TitleClimatic Drivers of Diarrheagenic Escherichia coli Incidence: A Systematic Review and Meta-analysis.
Publication TypeJournal Article
Year of Publication2016
AuthorsPhilipsborn, R, Ahmed, SM, Brosi, BJ, Levy, K
JournalJ Infect Dis
Date Published2016 Jul 01
KeywordsClimate Change, Diarrhea, Escherichia coli Infections, Humans, Incidence, Seasons, Temperature

BACKGROUND: Positive associations have been noted between temperature and diarrhea incidence, but considerable uncertainty surrounds quantitative estimates of this relationship because of pathogen-specific factors and a scarcity of data on the influence of meteorological factors on the risk of disease. Quantifying these relationships is important for disease prevention and climate change adaptation.

METHODS: To address these issues, we performed a systematic literature review of studies in which at least 1 full year of data on the monthly incidence of diarrheagenic Escherichia coli were reported. We characterized seasonal patterns of disease incidence from 28 studies. In addition, using monthly time- and location-specific weather data for 18 studies, we performed univariate Poisson models on individual studies and a meta-analysis, using a generalized estimating equation, on the entire data set.

RESULTS: We found an 8% increase in the incidence of diarrheagenic E. coli (95% confidence interval, 5%-11%; P < .0001) for each 1°C increase in mean monthly temperature. We found a modest positive association between 1-month-lagged mean rainfall and incidence of diarrheagenic E. coli, which was not statistically significant when we controlled for temperature.

CONCLUSIONS: These results suggest that increases in ambient temperature correspond to an elevated incidence of diarrheagenic E. coli and underscore the need to redouble efforts to prevent the transmission of these pathogens in the face of increasing global temperatures.

Alternate JournalJ. Infect. Dis.
PubMed ID26931446
PubMed Central IDPMC4907410
Grant ListK01 AI103544 / AI / NIAID NIH HHS / United States
R21 TW009032 / TW / FIC NIH HHS / United States