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Challenges in developing methods for quantifying the effects of weather and climate on water-associated diseases: A systematic review

Lo Iacono, Giovanni, Armstrong, Ben, Fleming, Lora E., Elson, Richard, Kovats, Sari, Vardoulakis, Sotiris and Nichols, Gordon L. (2017) Challenges in developing methods for quantifying the effects of weather and climate on water-associated diseases: A systematic review PLOS Neglected Tropical Diseases, 11 (6).

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Abstract

Infectious diseases attributable to unsafe water supply, sanitation and hygiene (e.g. Cholera, Leptospirosis, Giardiasis) remain an important cause of morbidity and mortality, especially in low-income countries. Climate and weather factors are known to affect the transmission and distribution of infectious diseases and statistical and mathematical modelling are continuously developing to investigate the impact of weather and climate on water-associated diseases. There have been little critical analyses of the methodological approaches. Our objective is to review and summarize statistical and modelling methods used to investigate the effects of weather and climate on infectious diseases associated with water, in order to identify limitations and knowledge gaps in developing of new methods. We conducted a systematic review of English-language papers published from 2000 to 2015. Search terms included concepts related to water-associated diseases, weather and climate, statistical, epidemiological and modelling methods. We found 102 full text papers that met our criteria and were included in the analysis. The most commonly used methods were grouped in two clusters: process-based models (PBM) and time series and spatial epidemiology (TS-SE). In general, PBM methods were employed when the bio-physical mechanism of the pathogen under study was relatively well known (e.g. Vibrio cholerae); TS-SE tended to be used when the specific environmental mechanisms were unclear (e.g. Campylobacter). Important data and methodological challenges emerged, with implications for surveillance and control of water-associated infections. The most common limitations comprised: non-inclusion of key factors (e.g. biological mechanism, demographic heterogeneity, human behavior), reporting bias, poor data quality, and collinearity in exposures. Furthermore, the methods often did not distinguish among the multiple sources of time-lags (e.g. patient physiology, reporting bias, healthcare access) between environmental drivers/exposures and disease detection. Key areas of future research include: disentangling the complex effects of weather/climate on each exposure-health outcome pathway (e.g. person-to-person vs environment-to-person), and linking weather data to individual cases longitudinally.

Item Type: Article
Divisions : Faculty of Health and Medical Sciences > School of Veterinary Medicine
Authors :
NameEmailORCID
Lo Iacono, Giovannig.loiacono@surrey.ac.uk
Armstrong, Ben
Fleming, Lora E.
Elson, Richard
Kovats, Sari
Vardoulakis, Sotiris
Nichols, Gordon L.
Date : 12 June 2017
Identification Number : 10.1371/journal.pntd.0005659
Copyright Disclaimer : © 2017 Lo Iacono et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Additional Information : Author summary: Unsafe water supplies, limited sanitation and poor hygiene are still important causes of infectious disease (e.g. Cholera, Leptospirosis, Giardiasis), especially in low-income countries. Climate and weather affect the transmission and distribution of infectious diseases. Therefore, scientists are continuously developing new analysis methods to investigate the impacts of weather and climate on infectious disease, and particularly, on those associated with water. As these methods are based on an imperfect representation of the real world, they are inevitably subjected to many challenges. Based on a systematic review of the literature, we identified seven important challenges for scientists who develop new analysis methods.
Depositing User : Clive Harris
Date Deposited : 03 Nov 2017 10:06
Last Modified : 15 Mar 2018 08:10
URI: http://epubs.surrey.ac.uk/id/eprint/844815

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