Associations Between Eight Earth Observation-Derived Climate Variables and Enteropathogen Infection: An Independent Participant Data Meta-Analysis of Surveillance Studies With Broad Spectrum Nucleic Acid Diagnostics

• Type of Material: Article
• Authors: Robert Breiman, Emory University; Josh M Colston, University of Virginia; Benjamin F Zaitchik, Johns Hopkins Krieger Sch Arts & Sci; Hamada S Badr, Johns Hopkins Krieger Sch Arts & Sci; Eleanor Burnett, US Centers for Disease Control and Prevention, Atlanta; Syed Asad Ali, Aga Khan University; Ajit Rayamajhi, Kanti Children's Hospital; Syed M Satter, International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR, B); Daniel Eibach, Bernhard Nocht Institute for Tropical Medicine (BNITM); Ralf Krumkamp, Bernhard Nocht Institute for Tropical Medicine (BNITM); Jürgen May, Bernhard Nocht Institute for Tropical Medicine (BNITM); Roma Chilengi, Centre for Infectious Disease Research in Zambia; Leigh M Howard, Vanderbilt University; Samba O Sow, Centre pour le Développement des Vaccins; Jahangir Hossain, The Gambia at the London School of Hygiene & Tropical Medicine; Debasish Saha, GSK Vaccine; Imran M Nisar, The Aga Khan University; Anita KM Zaidi, The Aga Khan University; Suman Kanungo, National Institute of Cholera and Enteric Diseases; Inácio Mandomando, Centro de Investigação em Saúde de Manhiça; Abu SG Faruque, International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR, B); Karen L Kotloff, University of Maryland; Myron M Levine, University of Maryland; Richard Omore, Kenya Medical Research Institute, Center for Global Health Research; Nicola Page, Natl Inst Communicable Dis; James A Platts-Mills, University of Virginia; Ulla Ashorn, Tampere University; Yue-Mei Fan, Tampere University; Prakash Sunder Shrestha, Tribhuvan University; Tahmeed Ahmed, International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR, B); Estomih Mduma, Haydom Global Health Institute; Pablo P Yori, University of Virginia; Zulfiqar Bhutta, Aga Khan University; Pascal Bessong, University of Venda; Maribel P Olortegui, Asociac Benef PRISMA; Aldo AM Lima, Federal University of Ceará; Gagandeep Kang, Christian Medical College, Vellore India; Jean Humphrey, Johns Hopkins Bloomberg School of Public Health; Andrew J Prendergast, Queen Mary University London; Robert Ntozini, Zvitambo Institute for Maternal and Child Health Research; Kazuhisa Okada, Osaka University; Warawan Wongboot, National Institute of Health, Nonthaburi Thailand; James Gaensbauer, Colorado School of Public Health; Mario T Melgar, Hospital Roosevelt; Tuula Pelkonen, Helsinki University Central Hospital; Cesar M Freitas, Hosp Pediat David Bernardino; Margaret N Kosek, University of Virginia
• Language: English
• Date: 2022-01-01
• Publisher: AMER GEOPHYSICAL UNION
• Publication Version: Final Published Version
• Copyright Statement: © 2021 The Authors. GeoHealth published by Wiley Periodicals LLC on behalf of American Geophysical Union.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1029/2021GH000452
• Title of Journal or Parent Work: GEOHEALTH
• Volume: 6
• Issue: 1
• Start Page: e2021GH000452
• End Page: e2021GH000452
• Grant/Funding Information: The research presented in this article was supported financially by NASA's Group on Earth Observations Work Programme (16‐GEO16‐0047) and the Department of Internal Medicine and the Division of Infectious Diseases and International Health of the University of Virginia. Further funding was obtained from the BMGF under OPP1066146 to M. N. Kosek. The funder played no role in the design and implementation of the study or the analysis and interpretation of the results.
• Keywords: Life Sciences & Biomedicine; RELATIVE-HUMIDITY; Science & Technology; Environmental Sciences; DIARRHEAL DISEASE; SURVIVAL; Environmental Sciences & Ecology; DEVELOPING-COUNTRIES; AMBIENT-TEMPERATURE; PATHOGENS; TIME-SERIES; YOUNG-CHILDREN; GLOBAL ENTERIC MULTICENTER; Public, Environmental & Occupational Health; ROTAVIRUS VACCINE
• Research Categories: Health Sciences, Medicine and Surgery; Health Sciences, Epidemiology

Abstract

Diarrheal disease, still a major cause of childhood illness, is caused by numerous, diverse infectious microorganisms, which are differentially sensitive to environmental conditions. Enteropathogen-specific impacts of climate remain underexplored. Results from 15 studies that diagnosed enteropathogens in 64,788 stool samples from 20,760 children in 19 countries were combined. Infection status for 10 common enteropathogens—adenovirus, astrovirus, norovirus, rotavirus, sapovirus, Campylobacter, ETEC, Shigella, Cryptosporidium and Giardia—was matched by date with hydrometeorological variables from a global Earth observation dataset—precipitation and runoff volume, humidity, soil moisture, solar radiation, air pressure, temperature, and wind speed. Models were fitted for each pathogen, accounting for lags, nonlinearity, confounders, and threshold effects. Different variables showed complex, non-linear associations with infection risk varying in magnitude and direction depending on pathogen species. Rotavirus infection decreased markedly following increasing 7-day average temperatures—a relative risk of 0.76 (95% confidence interval: 0.69–0.85) above 28°C—while ETEC risk increased by almost half, 1.43 (1.36–1.50), in the 20–35°C range. Risk for all pathogens was highest following soil moistures in the upper range. Humidity was associated with increases in bacterial infections and decreases in most viral infections. Several virus species' risk increased following lower-than-average rainfall, while rotavirus and ETEC increased with heavier runoff. Temperature, soil moisture, and humidity are particularly influential parameters across all enteropathogens, likely impacting pathogen survival outside the host. Precipitation and runoff have divergent associations with different enteric viruses. These effects may engender shifts in the relative burden of diarrhea-causing agents as the global climate changes.