{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T02:39:20Z","timestamp":1789699160878,"version":"4.0.1"},"reference-count":48,"publisher":"American Public Health Association","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Public Health"],"published-print":{"date-parts":[[2012,7]]},"abstract":"<jats:p> Objectives. To improve our understanding of climate variability and diarrheal disease at the community level and inform predictions for future climate change scenarios, we examined whether the El Ni\u00f1o climate pattern is associated with increased rates of diarrhea among Peruvian children. <\/jats:p><jats:p> Methods. We analyzed daily surveillance data for 367 children aged 0 to 12 years from 2 cohorts in a peri-urban shantytown in Lima, Peru, 1995 through 1998. We stratified diarrheal incidence by 6-month age categories, season, and El Ni\u00f1o, and modeled between-subject heterogeneity with random effects Poisson models. <\/jats:p><jats:p> Results. Spring diarrheal incidence increased by 55% during El Ni\u00f1o compared with before El Ni\u00f1o. This increase was most acute among children older than 60 months, for whom the risk of a diarrheal episode during the El Ni\u00f1o spring was nearly 100% greater (relative risk\u2009=\u20091.96; 95% confidence interval\u2009=\u20091.24, 3.09). <\/jats:p><jats:p> Conclusions. El Ni\u00f1o\u2013associated climate variability affects community rates of diarrhea, particularly during the cooler seasons and among older children. Public health officials should develop preventive strategies for future El Ni\u00f1o episodes to mitigate the increased risk of diarrheal disease in vulnerable communities. <\/jats:p>","DOI":"10.2105\/ajph.2011.300573","type":"journal-article","created":{"date-parts":[[2012,5,17]],"date-time":"2012-05-17T20:09:38Z","timestamp":1337285378000},"page":"e63-e69","source":"Crossref","is-referenced-by-count":21,"title":["Effects of the 1997\u20131998 El Ni\u00f1o Episode on Community Rates of Diarrhea"],"prefix":"10.2105","volume":"102","author":[{"given":"Adam","family":"Bennett","sequence":"first","affiliation":[{"name":"Adam Bennett, Robert H. Gilman, and William Checkley are with the Program in Global Disease Epidemiology and Control, Department of International Health, Johns Hopkins University, Baltimore, MD. Leonardo D. Epstein is with the School of Engineering, Universidad Adolfo Ibanez, Santiago, Chile. Vitaliano Cama and Lilia Cabrera are with Asociaci\u00f3n Ben\u00e9fica Proyectos de Inform\u00e1tica, Salud, Medicina, y Agricultura, Lima, Peru. Caryn Bern is with the Division of Parasitic Diseases, Centers for Disease Control..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonardo D.","family":"Epstein","sequence":"additional","affiliation":[{"name":"Adam Bennett, Robert H. Gilman, and William Checkley are with the Program in Global Disease Epidemiology and Control, Department of International Health, Johns Hopkins University, Baltimore, MD. Leonardo D. Epstein is with the School of Engineering, Universidad Adolfo Ibanez, Santiago, Chile. Vitaliano Cama and Lilia Cabrera are with Asociaci\u00f3n Ben\u00e9fica Proyectos de Inform\u00e1tica, Salud, Medicina, y Agricultura, Lima, Peru. Caryn Bern is with the Division of Parasitic Diseases, Centers for Disease Control..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert H.","family":"Gilman","sequence":"additional","affiliation":[{"name":"Adam Bennett, Robert H. Gilman, and William Checkley are with the Program in Global Disease Epidemiology and Control, Department of International Health, Johns Hopkins University, Baltimore, MD. Leonardo D. Epstein is with the School of Engineering, Universidad Adolfo Ibanez, Santiago, Chile. Vitaliano Cama and Lilia Cabrera are with Asociaci\u00f3n Ben\u00e9fica Proyectos de Inform\u00e1tica, Salud, Medicina, y Agricultura, Lima, Peru. Caryn Bern is with the Division of Parasitic Diseases, Centers for Disease Control..