Institute for Global Health (IGH), University College London (UCL), London, United Kingdom.
UK Public Health Rapid Support Team (UK-PHRST), Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine (LSHTM), London, United Kingdom.
PLoS Negl Trop Dis. 2024 Sep 26;18(9):e0012139. doi: 10.1371/journal.pntd.0012139. eCollection 2024 Sep.
Dhaka is one of the world's densely populated cities and faces significant public health challenges including high burden of diarrhoeal diseases. Climate change is intensifying existing environmental problems including urban heat island effect and poor water quality. While numerous epidemiological studies have linked meteorological factors to diarrhoeal diseases in Bangladesh, assessment of the impacts of future climate change on diarrhoeal diseases is scarce. We provide the assessment of climate change impacts on diarrhoeal disease in Dhaka and project future health risks under climate change scenarios. About 3 million acute diarrhoea cases presenting to the Dhaka Hospital of the International Centre for Diarrhoeal Disease Research Bangladesh (icddr,b) during 1981-2010 were linked to daily temperature, rainfall and humidity and association investigated using time series adapted negative binomial regression models employing constrained distributed lag linear models. The findings were applied to climate projections to estimate future risks of diarrhoea under various global warming scenarios. There was a significantly raised risk of diarrhoea hospitalisation in all ages with daily mean temperature (RR: 3.4, 95% CI: 3.0-3.7) after controlling for the confounding effects of heavy rainfall, humidity, autocorrelations, day of the week effect, long-term time, and seasonal trends. Using the incidence rate ratio (IRR) of 1.034, temperature increases based on the global warming targets of 1.5-2°C could result in an increase of diarrhoea hospitalisations by 4.5-7.4% in all age groups by the 2100s. These effects were more pronounced among <5 children where the predicted temperature increases could raise diarrhoea hospitalisation by 5.7% - 9.4%. Diarrhoea hospitalisation will increase significantly in Dhaka even if the global warming targets adopted by the Paris Agreement is reached. This underscores the importance of preparing the city for management and prevention of diarrhoeal diseases.
达卡是世界上人口最密集的城市之一，面临着包括腹泻病负担沉重在内的重大公共卫生挑战。气候变化正在加剧现有的环境问题，包括城市热岛效应和水质差。虽然许多流行病学研究已经将气象因素与孟加拉国的腹泻病联系起来，但评估未来气候变化对腹泻病的影响还很少。我们评估了气候变化对达卡腹泻病的影响，并预测了未来气候变化情景下的健康风险。在 1981-2010 年期间，有大约 300 万例急性腹泻病例在孟加拉国国际腹泻病研究中心（icddr,b）的达卡医院就诊，这些病例与每日温度、降雨量和湿度有关，使用时间序列适应的负二项回归模型和受限分布滞后线性模型进行了关联研究。这些发现被应用于气候预测，以估计在各种全球变暖情景下未来腹泻的风险。在控制大雨、湿度、自相关、星期几效应、长期时间和季节性趋势等混杂因素的影响后，每日平均温度与所有年龄段的腹泻住院风险显著升高（RR：3.4，95%CI：3.0-3.7）。在全球变暖目标为 1.5-2°C 的情况下，基于 1.034 的发病率比值（IRR），温度升高可能导致所有年龄段的腹泻住院率增加 4.5-7.4%，到 2100 年代。在<5 岁儿童中，这些影响更为明显，预测的温度升高可能会使腹泻住院率增加 5.7%-9.4%。即使达到《巴黎协定》所通过的全球变暖目标，达卡的腹泻住院率也将显著增加。这凸显了为管理和预防腹泻病做好城市准备的重要性。
