Abstract
El Niño is responsible for natural disasters and infectious disease outbreaks worldwide. During the 1997–1998 El Niño, northern Peru endured extreme rainfall and flooding. Since short stature may occur as a result of undernutrition or repeated infections during childhood, both of which are highly prevalent during natural disasters, we sought to determine if the 1997–1998 El Niño had an adverse effect on stature and body composition a decade later. In 2008–2009, we measured height, weight, and bioimpedance in a random sample of 2,095 children born between 1991 and 2001 in Tumbes, Peru. Height-for-age increased by 0.09 SD/year of birth between 1991 and 1997 (P < 0.001), indicating overall improvements in health over time in the study area; however, this rate fell to 0.04 SD/year of birth during and shortly after El Niño, less than half the rate prior to El Niño (P = 0.046). Height shortfalls were even greater in children residing in households most likely to be flooded after El Niño. Any improvement over time was completely blunted and became negative in children living in households with flood likelihoods of ≥7% (P = 0.001). In the subset of 912 children with bioimpedance measurements, those born after the onset of El Niño had less lean mass (P < 0.001), whereas fat mass was unaffected (P = 0.48). Children born during and after 1997–1998 El Niño were on average shorter and had less lean mass for their age and sex than expected had El Niño not occurred. The effects of El Niño on health are long lasting and, given its cyclical nature, may continue to negatively impact future generations.
Highlights
The El Niño phenomenon is an anomalous warming of sea surface temperatures (SST) in the equatorial Pacific that causes extreme weather variability every 2 to 7 years [1], leading to disaster and disease worldwide
We examined 1) whether children born after the onset of El Niño had differences in later body composition (lean mass (LM) and fat mass (FM)) and 2) whether birth and death rates in Tumbes changed significantly in 1997–1998, the period of El Niño, using data collected by the Peruvian National Institute of Statistics and Information between 1994 and 2002
The negative effect in height and lean mass was not prevented, if the major effort to intervene by the Peruvian government had not occurred, this disaster might have produced a severe impact on mortality which has been seen in other similar disaster situations such as the 1999 flood in Venezuela [38], the 2000 flood [38] and 2002– 2003 droughts in Mozambique [39], and more recently, the 2009 flood in the Philippines [40] and the 2010 flood in Pakistan [41]
Summary
The El Niño phenomenon is an anomalous warming of sea surface temperatures (SST) in the equatorial Pacific that causes extreme weather variability every 2 to 7 years [1], leading to disaster and disease worldwide. While many studies have evaluated the short-term effects of El Niño episodes such as an increase in the burden of infectious diseases, the long-term consequences on human health have not been studied. Due to the recurrent and global nature of El Niño, it is important that we gain a better understanding of possible long-term adverse effects on the health of affected human populations. One such measure of poor health is failure to grow adequately in height, known as stunting. In 2008–2009, we measured height, weight, and bioimpedance in a random sample of 2,095 children born between 1991 and 2001 in Tumbes, Peru
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