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Original Article
Quantifying the effects of anomalies of temperature, precipitation, and surface water storage on diarrhea risk in Taiwan
Gerry Andhikaputra, Ayushi Sharma, Amir Sapkota, Hao He, Yu-Kai Lin, Li-Wen Deng, Yu-Chun Wang
Epidemiol Health. 2023;45:e2023024.   Published online February 15, 2023
DOI: https://doi.org/10.4178/epih.e2023024
  • 3,460 View
  • 101 Download
  • 2 Web of Science
  • 2 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Diarrheal disease continues to be a significant cause of morbidity and mortality. We investigated how anomalies in monthly average temperature, precipitation, and surface water storage (SWS) impacted bacterial, and viral diarrhea morbidity in Taiwan between 2004 and 2015.
METHODS
A multivariate analysis using negative binomial generalized estimating equations was employed to quantify age-specific and cause-specific cases of diarrhea associated with anomalies in temperature, precipitation, and SWS.
RESULTS
Temperature anomalies were associated with an elevated rate of all-cause infectious diarrhea at a lag of 2 months, with the highest risk observed in the under-5 age group (incidence rate ratio [IRR], 1.03, 95% confidence interval [CI], 1.01 to 1.07). Anomalies in SWS were associated with increased viral diarrhea rates, with the highest risk observed in the under-5 age group at a 2-month lag (IRR, 1.27; 95% CI, 1.14 to 1.42) and a lesser effect at a 1-month lag (IRR, 1.18; 95% CI, 1.06 to 1.31). Furthermore, cause-specific diarrheal diseases were significantly affected by extreme weather events in Taiwan. Both extremely cold and hot conditions were associated with an increased risk of all-cause infectious diarrhea regardless of age, with IRRs ranging from 1.03 (95% CI, 1.02 to 1.12) to 1.18 (95% CI, 1.16 to 1.40).
CONCLUSIONS
The risk of all-cause infectious diarrhea was significantly associated with average temperature anomalies in the population aged under 5 years. Viral diarrhea was significantly associated with anomalies in SWS. Therefore, we recommend strategic planning and early warning systems as major solutions to improve resilience against climate change.
Summary
Key Message
New study reveals the impact of climate on diarrheal diseases in Taiwan. Anomalies have been adopted to represent the changes in the historical context of climate. Temperature anomaly was linked to increased infectious diarrhea, especially in the young population. Anomaly in surface water storage (SWS) was associated with higher rates of viral diarrhea. Extreme weather events further contribute to the risks. Urgent need for strategic planning and early warning systems to combat climate change and improve resilience are recommended.

Citations

Citations to this article as recorded by  
  • The impact of climate variability on dengue fever risk in central java, Indonesia
    Bima Sakti Satria Wibawa, Yu-Chun Wang, Gerry Andhikaputra, Yu-Kai Lin, Lin-Han Chiang Hsieh, Kun-Hsien Tsai
    Climate Services.2024; 33: 100433.     CrossRef
  • Characteristics and related factors of waterborne and foodborne infectious disease outbreaks before and after the onset of the COVID-19 pandemic (2017–2021) in the Republic of Korea: a descriptive study
    Eunkyoung Kim, Bryan Inho Kim
    Osong Public Health and Research Perspectives.2023; 14(6): 483.     CrossRef
Brief Communication
Prophylactic efficacy of probiotics on travelers’ diarrhea: an adaptive meta-analysis of randomized controlled trials
Jong-Myon Bae
Epidemiol Health. 2018;40:e2018043.   Published online August 29, 2018
DOI: https://doi.org/10.4178/epih.e2018043
  • 14,121 View
  • 441 Download
  • 16 Web of Science
  • 17 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
The 2017 guideline for the prevention of travelers’ diarrhea (TD) by the International Society of Travel Medicine suggested that ‘there is insufficient evidence to recommend the use of commercially available prebiotics or probiotics to prevent or treat TD.’ However, a meta-analysis published in 2007 reported significant efficacy of probiotics in the prevention of TD (summary relative risk [sRR], 0.85, 95% confidence interval [CI], 0.79 to 0.91). This study aimed to synthesize the efficacy of probiotics on TD by updating the meta-analysis of double-blind, placebo-controlled, randomized human trials.
METHODS
The search process was conducted by the adaptive meta-analysis method using the ‘cited by’ and ‘similar articles’ options provided by PubMed. The inclusion criteria were double-blind, placebo-controlled, randomized human trials with hypotheses of probiotics as intervention and TD as an outcome. The adaptive meta-analysis was conducted using Stata software using the csi, metan, metafunnel, and metabias options.
RESULTS
Eleven articles were selected for the meta-analysis. The sRR was 0.85 (95% CI, 0.79 to 0.91) and showed statistical significance. There was no heterogeneity (I-squared=28.4%) and no publication bias.
CONCLUSIONS
Probiotics showed statistically significant efficacy in the prevention of TD.
Summary
Korean summary
활생제가 여행자설사를 예방하는 효과가 있는가에 대한 기존 메타분석결과들과 지침간의 괴리가 확인되어서 갱신용 메타분석을 수행하였다. 총 11편의 무작위배정, 위약대조비교 임상시험결과에 대한 메타분석결과 통계적으로 유의한 효과가 있는 것으로 산출되었다 (summary relative risk =0.85; 95% confidence interval: 0.77-0.91).

