ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
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Stanke C, Kerac M, Prudhomme C, Medlock J, Murray V, 2013. Health effects of drought: a systematic review of the evidence. PLoS Curr. Available at: http://currents.plos.org/disasters/article/dis-13-0001-health-effects-of-drought-a-systematic-review-of-the-evidence/. Accessed April 4, 2015.
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Ropelewski CF, Halpert MS, 1987. Global and regional scale precipitation patterns associated with the El Niño/Southern Oscillation. Mon Wea Rev 115: 1606–1626.
-
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Dilley M, Heyman BN, 1995. ENSO and disaster: droughts, floods and El Niño/Southern Oscillation warm events. Disasters 19: 181–193.
-
4.
Gergis JL, Fowler AM, 2008. A history of ENSO events since A.D. 1525: implications for future climate change. Clim Change 92: 343–387.
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Dai A, 2011. Drought under global warming: a review. Wiley Interdiscip Rev Clim Chang 2: 45–65.
-
6.
Kool JL, Paterson B, Pavlin BI, Durrheim D, Musto J, Kolbe A, 2012. Pacific-wide simplified syndromic surveillance for early warning of outbreaks. Glob Public Health 7: 670–681.
-
7.
Burr ML, Davis AR, Zbijowski AG, 1978. Diarrhoea and the drought. Public Health 92: 86–87.
-
8.
Thacker SB, Music SI, Pollard RA, Berggren G, Boulos C, Nagy T, Brutus M, Pamphile M, Ferdinand RO, Joseph VR, 1980. Acute water shortage and health problems in Haiti. Lancet 1: 471–473.
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United Nations Office for the Coordination of Humanitarian Affairs, 2011. Situation Update: Tuvalu Drought, 4 October 2011. Available at: http://www.pacificdisaster.net/pdnadmin/data/documents/7602.html. Accessed October 14, 2015.
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The SPHERE Project, 2011. Water Supply Standard 1: Access and Water Quantity. Available at: http://www.spherehandbook.org/en/water-supply-standard-1-access-and-water-quantity/. Accessed October 16, 2015.
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United Nations Office for the Coordination of Humanitarian Affairs, 2011. Tuvalu, Tokelau, and the Cook Islands: Drought Situation Update, Friday, October 14, 2011. Available at: http://www.pacificdisaster.net/pdnadmin/data/original/OCHA_20111014_TUV_DR_situpdate.pdf. Accessed October 14, 2015.
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World Health Organization, 2011. Pacific Public Health Surveillance Network, Pacific Syndromic Surveillance Reports. Available at: http://www.pphsn.net/Surveillance/Syndromic_reports-2011.htm. Accessed October 15, 2015.
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World Health Organization, 2004. Guidelines for Drinking-Water Quality, 3rd edition. Available at: http://www.who.int/water_sanitation_health/dwq/fulltext.pdf. Accessed October 14, 2015.
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Tauxe RV, Holmberg SD, Dodin A, Wells JV, Blake PA, 1988. Epidemic cholera in Mali: high mortality and multiple routes of transmission in a famine area. Epidemiol Infect 100: 279–289.
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Bhavnani D, Goldstick JE, Cevallos W, Trueba G, Eisenberg JNS, 2014. Impact of rainfall on diarrheal disease risk associated with unimproved water and sanitation. Am J Trop Med Hyg 90: 705–711.
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Moors E, Singh T, Siderius C, Balakrishnan S, Mishra A, 2013. Climate change and waterborne diarrhoea in northern India: impacts and adaptation strategies. Sci Total Environ 468–469: S139–S151.
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21.
Ahmed W, Hodgers L, Sidhu JPS, Toze S, 2011. Fecal indicators and zoonotic pathogens in household drinking water taps fed from rainwater tanks in southeast Queensland, Australia. Appl Environ Microbiol 78: 219–226.
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22.
Evans CA, Coombes PJ, Dunstan RH, 2006. Wind, rain and bacteria: the effect of weather on the microbial composition of roof-harvested rainwater. Water Res 40: 37–44.
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23.
Climate Prediction Center, 2015. ENSO Diagnostic Discussion. Available at: http://www.cpc.ncep.noaa.gov/products/analysis_monitoring/enso_advisory/ensodisc.html. Accessed November 5, 2015.
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24.
Barnett TP, Adam JC, Lettenmaier DP, 2005. Potential impacts of a warming climate on water availability in snow-dominated regions. Nature 438: 303–309.
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25.
Cobb KM, Westphal N, Sayani HR, Watson JT, Di Lorenzo E, Cheng H, Edwards RL, Charles CD, 2013. Highly variable El Niño-Southern Oscillation throughout the Holocene. Science 339: 67–70.
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Government of Australia, 2014. Climate Variability, Extremes and Change in the Western Tropical Pacific: Pacific Climate Change Science. Available at: http://www.pacificclimatechangescience.org/publications/reports/climate-variability-.extremes-and-change-in-the-western-tropical-pacific-2014/. Accessed April 5, 2015.
