Associations Between Eight Earth Observation-Derived Climate Variables and Enteropathogen Infection: An Independent Participant Data Meta-Analysis of Surveillance Studies With Broad Spectrum Nucleic Acid Diagnostics

Josh M Colston, Benjamin F Zaitchik, Hamada S Badr, Eleanor Burnett, Syed Asad Ali, Ajit Rayamajhi, Syed M Satter, Daniel Eibach, Ralf Krumkamp, Jürgen May, Roma Chilengi, Leigh M Howard, Samba O Sow, M Jahangir Hossain, Debasish Saha, M Imran Nisar, Anita K M Zaidi, Suman Kanungo, Inácio Mandomando, Abu S G FaruqueKaren L Kotloff, Myron M Levine, Robert F Breiman, Richard Omore, Nicola Page, James A Platts-Mills, Ulla Ashorn, Yue-Mei Fan, Prakash Sunder Shrestha, Tahmeed Ahmed, Estomih Mduma, Pablo Penatero Yori, Zulfiqar Bhutta, Pascal Bessong, Maribel P Olortegui, Aldo A M Lima, Gagandeep Kang, Jean Humphrey, Andrew J Prendergast, Robert Ntozini, Kazuhisa Okada, Warawan Wongboot, James Gaensbauer, Mario T Melgar, Tuula Pelkonen, Cesar Mavacala Freitas, Margaret N Kosek

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    Abstract

    Diarrheal disease, still a major cause of childhood illness, is caused by numerous, diverse infectious microorganisms, which are differentially sensitive to environmental conditions. Enteropathogen-specific impacts of climate remain underexplored. Results from 15 studies that diagnosed enteropathogens in 64,788 stool samples from 20,760 children in 19 countries were combined. Infection status for 10 common enteropathogens-adenovirus, astrovirus, norovirus, rotavirus, sapovirus, Campylobacter, ETEC, Shigella, Cryptosporidium and Giardia-was matched by date with hydrometeorological variables from a global Earth observation dataset-precipitation and runoff volume, humidity, soil moisture, solar radiation, air pressure, temperature, and wind speed. Models were fitted for each pathogen, accounting for lags, nonlinearity, confounders, and threshold effects. Different variables showed complex, non-linear associations with infection risk varying in magnitude and direction depending on pathogen species. Rotavirus infection decreased markedly following increasing 7-day average temperatures-a relative risk of 0.76 (95% confidence interval: 0.69-0.85) above 28°C-while ETEC risk increased by almost half, 1.43 (1.36-1.50), in the 20-35°C range. Risk for all pathogens was highest following soil moistures in the upper range. Humidity was associated with increases in bacterial infections and decreases in most viral infections. Several virus species' risk increased following lower-than-average rainfall, while rotavirus and ETEC increased with heavier runoff. Temperature, soil moisture, and humidity are particularly influential parameters across all enteropathogens, likely impacting pathogen survival outside the host. Precipitation and runoff have divergent associations with different enteric viruses. These effects may engender shifts in the relative burden of diarrhea-causing agents as the global climate changes.

    Original languageEnglish
    Article numbere2021GH000452
    Number of pages20
    JournalGeoHealth
    Volume6
    Issue number1
    Early online dateDec 2021
    DOIs
    Publication statusPublished - Jan 2022
    Publication typeA1 Journal article-refereed

    Publication forum classification

    • Publication forum level 1

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