Citations

Citations to this article as recorded by  
  • The Potential Impact of Probiotics on Human Health: An Update on Their Health-Promoting Properties
    Nicoleta-Maricica Maftei, Cosmin Raducu Raileanu, Alexia Anastasia Balta, Lenuta Ambrose, Monica Boev, Denisa Batîr Marin, Elena Lacramioara Lisa
    Microorganisms.2024; 12(2): 234.     CrossRef
  • Next generation probiotics: Engineering live biotherapeutics
    Sanjeeva Kumar Murali, Thomas J. Mansell
    Biotechnology Advances.2024; 72: 108336.     CrossRef
  • Bismuth subsalicylate, probiotics, rifaximin and vaccines for the prevention of travelers’ diarrhea: a systematic review and network meta-analysis
    Hao Fan, I-Chun Liu, Lei Gao, Lanka Wu
    Frontiers in Pharmacology.2024;[Epub]     CrossRef
  • Controlling Intestinal Infections and Digestive Disorders Using Probiotics
    Sanjeev Kumar, Md Faruque Ahmad, Priyakshi Nath, Rubina Roy, Rudrarup Bhattacharjee, Eman Shama, Indira Gahatraj, Manisha Sehrawat, Vaishali Dasriya, Harmeet Singh Dhillon, Monica Puniya, Mrinal Samtiya, Tejpal Dhewa, Rotimi E. Aluko, Gulab D. Khedkar, An
    Journal of Medicinal Food.2023; 26(10): 705.     CrossRef
  • Antibiotic treatment to reduce the duration and severity of travellers’ diarrhoea
    Romeo Toriro, William Nevin, Rebecca Kuehn, Hannah Ryan, Nicholas Beeching, Tom Fletcher, Dan Burns
    Cochrane Database of Systematic Reviews.2023;[Epub]     CrossRef
  • Phenotypic Assessment of Probiotic and Bacteriocinogenic Efficacy of Indigenous LAB Strains from Human Breast Milk
    Senbagam Duraisamy, Fazal Husain, Senthilkumar Balakrishnan, Aswathy Sathyan, Prabhu Subramani, Prahalathan Chidambaram, Selvaraj Arokiyaraj, Wahidah H. Al-Qahtani, Jothiramalingam Rajabathar, Anbarasu Kumarasamy
    Current Issues in Molecular Biology.2022; 44(2): 731.     CrossRef
  • Probiotics, their prophylactic and therapeutic applications in human health development: A review of the literature
    Bantayehu Addis Tegegne, Bekalu Kebede
    Heliyon.2022; 8(6): e09725.     CrossRef
  • Probiotics and rifaximin for the prevention of travelers’ diarrhea: A systematic review and network meta-analysis
    Hao Fan, Lei Gao, Zidan Yin, Sheng Ye, Hua Zhao, Qi Peng
    Medicine.2022; 101(40): e30921.     CrossRef
  • Gut Microbiota-targeted Interventions for Reducing the Incidence, Duration, and Severity of Respiratory Tract Infections in Healthy Non-elderly Adults
    J Philip Karl
    Military Medicine.2021; 186(3-4): e310.     CrossRef
  • The effects of probiotics, prebiotics and synbiotics on the reduction of IBD complications, a periodic review during 2009–2020
    A. Darb Emamie, M. Rajabpour, R. Ghanavati, P. Asadolahi, S. Farzi, B. Sobouti, A. Darbandi
    Journal of Applied Microbiology.2021; 130(6): 1823.     CrossRef
  • Pediatric Digestive Health and the Gut Microbiome: Existing Therapies and a Look to the Future
    Samantha Saul, Jessika Fuessel, Joseph Runde
    Pediatric Annals.2021;[Epub]     CrossRef
  • A Brief Overview on Probiotics: The Health Friendly Microbes
    Sanjukta Mishra, Swastik Acharya
    Biomedical and Pharmacology Journal.2021; 14(4): 1869.     CrossRef
  • Therapeutic, Prophylactic, and Functional Use of Probiotics: A Current Perspective
    Maria Aponte, Nicoletta Murru, Mahtab Shoukat
    Frontiers in Microbiology.2020;[Epub]     CrossRef
  • Probiotics: Reiterating What They Are and What They Are Not
    Gregor Reid, Azza A. Gadir, Raja Dhir
    Frontiers in Microbiology.2019;[Epub]     CrossRef
  • Probiotics and prebiotics in clinical tests: an update
    Harald Brüssow
    F1000Research.2019; 8: 1157.     CrossRef
  • A successful history: probiotics and their potential as antimicrobials
    Luigi Santacroce, Ioannis Alexandros Charitos, Lucrezia Bottalico
    Expert Review of Anti-infective Therapy.2019; 17(8): 635.     CrossRef
  • Emerging concepts in the diagnosis, treatment, and prevention of travelers’ diarrhea
    Lorne Schweitzer, Bhagteshwar Singh, Priscilla Rupali, Michael Libman
    Current Opinion in Infectious Diseases.2019; 32(5): 468.     CrossRef
Original Article
Using Bayesian Networks to Model Hierarchical Relationships in Epidemiological Studies
Georges Nguefack-Tsague
Epidemiol Health. 2011;33:e2011006.   Published online June 17, 2011
DOI: https://doi.org/10.4178/epih/e2011006
  • 48,849 View
  • 117 Download
  • 12 Crossref
AbstractAbstract PDF
Abstract
<sec><title>OBJECTIVES</title><p>To propose an alternative procedure, based on a Bayesian network (BN), for estimation and prediction, and to discuss its usefulness for taking into account the hierarchical relationships among covariates.</p></sec><sec><title>METHODS</title><p>The procedure is illustrated by modeling the risk of diarrhea infection for 2,740 children aged 0 to 59 months in Cameroon. We compare the procedure with a standard logistic regression and with a model based on multi-level logistic regression.</p></sec><sec><title>RESULTS</title><p>The standard logistic regression approach is inadequate, or at least incomplete, in that it does not attempt to account for potentially causal relationships between risk factors. The multi-level logistic regression does model the hierarchical structure, but does so in a piecewise manner; the resulting estimates and interpretations differ from those of the BN approach proposed here. An advantage of the BN approach is that it enables one to determine the probability that a risk factor (and/or the outcome) is in any specific state, given the states of the others. The currently available approaches can only predict the outcome (disease), given the states of the covariates.</p></sec><sec><title>CONCLUSION</title><p>A major advantage of BNs is that they can deal with more complex interrelationships between variables whereas competing approaches deal at best only with hierarchical ones. We propose that BN be considered as well as a worthwhile method for summarizing the data in epidemiological studies whose aim is understanding the determinants of diseases and quantifying their effects.</p></sec>
Summary