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vitaliano","family":"Cama","sequence":"additional","affiliation":[{"name":"Adam Bennett, Robert H. Gilman, and William Checkley are with the Program in Global Disease Epidemiology and Control, Department of International Health, Johns Hopkins University, Baltimore, MD. Leonardo D. Epstein is with the School of Engineering, Universidad Adolfo Ibanez, Santiago, Chile. Vitaliano Cama and Lilia Cabrera are with Asociaci\u00f3n Ben\u00e9fica Proyectos de Inform\u00e1tica, Salud, Medicina, y Agricultura, Lima, Peru. Caryn Bern is with the Division of Parasitic Diseases, Centers for Disease Control..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caryn","family":"Bern","sequence":"additional","affiliation":[{"name":"Adam Bennett, Robert H. Gilman, and William Checkley are with the Program in Global Disease Epidemiology and Control, Department of International Health, Johns Hopkins University, Baltimore, MD. Leonardo D. Epstein is with the School of Engineering, Universidad Adolfo Ibanez, Santiago, Chile. Vitaliano Cama and Lilia Cabrera are with Asociaci\u00f3n Ben\u00e9fica Proyectos de Inform\u00e1tica, Salud, Medicina, y Agricultura, Lima, Peru. Caryn Bern is with the Division of Parasitic Diseases, Centers for Disease Control..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lilia","family":"Cabrera","sequence":"additional","affiliation":[{"name":"Adam Bennett, Robert H. Gilman, and William Checkley are with the Program in Global Disease Epidemiology and Control, Department of International Health, Johns Hopkins University, Baltimore, MD. Leonardo D. Epstein is with the School of Engineering, Universidad Adolfo Ibanez, Santiago, Chile. Vitaliano Cama and Lilia Cabrera are with Asociaci\u00f3n Ben\u00e9fica Proyectos de Inform\u00e1tica, Salud, Medicina, y Agricultura, Lima, Peru. Caryn Bern is with the Division of Parasitic Diseases, Centers for Disease Control..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andres G.","family":"Lescano","sequence":"additional","affiliation":[{"name":"Adam Bennett, Robert H. Gilman, and William Checkley are with the Program in Global Disease Epidemiology and Control, Department of International Health, Johns Hopkins University, Baltimore, MD. Leonardo D. Epstein is with the School of Engineering, Universidad Adolfo Ibanez, Santiago, Chile. Vitaliano Cama and Lilia Cabrera are with Asociaci\u00f3n Ben\u00e9fica Proyectos de Inform\u00e1tica, Salud, Medicina, y Agricultura, Lima, Peru. Caryn Bern is with the Division of Parasitic Diseases, Centers for Disease Control..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Patz","sequence":"additional","affiliation":[{"name":"Adam Bennett, Robert H. Gilman, and William Checkley are with the Program in Global Disease Epidemiology and Control, Department of International Health, Johns Hopkins University, Baltimore, MD. Leonardo D. Epstein is with the School of Engineering, Universidad Adolfo Ibanez, Santiago, Chile. Vitaliano Cama and Lilia Cabrera are with Asociaci\u00f3n Ben\u00e9fica Proyectos de Inform\u00e1tica, Salud, Medicina, y Agricultura, Lima, Peru. Caryn Bern is with the Division of Parasitic Diseases, Centers for Disease Control..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cesar","family":"Carcamo","sequence":"additional","affiliation":[{"name":"Adam Bennett, Robert H. Gilman, and William Checkley are with the Program in Global Disease Epidemiology and Control, Department of International Health, Johns Hopkins University, Baltimore, MD. Leonardo D. Epstein is with the School of Engineering, Universidad Adolfo Ibanez, Santiago, Chile. Vitaliano Cama and Lilia Cabrera are with Asociaci\u00f3n Ben\u00e9fica Proyectos de Inform\u00e1tica, Salud, Medicina, y Agricultura, Lima, Peru. Caryn Bern is with the Division of Parasitic Diseases, Centers for Disease Control..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles R.","family":"Sterling","sequence":"additional","affiliation":[{"name":"Adam Bennett, Robert H. Gilman, and William Checkley are with the Program in Global Disease Epidemiology and Control, Department of International Health, Johns Hopkins University, Baltimore, MD. Leonardo D. Epstein is with the School of Engineering, Universidad Adolfo Ibanez, Santiago, Chile. Vitaliano Cama and Lilia Cabrera are with Asociaci\u00f3n Ben\u00e9fica Proyectos de Inform\u00e1tica, Salud, Medicina, y Agricultura, Lima, Peru. 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