo; Inácio Mandomando; Abu S G Faruque; Karen L Kotloff; Myron M Levine; Robert F Breiman; Richard Omore; Nicola Page; James A Platts-Mills; Ulla Ashorn; Yue-Mei Fan; Prakash Sunder Shrestha; Tahmeed Ahmed; Estomih Mduma; Pablo Penatero Yori; Zulfiqar Bhutta; Pascal Bessong; Maribel P Olortegui; Aldo A M Lima; Gagandeep Kang; Jean Humphrey; Andrew J Prendergast; Robert Ntozini; Kazuhisa Okada; Warawan Wongboot; James Gaensbauer; Mario T Melgar; Tuula Pelkonen; Cesar Mavacala Freitas; Margaret N Kosek Journal: Geohealth Date: 2022-01-01