title: Effect of El Niño and ambient temperature on hospital admissions for diarrhoeal diseases in Peruvian children.
abstract: BACKGROUND
  To investigate whether the El Niño phenomenon and ambient temperature had an effect on the epidemiology of childhood diarrhoea, we analysed data on daily number of admissions of children with diarrhoea to the Oral Rehydration Unit of the Instituto de Salud del Niño in Lima, Peru, between January, 1993, and November, 1998.
  
  
  METHODS
  We obtained daily data on hospital admissions from the Oral Rehydration Unit, and meteorological data from the Peruvian Weather Service, and used time-series linear regression models to assess the effects of the 1997-98 El Niño event on admissions for diarrhoea.
  
  
  RESULTS
  57,331 children under 10 years old were admitted to the unit during the study. During the 1997-98 El Niño episode, mean ambient temperature in Lima increased up to 5 degrees C above normal, and the number of daily admissions for diarrhoea increased to 200% of the previous rate. 6225 excess admissions were attributable to El Niño, and these cost US$277,000. During the period before the El Niño episode, admissions for diarrhoea increased by 8% per 1 degree C increase in mean ambient temperature. The effects of El Niño and ambient temperature on the number of admissions for diarrhoea were greatest during the winter months.
  
  
  CONCLUSIONS
  El Niño had an effect on hospital admissions greater than that explained by the regular seasonal variability in ambient temperature. The excess increase in ambient temperature was the main environmental variable affecting admissions. If our findings are reproducible in other regions, diarrhoeal diseases may increase by millions of cases worldwide with each degree of increase in ambient temperature above normal.
authors.affiliation: Department of International Health, The Johns Hopkins School of Public Health, Baltimore, MD 21205, USA.
authors.forename: W
authors.initials: W
authors.lastname: Checkley
authors.forename: L D
authors.initials: LD
authors.lastname: Epstein
authors.forename: R H
authors.initials: RH
authors.lastname: Gilman
authors.forename: D
authors.initials: D
authors.lastname: Figueroa
authors.forename: R I
authors.initials: RI
authors.lastname: Cama
authors.forename: J A
authors.initials: JA
authors.lastname: Patz
authors.forename: R E
authors.initials: RE
authors.lastname: Black
mesh_terms: D002648:Child; D003967:Diarrhea / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy; D003968:Diarrhea, Infantile / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D008297:Male; D010568:Peru / Q000453:epidemiology; D015532:Rehydration Solutions; D012621:Seasons; D013696:Temperature; D014887:Weather
chemical_list: D015532:Rehydration Solutions