Examining the effects of precipitation on diarrheal mortality in The City of Tshwane, South Africa Open Access

Talukdar, Asmita (Spring 2021)

Permanent URL: https://etd.library.emory.edu/concern/etds/4x51hk08z?locale=en
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Abstract

Background: South Africa is anticipated to experience higher levels of climate change compared to many other parts of the world. This includes changes to rainfall, which has been associated with diarrheal disease in other parts of the world. Here we explore the relationship between rainfall and diarrheal mortality in the City of Tshwane, South Africa.

Objectives: In a time-series study consisting of the whole of the population of the City of Tshwane from the years 1997-2013, I examined whether heavy rainfall, and other key factors like temperature, time, and age, was associated with increased diarrheal mortality.

Methods: Binary exposure variables along with the rainfall count variables were compared against overall diarrheal mortality and that of children <5. Seven day and fourteen day lagged rain variables were also calculated and factored into the continuous and binary models. With these, I estimated associations between both rainfall exposure variables, temperature, and time using poisson regression models, then subsequently, confidence interval plots.

Results: There was no risk of mortality from neither heavy rainfall events, nor continuous rainfall in the final interval plots with 95% CI. In subsequent sensitivity analyses, neither heavy rainfall exposure nor continuous rainfall was associated with changes to several spline functions nor when the thresholds for heavy rainfall were changed.

Conclusions: The results suggest that, in the City of Tshwane, over the past 17 years, neither continuous rainfall nor heavy rainfall, coupled with temperature, resulted in significant risk of mortality for the population. General rainfall trends over 17-years indicated that temperature and time are major factors in diarrheal mortality overall, especially among children; this was not the case for the overall population though. The findings of this study warrant future studies focusing specifically on the seasonality of rainfall trends relating to diarrheal mortality to establish the environmental pathway of diarrheal disease in this part of South Africa.

Table of Contents

Table of Contents

Introduction ………………………………………………………………………...1

Methods……………………………………………………………………………...3

Results……………………………………………………………………………….5

Discussion…………………………………………………………………………...11

References…………………………………………………………………………...14

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