Effects of Ambient Temperature, Relative Humidity, and Precipitation on Diarrhea Incidence in Surabaya

Abstract

Background: Diarrhea remains a common infectious disease caused by various risk factors in developing countries. This study investigated the incidence rate and temporal associations between diarrhea and meteorological determinants in five regions of Surabaya, Indonesia. Method: Monthly diarrhea records from local governmental health facilities in Surabaya and monthly means of weather variables, including average temperature, precipitation, and relative humidity from Meteorology, Climatology, and Geophysical Agency were collected from January 2018 to September 2020. The generalized additive model was employed to quantify the time lag association between diarrhea risk and extremely low (5th percentile) and high (95th percentile) monthly weather variations in the north, central, west, south, and east regions of Surabaya (lag of 0–2 months). Result: The average incidence rate for diarrhea was 11.4 per 100,000 during the study period, with a higher incidence during rainy season (November to March) and in East Surabaya. This study showed that the weather condition with the lowest diarrhea risks varied with the region. The diarrhea risks were associated with extremely low and high temperatures, with the highest RR of 5.39 (95% CI 4.61, 6.17) in the east region, with 1 month of lag time following the extreme temperatures. Extremely low relative humidity increased the diarrhea risks in some regions of Surabaya, with the highest risk in the west region at lag 0 (RR = 2.13 (95% CI 1.79, 2.47)). Extremely high precipitation significantly affects the risk of diarrhea in the central region, at 0 months of lag time, with an RR of 3.05 (95% CI 2.09, 4.01). Conclusion: This study identified a high incidence of diarrhea in the rainy season and in the deficient developed regions of Surabaya, providing evidence that weather magnifies the adverse effects of inadequate environmental sanitation. This study suggests the local environmental and health sectors codevelop a weather-based early warning system and improve local sanitation practices as prevention measures in response to increasing risks of infectious diseases.

Associations between meteorological variation and hospitalisations for rotavirus infections in Kuala Lumpur, Malaysia

“…A study by Kraay et al corroborated our findings that in general, the occurrence of diarrhoea is more frequent during seasons with higher rainfall [ 17 ]. In Surabaya, Indonesia, Wibawa et al [ 18 ] observed a diarrhoea incidence of 11.4 cases per 100,000 population, especially during the rainy season. In contrast, Mejiozem et al [ 19 ] concluded that lower rainfall levels and higher temperatures were associated with the highest prevalence of RoV-induced diarrhoea.…”

“…Although we could not calculate the correlation between RoV incidence and temperature due to minimal variation in average temperatures across different years, the available data indicates that a 1 °C increase in temperature corresponds to a 4–10% decrease in the incidence of RoV associated diarrheal disease in tropical regions [ 6 ]. RoV diarrhoea could potentially be heightened due to the favourable conditions for viral replication and survival that low temperatures provide [ 18 ]. On the contrary note, the same study also observed elevated temperatures in the western, southern, and eastern regions of Surabaya were associated with an increased risk of diarrhoea [ 18 ].…”

“…RoV diarrhoea could potentially be heightened due to the favourable conditions for viral replication and survival that low temperatures provide [ 18 ]. On the contrary note, the same study also observed elevated temperatures in the western, southern, and eastern regions of Surabaya were associated with an increased risk of diarrhoea [ 18 ]. An interesting observation by a study [ 34 ] that even when stored for 2.5 months, RoV particles in faeces exhibit stability and remain potentially infectious in vitro, even under ambient temperatures exceeding 30 °C.…”

Exploring the Association between Ambient Temperature and Daily Hospital Admissions for Diarrhea in Mopani District, Limpopo Province, South Africa

“…Previous studies considered the relations between meteorological variables, e.g. daily temperature, relative humidity, rainfall, and diarrhea, (either as individual variables or combined in various forms), including Tapp [28][29][30]. Tapp has also been applied for other health outcomes such as cardiovascular diseases and respiratory diseases [31][32][33].…”

Climate influence on Diarrhea Disease in Tropical Regions based on Systematic Literature Review

“…Studies that examined viral diarrhea in relation to humidity showed inconsistent results. This inconsistent association may relate to viral pathogens (such as rotavirus diarrhea) that can survive under low and high humidity (Wibawa et al, 2023).…”