Potential impact of macroclimatic variability on the epidemiology of giardiasis in three provinces of Cuba, 2010–2012

Abstract

Climate change and variability are common phenomena affecting various infectious diseases. Many studies have been performed on vector-borne diseases; however, few studies have addressed such influences on intestinal parasitic diseases (e.g., giardiasis). In this study, using nonlinear Poisson regression models, we assessed the potential associations between macroclimatic variation and giardiasis cases in children and school workers from three provinces of Cuba in the context of large sampling and parasitological assessment. Between 2010 and 2012, 293,019 subjects were assessed, resulting in 6357 positive for Giardia (216.95 cases/10,000 pop.; 95%CI 211.7-222.2). The variation in time for those giardiasis rates ranged from 35.8 to 525.8 cases/10,000 pop. Nonlinear Poisson regression models between the ONI index and the giardiasis incidence indicated a significant association (p<0.01). With lower values of ONI, lower incidence of giardiasis was observed at Havana (pseudo r(2)=0.0576; p<0.001) and Guantánamo (pseudo r(2)=0.0376; p<0.001). Although these results are preliminary and the magnitude of association is not higher, the results were of statistical significance. This result indicates the need to assess in detail in further studies the impact of additional macroclimatic and microclimatic variables on the epidemiology of this still important intestinal parasitic disease, not only in Cuba but also in other countries of the Caribbean and Latin American region.

Risk Assessment for Giardia in Environmental Samples

“…Escobedo et al [83] in their ecological study verified statistically that giardiasis increases significantly during the climate change that occurs with the "El Niño" phenomenon by using nonlinear Poisson models similar to those in QMRA and proving that Giardia infections are sensitive to climate. This knowledge can be helpful to identify sources of infection and support in the prevention and control of these diseases.…”

Introductory Chapter: Giardiasis - Still a Globally Relevant Protozoan and Zoonotic Disease

“…Some epidemiological studies have shown that its prevalence varies between the population studied and the location, from 2 to 5% on industrialized countries to 20-30% in developing countries [1,5,11], and these changes in prevalence are associated, among others, with the hygiene infrastructure and the impact of the weather conditions, reason why environmental control eforts are necessary, which requires an integrated and systematic approach to decrease and mitigate the inluence on the disease epidemiology; for this reason, it is linked to educational programs and other interventional measures [2,6,12].…”

“…Consequently, ingestion of water or food that contains small levels of contamination can result in the disease, which is more recurrent in summer and fall. Other usual ways to transmit them could be among day care center atendees and people who live in residential institutions, and it could also spread by means of sexual activity, by oral-anal contact [1,5,11,12].…”

“…The roles of the host's intestinal normal lora and co-infections during Giardia infections are still largely unascertained [3,12,15,19].…”

“…Most symptomatic infections resolve spontaneously; however, sometimes, hospitalization is required when infections have longterm consequences and do not respond to the normal treatment. Chronic Giardia infections are reported frequently in nonendemic areas and also could result in irritable bowel syndrome, food allergies, arthritis, aphthous ulcers, or chronic fatigue syndrome after resolution [3,[10][11][12].…”