Modeling the effect of climate variability on childhood diarrhea in Kathmandu, Nepal

Abstract

PDS 72: Environmental health issues in LMIC, Exhibition Hall (PDS), Ground floor, August 28, 2019, 10:30 AM - 12:00 PM Background: Evidence suggests that diarrhea onset can be influenced by change in climate parameters like precipitation and temperature. Hence, this study was undertaken to assess the effect of climate variability on diarrhea burden among children below 5 years of age living in Kathmandu, Nepal. Methods: We conducted a time-series study using the monthly count of diarrhea (2003- 2013), among children below 5 years of age living in Kathmandu Nepal. Generalized linear model assuming quasi Poisson distribution was fitted to estimate the effect of monthly maximum temperature and precipitation on childhood diarrhea. Seasonality and long term effects were adjusted using natural cubic splines with 4 degree of freedom per year and the lag effect was modeled using distributed lag linear model using, DLNM package in software R. Results: In total, 219,774 cases of diarrhea were recorded during the study period with a range between 100 to 4323 cases per month. The results of regression model revealed monthly count of diarrhea to increase by 8.1% (RR: 1.081; 95% CI: 1.02-1.14) per 1 degree Celsius increase in maximum temperature above the monthly average, within the same month. Likewise, rainfall was found to have significant effect on diarrhea with a 0.9% (RR: 1.009; 95% CI: 1.004 -1.015) increase in cases per 10 mm increase in rainfall above the monthly average, within the same month. Conclusion: The results of our analysis demonstrated a strong association between childhood diarrhea and increase in maximum temperature as well as precipitation for Kathmandu, Nepal.