2026-10-06T10:53:16Z https://api.figshare.com/v2/oai

oai:figshare.com:article/33896386 2026-09-17T14:06:45Z category_7 category_21 category_272 category_39 category_64 category_135 portal_63 item_type_3 month_year_09_2026

El Niño–Southern Oscillation and Diarrhea Risk among Young Children in Low- and Middle-Income Countries Guoao Li (13176202) Bo Lu (241075) Mengjie Geng (742542) Haitao Wang (165102) Qi Zhao (124612) Jie Yan (119530) Wei Ma (299083) Medicine Biotechnology Environmental Sciences not elsewhere classified Ecology Cancer Computational Biology – southern oscillation unimproved toilet facilities standard deviation increase la nin ̃ health surveys program el nin ̃ control policy development benefit international prevention 2005 – 2019 sea surface temperature multicountry study indicates showed similar results results :</ b objectives :</ b methods :</ b five years globally drinking water compared discussion :</ b background :</ b immediately reduce enso specific enso indexes e </ sup five years weighted temperature study aimed enso indexes wash conditions wash ). total precipitation subgroup analyses stronger among sensitive disease rural areas remains unclear related impacts odds ratios individual data income households income countries including information Background: Diarrhea in children is a climate-sensitive disease that causes a large disease burden worldwide, while the impact of El Niño–Southern Oscillation (ENSO) remains unclear. Objectives: This study aimed to evaluate the diarrhea risk among children associated with ENSO in low- and middle-income countries. Methods: Individual data on 1,340,334 children under five years of age were collected from 53 low- and middle-income countries from the Demographic and Health Surveys Program during 2005–2019, including information on diarrhea, demographic characteristics, cluster location, water, sanitation, and hygiene (WASH). ENSO indexes (E and C index) were calculated with sea surface temperature through Empirical Orthogonal Function analysis. Teleconnection (τE and τC) of the locations where the cluster sites were located was calculated based on population-weighted temperature and total precipitation. For each location, ENSO exposure (El Niño and La Niña strength) were calculated by month-specific ENSO indexes and its teleconnection, respectively. A binomial generalized linear mixed-effects model was used to explore the association between ENSO exposure and diarrhea risk in children. Results: Odds ratios of diarrhea in children were 1.032 (95%CI: 1.025, 1.040) and 0.977 (95%CI: 0.971, 0.984) for each standard deviation increase in El Niño and La Niña strength, respectively. The effect size of El Niño was greater for children in rural areas [OR: 1.042 (95%CI: 1.033, 1.052)] and low-income households [OR: 1.047 (95%CI: 1.035, 1.060)]. The association between El Niño and diarrhea risk was stronger among those with unimproved toilet facilities and source of drinking water compared to those with improved conditions, while associations were similar by other WASH conditions, and La Niña showed similar results in the subgroup analyses. Discussion: This multicountry study indicates an association between ENSO and the diarrhea risk in children under five years globally. Our findings will benefit international prevention and control policy development for diarrhea in children to immediately reduce ENSO-related impacts. 2026-09-17T00:00:00Z Dataset Dataset 10.1021/EHP.6c00005.s002 https://figshare.com/articles/dataset/El_Nin_o_Southern_Oscillation_and_Diarrhea_Risk_among_Young_Children_in_Low-_and_Middle-Income_Countries/33896386 CC BY-NC 4.0