Is diurnal temperature range a risk factor for childhood diarrhea?

Zhiwei Xu,Hong Su,Lyle R Turner,Cunrui Huang,Zhen Qiao,Shilu Tong,Qinghua Sun

doi:10.1371/journal.pone.0064713

Zhiwei Xu, Hong Su + Show 5 more

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https://doi.org/10.1371/journal.pone.0064713

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Abstract

BackgroundPrevious studies have found that high and cold temperatures increase the risk of childhood diarrhea. However, little is known about whether the within-day variation of temperature has any effect on childhood diarrhea.MethodsA Poisson generalized linear regression model combined with a distributed lag non-linear model was used to examine the relationship between diurnal temperature range and emergency department admissions for diarrhea among children under five years in Brisbane, from 1st January 2003 to 31st December 2009.ResultsThere was a statistically significant relationship between diurnal temperature range and childhood diarrhea. The effect of diurnal temperature range on childhood diarrhea was the greatest at one day lag, with a 3% (95% confidence interval: 2%–5%) increase of emergency department admissions per 1°C increment of diurnal temperature range.ConclusionWithin-day variation of temperature appeared to be a risk factor for childhood diarrhea. The incidence of childhood diarrhea may increase if climate variability increases as predicted.

Highlights

Despite an increasing number of vaccine programs implemented globally [1], diarrhea remains a major cause of morbidity and mortality worldwide among children under five years [2]
This study addressed three questions: 1) What is the relationship between diurnal temperature range (DTR) and childhood diarrhea? 2) What is the lag structure of the effect of DTR on childhood diarrhea? 3) Between two genders, are there any differences in the magnitudes and lagged periods of DTR effect on diarrhea?
We found the effect of DTR on childhood diarrhea was negligible for lags above 10 days, so we calculated the relative risk of DTR with lags up to 10 days

Summary

Introduction

Despite an increasing number of vaccine programs implemented globally [1], diarrhea remains a major cause of morbidity and mortality worldwide among children under five years [2]. It is a big problem in developing countries [3]. While the incidence of mortality due to childhood diarrhea has been declining in some industrialized countries [4,5,6], it is still an important source of morbidity in these regions [7]. For rotavirus associated diarrhea which is spread from person-to person, these interventions may be less effective [11]. Little is known about whether the within-day variation of temperature has any effect on childhood diarrhea

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