Climatic Factors in Relation to Diarrhea for Informed Public Health Decision-Making: A Novel Methodological Approach

Background Diarrheal disease is one of the leading causes of morbidity and mortality globally, particularly in children under 5 years of age. Factors related to diarrheal disease incidence include infection, malnutrition, and exposure to contaminated water and food. Climate factors also contribute to diarrheal disease. Objectives We aimed to explore the relationship between temperature, precipitation and diarrhea case counts of hospital admissions among vulnerable communities living in a rural setting in South Africa. Methods We applied a novel approach of ‘contour analysis’ to visually examine simultaneous observations in frequencies of anomalously high and low diarrhea case counts occurring in a season and assigning colors to differences that were statistically significant based on chi-squared test results. Results There was a significantly positive difference between high and low ‘groups’ when there was a lack of rain (0 mm of cumulative rain) for 1 to 2 weeks in winter for children under 5. Diarrhea prevalence was greater among children under 5 years when conditions were hotter than usual during winter and spring. Discussion Dry conditions may lead to increased water storage raising the risks of water contamination. Reduced use of water for personal hygiene and cleaning of outdoor pit latrines affect sanitation quality. Rural communities require adequate and uninterrupted water provision and healthcare providers should raise awareness about potential diarrheal risks especially during the dry season.