Epidemiological Investigation of a Diarrhea Outbreak in the South Pacific Island Nation of Tuvalu during a Severe La Nina-Associated Drought Emergency in 2011
Epidemiological Investigation of a Diarrhea Outbreak in the South Pacific Island Nation of Tuvalu during a Severe La Nina-Associated Drought Emergency in 2011
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DOI：
10.4269/ajtmh.16-0812
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发表时间：
2017-01-01
影响因子：
3.3
通讯作者：
Nilles, Eric J.
中科院分区：
文献类型：
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作者：
Emont, Jordan P.;Ko, Albert I.;Nilles, Eric J.
暴雨和腹泻风险增加之间的联系已经得到了很好的证实，但对干旱对腹泻传播的影响知之甚少。2011年，太平洋岛国图瓦卢同时经历了与拉尼娜现象相关的严重干旱和大规模腹泻疫情。我们在图瓦卢进行了一次实地调查，以确定在干旱紧急情况下促成流行病传播的因素。病例数的高峰与记录的月降雨量的最低点相吻合，这是自1930年以来记录的最低点。与腹泻风险增加相关的独立因素是水箱水位低于20%的家庭（比值比[OR] = 2.31; 95%置信区间= 1.16-4.60）和洗手频率减少（OR = 3.00 [1.486.08]）。尽管持续干旱和供水有限，但在开展卫生宣传运动后，疫情得到了缓解。鉴于预测未来气候变化将导致更频繁和更严重的干旱，这些发现可能很重要。
The association between heavy rainfall and an increased risk of diarrhea has been well established but less is known about the effect of drought on diarrhea transmission. In 2011, the Pacific island nation of Tuvalu experienced a concurrent severe La Nina-associated drought and large diarrhea outbreak. We conducted a field investigation in Tuvalu to identify factors that contributed to epidemic transmission in the context of a drought emergency. Peak case numbers coincided with the nadir of recorded monthly rainfall, the lowest recorded since 1930. Independent factors associated with increased risk of diarrhea were households with water tank levels below 20% (odds ratio [OR] = 2.31; 95% confidence interval = 1.16-4.60) and decreased handwashing frequency (OR = 3.00 [1.486.08]). The resolution of the outbreak occurred after implementation of a hygiene promotion campaign, despite persistent drought and limited water access. These findings are potentially important given projections that future climate change will cause more frequent and severe droughts.