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  1. IMPACTS OF CLIMATE CHANGE ON THE SPREAD OF INFECTIOUS DISEASESR. Oyungerel1, N. Dondog1,D. Naranzul1,L. Oyuntsetseg1,B. Gantsooj1,A. Burmaa1, J. Myagmar2,G. Bolormaa2,Ts. Gankhuyag2,D. Orgil3,P. Nymadawa4, B. Burmaa5, Hae Kwan Cheong61National Center for Communicable Disease,2National Center for Infectiuos Diseases with Natural Foci3Agency of Veterinary Medicine, 4Mongolian Academy of Medical Science ,5 Ministry of Health 6World Health Organization

  2. Content Climate change – infectious diseases Climate change – infectious diseasesin Mongolia Conclusion Recommendation

  3. World climate change- infectious diseases

  4. Study results Climate change – infectious diseasesin Mongolia Respiratory diseases (ILI, meningococcal infection, TB) Food - borne and water- borne diseases (Viral hepatitis A, shigelliosis, typhoid fever) Vector – borne diseases (Plague, tick-borne encephalitis) Zoonosis (Anthrax)

  5. Goal To study and assess correlation of some selected infectious diseases in Mongolia with climate parameters and to strengthen the capacity of health sector for adaptation and protection of the population from the impact of the climate change.

  6. Objectives To analyze and assess the relation of the reported morbidity of some infectious diseases with temperature and precipitation; To develop the national strategy and action plan for adaptation and protection of the population from the impact of climate change

  7. Methodology Material: Data of database of NCCD and NCIDNF (ILI, meningococcal infection, TB, typhoid, viral hepatitis A, dysentery, plague, tick-borne encephalitis, anthrax, 1996-2008). Monthly average of temperature, precipitation (1996-2008, 21 aimags of Mongolia). Method: Regress, correlation analysis Excel, Statgraphics program

  8. Respiratory Diseases Influenza and Influenza like illness (ILI) Figure1.ILI weekly morbidity and air temperature, precipitation in same period of time

  9. Respiratory Diseases Meningococcal infection Figure4. Meningococcal infection morbidity and air temperature, precipitation, nationwide

  10. Respiratory diseases Tuberculosis Figure7. Tuberculosis morbidity, air temperature, precipitation, nationwide

  11. Respiratory diseases Influenza and Influenza like illness (ILI) Meningococcal infection Tuberculosis

  12. r = -0.61, p<0.0001 y=-0.704x+21.145 R2=0.3222 Respiratory diseases Influenza and Influenza like illness (ILI) Meningococcal infection Tuberculosis r = -0.65, p<0.0001 y=-0.0021x+0.0105 R2=0.1167 r = -0.44, p<0.001 y=-0.0209+1.1783 R2=0.188

  13. Tuberculosis Figure9. Tuberculosis morbidity and air temperature correlation by region (1996-2008) -0.49 -0.49 -0.68 -0.54 -0.83 -0.64 -0.30 -0.73 -0.31 -0.49 Temp(-2) Temp(-4)

  14. Food – borne, water- borne diseases Viral hepatitis À Figure10. Morbidity of viral hepatitis A, air temperature, precipitation, nationwide

  15. Food borne and water-borne diseases Typhoid fever Figure 12. Morbidity of typhoid fever per 10 000 population, temperature, precipitation.

  16. Food borne and water-borne diseases Shigelliosis Figure 14. Morbidity of shigelliosis, monthly by regions

  17. Food – borne, water- borne diseases Viral hepatitis A Typhoid fever Shigelliosis

  18. r = -0.46, p<0.001 y=-0.0561+2.573 R2=0.2184 r = 0.58, p<0.001 y=0.073x+2.409 R2=0.358

  19. Food borne and water-borne diseases Shigelliosis r = 0.31, p<0.001 y=-0.0147x+0.5266 R2=0.095 Figure 16. Morbidity of shigelliosis,air temperature correlation and regression (1996-2008)

  20. Plague

  21. Anthrax

  22. Preliminary vulnerability assessment Summary based on relation on climate parameters and infectious diseases: • More direct effect s • Changed the environment • Changed agents of infectious diseases • Changed human life-style • Increased frequency of outbreak of infectious diseases • Increased frequency of emerging and remerging infectious diseases • More indirect effects • Population migration • Increased poverty • Increased burden of economic • Increased risk of exposure of the population to the infectious diseases • Vulnerable people • Elderly • Children • Woman • Poor • Chronic disease people • Professional risk group

  23. Possible activities in adaptation strategy • Management of infectious diseases: • To establish early warming and response system for infectious diseases in the activities of the health sector’s level • Public awareness and education: • Training for public • Kindergarten and school training in education system • Awareness for behavior change • Decision makers: • To establish appropriate institution structure for climate change • Reflect vulnerability and adaptation assessment in national development planning

  24. Conclusion The studied infectious diseases have a relation with climate parameters such as air temperature and precipitation. In Ulaanbaatar the air –borne diseases, shigelliosis, viral hepatitis A, in central region - ILI, TB, anthrax, plague, in western - plague, eastern – TB, viral hepatitis, typhoid fever, southern – food and water borne diseases are higher than in other region.

  25. Conclusion 3.Since there is lack of registration and reporting system of daily morbidity nationwide, we had have difficulties to study the relation of infectious diseases and climate parameters. 4. The intersectoral collaboration mechanism for sharing the information is also insufficient.

  26. Recommendation To revise the reporting, registration and analysis system of infectious diseases. To establish the early warning and response (EWAR) system into the intersectoral activities. To implement the short and long term scientific projects to study the correlation of climate change and emerging and re-emerging diseases. 4. To organize the prevention activities among the population depending on regional climate and infectious diseases features.

  27. Thank your for attention

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