Abstract

Background:

Climate change is expected to increase the frequency of flooding events. Although rainfall is highly correlated with mosquito-borne diseases (MBD) in humans, less research focuses on understanding the impact of flooding events on disease incidence. This lack of research presents a significant gap in climate change–driven disease forecasting.

Objectives:

We conducted a scoping review to assess the strength of evidence regarding the potential relationship between flooding and MBD and to determine knowledge gaps.

Methods:

PubMed, Embase, and Web of Science were searched through 31 December 2020 and supplemented with review of citations in relevant publications. Studies on rainfall were included only if the operationalization allowed for distinction of unusually heavy rainfall events. Data were abstracted by disease (dengue, malaria, or other) and stratified by post-event timing of disease assessment. Studies that conducted statistical testing were summarized in detail.

Results:

From 3,008 initial results, we included 131 relevant studies (dengue $n=45$, malaria $n=61$, other MBD $n=49$). Dengue studies indicated short-term ($<1\text{\hspace{0.17em}month}$) decreases and subsequent (1–4 month) increases in incidence. Malaria studies indicated post-event incidence increases, but the results were mixed, and the temporal pattern was less clear. Statistical evidence was limited for other MBD, though findings suggest that human outbreaks of Murray Valley encephalitis, Ross River virus, Barmah Forest virus, Rift Valley fever, and Japanese encephalitis may follow flooding.

Discussion:

Flooding is generally associated with increased incidence of MBD, potentially following a brief decrease in incidence for some diseases. Methodological inconsistencies significantly limit direct comparison and generalizability of study results. Regions with established MBD and weather surveillance should be leveraged to conduct multisite research to a) standardize the quantification of relevant flooding, b) study nonlinear relationships between rainfall and disease, c) report outcomes at multiple lag periods, and d) investigate interacting factors that modify the likelihood and severity of outbreaks across different settings. https://doi.org/10.1289/EHP8887

中文翻译：

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洪水事件与人类蚊媒疾病爆发之间复杂的流行病学关系：范围界定综述

摘要

背景：

气候变化预计将增加洪水事件的发生频率。尽管降雨量与人类蚊媒疾病 (MBD) 高度相关，但很少有研究关注洪水事件对疾病发病率的影响。研究的缺乏使得气候变化驱动的疾病预测存在巨大差距。

目标：

我们进行了范围界定审查，以评估有关洪水与 MBD 之间潜在关系的证据强度，并确定知识差距。

方法：

PubMed、Embase 和 Web of Science 的检索截止日期为 2020 年 12 月 31 日，并补充了相关出版物中引文的审查。仅当可操作性允许区分异常强降雨事件时，才会纳入对降雨的研究。数据按疾病（登革热、疟疾或其他）提取，并按疾病评估的事件后时间进行分层。详细总结了进行统计测试的研究。

结果：

从 3,008 项初步结果中，我们纳入了 131 项相关研究（登革热$n=45$, 疟疾$n=61$, 其他MBD$n=49$）。登革热研究表明短期（$<1\text{\hspace{0.17em}月}$）减少，随后（1-4 个月）发病率增加。疟疾研究表明事件后发病率有所增加，但结果好坏参半，而且时间模式不太清楚。其他MBD的统计证据有限，但研究结果表明，墨累谷脑炎、罗斯河病毒、巴尔马森林病毒、裂谷热和日本脑炎的人类爆发可能会在洪水之后发生。

讨论：

洪水通常与 MBD 发病率增加有关，而某些疾病的发病率可能会短暂下降。方法学上的不一致极大地限制了研究结果的直接比较和普遍性。应利用已建立 MBD 和天气监测的地区开展多地点研究，以a ) 标准化相关洪水的量化，b ) 研究降雨与疾病之间的非线性关系，c ) 报告多个滞后期的结果，以及d ) 调查影响这些因素的相互作用因素修改不同环境下爆发的可能性和严重程度。https://doi.org/10.1289/EHP8887