The impact of temperature and precipitation on all-infectious-, bacterial-, and viral-diarrheal disease in Taiwan

Background: The ongoing climate change will elevate the incidence of diarrheal in 2030-2050 in Asia, including Taiwan. This study investigated associations between meteorological factors (temperature, precipitation) and burden of age-cause-specific diarrheal diseases in six regions of Taiwan using 13 years of (2004-2016) population-based data.Methods: Weekly cause-specific diarrheal and meteorological data were obtained from 2004 to 2016. We used distrib-uted lag non-linear model to assess age (under five, all age) and cause-specific (viral, bacterial) diarrheal disease bur-den associated with extreme high (99th percentile) and low (5th percentile) of climate variables up to lag 8 weeks in six regions of Taiwan. Random-effects meta-analysis was used to pool these region-specific estimates.Results: Extreme low temperature (15.30 degrees C) was associated with risks of all-infectious and viral diarrhea, with the highest risk for all-infectious diarrheal found at lag 8 weeks among all age [Relative Risk (RR): 1.44; 95 % Confidence Interval (95 % CI): 1.24-1.67]. The highest risk of viral diarrheal infection was observed at lag 2 weeks regardless the age. Extreme high temperature (30.18 degrees C) was associated with risk of bacterial diarrheal among all age (RR: 1.07; 95 % CI: 1.02-1.13) at lag 8 weeks. Likewise, extreme high precipitation (290 mm) was associated with all infectious diar-rheal, with the highest risk observed for bacterial diarrheal among population under five years (RR: 2.77; 95 % CI: 1.60-4.79) at lag 8 weeks. Extreme low precipitation (0 mm) was associated with viral diarrheal in all age at lag 1 week (RR: 1.08; 95 % CI: 1.01-1.15)].Conclusion: In Taiwan, extreme low temperature is associated with an increased burden of viral diarrheal, while ex-treme high temperature and precipitation elevated burden of bacterial diarrheal. This distinction in cause-specific and climate-hazard specific diarrheal disease burden underscore the importance of incorporating differences in public health preparedness measures designed to enhance community resilience against climate change.

Automated summary

This study investigated the association between meteorological factors and burden of age-cause-specific diarrheal diseases in six regions of Taiwan. The results showed that extreme low temperature was associated with viral diarrheal, while extreme high temperature and precipitation were associated with bacterial diarrheal.