Heterogeneous effects of tropical cyclones on diarrheal diseases across multiple Asian regions by cyclone definitions

Tropical cyclones (TCs) can elevate diarrheal disease risk yet inconsistent definitions and types of diarrheal data being used can obscure important heterogeneity. Here, we used harmonized weekly diarrheal mortality and morbidity data from 10 Asian regions between 2000 and 2021. We applied two-way fixed effects models to estimate TC-diarrhea associations across regions and compare associations across multiple TC definitions. These definitions include wind-based (wind intensity), rainfall-based (percentile threshold), and combined wind-rainfall metrics. We then assessed differences across a range of diarrheal outcomes. We found that mortality associations were generally not statistically significant and had wide confidence intervals across regions. For morbidity, we observed substantial heterogeneity across regions and definitions, with the greatest TC-attributable burden observed in Taiwan. These findings suggest that tailored TC definitions, calibrated to local health burden profiles, represent a promising strategy to improve early warning systems and guide interventions.

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Publication Details

Journal
npj natural hazards.
Published
2026-07-23
DOI
https://doi.org/10.1038/s44304-026-00246-z
Primary Topic
Tropical and Extratropical Cyclones Research
Type
article
Field-Weighted Citation Impact
0.00

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article

Heterogeneous effects of tropical cyclones on diarrheal diseases across multiple Asian regions by cyclone definitions

Chris Fook Sheng Ng, Vera Ling Hui Phung, Muhammad Abdul Basit Ahmad Tajudin, Noémie Letellier et al.
npj natural hazards.
Tropical and Extratropical Cyclones Research
article

Heterogeneous effects of tropical cyclones on diarrheal diseases across multiple Asian regions by cyclone definitions

Chris Fook Sheng Ng, Vera Ling Hui Phung, Muhammad Abdul Basit Ahmad Tajudin, Noémie Letellier, Rafaela Jane Delfino, K. Tai, Szu Yu Lin, Lina Madaniyazi, Zhesi Yang, Patrick Brown, Chau-Ren Jung, Jinah Park, Kraichat Tantrakarnapa, Miguel Antonio Salazar, Yoonhee Kim, Abu Syed Golam Faruque, Anais Teyton, Changwoo Han, Cunrui Huang, Masahiro Hashizume, Christian Otto, Paul LC Chua, Dung T. Phung, Tarik Benmarhnia, Wissanupong Kliengchuay
article en

Abstract

Tropical cyclones (TCs) can elevate diarrheal disease risk yet inconsistent definitions and types of diarrheal data being used can obscure important heterogeneity. Here, we used harmonized weekly diarrheal mortality and morbidity data from 10 Asian regions between 2000 and 2021. We applied two-way fixed effects models to estimate TC-diarrhea associations across regions and compare associations across multiple TC definitions. These definitions include wind-based (wind intensity), rainfall-based (percentile threshold), and combined wind-rainfall metrics. We then assessed differences across a range of diarrheal outcomes. We found that mortality associations were generally not statistically significant and had wide confidence intervals across regions. For morbidity, we observed substantial heterogeneity across regions and definitions, with the greatest TC-attributable burden observed in Taiwan. These findings suggest that tailored TC definitions, calibrated to local health burden profiles, represent a promising strategy to improve early warning systems and guide interventions.

npj natural hazards.
Monash University Malaysia (MY), Seoul National University (KR), Scripps Institution of Oceanography (US), Inserm (FR), The University of Queensland (AU), China Medical University (TW), Chungnam National University (KR), Angeles University Foundation (PH), Hokkaido University (JP), International Centre for Diarrhoeal Disease Research (BD), Mahidol University (TH), University Kebangsaan Malaysia Medical Centre (MY), University of California San Diego (US), Institut de Recherche en Santé, Environnement et Travail (FR), Public Health Ontario (CA), Mahidol Oxford Tropical Medicine Research Unit (TH), Vanke (China) (CN), Centre for Global Health Research (CA), Nagasaki University (JP), Université de Rennes (FR), Potsdam Institute for Climate Impact Research (DE), The University of Tokyo (JP), University of the Philippines Diliman (PH), National University of Malaysia (MY), Tsinghua University (CN)
Environmental Restoration and Conservation Agency, Ministry of Environment, Japan Society for the Promotion of Science, Japan Science and Technology Agency
Climate action
Openalex Percentile: Top 12%
Tropical and Extratropical Cyclones Research
DOIOpen Access PDFOpenAlex
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