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1 "Extreme weather"
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Original Article
Quantifying the effects of anomalies of temperature, precipitation, and surface water storage on diarrhea risk in Taiwan
Gerry Andhikaputra, Ayushi Sharma, Amir Sapkota, Hao He, Yu-Kai Lin, Li-Wen Deng, Yu-Chun Wang
Epidemiol Health. 2023;45:e2023024.   Published online February 15, 2023
DOI: https://doi.org/10.4178/epih.e2023024
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Diarrheal disease continues to be a significant cause of morbidity and mortality. We investigated how anomalies in monthly average temperature, precipitation, and surface water storage (SWS) impacted bacterial, and viral diarrhea morbidity in Taiwan between 2004 and 2015.
METHODS
A multivariate analysis using negative binomial generalized estimating equations was employed to quantify age-specific and cause-specific cases of diarrhea associated with anomalies in temperature, precipitation, and SWS.
RESULTS
Temperature anomalies were associated with an elevated rate of all-cause infectious diarrhea at a lag of 2 months, with the highest risk observed in the under-5 age group (incidence rate ratio [IRR], 1.03, 95% confidence interval [CI], 1.01 to 1.07). Anomalies in SWS were associated with increased viral diarrhea rates, with the highest risk observed in the under-5 age group at a 2-month lag (IRR, 1.27; 95% CI, 1.14 to 1.42) and a lesser effect at a 1-month lag (IRR, 1.18; 95% CI, 1.06 to 1.31). Furthermore, cause-specific diarrheal diseases were significantly affected by extreme weather events in Taiwan. Both extremely cold and hot conditions were associated with an increased risk of all-cause infectious diarrhea regardless of age, with IRRs ranging from 1.03 (95% CI, 1.02 to 1.12) to 1.18 (95% CI, 1.16 to 1.40).
CONCLUSIONS
The risk of all-cause infectious diarrhea was significantly associated with average temperature anomalies in the population aged under 5 years. Viral diarrhea was significantly associated with anomalies in SWS. Therefore, we recommend strategic planning and early warning systems as major solutions to improve resilience against climate change.
Summary
Key Message
New study reveals the impact of climate on diarrheal diseases in Taiwan. Anomalies have been adopted to represent the changes in the historical context of climate. Temperature anomaly was linked to increased infectious diarrhea, especially in the young population. Anomaly in surface water storage (SWS) was associated with higher rates of viral diarrhea. Extreme weather events further contribute to the risks. Urgent need for strategic planning and early warning systems to combat climate change and improve resilience are recommended.

Epidemiol Health : Epidemiology and Health