<p>Tropical cyclones (TCs) can elevate diarrheal disease risk yet inconsistent definitions and types of diarrheal data being used can obscure important heterogeneity. Here, we used harmonized weekly diarrheal mortality and morbidity data from 10 Asian regions between 2000 and 2021. We applied two-way fixed effects models to estimate TC-diarrhea associations across regions and compare associations across multiple TC definitions. These definitions include wind-based (wind intensity), rainfall-based (percentile threshold), and combined wind-rainfall metrics. We then assessed differences across a range of diarrheal outcomes. We found that mortality associations were generally not statistically significant and had wide confidence intervals across regions. For morbidity, we observed substantial heterogeneity across regions and definitions, with the greatest TC-attributable burden observed in Taiwan. These findings suggest that tailored TC definitions, calibrated to local health burden profiles, represent a promising strategy to improve early warning systems and guide interventions.</p>

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Heterogeneous effects of tropical cyclones on diarrheal diseases across multiple Asian regions by cyclone definitions

  • Szu Yu Lin,
  • Changwoo Han,
  • Chris Fook Sheng Ng,
  • Anais Teyton,
  • Noémie Letellier,
  • Lina Madaniyazi,
  • Yoonhee Kim,
  • Chau-Ren Jung,
  • Vera Ling Hui Phung,
  • Paul LC Chua,
  • Ka Hin Tai,
  • Jinah Park,
  • Zhesi Yang,
  • Abu Syed Golam Faruque,
  • Christian Otto,
  • Cunrui Huang,
  • Dung T. Phung,
  • Kraichat Tantrakarnapa,
  • Miguel Antonio Salazar,
  • Muhammad Abdul Basit Ahmad Tajudin,
  • Patrick Brown,
  • Wissanupong Kliengchuay,
  • Rafaela Jane P. Delfino,
  • Tarik Benmarhnia,
  • Masahiro Hashizume

摘要

Tropical cyclones (TCs) can elevate diarrheal disease risk yet inconsistent definitions and types of diarrheal data being used can obscure important heterogeneity. Here, we used harmonized weekly diarrheal mortality and morbidity data from 10 Asian regions between 2000 and 2021. We applied two-way fixed effects models to estimate TC-diarrhea associations across regions and compare associations across multiple TC definitions. These definitions include wind-based (wind intensity), rainfall-based (percentile threshold), and combined wind-rainfall metrics. We then assessed differences across a range of diarrheal outcomes. We found that mortality associations were generally not statistically significant and had wide confidence intervals across regions. For morbidity, we observed substantial heterogeneity across regions and definitions, with the greatest TC-attributable burden observed in Taiwan. These findings suggest that tailored TC definitions, calibrated to local health burden profiles, represent a promising strategy to improve early warning systems and guide interventions.