The Impact of El Niño on Diarrheal Disease Incidence: A Systematic Review
Science Journal of Public Health
Volume 5, Issue 6, November 2017, Pages: 446-451
Received: Mar. 22, 2017; Accepted: Apr. 5, 2017; Published: Nov. 17, 2017
Views 2017      Downloads 142
Solomon Demissie, Ethiopian Institute of Water Resources, Addis Ababa University, Addis Ababa, Ethiopia
Bezatu Mengisitie, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
Article Tools
Follow on us
Climate change is becoming a huge threat to the health especially for those from developing countries. Diarrhea is one of the major diseases linked with changing climate. Global climate change is expected to increase the risk of diarrheal diseases, a leading cause of childhood mortality. El Niño Southern Oscillation (ENSO) is a climate event that originates in the Pacific Ocean but has wide-ranging consequences for weather around the world, and is especially associated with droughts and floods. An El Niño occurs approximately every 3 to 7 years when warm equatorial water shifts from Western to Eastern Pacific ocean. However, there is uncertainty about the impact of climate change/ESNO on the transmission of diarrheal pathogens and diarrhea disease. The aim of this systematical review is to examine the impact of El Niño on diarrheal disease incidence in children and adults. An extensive literature review was conducted in January 2017 using electronic databases Google Scholar, PubMed, and Directory of Open Access Journals (DOAJ). The review was limited to studies reporting the impacts of El Niño on diarrheal diseases or studying associations between climate change associated with El Niño and diarrheal diseases outcomes. Over 2600 scholarly papers and potential published articles identified in the initial electronic search, of which 30 fulfilled the inclusion criteria. Evidence for an association between disease risk and ENSO is more robust when analyses use a long time-series that incorporate more than one event and when there is an appropriate geographical aggregation of data. On the basis of the evidence available, this review primarily draws upon observational studies. The result of this systematic review confirmed that most of the studies noted a significant association between diarrheal disease and El Niño. However, research on the impact of El Nino/climate change on diarrhoeal disease is limited. Longitudinal studies over extended periods of time that investigate the link between El Nino/climate change and diarrheal disease are needed. There is a need for studies to be expanded to include more countries in the region and to include other environmental, social and economic factors that might affect the incidence of diarrheal disease.
Climate Change, El Niño, Diarrhea, Systematic Review
To cite this article
Solomon Demissie, Bezatu Mengisitie, The Impact of El Niño on Diarrheal Disease Incidence: A Systematic Review, Science Journal of Public Health. Vol. 5, No. 6, 2017, pp. 446-451. doi: 10.11648/j.sjph.20170506.16
Copyright © 2017 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License ( which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Van der Linden PJ, Hanson CE. Climate change 2007: impacts, adaptation, and vulnerability. Parry M, Canziani O, Palutikof J, editors. Cambridge: Cambridge University Press; 2007.
Kovats RS, Bouma MJ, Hajat S, Worrall E, Haines A. El Niño and health. The Lancet. 2003 Nov 1; 362(9394):1481-9.
Bennett A, Epstein LD, Gilman RH, Cama V, Bern C, Cabrera L, Lescano AG, Patz J, Carcamo C, Sterling CR, Checkley W. Effects of the 1997–1998 El Niño episode on community rates of diarrhea. American journal of public health. 2012 Jul; 102(7): e63-9.
Carlton EJ, Eisenberg JN, Goldstick J, Cevallos W, Trostle J, Levy K. Heavy rainfall events and diarrhea incidence: the role of social and environmental factors. American journal of epidemiology. 2013 Nov 19; 179(3):344-52.
De Magny GC, Guégan JF, Petit M, Cazelles B. Regional-scale climate-variability synchrony of cholera epidemics in West Africa. BMC infectious diseases. 2007 Mar 19; 7(1):20.
Rodó X, Pascual M, Fuchs G, Faruque AS. ENSO and cholera: A nonstationary link related to climate change? Proceedings of the national Academy of Sciences. 2002 Oct 1; 99(20):12901-6.
Lama JR, Seas CR, León-Barúa R, Gotuzzo E, Sack RB. Environmental temperature, cholera, and acute diarrhoea in adults in Lima, Peru. Journal of Health, Population and Nutrition. 2004 Dec 1:399-403.
