ArticleThe American journal of tropical medicine and hygiene2020
Heavy Rainfall Events and Diarrheal Diseases: The Role of Urban-Rural Geography.
Article in The American journal of tropical medicine and hygiene, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
20 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Impact of Climate Variability on Foodborne Diarrheal Disease: Systematic Review and Meta-Analysis.Public health reviews · 2025Pooled it
- Floods and diarrheal morbidity: Evidence on the relationship, effect modifiers, and attributable risk from Sichuan Province, China.Journal of global health · 2022Pooled it
- Waterborne diseases and climate change.Nature reviews. Microbiology · 2026Review
- Time-Series Analysis and Age-Stratified Forecasting of Diarrheal Disease in Rwanda Using SARIMA Models.Tropical medicine and infectious disease · 2026Article
- Associations between storm exposure patterns and metabolic syndrome risk in Chinese adults: a CHARLS-based prospective cohort study.International journal of health geographics · 2026Article
- Variability of enteric pathogen infections by season and meteorological conditions in a low-income, urban setting in Mozambique.PLOS global public health · 2026Article
- Seasonal trends and short-term association between meteorological factors and diarrheal diseases among children under five in Tanzania.PloS one · 2026Article
- Acute gastroenteritis in Trinidad and Tobago: identifying trend by season, geography, and demographics from 2006 to 2023.IJID regions · 2025Review
- Epidemiology and clinical profile of diarrhea associated with enterotoxigenic Escherichia coli and Vibrio cholerae in Bangladesh: Findings from a hospital-based surveillance system, 2008-2023.PLoS neglected tropical diseases · 2025Article
- Variability of enteric pathogen infections by season and meteorological conditions in a low-income, urban setting in Mozambique.medRxiv : the preprint server for health sciences · 2025Article
- Global spillover of land-derived microbes to Ocean hosts: Sources, transmission pathways, and one health threats.Environmental science and ecotechnology · 2025Review
- Spatiotemporal variation of under-5 children diarrhea incidence and associated meteorological factors in central Gondar zone, Northwest Ethiopia. A retrospective time series study.BMC infectious diseases · 2025Article
- Unveiling the future: Wavelet- ARIMAX analysis of climate and diarrhea dynamics in Bangladesh's Urban centers.BMC public health · 2025Article
- Short-term associations of diarrhoeal diseases in children with temperature and precipitation in seven low- and middle-income countries from Sub-Saharan Africa and South Asia in the Global Enteric Multicenter Study.PLoS neglected tropical diseases · 2024Article
- Association between precipitation and mortality due to diarrheal diseases by climate zone: A multi-country modeling study.Environmental epidemiology (Philadelphia, Pa.) · 2024Article
- Detection of spatial, temporal and spatiotemporal distribution of diarrhea incidence among under-five children in Central Gondar zone, Northwest Ethiopia: a time-series study (2019-2022).BMC pediatrics · 2024Article
- The mediatory role of water quality on the association between extreme precipitation events and infectious diarrhea in the Yangtze River Basin, China.Fundamental research · 2024Article
- Identifying gaps on health impacts, exposures, and vulnerabilities to climate change on human health and wellbeing in South America: a scoping review.Lancet regional health. Americas · 2023Article
- Effects of High Temperature and Heavy Precipitation on Drinking Water Quality and Child Hand Contamination Levels in Rural Kenya.Environmental science & technology · 2023Article
- Impact of climate change on diarrheal diseases: A scoping review.The journal of climate change and healthArticle
Corrections and comments
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Authors and funding
3 authors.
Funding
Abstract
Diarrheal diseases remain a significant contributor to the global burden of disease. Climate change may increase their incidence by altering the epidemiology of waterborne pathogens through changes in rainfall patterns. To assess potential impacts of future changes in rainfall patterns, we analyzed 33,927 cases of diarrhea across all Ministry of Health clinical facilities in Esmeraldas Province, Ecuador, for a 24-month period from 2013 to 2014, using mixed-effects Poisson regression. We assessed the association between the incidence of diarrheal diseases and heavy rainfall events (HREs) and antecedent rainfall conditions. In rural areas, we found no significant associations between HREs and incidence. In urban areas, dry antecedent conditions were associated with higher incidence than wet conditions. In addition, HREs with dry antecedent conditions were associated with elevated incidence by up to 1.35 (incidence rate ratio, 95% CI: 1.14-1.60) times compared with similar conditions without HREs. These patterns may be driven by accumulation of fecal contamination during dry periods, followed by a flushing effect during HREs. This phenomenon is more important in dense urban environments with more impervious surfaces. These findings suggest that projected increases in rainfall variability and HREs may increase diarrhea burden in urban regions, which are rapidly expanding globally.
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