Abstract
The study examined relationships among meteorological parameters, water quality and diarrheal disease counts in two urban and three rural sites in Tamil Nadu, India. Disease surveillance was conducted between August 2010 and March 2012; concurrently water samples from street-level taps in piped distribution systems and from household storage containers were tested for pH, nitrate, total dissolved solids, and total and fecal coliforms. Methodological advances in data collection (concurrent prospective disease surveillance and environmental monitoring) and analysis (preserving temporality within the data through time series analysis) were used to quantify independent effects of meteorological conditions and water quality on diarrheal risk. The utility of a local calendar in communicating seasonality is also presented. Piped distribution systems in the study area showed high seasonal fluctuations in water quality. Higher ambient temperature decreased and higher rainfall increased diarrheal risk with temperature being the predominant factor in urban and rainfall in rural sites. Associations with microbial contamination were inconsistent; however, disease risk in the urban sites increased with higher median household total coliform concentrations. Understanding seasonal patterns in health outcomes and their temporal links to environmental exposures may lead to improvements in prospective environmental and disease surveillance tailored to addressing public health problems.
Highlights
IntroductionCorrespondence and requests for materials should be addressed to E.N.N. contaminated environments by practices such as open defecation[7]
We examined the seasonal patterns in water quality (WQ) and diarrheal disease counts by first creating weekly time series of all study parameters for urban and rural sites
TC concentrations in the public domain in both study sites peaked during the wet seasons, with the lowest concentrations occurring in the hottest months
Summary
Correspondence and requests for materials should be addressed to E.N.N. contaminated environments by practices such as open defecation[7]. Contaminated environments by practices such as open defecation[7] In this context, an estimated 37.7 million Indians are affected by waterborne diseases annually with 1.5 million diarrheal deaths in children[3]. Water quality[8,9,10] and diarrheal infections[11,12,13,14,15,16,17] have been shown to exhibit seasonality. Associations between diarrheal infections and meteorological parameters such as rainfall and temperature are not uniform across climates zones and time periods, highlighting a complex relationship between weather, WQ and waterborne diseases[12,17]. The data were analyzed using regression models applied to time series data considering the effects of meteorological parameters and the use of the local Tamil calendar
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