Effect of climatic variability on childhood diarrhea and its high risk periods in northwestern parts of Ethiopia

Muluken Azage; Abera Kumie; Alemayehu Worku; Amvrossios C Bagtzoglou; Emmanouil Anagnostou

doi:10.1371/journal.pone.0186933

Effect of climatic variability on childhood diarrhea and its high risk periods in northwestern parts of Ethiopia

PLoS One. 2017 Oct 26;12(10):e0186933. doi: 10.1371/journal.pone.0186933. eCollection 2017.

Authors

Muluken Azage^{1

2}, Abera Kumie³, Alemayehu Worku³, Amvrossios C Bagtzoglou⁴, Emmanouil Anagnostou⁴

Affiliations

¹ School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.
² Ethiopian Institute of Water Resources, Addis Ababa University, Addis Ababa, Ethiopia.
³ School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
⁴ Department of Civil and Environmental Engineering, School of Engineering, University of Connecticut, Storrs, CT, United States of America.

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.

MeSH terms

Adolescent
Child
Child, Preschool
Climate*
Diarrhea / epidemiology*
Ethiopia / epidemiology
Female
Humans
Infant
Infant, Newborn
Male
Risk Factors
Young Adult

Grants and funding

Ethiopian Institute of Water resources, Addis Ababa University, Bahir Dar University, the University of Connecticut and USAID covered the cost of expense for data collection during field visit. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.