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Effects of the 1997–1998 El Niño Episode on Community Rates of Diarrhea

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To improve our understanding of climate variability and diarrheal disease at the community level and inform predictions for future climate change scenarios, we examined whether the El Niño climate pattern is associated with increased rates of diarrhea among Peruvian children. We analyzed daily surveillance data for 367 children aged 0 to 12 years from 2 cohorts in a peri-urban shantytown in Lima, Peru, 1995 through 1998. We stratified diarrheal incidence by 6-month age categories, season, and El Niño, and modeled between-subject heterogeneity with random effects Poisson models. Spring diarrheal incidence increased by 55% during El Niño compared with before El Niño. This increase was most acute among children older than 60 months, for whom the risk of a diarrheal episode during the El Niño spring was nearly 100% greater (relative risk=1.96; 95% confidence interval=1.24, 3.09). El Niño-associated climate variability affects community rates of diarrhea, particularly during the cooler seasons and among older children. Public health officials should develop preventive strategies for future El Niño episodes to mitigate the increased risk of diarrheal disease in vulnerable communities.
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... This systematic review answers the call for better understanding of HWI across time Wutich et al., 2017). It also builds on the extensive literature base that identifies seasonality in dimensions that affect household water, such as water quantity, water quality, or seasonal water-borne health risks (Ake et al., 2015;Amenu et al., 2013;Bennett et al., 2012;Cheng et al., 2005;Chuah & Ziegler, 2018;Emch et al., 2010;Murphy et al., 2020;Pascual, 2000). While such studies imply the effects of environmental seasonality on household well-being, most do not examine the pathways or measure the connections between seasonal changes in, for example, water safety and household perceptions and experiences with those changes. ...
... Only articles that met all inclusion criteria were included in the review. For example, several articles were excluded from the review because they discussed water quality at the household level or water-borne health risks but did not draw explicit connections to household experiences with the different domains of water provisioning (Ake et al., 2015;Amenu et al., 2013;Bennett et al., 2012;Cheng et al., 2005;Chuah & Ziegler, 2018;Emch et al., 2010;Murphy et al., 2020;Pascual, 2000). ...
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Household water insecurity (HWI) can have far‐reaching consequences for human health and well‐being, yet little is known about how environmental seasonality contributes to HWI variation. Using a systematic literature review, we examined the following questions: (1) How does environmental seasonality affect HWI? and (2) How do the effects vary over time? We also highlighted strategic areas for future research. We conducted the search using Scopus, Web of Science, PubMed, ProQuest, and EBSCO Academic Search Complete, with an end search date of February 3, 2021; only English‐language studies were included. Articles were included in the review if analysis studied seasonal temperature, precipitation, or freshwater variation and individual or household experiences with household water adequacy, water reliability, water affordability, or water safety. Bias was evaluated via hand assessment, and articles of poor quality were excluded. Studies that focused on extreme weather events or water insecurity at community or watershed levels were omitted. We identified 67 articles, the majority of which were cross‐sectional ( n = 46, 68.7%). Among longitudinal studies ( n = 21, 31.3%), only one used a quantitative HWI scale, while the rest relied on proxies ( n = 20, 95.2%). Our review also revealed literature gaps related to unequal coverage of freshwater ecosystem habitat types and forms of environmental seasonality. There is a need for more attention to extreme climate events, such as a prolonged multiyear drought. With changing climate expected to exacerbate weather patterns with serious implications, especially for vulnerable populations, understanding seasonality in HWI is important for crafting sustainable engineering and policy responses to water insecurity. This article is categorized under: Water and Life > Nature of Freshwater Ecosystems Science of Water > Water and Environmental Change Engineering Water > Sustainable Engineering of Water
... C limate variability is increasingly recognized as a key determinant of health outcomes 1 and a major concern for global climate policy and international public health 2 , with the Intergovernmental Panel on Climate Change warning that anthropogenic climate change will very likely increase the frequency and intensity of extreme events 3,4 . The El Niño Southern Oscillation (ENSO) is a major source of climate variability known to affect key social, economic, and health outcomes [5][6][7][8][9][10][11][12][13][14] ; however, the systematic effects that these correlated shifts in the tropical climate have on global health remain understudied. ENSO's adverse large-scale effects have been documented for hundreds of years 15 . ...
... ENSO has destabilizing effects on agriculture 6,15 , economic production 7 , and social stability 8 throughout areas of the global tropics that are teleconnected to it. It has been linked to human health outcomes directly through its effects on vector-and waterborne infectious diseases [9][10][11][12][13] , as well as indirectly by decreasing agricultural yields and increasing food insecurity 14 and the likelihood of conflict 8 . ENSO's adverse effects on yields are particularly acute in the tropics 6 , where the vulnerable population of food-insecure children is larger and temperatures are closer to critical crop collapse thresholds 18,19 . ...
