Heat Index: An Alternative Indicator for Measuring the Impacts of Meteorological Factors on Diarrhoea in the Climate Change Era: A Time Series Study in Dhaka, Bangladesh.

Heat index (HI) is a biometeorological indicator that combines temperature and relative humidity. This study aimed to investigate the relationship between the Heat Index and daily counts of diarrhoea hospitalisation in Dhaka, Bangladesh. Data on daily diarrhoea hospitalisations and meteorological variables from 1981 to 2010 were collected. We categorised the Heat Index of >94.3 °F (>34.6 °C), >100.7 °F (>38.2 °C) and >105 °F (>40.6 °C) as high, very high and extremely high Heat Index, respectively. We applied a time series adjusted generalised linear model (GLM) with negative binomial distribution to investigate the effects of the Heat Index and extreme Heat Index on hospitalisations for diarrhoea. Effects were assessed for all ages, children under 5 years old and by gender. A unit higher HI and high, very high and extremely high HI were associated with 0.8%, 8%, 7% and 9% increase in diarrhoea hospitalisations in all ages, respectively. The effects varied slightly by gender and were most pronounced in children under 5 years old with a rise of 1°F in high, very high and extremely high HI associated with a 14.1% (95% CI: 11.3-17.0%), 18.3% (95% CI: 13.4-23.5%) and 18.1% (95% CI: 8.4-28.6%) increase of diarrhoea, respectively. This suggests that the Heat Index may serve as an alternative indicator for measuring the combined effects of temperature and humidity on diarrhoea.