Seasonality of rotavirus disease in the tropics: a systematic review and meta-analysis

Background To date little conclusive evidence exists on the seasonality of rotavirus incidence in the tropics. We present a systematic review and meta-analysis on the seasonal epidemiology of rotavirus in the tropics, including 26 studies reporting continuous monthly rotavirus incidence for which co...

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Bibliographic Details
Published in:International journal of epidemiology 2009-12, Vol.38 (6), p.1487-1496
Main Authors: Levy, Karen, Hubbard, Alan E, Eisenberg, Joseph NS
Format: Article
Language:English
Subjects:
Biological and medical sciences
Diarrhea - epidemiology
Diarrhea - virology
diarrhoea
epidemiology
gastroenteritis
Human viral diseases
Humans
Humidity
Incidence
Infectious diseases
Linear Models
Medical sciences
Miscellaneous
Public health. Hygiene
Public health. Hygiene-occupational medicine
Rain
Risk Factors
Rotavirus
Rotavirus Infections - epidemiology
Rotavirus Infections - transmission
seasonality
Seasons
Systematic Reviews
Temperature
tropical
Tropical Climate
Viral diseases
Viral diseases of the digestive system
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Summary:Background To date little conclusive evidence exists on the seasonality of rotavirus incidence in the tropics. We present a systematic review and meta-analysis on the seasonal epidemiology of rotavirus in the tropics, including 26 studies reporting continuous monthly rotavirus incidence for which corresponding climatological data was available. Methods Using linear regression models that account for serial correlation between months, monthly rotavirus incidence was significantly negatively correlated with temperature, rainfall and relative humidity in 65%, 55% and 60% of studies, respectively. We carried out pooled analyses using a generalized estimating equation (GEE) that accounts for correlation from between-study variation and serial correlation between months within a given study. Results For every 1°C (1.8°F) increase in mean temperature, 1 cm (0.39 in.) increase in mean monthly rainfall, and 1% increase in relative humidity (22%) this analysis showed reductions in rotavirus incidence of 10% (95% CI: 6–13%), 1% (95% CI: 0–1%), and 3% (95% CI:0–5%), respectively. Conclusions On the basis of the evidence, we conclude that rotavirus responds to changes in climate in the tropics, with the highest number of infections found at the colder and drier times of the year.
ISSN:0300-5771
1464-3685
DOI:10.1093/ije/dyn260