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The impact of environmental and climatic variation on the spatiotemporal trends of hospitalized pediatric diarrhea in Ho Chi Minh City, Vietnam.

Thompson CN, Zelner JL, Nhu Tdo H, Phan MV, Hoang Le P, Nguyen Thanh H, Vu Thuy D, Minh Nguyen N, Ha Manh T, Van Hoang Minh T, Lu Lan V, Nguyen Van Vinh C, Tran Tinh H, von Clemm E, Storch H, Thwaites G, Grenfell BT, Baker S - Health Place (2015)

Bottom Line: Using all inpatient diarrheal admissions data from three large hospitals within HCMC, we developed a mixed effects regression model to differentiate district-level variation in risk due to environmental conditions from the overarching seasonality of diarrheal disease hospitalization in HCMC.We identified considerable spatial heterogeneity in the risk of all-cause diarrhea across districts of HCMC with low elevation and differential responses to flooding, air temperature, and humidity driving further spatial heterogeneity in diarrheal disease risk.The incorporation of these results into predictive forecasting algorithms will provide a powerful resource to aid diarrheal disease prevention and control practices in HCMC and other similar settings.

View Article: PubMed Central - PubMed

Affiliation: Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine, Nuffield Department of Medicine, University of Oxford, United Kingdom; The London School of Hygiene & Tropical Medicine, United Kingdom. Electronic address: cthompson@oucru.org.

No MeSH data available.


Related in: MedlinePlus

The rate of reported diarrhea in Ho Chi Minh City, 2008–2010. (A) Map of HCMC showing the smoothed rate of reported diarrheal cases per 100,000 population by ward, with the scale in units of standard deviations from normalized monthly citywide mean. Districts are labeled by number in black. (B) Map showing the corresponding population density of HCMC, with darker colors indicating higher densities per square kilometer. (C) Map showing the predicted error of reported diarrheal rate estimates across HCMC, with darker colors indicating increasing uncertainty (scale shown in bottom right of figure, interpreted as standard deviations from predicted local estimate). (For interpretation of the references to color in this figure legend, the reader is referred to the web version of this article.)
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f0010: The rate of reported diarrhea in Ho Chi Minh City, 2008–2010. (A) Map of HCMC showing the smoothed rate of reported diarrheal cases per 100,000 population by ward, with the scale in units of standard deviations from normalized monthly citywide mean. Districts are labeled by number in black. (B) Map showing the corresponding population density of HCMC, with darker colors indicating higher densities per square kilometer. (C) Map showing the predicted error of reported diarrheal rate estimates across HCMC, with darker colors indicating increasing uncertainty (scale shown in bottom right of figure, interpreted as standard deviations from predicted local estimate). (For interpretation of the references to color in this figure legend, the reader is referred to the web version of this article.)

Mentions: The minimum district-level rate of hospitalized diarrhea in children <16 years of age was 11.9/100,000 population (range: 1.1–42.2/100,000). The smoothed ward-level rates in Fig. 2A illustrate substantial heterogeneity in overall risk of diarrheal disease across HCMC. We observed that wards situated adjacent to waterways in the central regions of the city were more likely to have a higher rate of all-cause diarrhea in comparison to the normalized citywide monthly mean. The minimum reported incidence rates in the waterway-laden areas (specifically in wards within district 6 and 8) exceeded 50 cases/100,000 population in some months. These central areas are amongst the most densely populated in the city with a mean population density of 44,300/km2 (Fig. 2C), and are situated below the average city elevation (2.8 m) at a ward mean of 1.14 m above sea level (Fig. 2D). The trend of an elevated rate of diarrheal hospitalizations extended south along the river ways and canals through districts 7, 13 and 20 (district locations shown in Fig. 5).


The impact of environmental and climatic variation on the spatiotemporal trends of hospitalized pediatric diarrhea in Ho Chi Minh City, Vietnam.

Thompson CN, Zelner JL, Nhu Tdo H, Phan MV, Hoang Le P, Nguyen Thanh H, Vu Thuy D, Minh Nguyen N, Ha Manh T, Van Hoang Minh T, Lu Lan V, Nguyen Van Vinh C, Tran Tinh H, von Clemm E, Storch H, Thwaites G, Grenfell BT, Baker S - Health Place (2015)

The rate of reported diarrhea in Ho Chi Minh City, 2008–2010. (A) Map of HCMC showing the smoothed rate of reported diarrheal cases per 100,000 population by ward, with the scale in units of standard deviations from normalized monthly citywide mean. Districts are labeled by number in black. (B) Map showing the corresponding population density of HCMC, with darker colors indicating higher densities per square kilometer. (C) Map showing the predicted error of reported diarrheal rate estimates across HCMC, with darker colors indicating increasing uncertainty (scale shown in bottom right of figure, interpreted as standard deviations from predicted local estimate). (For interpretation of the references to color in this figure legend, the reader is referred to the web version of this article.)
© Copyright Policy - CC BY
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4664115&req=5

f0010: The rate of reported diarrhea in Ho Chi Minh City, 2008–2010. (A) Map of HCMC showing the smoothed rate of reported diarrheal cases per 100,000 population by ward, with the scale in units of standard deviations from normalized monthly citywide mean. Districts are labeled by number in black. (B) Map showing the corresponding population density of HCMC, with darker colors indicating higher densities per square kilometer. (C) Map showing the predicted error of reported diarrheal rate estimates across HCMC, with darker colors indicating increasing uncertainty (scale shown in bottom right of figure, interpreted as standard deviations from predicted local estimate). (For interpretation of the references to color in this figure legend, the reader is referred to the web version of this article.)
Mentions: The minimum district-level rate of hospitalized diarrhea in children <16 years of age was 11.9/100,000 population (range: 1.1–42.2/100,000). The smoothed ward-level rates in Fig. 2A illustrate substantial heterogeneity in overall risk of diarrheal disease across HCMC. We observed that wards situated adjacent to waterways in the central regions of the city were more likely to have a higher rate of all-cause diarrhea in comparison to the normalized citywide monthly mean. The minimum reported incidence rates in the waterway-laden areas (specifically in wards within district 6 and 8) exceeded 50 cases/100,000 population in some months. These central areas are amongst the most densely populated in the city with a mean population density of 44,300/km2 (Fig. 2C), and are situated below the average city elevation (2.8 m) at a ward mean of 1.14 m above sea level (Fig. 2D). The trend of an elevated rate of diarrheal hospitalizations extended south along the river ways and canals through districts 7, 13 and 20 (district locations shown in Fig. 5).

Bottom Line: Using all inpatient diarrheal admissions data from three large hospitals within HCMC, we developed a mixed effects regression model to differentiate district-level variation in risk due to environmental conditions from the overarching seasonality of diarrheal disease hospitalization in HCMC.We identified considerable spatial heterogeneity in the risk of all-cause diarrhea across districts of HCMC with low elevation and differential responses to flooding, air temperature, and humidity driving further spatial heterogeneity in diarrheal disease risk.The incorporation of these results into predictive forecasting algorithms will provide a powerful resource to aid diarrheal disease prevention and control practices in HCMC and other similar settings.

View Article: PubMed Central - PubMed

Affiliation: Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine, Nuffield Department of Medicine, University of Oxford, United Kingdom; The London School of Hygiene & Tropical Medicine, United Kingdom. Electronic address: cthompson@oucru.org.

No MeSH data available.


Related in: MedlinePlus