Effects of Climatic Factors on Diarrheal Diseases among Children below 5 Years of Age at National and Subnational Levels in Nepal: An Ecological Study

Meghnath Dhimal, Dinesh Bhandari, Khem B. Karki, Srijan Lal Shrestha, Mukti Khanal, Raja Ram Pote Shrestha, Sushma Dahal, Bihungum Bista, Kristie L. Ebi, Guéladio Cissé, Amir Sapkota and David A. Groneberg
Additional contact information
Meghnath Dhimal: Nepal Health Research Council, Ramshah Path, Kathmandu 44600, Nepal
Dinesh Bhandari: Nepal Health Research Council, Ramshah Path, Kathmandu 44600, Nepal
Khem B. Karki: Nepal Health Research Council, Ramshah Path, Kathmandu 44600, Nepal
Srijan Lal Shrestha: Central Department of Statistics, Tribhuvan University, Kirtipur 44600, Nepal
Mukti Khanal: Management Division, Department of Health Services, Teku, Kathmandu 44600, Nepal
Raja Ram Pote Shrestha: World Health Organization, Country Office for Nepal, Lalitpur 44600, Nepal
Sushma Dahal: Nepal Health Research Council, Ramshah Path, Kathmandu 44600, Nepal
Bihungum Bista: Nepal Health Research Council, Ramshah Path, Kathmandu 44600, Nepal
Kristie L. Ebi: Center for Health and the Global Environment, University of Washington, Seattle, WA 98195, USA
Guéladio Cissé: Department of Epidemiology and Public Health, Swiss TPH, 4051 Basel, Switzerland
Amir Sapkota: Maryland Institute for Applied Environmental Health, School of Public Health, University of Maryland, College Park, MD 20742, USA
David A. Groneberg: Institute of Occupation, Social and Environmental Medicine, Goethe University, 60323 Frankfurt am Main, Germany

IJERPH, 2022, vol. 19, issue 10, 1-12

Abstract: Introduction: The incidence of diarrhea, a leading cause of morbidity and mortality in low-income countries such as Nepal, is temperature-sensitive, suggesting it could be associated with climate change. With climate change fueled increases in the mean and variability of temperature and precipitation, the incidence of water and food-borne diseases are increasing, particularly in sub-Saharan Africa and South Asia. This national-level ecological study was undertaken to provide evidence linking weather and climate with diarrhea incidence in Nepal. Method: We analyzed monthly diarrheal disease count and meteorological data from all districts, spanning 15 eco-development regions of Nepal. Meteorological data and monthly data on diarrheal disease were sourced, respectively, from the Department of Hydrology and Meteorology and Health Management Information System (HMIS) of the Government of Nepal for the period from 2002 to 2014. Time-series log-linear regression models assessed the relationship between maximum temperature, minimum temperature, rainfall, relative humidity, and diarrhea burden. Predictors with p -values < 0.25 were retained in the fitted models. Results: Overall, diarrheal disease incidence in Nepal significantly increased with 1 °C increase in mean temperature (4.4%; 95% CI: 3.95, 4.85) and 1 cm increase in rainfall (0.28%; 95% CI: 0.15, 0.41). Seasonal variation of diarrheal incidence was prominent at the national level (11.63% rise in diarrheal cases in summer (95% CI: 4.17, 19.61) and 14.5% decrease in spring (95% CI: −18.81, −10.02) compared to winter season). Moreover, the effects of temperature and rainfall were highest in the mountain region compared to other ecological regions of Nepal. Conclusion: Our study provides empirical evidence linking weather factors and diarrheal disease burden in Nepal. This evidence suggests that additional climate change could increase diarrheal disease incidence across the nation. Mountainous regions are more sensitive to climate variability and consequently the burden of diarrheal diseases. These findings can be utilized to allocate necessary resources and envision a weather-based early warning system for the prevention and control of diarrheal diseases in Nepal.

Keywords: climate change; Nepal; diarrhea (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (2)

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