Effects of the 1997-1998 El Nino Episode on Community Rates of Diarrhea.

FECAL analysis; DIARRHEA; AGE distribution; ANALYSIS of variance; CLIMATOLOGY; CONFIDENCE intervals; STATISTICAL correlation; DIARRHEA in children; LONGITUDINAL method; PARASITES; POISSON distribution; PUBLIC health surveillance; RESEARCH funding; STATISTICAL sampling; SANITATION; SEASONS; TEMPERATURE; TIME; CITY dwellers; RELATIVE medical risk; DISEASE incidence; STATISTICAL models; DESCRIPTIVE statistics

Objectives. To improve our understanding of climate variability and diarrheal disease at the community level and inform predictions for future climate change scenarios, we examined whether the El Niño climate pattern is associated withincreased rates of diarrhea among Peruvian children. Methods. We analyzed daily surveillance data for 367 children aged 0 to 12 years from 2 cohorts in a peri-urban shantytown in Lima, Peru, 1995 through Niño , and modeled between-subject heterogeneity with random effects Poisson models. Results. Spring diarrheal incidence increased by 55% during El Niño compared with before El Niño. This increase was most acute among children older than 60 months, for whom the risk of a diarrheal episode during the El Niño spring was nearly 100% greater (relative risk = 1.96; 95% confidence interval = 1.24, 3.09). Conclusions. El Niño-associated climate variability affects community rates of diarrhea, particularly during the cooler seasons and among older children. Public health officials should develop preventive strategies for future El Niño episodes to mitigate the increased risk of diarrheal disease in vulnerable communities. [ABSTRACT FROM AUTHOR]

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