Effects of Ambient Temperature, Relative Humidity, and Precipitation on Diarrhea Incidence in Surabaya

Bima Sakti Satria Wibawa; Aussie Tahta Maharani; Gerry Andhikaputra; Marsha Savira Agatha Putri; Aditya Prana Iswara; Amir Sapkota; Ayushi Sharma; Arie Dipareza Syafei; Yu-Chun Wang

doi:10.3390/ijerph20032313

Effects of Ambient Temperature, Relative Humidity, and Precipitation on Diarrhea Incidence in Surabaya

Int J Environ Res Public Health. 2023 Jan 28;20(3):2313. doi: 10.3390/ijerph20032313.

Authors

Affiliations

¹ Department of Environmental Engineering, College of Engineering, Chung Yuan Christian University, 200 Chung-Pei Road, Zhongli, Taoyuan City 320314, Taiwan.
² Institute of Tropical Disease, Universitas Airlangga, Surabaya 60286, Indonesia.
³ Department of Environmental Health, Faculty of Health Science, Universitas Islam Lamongan, Lamongan 62211, Indonesia.
⁴ Department of Civil Engineering, College of Engineering, Chung Yuan Christian University, 200 Chung-Pei Road, Zhongli, Taoyuan City 320314, Taiwan.
⁵ Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, Maryland, MD 20742, USA.
⁶ Department of Environmental Engineering, Institut Teknologi Sepuluh Nopember, Surabaya 60111, Indonesia.
⁷ Research Center for Environmental Changes, Academia Sinica, 128 Academia Road, Section 2, Nankang, Taipei 11529, Taiwan.

Abstract

Background: Diarrhea remains a common infectious disease caused by various risk factors in developing countries. This study investigated the incidence rate and temporal associations between diarrhea and meteorological determinants in five regions of Surabaya, Indonesia.

Method: Monthly diarrhea records from local governmental health facilities in Surabaya and monthly means of weather variables, including average temperature, precipitation, and relative humidity from Meteorology, Climatology, and Geophysical Agency were collected from January 2018 to September 2020. The generalized additive model was employed to quantify the time lag association between diarrhea risk and extremely low (5th percentile) and high (95th percentile) monthly weather variations in the north, central, west, south, and east regions of Surabaya (lag of 0-2 months).

Result: The average incidence rate for diarrhea was 11.4 per 100,000 during the study period, with a higher incidence during rainy season (November to March) and in East Surabaya. This study showed that the weather condition with the lowest diarrhea risks varied with the region. The diarrhea risks were associated with extremely low and high temperatures, with the highest RR of 5.39 (95% CI 4.61, 6.17) in the east region, with 1 month of lag time following the extreme temperatures. Extremely low relative humidity increased the diarrhea risks in some regions of Surabaya, with the highest risk in the west region at lag 0 (RR = 2.13 (95% CI 1.79, 2.47)). Extremely high precipitation significantly affects the risk of diarrhea in the central region, at 0 months of lag time, with an RR of 3.05 (95% CI 2.09, 4.01).

Conclusion: This study identified a high incidence of diarrhea in the rainy season and in the deficient developed regions of Surabaya, providing evidence that weather magnifies the adverse effects of inadequate environmental sanitation. This study suggests the local environmental and health sectors codevelop a weather-based early warning system and improve local sanitation practices as prevention measures in response to increasing risks of infectious diseases.

Keywords: Surabaya; diarrhea; generalized additive model; meteorological variables.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

China / epidemiology
Diarrhea* / epidemiology
Humans
Humidity
Incidence
Risk Factors
Temperature
Weather*

Grants and funding

This study was supported by grants from the Taiwan Ministry of Science and Technology (MOST 108-2625-M-033-002-; MOST 109-2625-M-033-002-; MOST 110-2625-M-033-002-; MOST 109-2621-M-033 -001 -MY3). Additional support was obtained from the US National Science Foundation (NSF) through Belmont Forum (award number (FAIN): 2025470).