Rainfall variation and child health: effect of rainfall on diarrhea among under 5 children in Rwanda, 2010

Abstract

BackgroundDiarrhea among children under 5 years of age has long been a major public health concern. Previous studies have suggested an association between rainfall and diarrhea. Here, we examined the association between Rwandan rainfall patterns and childhood diarrhea and the impact of household sanitation variables on this relationship.MethodsWe derived a series of rain-related variables in Rwanda based on daily rainfall measurements and hydrological models built from daily precipitation measurements collected between 2009 and 2011. Using these data and the 2010 Rwanda Demographic and Health Survey database, we measured the association between total monthly rainfall, monthly rainfall intensity, runoff water and anomalous rainfall and the occurrence of diarrhea in children under 5 years of age.ResultsAmong the 8601 children under 5 years of age included in the survey, 13.2 % reported having diarrhea within the 2 weeks prior to the survey. We found that higher levels of runoff were protective against diarrhea compared to low levels among children who lived in households with unimproved toilet facilities (OR = 0.54, 95 % CI: [0.34, 0.87] for moderate runoff and OR = 0.50, 95 % CI: [0.29, 0.86] for high runoff) but had no impact among children in household with improved toilets.ConclusionOur finding that children in households with unimproved toilets were less likely to report diarrhea during periods of high runoff highlights the vulnerabilities of those living without adequate sanitation to the negative health impacts of environmental events.

Use, microbiological effectiveness and health impact of a household water filter intervention in rural Rwanda—A matched cohort study

“…In order to control for the potential impact of precipitation on water quality and diarrhoea Levy et al, 2016;Mukabutera et al, 2016), total precipitation within the previous 10 days to each household's survey date was included in analyses as a potential confounder (Ercumen et al, 2015b). Data were downloaded in Network Common Data Format (NetCDF) for each village centroid from Climate Hazards Group InfraRed Precipitation with Station data 2.0 (CHIRPS) (Funk et al, 2015), which comprises daily gridded precipitation data derived from satellite and in-situ station data at 0.05 degree spatial resolution (approximately 5.3km).…”

Exogenous factors matter when interpreting the results of an impact evaluation: a case study of rainfall and child health programme intervention in Rwanda

“…Our preliminary results showed that the point prevalence of ARI, diarrhoea, fever, stunting, underweight and wasting was reduced by an additional 12.6%, 6.2%, 12.4% 5.9%, 6.7% and 1.0%, respectively in the PIH‐supported areas compared to other rural areas (unpublished results). In another analysis, we found that rainfall‐related factors were also associated with these outcomes , and mechanisms for weather to impact these child health outcomes include crop production, water availability and quality, mosquito populations, bacteria and parasite growth, air quality and flooding . Finally, there is evidence that rainfall‐related factors vary between PIH‐supported areas and other areas of Rwanda (Figure ).…”

“…Although many such contextual factors may vary across geographical regions, we chose to examine the impact of rainfall which is well known to affect the incidence of some common infectious diseases and to vary in intensity and duration in different regions over time. Rainfall is unlike political or cultural factors that may affect the health of an area in that it is consistently and relatively accurately measured, and that rainfall patterns are extremely unlikely to vary based on the intervention and so are unlikely to be an intermediate on the causal pathway between the intervention and the outcome.…”

Diarrhoeal Diseases in Children Under Five Years Exhibited Space-Time Disparities and Priority Areas for Control Interventions in Rwanda

“…Another study from Ghana reported a negative relationship between diarrhoeal diseases and rainfall by analyzing routine data reported on childhood diarrhoea [29]. The findings of the research that employed secondary data of DHS in Rwanda found that higher runoff was protective of diarrhoea in children living household with unimproved toilet facilities [30]. The DHS 2014/2015 elucidated that only 11.6% of household used surface water and more than a half of households used improved latrines [31].…”