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... However, Peru and other countries that have made substantial gains toward lowering diarrhea morbidity may have these trends slowed or reversed as climate change and increasing temperatures bring additional challenges to reducing diarrheal disease morbidity [2]. The El Niño phenomenon may also contribute to such challenges: research in Peru has shown significant increases in diarrhea cases during El Niño events [8][9][10][11][12][13][14][15]. Climate change is expected to increase the frequency and intensity of El Niño periods [16]; in recent decades, El Niño events have been intensifying in the Eastern Pacific, near the coast of Peru [17]. ...
... A supplemental analysis showed similar results when instead considering access to sewerage, i.e., the associations between childhood diarrhea and El Niño events and the dry season were also stronger in areas with low sewerage access (Additional File 8). Other research in Peru has found increased risk of diarrhea in children > 5 years old during El Niño in households lacking a sewerage connection, but not in households that do have a sewerage connection [10]. The authors suggest that these children may be more susceptible to the effects of El Niño when they leave their homes to defecate. ...
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Abstract Background Global 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. Methods We 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 (
... Strong social capital can diminish the chances of PTSD and related symptoms, as demonstrated in previous studies conducted after earthquakes and floodings [12,13]. Additionally, flooding and other disasters impact significantly the health of mothers and children, increasing the risk of respiratory disease, diarrheal illness and nutritional status [14][15][16]. ...
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... Se ha registrado, por ejemplo, que luego de El Niño de 1997-1998 en las zonas afectadas en Tumbes los niños tuvieron una menor ganancia en estatura y masa magra en comparación con otros periodos (Danysh, Gilman, Wells et al. 2014). Asimismo, en las comunidades afectadas por este evento se reportó el aumento de episodios de diarreas en los niños, entre un 50% en niños de 0-12 años de edad en el mismo periodo (Bennett, Epstein, Gilman et al. 2012). Estos estudios muestran el enlace entre el evento climático y el impacto que genera en los medios de vida de las poblaciones, a la vez que muestra el resultado en la salud de las poblaciones más vulnerables como son los niños, probablemente generadas por las condiciones de infraestructura deteriorada o inexistente. ...
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En este libro que presentamos a continuación hay muchos tópicos de investigación y muchas reflexiones, ideas y experiencia sistematizada que han sido elaborados gracias a la generosidad y sapiencia de los autores, que nos respondieron con mucho entusiasmo y compromiso en esta tarea de repensar y de aportar en nuestro bicentenario. Habrá que reconocer que son ensayos y artículos sobre diversos temas relacionados con la sociedad y el ambiente, y todos tratados con esmero, integridad y maestría. Nuestro ha sido el trabajo de revisarlos, arbitrarlos y darles un diseño para su publicación. Les estamos muy agradecidos a los autores, y a la vez les señalamos a los lectores de este libro que las páginas que a continuación se presentan deben servir para comprender y transformar nuestra realidad social y ambiental.
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Context. —Malaria has been increasing globally, and epidemics tend to occur when weather conditions favor this vector-borne disease. Long-term meteorologic forecasting using El Niño Southern Oscillation (ENSO) may assist in anticipating epidemics and targeting scarce resources.Objective. —To determine whether malaria epidemics in Venezuela are related to ENSO and rainfall and to determine whether such a relationship could be used to predict outbreaks.Design. —Retrospective analysis of national malaria morbidity (1975-1995) and mortality (1910-1935) data in the coastal zone and interior of Venezuela in relation to El Niño events and rainfall.Main Outcome Measure. —Correlation between malaria mortality and morbidity and sea surface temperatures (SSTs) in the Eastern Tropical Pacific, a parameter of ENSO.Results. —Malaria mortality and morbidity have increased by an average of 36.5% (95% confidence interval, 3.7%-69.3%; P=.004) in years following recognized El Niño events. A moderate correlation was found between Pacific tropical SST during a Niño event and malaria 1 year later (r=0.50, P<.001). Malaria mortality is more strongly related to drought in the year preceding outbreaks than to rainfall during epidemic years.Conclusions. —Historic and recent data from Venezuela demonstrate that malaria increases by an average of about one third in the year following a Niño event; change in malaria risk can be predicted from Pacific SSTs in the previous year. Therefore, the occurrence of an El Niño event may help predict malaria epidemics in this part of South America.
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