Meteorological factors and childhood diarrhea in Peru, 2005–2015: a time series analysis of historic associations, with implications for climate change

Environmental Health

Vanessa Vasquez¹  Gustavo F. Gonzales¹  Benjamin Lopman²  César Cárcamo³  Miranda J. Delahoy⁴  Thomas Clasen⁴  Kyle Steenland⁴  Karen Levy⁵  Luís Ordoñez⁶  Yury Escajadillo⁷  Waldo Lavado⁷  Adrian Huerta⁷ 

[1] Department of Biological and Physiological Sciences, Faculty of Sciences and Philosophy, Universidad Peruana Cayetano Heredia, Avenida Honorio Delgado 430, San Martín de Porres, Lima, Peru;Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA, USA;Department of Public Health, Administration, and Social Sciences, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Avenida Armendáriz 445, Miraflores, Lima, Peru;Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA, USA;Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA, USA;Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, 1959 NE Pacific Street, Seattle, Washington, USA;National Center for Epidemiology, Prevention and Control of Diseases, Ministerio de Salud (MINSA; Ministry of Health), Avenida Salaverry 801, Jesús María, Lima, Peru;Servicio Nacional de Meteorología e Hidrología del Perú (SENAMHI; National Meteorology and Hydrology Service of Peru), Jirón Cahuide 785, Jesús María, Lima, Peru;

关键词: Diarrhea;    Climate change;    Temperature;    El Niño;    Drinking water;   

DOI  :  10.1186/s12940-021-00703-4

来源: Springer

【 摘 要 】

BackgroundGlobal temperatures are projected to rise by ≥2 °C by the end of the century, with expected impacts on infectious disease incidence. Establishing the historic relationship between temperature and childhood diarrhea is important to inform future vulnerability under projected climate change scenarios.MethodsWe compiled a national dataset from Peruvian government data sources, including weekly diarrhea surveillance records, annual administered doses of rotavirus vaccination, annual piped water access estimates, and daily temperature estimates. We used generalized estimating equations to quantify the association between ambient temperature and childhood (< 5 years) weekly reported clinic visits for diarrhea from 2005 to 2015 in 194 of 195 Peruvian provinces. We estimated the combined effect of the mean daily high temperature lagged 1, 2, and 3 weeks, in the eras before (2005–2009) and after (2010–2015) widespread rotavirus vaccination in Peru and examined the influence of varying levels of piped water access.ResultsNationally, an increase of 1 °C in the temperature across the three prior weeks was associated with a 3.8% higher rate of childhood clinic visits for diarrhea [incidence rate ratio (IRR): 1.04, 95% confidence interval (CI): 1.03–1.04]. Controlling for temperature, there was a significantly higher incidence rate of childhood diarrhea clinic visits during moderate/strong El Niño events (IRR: 1.03, 95% CI: 1.01–1.04) and during the dry season (IRR: 1.01, 95% CI: 1.00–1.03). Nationally, there was no evidence that the association between temperature and the childhood diarrhea rate changed between the pre- and post-rotavirus vaccine eras, or that higher levels of access to piped water mitigated the effects of temperature on the childhood diarrhea rate.ConclusionsHigher temperatures and intensifying El Niño events that may result from climate change could increase clinic visits for childhood diarrhea in Peru. Findings underscore the importance of considering climate in assessments of childhood diarrhea in Peru and globally, and can inform regional vulnerability assessments and mitigation planning efforts.

【 授权许可】

CC BY