Citations

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  • Predicting COVID-19 community infection relative risk with a Dynamic Bayesian Network
    Daniel P. Johnson, Vijay Lulla
    Frontiers in Public Health.2022;[Epub]     CrossRef
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    Johann Detilleux
    Equine Veterinary Journal.2021; 53(2): 199.     CrossRef
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    Neville Kenneth Kitson, Anthony C. Constantinou
    Journal of Biomedical Informatics.2021; 113: 103588.     CrossRef
  • Novel statistical approaches to identify risk factors for soil-transmitted helminth infection in Timor-Leste
    Jessica Yi Han Aw, Naomi E. Clarke, Helen J. Mayfield, Colleen L. Lau, Alice Richardson, Susana Vaz Nery
    International Journal for Parasitology.2021; 51(9): 729.     CrossRef
  • Using Bayesian Networks to Predict Long-Term Health-Related Quality of Life and Comorbidity after Bariatric Surgery: A Study Based on the Scandinavian Obesity Surgery Registry
    Yang Cao, Mustafa Raoof, Eva Szabo, Johan Ottosson, Ingmar Näslund
    Journal of Clinical Medicine.2020; 9(6): 1895.     CrossRef
  • Can dementia be predicted using olfactory identification test in the elderly? A Bayesian network analysis
    Ding Ding, Xiaoniu Liang, Zhenxu Xiao, Wanqing Wu, Qianhua Zhao, Yang Cao
    Brain and Behavior.2020;[Epub]     CrossRef
  • Development of a multivariable predictive model for postoperative nausea and vomiting after cancer surgery in adults
    Léia Alessandra Pinto Yamada, Gabriel Magalhães Nunes Guimarães, Magda Aparecida Santos Silva, Angela Maria Sousa, Hazem Adel Ashmawi
    Brazilian Journal of Anesthesiology (English Edition).2019; 69(4): 342.     CrossRef
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    Brazilian Journal of Anesthesiology.2019; 69(4): 342.     CrossRef
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    Georges Nguefack-Tsague, Walter Zucchini
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