High Temperature as a Risk Factor for Infectious Diarrhea in Shanghai, China

Background: Recent studies indicate that ambient temperature could be a risk factor for infectious diarrhea, but evidence for such a relation is limited in China. Methods: We investigated the short-term association between daily temperature and physician-diagnosed infectious diarrhea during 2008-2010 in Shanghai, China. We adopted a time-series approach to analyze the data and a quasi-Poisson regression model with a natural spline-smoothing function to adjust for long-term and seasonal trends, as well as other time-varying covariates. Results: There was a significant association between temperature and outpatient visits for diarrhea. A 1 degrees C increase in the 6-day moving average of temperature was associated with a 2.68% (95% CI: 1.83%, 3.52%) increase in outpatient visits for diarrhea. We did not find a significant association between rainfall and infectious diarrhea. Conclusions: High temperature might be a risk factor for infectious diarrhea in Shanghai. Public health programs should focus on preventing diarrhea related to high temperature among city residents.