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Mimura N, Nurse L, McLean RF, Agard J, Brigguglio L, Lefale P, Payet R, Sem G, 2007. 16: Small Islands. Climate Change 2007: Impacts, Adaptation and Vulnerability Contribution of Working Group II in the Fourth Assessment Report of the Intergovernmental Panel on Climate Change, 687–716. Available at: http://www.ipcc.ch/pdf/assessment-report/ar4/wg2/ar4-wg2-chapter16.pdf. Accessed April 5, 2015.
| Past two years | Past Year | Past 30 Days | |
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| Abstract Views | 783 | 570 | 101 |
| Full Text Views | 755 | 25 | 1 |
| PDF Downloads | 380 | 28 | 0 |
Epidemiological Investigation of a Diarrhea Outbreak in the South Pacific Island Nation of Tuvalu During a Severe La Niña–Associated Drought Emergency in 2011
Jordan P. Emont
Jordan P. Emont
Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut.
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Albert I. Ko
Albert I. Ko
Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut.
Fundação Oswaldo Cruz, Salvador, Brazil.
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Fundação Oswaldo Cruz, Salvador, Brazil.
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Avanoa Homasi-Paelate
Avanoa Homasi-Paelate
Tuvalu Ministry of Health, Funafuti, Tuvalu.
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Nese Ituaso-Conway
Nese Ituaso-Conway
Tuvalu Ministry of Health, Funafuti, Tuvalu.
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Eric J. Nilles
Eric J. Nilles
World Health Organization, Suva, Fiji.
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The association between heavy rainfall and an increased risk of diarrhea has been well established but less is known about the effect of drought on diarrhea transmission. In 2011, the Pacific island nation of Tuvalu experienced a concurrent severe La Niña–associated drought and large diarrhea outbreak. We conducted a field investigation in Tuvalu to identify factors that contributed to epidemic transmission in the context of a drought emergency. Peak case numbers coincided with the nadir of recorded monthly rainfall, the lowest recorded since 1930. Independent factors associated with increased risk of diarrhea were households with water tank levels below 20% (odds ratio [OR] = 2.31; 95% confidence interval = 1.16–4.60) and decreased handwashing frequency (OR = 3.00 [1.48–6.08]). The resolution of the outbreak occurred after implementation of a hygiene promotion campaign, despite persistent drought and limited water access. These findings are potentially important given projections that future climate change will cause more frequent and severe droughts.
Author Notes
Financial support: We would like to thank the support of the National Institutes of Health (1 R01 TW009504); the Stolwijk Fellowship, Yale Global Health Initiative; and the Coca-Cola World Fund at Yale University.
Authors' addresses: Jordan P. Emont, Department of Epidemiology of Microbial Diseases, Yale University Yale School of Public Health, New Haven, CT, E-mail: jordan.emont@yale.edu. Albert I. Ko, Department of Epidemiology of Microbial Diseases, Yale University Yale School of Public Health, New Haven, CT, and Fundação Oswaldo Cruz, Centro de Pesquisas Gonçalo Moniz–FIOCRUZ, Salvador, Brazil, E-mail: albert.ko@yale.edu. Avanoa Homasi-Paelate and Nese Ituaso-Conway, Public Health, Tuvalu Ministry of Health, Funafuti, Tuvalu, E-mails: mysabs@yahoo.com and n_ituaso@yahoo.com. Eric J. Nilles, Division of Pacific Technical Support, Emerging Disease Surveillance and Response, World Health Organization Regional Office for the Western Pacific, Suva, Fiji, E-mail: ericnilles@gmail.com.
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
Stanke C, Kerac M, Prudhomme C, Medlock J, Murray V, 2013. Health effects of drought: a systematic review of the evidence. PLoS Curr. Available at: http://currents.plos.org/disasters/article/dis-13-0001-health-effects-of-drought-a-systematic-review-of-the-evidence/. Accessed April 4, 2015.
-
2.
Ropelewski CF, Halpert MS, 1987. Global and regional scale precipitation patterns associated with the El Niño/Southern Oscillation. Mon Wea Rev 115: 1606–1626.
-
3.
Dilley M, Heyman BN, 1995. ENSO and disaster: droughts, floods and El Niño/Southern Oscillation warm events. Disasters 19: 181–193.
-
4.
Gergis JL, Fowler AM, 2008. A history of ENSO events since A.D. 1525: implications for future climate change. Clim Change 92: 343–387.
-
5.
Dai A, 2011. Drought under global warming: a review. Wiley Interdiscip Rev Clim Chang 2: 45–65.
-
6.
Kool JL, Paterson B, Pavlin BI, Durrheim D, Musto J, Kolbe A, 2012. Pacific-wide simplified syndromic surveillance for early warning of outbreaks. Glob Public Health 7: 670–681.
-
7.
Burr ML, Davis AR, Zbijowski AG, 1978. Diarrhoea and the drought. Public Health 92: 86–87.
-
8.