Fricas J, Martz T. The impact of climate change on water, sanitation, and diarrheal diseases in Latin America and the Caribbean. Population Reference Bureau, www. prb. Org/Articles/2007/Climate Change in Latin America. aspx, last accessed. 2010 Oct; 29.
Hales S, Edwards SJ, Kovats RS. Impacts on health of climate extremes. Climate change and health: risks and responses. Geneva, World Health Organization. 2003.
Hales S, Kovats S, Woodward A. What El Niño can tell us about human health and global climate change. Global change & human health. 2000 Jul 1; 1(1):66-77.
Musengimana G, Mukinda FK, Machekano R, Mahomed H. Temperature variability and occurrence of diarrhoea in children under five-years-old in Cape Town Metropolitan Sub-Districts. International journal of environmental research and public health. 2016 Aug 29; 13(9):859.
Patz JA, Khaliq M. Global climate change and health: challenges for future practitioners. Jama. 2002 May 1; 287(17):2283-4.
Patz JA. Climate change and health: new research challenges. Ecosystem Health. 2000 Mar 1; 6(1):52-8.
Haines A, Kovats RS, Campbell-Lendrum D, Corvalán C. Climate change and human health: impacts, vulnerability, and public health. Public health. 2006 Jul 31; 120(7):585-96.
Shea KM. Global climate change and children's health. Pediatrics. 2007 Nov 1; 120(5): e1359-67.
Paz S. Impact of temperature variability on cholera incidence in southeastern Africa, 1971–2006. Ecohealth. 2009 Sep 1; 6(3):340-5.
Lauerman JF. Weathering diarrheal illness effects of El Niño in the South Pacific. Environmental health perspectives. 2001 Feb; 109(2): A84.
Hashizume M, Faruque AS, Terao T, Yunus M, Streatfield K, Yamamoto T, Moji K. The Indian Ocean dipole and cholera incidence in Bangladesh: a time-series analysis. Environmental health perspectives. 2011 Feb 1; 119(2):239.
Cazelles B, Hales S. Infectious diseases, climate influences, and nonstationarity. PLoS Med. 2006 Aug 15; 3(8): e328.
Bhandari GP, Gurung S, Dhimal M, Bhusal CL. Climate change and occurrence of diarrheal diseases: Evolving facts from Nepal. Journal of Nepal Health Research Council. 2013 Jan 3.
Haines A, McMichael AJ, Epstein PR. Environment and health: 2. Global climate change and health. Canadian Medical Association Journal. 2000 Sep 19; 163(6):729-34.
Kovats RS. El Niño and human health. Bulletin of the World Health Organization. 2000 Jan; 78(9):1127-35.
Kolstad EW, Johansson KA. Uncertainties associated with quantifying climate change impacts on human health: a case study for diarrhea. Environmental health perspectives. 2011 Mar; 119(3):299.
Mack A, Choffnes ER, editors. Global issues in water, sanitation, and health: workshop summary. National Academies Press; 2009 Oct 25.
Deb AK, Kanungo S, Deb M, Nair GB. Impact of climate change on health and strategies for mitigation and adaptation. WHO South-East Asia Journal of Public Health. 2012 Jan 1; 1(1):8.
Nkoko DB, Giraudoux P, Plisnier PD, Tinda AM, Piarroux M, Sudre B, Horion S, Tamfum JJ, Ilunga BK, Piarroux R. Dynamics of cholera outbreaks in Great Lakes region of Africa, 1978–2008. Emerging infectious diseases. 2011 Nov; 17(11):2026.
Alexander KA, Carzolio M, Goodin D, Vance E. Climate change is likely to worsen the public health threat of diarrheal disease in Botswana. International journal of environmental research and public health. 2013 Mar 26; 10(4):1202-30.
World Health Organization. WHO South-East Asia Journal of Public Health, Volume 6, Issue 1, April 2017.
Field CB, editor. Managing the risks of extreme events and disasters to advance climate change adaptation: special report of the intergovernmental panel on climate change. Cambridge University Press; 2012 May 28.
Moreno AR. Climate change and human health in Latin America: drivers, effects, and policies. Regional Environmental Change. 2006 May 1; 6(3):157-64.
Science Publishing Group
1 Rockefeller Plaza,
10th and 11th Floors,
New York, NY 10020
Tel: (001)347-983-5186