Precipitation variability and risk of infectious disease in children under 5 years for 32 countries: a global analysis using Demographic and Health Survey data

Anna Dimitrova; Sara McElroy; Morgan Levy; Alexander Gershunov; Tarik Benmarhnia

doi:10.1016/S2542-5196(21)00325-9

Precipitation variability and risk of infectious disease in children under 5 years for 32 countries: a global analysis using Demographic and Health Survey data

Lancet Planet Health. 2022 Feb;6(2):e147-e155. doi: 10.1016/S2542-5196(21)00325-9.

Authors

Anna Dimitrova¹, Sara McElroy², Morgan Levy³, Alexander Gershunov⁴, Tarik Benmarhnia⁴

Affiliations

¹ Scripps Institution of Oceanography, University of California, San Diego, CA, USA. Electronic address: adimitrova@ucsd.edu.
² Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, CA, USA; School of Public Health, San Diego State University, San Diego, CA, USA.
³ Scripps Institution of Oceanography, University of California, San Diego, CA, USA; School of Global Policy and Strategy, University of California, San Diego, CA, USA.
⁴ Scripps Institution of Oceanography, University of California, San Diego, CA, USA.

PMID: 35150623
DOI: 10.1016/S2542-5196(21)00325-9

Abstract

Background: Precipitation variability is a potentially important driver of infectious diseases that are leading causes of child morbidity and mortality worldwide. Disentangling the links between precipitation variability and disease risk is crucial in a changing climate. We aimed to investigate the links between precipitation variability and reported symptoms of infectious disease (cough, fever, and diarrhoea) in children younger than 5 years.

Methods: We used nationally representative survey data collected between 2014 and 2019 from Demographic and Health Survey (DHS) surveys for 32 low-income to middle-income countries in combination with high-resolution precipitation data (via the Climate Hazards Group InfraRed Precipitation with Station dataset). We only included DHS data for which interview dates and GPS coordinates (latitude and longitude) of household clusters were available. We used a regression modelling approach to assess the relationship between different precipitation variability measures and infectious disease symptoms (cough, fever, and diarrhoea), and explored the effect modification of different climate zones and disease susceptibility factors.

Findings: Our global analysis showed that anomalously wet conditions increase the risk of cough, fever, and diarrhoea symptoms in humid, subtropical regions. These health risks also increased in tropical savanna regions as a result of anomalously dry conditions. Our analysis of susceptibility factors suggests that unimproved sanitation and unsafe drinking water sources are exacerbating these effects, particularly for rural populations and in drought-prone areas in tropical savanna.

Interpretation: Weather shifts can affect the survival and transmission of pathogens that are particularly harmful to young children. As our findings show, the health burden of climate-sensitive infectious diseases can be substantial and is likely to fall on populations that are already among the most disadvantaged, including households living in remote rural areas and those lacking access to safe water and sanitation infrastructure.

Funding: University of California, San Diego FY19 Center Launch programme.

Publication types

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

MeSH terms

Child
Child, Preschool
Communicable Diseases* / epidemiology
Diarrhea / epidemiology
Drinking Water*
Family Characteristics
Humans
Sanitation

Substances

Drinking Water