Thacker SB, Music SI, Pollard RA, Berggren G, Boulos C, Nagy T, Brutus M, Pamphile M, Ferdinand RO, Joseph VR, 1980. Acute water shortage and health problems in Haiti. Lancet 1: 471–473.
-
9.
Tuvalu Statistics, Population Census 2012. Available at: http://www.spc.int/prism/tuvalu/. Accessed April 3, 2015.
-
10.
Government of Tuvalu, 2010. Secretariat of the Pacific Regional Environment Programme. Integrated Waste Management, Water and Sanitation Review Action Plan.
-
11.
Government of Tuvalu, 2010. Secretariat of the Pacific Community Geoscience Division. Tuvalu Rainwater Harvesting Survey.
-
12.
Government of Tuvalu, 2011. Tokelau Census of Population and Dwellings. Available at: http://stats.govt.nz/browse_for_stats/people_and_communities/pacific_peoples/2011-tokelau-census-landing-page.aspx. Accessed October 12, 2015.
-
13.
United Nations Office for the Coordination of Humanitarian Affairs, 2011. Situation Update: Tuvalu Drought, 4 October 2011. Available at: http://www.pacificdisaster.net/pdnadmin/data/documents/7602.html. Accessed October 14, 2015.
-
14.
The SPHERE Project, 2011. Water Supply Standard 1: Access and Water Quantity. Available at: http://www.spherehandbook.org/en/water-supply-standard-1-access-and-water-quantity/. Accessed October 16, 2015.
-
15.
United Nations Office for the Coordination of Humanitarian Affairs, 2011. Tuvalu, Tokelau, and the Cook Islands: Drought Situation Update, Friday, October 14, 2011. Available at: http://www.pacificdisaster.net/pdnadmin/data/original/OCHA_20111014_TUV_DR_situpdate.pdf. Accessed October 14, 2015.
-
16.
World Health Organization, 2011. Pacific Public Health Surveillance Network, Pacific Syndromic Surveillance Reports. Available at: http://www.pphsn.net/Surveillance/Syndromic_reports-2011.htm. Accessed October 15, 2015.
-
17.
World Health Organization, 2004. Guidelines for Drinking-Water Quality, 3rd edition. Available at: http://www.who.int/water_sanitation_health/dwq/fulltext.pdf. Accessed October 14, 2015.
-
18.
Tauxe RV, Holmberg SD, Dodin A, Wells JV, Blake PA, 1988. Epidemic cholera in Mali: high mortality and multiple routes of transmission in a famine area. Epidemiol Infect 100: 279–289.
-
19.
Bhavnani D, Goldstick JE, Cevallos W, Trueba G, Eisenberg JNS, 2014. Impact of rainfall on diarrheal disease risk associated with unimproved water and sanitation. Am J Trop Med Hyg 90: 705–711.
-
20.
Moors E, Singh T, Siderius C, Balakrishnan S, Mishra A, 2013. Climate change and waterborne diarrhoea in northern India: impacts and adaptation strategies. Sci Total Environ 468–469: S139–S151.
-
21.
Ahmed W, Hodgers L, Sidhu JPS, Toze S, 2011. Fecal indicators and zoonotic pathogens in household drinking water taps fed from rainwater tanks in southeast Queensland, Australia. Appl Environ Microbiol 78: 219–226.
-
22.
Evans CA, Coombes PJ, Dunstan RH, 2006. Wind, rain and bacteria: the effect of weather on the microbial composition of roof-harvested rainwater. Water Res 40: 37–44.
-
23.
Climate Prediction Center, 2015. ENSO Diagnostic Discussion. Available at: http://www.cpc.ncep.noaa.gov/products/analysis_monitoring/enso_advisory/ensodisc.html. Accessed November 5, 2015.
-
24.
Barnett TP, Adam JC, Lettenmaier DP, 2005. Potential impacts of a warming climate on water availability in snow-dominated regions. Nature 438: 303–309.
-
25.
Cobb KM, Westphal N, Sayani HR, Watson JT, Di Lorenzo E, Cheng H, Edwards RL, Charles CD, 2013. Highly variable El Niño-Southern Oscillation throughout the Holocene. Science 339: 67–70.
-
26.
Government of Australia, 2014. Climate Variability, Extremes and Change in the Western Tropical Pacific: Pacific Climate Change Science. Available at: http://www.pacificclimatechangescience.org/publications/reports/climate-variability-.extremes-and-change-in-the-western-tropical-pacific-2014/. Accessed April 5, 2015.
-
27.
Mimura N, Nurse L, McLean RF, Agard J, Brigguglio L, Lefale P, Payet R, Sem G, 2007. 16: Small Islands. Climate Change 2007: Impacts, Adaptation and Vulnerability Contribution of Working Group II in the Fourth Assessment Report of the Intergovernmental Panel on Climate Change, 687–716. Available at: http://www.ipcc.ch/pdf/assessment-report/ar4/wg2/ar4-wg2-chapter16.pdf. Accessed April 5, 2015.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 783 | 570 | 101 |
| Full Text Views | 755 | 25 | 1 |
| PDF Downloads | 380 | 28 | 0 |