Association between Precipitation and Diarrheal Disease in Mozambique
Diarrheal diseases are a leading cause of morbidity and mortality in Africa. Although research documents the magnitude and pattern of diarrheal diseases are associated with weather in particular locations, there is limited quantification of this association in sub-Saharan Africa and no studies condu...
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doaj-6702182442ff484b91d6d8526c29adc52020-11-25T00:34:44ZengMDPI AGInternational Journal of Environmental Research and Public Health1660-46012018-04-0115470910.3390/ijerph15040709ijerph15040709Association between Precipitation and Diarrheal Disease in MozambiqueLindsay M. Horn0Anjum Hajat1Lianne Sheppard2Colin Quinn3James Colborn4Maria Fernanda Zermoglio5Eduardo S. Gudo6Tatiana Marrufo7Kristie L. Ebi8Department of Epidemiology, University of Washington, 1959 NE Pacific Street, P.O. Box 357236, Seattle, WA 98195, USADepartment of Epidemiology, University of Washington, 1959 NE Pacific Street, P.O. Box 357236, Seattle, WA 98195, USADepartment of Environmental and Occupational Health Sciences, University of Washington, 1959 NE Pacific Street, P.O. Box 357234, Seattle, WA 98195, USAUnited States Agency for International Development (USAID 1300 Pennsylvania Ave NW, Washington, DC 20004, USAClinton Global Health Initiative, 383 Dorchester Ave., Suite 400, Boston, MA 02127, USAChemonics International, 1717 H St NW # 1, Washington, DC 20006, USAInstituto Nacional de Saude, Av Eduardo Mondlane, 1008, 2nd Floor, P.O. Box 264, Maputo, MozambiqueInstituto Nacional de Saude, Av Eduardo Mondlane, 1008, 2nd Floor, P.O. Box 264, Maputo, MozambiqueDepartment of Environmental and Occupational Health Sciences, University of Washington, 1959 NE Pacific Street, P.O. Box 357234, Seattle, WA 98195, USADiarrheal diseases are a leading cause of morbidity and mortality in Africa. Although research documents the magnitude and pattern of diarrheal diseases are associated with weather in particular locations, there is limited quantification of this association in sub-Saharan Africa and no studies conducted in Mozambique. Our study aimed to determine whether variation in diarrheal disease was associated with precipitation in Mozambique. In secondary analyses we investigated the associations between temperature and diarrheal disease. We obtained weekly time series data for weather and diarrheal disease aggregated at the administrative district level for 1997–2014. Weather data include modeled estimates of precipitation and temperature. Diarrheal disease counts are confirmed clinical episodes reported to the Mozambique Ministry of Health (n = 7,315,738). We estimated the association between disease counts and precipitation, defined as the number of wet days (precipitation > 1 mm) per week, for the entire country and for Mozambique’s four regions. We conducted time series regression analyses using an unconstrained distributed lag Poisson model adjusted for time, maximum temperature, and district. Temperature was similarly estimated with adjusted covariates. Using a four-week lag, chosen a priori, precipitation was associated with diarrheal disease. One additional wet day per week was associated with a 1.86% (95% CI: 1.05–2.67%), 1.37% (95% CI: 0.70–2.04%), 2.09% (95% CI: 1.01–3.18%), and 0.63% (95% CI: 0.11–1.14%) increase in diarrheal disease in Mozambique’s northern, central, southern, and coastal regions, respectively. Our study indicates a strong association between diarrheal disease and precipitation. Diarrheal disease prevention efforts should target areas forecast to experience increased rainfall. The burden of diarrheal disease may increase with increased precipitation associated with climate change, unless additional health system interventions are undertaken.http://www.mdpi.com/1660-4601/15/4/709climate changediarrheal diseaseMozambiqueprecipitationtemperature |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Lindsay M. Horn Anjum Hajat Lianne Sheppard Colin Quinn James Colborn Maria Fernanda Zermoglio Eduardo S. Gudo Tatiana Marrufo Kristie L. Ebi |
spellingShingle |
Lindsay M. Horn Anjum Hajat Lianne Sheppard Colin Quinn James Colborn Maria Fernanda Zermoglio Eduardo S. Gudo Tatiana Marrufo Kristie L. Ebi Association between Precipitation and Diarrheal Disease in Mozambique International Journal of Environmental Research and Public Health climate change diarrheal disease Mozambique precipitation temperature |
author_facet |
Lindsay M. Horn Anjum Hajat Lianne Sheppard Colin Quinn James Colborn Maria Fernanda Zermoglio Eduardo S. Gudo Tatiana Marrufo Kristie L. Ebi |
author_sort |
Lindsay M. Horn |
title |
Association between Precipitation and Diarrheal Disease in Mozambique |
title_short |
Association between Precipitation and Diarrheal Disease in Mozambique |
title_full |
Association between Precipitation and Diarrheal Disease in Mozambique |
title_fullStr |
Association between Precipitation and Diarrheal Disease in Mozambique |
title_full_unstemmed |
Association between Precipitation and Diarrheal Disease in Mozambique |
title_sort |
association between precipitation and diarrheal disease in mozambique |
publisher |
MDPI AG |
series |
International Journal of Environmental Research and Public Health |
issn |
1660-4601 |
publishDate |
2018-04-01 |
description |
Diarrheal diseases are a leading cause of morbidity and mortality in Africa. Although research documents the magnitude and pattern of diarrheal diseases are associated with weather in particular locations, there is limited quantification of this association in sub-Saharan Africa and no studies conducted in Mozambique. Our study aimed to determine whether variation in diarrheal disease was associated with precipitation in Mozambique. In secondary analyses we investigated the associations between temperature and diarrheal disease. We obtained weekly time series data for weather and diarrheal disease aggregated at the administrative district level for 1997–2014. Weather data include modeled estimates of precipitation and temperature. Diarrheal disease counts are confirmed clinical episodes reported to the Mozambique Ministry of Health (n = 7,315,738). We estimated the association between disease counts and precipitation, defined as the number of wet days (precipitation > 1 mm) per week, for the entire country and for Mozambique’s four regions. We conducted time series regression analyses using an unconstrained distributed lag Poisson model adjusted for time, maximum temperature, and district. Temperature was similarly estimated with adjusted covariates. Using a four-week lag, chosen a priori, precipitation was associated with diarrheal disease. One additional wet day per week was associated with a 1.86% (95% CI: 1.05–2.67%), 1.37% (95% CI: 0.70–2.04%), 2.09% (95% CI: 1.01–3.18%), and 0.63% (95% CI: 0.11–1.14%) increase in diarrheal disease in Mozambique’s northern, central, southern, and coastal regions, respectively. Our study indicates a strong association between diarrheal disease and precipitation. Diarrheal disease prevention efforts should target areas forecast to experience increased rainfall. The burden of diarrheal disease may increase with increased precipitation associated with climate change, unless additional health system interventions are undertaken. |
topic |
climate change diarrheal disease Mozambique precipitation temperature |
url |
http://www.mdpi.com/1660-4601/15/4/709 |
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