Dataset Information

Cholera and shigellosis: different epidemiology but similar responses to climate variability.

ABSTRACT:

Background

Comparative studies of the associations between different infectious diseases and climate variability, such as the El Niño-Southern Oscillation, are lacking. Diarrheal illnesses, particularly cholera and shigellosis, provide an important opportunity to apply a comparative approach. Cholera and shigellosis have significant global mortality and morbidity burden, pronounced differences in transmission pathways and pathogen ecologies, and there is an established climate link with cholera. In particular, the specific ecology of Vibrio cholerae is often invoked to explain the sensitivity of that disease to climate.

Methods and findings

The extensive surveillance data of the International Center for Diarrheal Disease Research, Bangladesh are used here to revisit the known associations between cholera and climate, and to address their similarity to previously unexplored patterns for shigellosis. Monthly case data for both the city of Dhaka and a rural area known as Matlab are analyzed with respect to their association with El Niño and flooding. Linear correlations are examined between flooding and cumulative cases, as well as for flooding and El Niño. Rank-correlation maps are also computed between disease cases in the post-monsoon epidemic season and sea surface temperatures in the Pacific. Similar climate associations are found for both diseases and both locations. Increased cases follow increased monsoon flooding and increased sea surface temperatures in the preceding winter corresponding to an El Niño event.

Conclusions

The similarity in association patterns suggests a systemic breakdown in population health with changing environmental conditions, in which climate variability acts primarily through increasing the exposure risk of the human population. We discuss these results in the context of the on-going debate on the relative importance of the environmental reservoir vs. secondary transmission, as well as the implications for the use of El Niño as an early indicator of flooding and enteric disease risk.

SUBMITTER: Cash BA

PROVIDER: S-EPMC4168003 | biostudies-literature | 2014

REPOSITORIES: biostudies-literature

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Publications

Cholera and shigellosis: different epidemiology but similar responses to climate variability.

Cash Benjamin A BA Rodó Xavier X Emch Michael M Yunus Md M Faruque Abu S G AS Pascual Mercedes M

PloS one 20140917 9

<h4>Background</h4>Comparative studies of the associations between different infectious diseases and climate variability, such as the El Niño-Southern Oscillation, are lacking. Diarrheal illnesses, particularly cholera and shigellosis, provide an important opportunity to apply a comparative approach. Cholera and shigellosis have significant global mortality and morbidity burden, pronounced differences in transmission pathways and pathogen ecologies, and there is an established climate link with ...[more]

PMID: 25229494

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Project description:BackgroundResponding to the high burden of cholera in developing countries, the WHO now considers vaccination as a supplement to the provision of safe drinking water and improved sanitation in the strategy for cholera control in endemic settings. Cultural concepts of illness affect many aspects of public health. In the first step of a two-step strategy to examine determinants of cholera vaccine acceptance, this study identified social and cultural features of diarrhoeal illness for cholera control in endemic communities.MethodsA cultural epidemiological study with locally adapted vignette-based interviews was conducted in two cholera-endemic communities of Zanzibar. A random sample of unaffected peri-urban (n = 179) and rural (n = 177) adults was interviewed to study community ideas of cholera and shigellosis, considering categories of distress, perceived causes, and help-seeking behaviour.ResultsCholera was recognised by 88%. Symptoms of dehydration were most prominent in reports at the peri-urban site. Interference with work leading to strain on household finances was frequently emphasised. Dirty environment was the most prominent perceived cause, followed by unsafe drinking water and germ-carrying flies. Causes unrelated to the biomedical basis of cholera were reported more often by rural respondents. Rural women had more difficulty (20%) to identify a cause than men (7.1%, p = 0.016). Peri-urban self treatment emphasised rehydration; the rural community preferred herbal treatment and antibiotics. Shigellosis was recognised by 70%. Fewer regarded it as very serious compared with cholera (76% vs. 97%, p < 0.001) and regarded it as less likely to be fatal (48% vs. 78%, p < 0.001). More respondents could not explain causes of shigellosis (23%) compared with cholera (7.3%, p < 0.001). Community respondents less frequently identified dehydration and contagiousness for shigellosis. Government facilities were preferred healthcare providers for both conditions.ConclusionsThis study clarified local views of cholera and shigellosis relevant for diarrhoeal disease control in Zanzibar. The finding that rural women were less likely than men to specify causes of cholera suggests more attention to them is required. Better health education is needed for cholera in rural areas and for shigellosis in general. This study also identified variables for subsequent analysis of social and cultural determinants of cholera vaccine acceptance.

Project description:Upper treeline ecotones are important life form boundaries and particularly sensitive to a warming climate. Changes in growth conditions at these ecotones have wide-ranging implications for the provision of ecosystem services in densely populated mountain regions like the European Alps. We quantify climate effects on short- and long-term tree growth responses, focusing on among-tree variability and potential feedback effects. Although among-tree variability is thought to be substantial, it has not been considered systematically yet in studies on growth-climate relationships. We compiled tree-ring data including almost 600 trees of major treeline species (Larix decidua, Picea abies, Pinus cembra, and Pinus mugo) from three climate regions of the Swiss Alps. We further acquired tree size distribution data using unmanned aerial vehicles. To account for among-tree variability, we employed information-theoretic model selections based on linear mixed-effects models (LMMs) with flexible choice of monthly temperature effects on growth. We isolated long-term trends in ring-width indices (RWI) in interaction with elevation. The LMMs revealed substantial amounts of previously unquantified among-tree variability, indicating different strategies of single trees regarding when and to what extent to invest assimilates into growth. Furthermore, the LMMs indicated strongly positive temperature effects on growth during short summer periods across all species, and significant contributions of fall (L. decidua) and current year's spring (L. decidua, P. abies). In the longer term, all species showed consistently positive RWI trends at highest elevations, but different patterns with decreasing elevation. L. decidua exhibited even negative RWI trends compared to the highest treeline sites, whereas P. abies, P. cembra, and P. mugo showed steeper or flatter trends with decreasing elevation. This does not only reflect effects of ameliorated climate conditions on tree growth over time, but also reveals first signs of long-suspected negative and positive feedback of climate change on stand dynamics at treeline.

Dataset Information

Cholera and shigellosis: different epidemiology but similar responses to climate variability.

Background

Methods and findings

Conclusions

Publications

Cholera and shigellosis: different epidemiology but similar responses to climate variability.

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