5, No. 1 - Pacific Health Dialog

PRclrrc Hrelrn Dinloc Vor- 5, No. 1 ORrcrrul PRprns

F i g u r e 2 . R e p o r t e d c a s e s o f d i a r r h e a i n K i r i b a t i , 1 9 9 2 - 1995

2000

Data was compiled as in Figure 1 for the years 1992-1995 The years 1992 and '1995 were incomplete, as indicated by the dashed lines in the table The years 1993 and 1994 were comolete,

For a number of months the Republic of Kiribati did not give a reportto to SPEHIS, as indicated by NR (not reported). Thus, the calculated monthly means were determined overthe course of the fouryearperiod from 1992 to 1995 but, as can be seen, onlyone month has data for all four years (August). The means here are therefore to be taken with a 'grain of salt' although, however, the monthly means do not differ significantly from 7994 (F-test, p = 0 . 2 1 8 ) .

. Mean monthly rainfall In inches was taken from Karolle's Ailas of Micronesia,2nd ed.

To assess whether rainfall has a role in Kiribati, the correla- tion betweerr the rneans o{ rnonthly reportecl cases of diarrhea (deterrrined over a four year span - see Figure 2), and rainfall measured in rrean ir.rches per rnonth was tested.

Rainfall and the reported cases of diarrhea were found to be somewhat negatively correlated, but not significantly so (r =

- 0 . 4 2 2 , n s ; s e e F i g u r e 2 ) .

Further, the peak for reported cases of diarrhea, July and August, overlaps with that part of the year when rainfall is lowest, June to Noventber (see Figure 2). This pattern is similar to that for the 1977 choleraepidemic which occurred in September of that year. lt was noted that,,fm)oderately heavy rains, following a period of relatively little rainfall, were experienced severa/ months prior to the cholera outbreak (p.

6821" .tt0 " Several ntonths prior to" are the key words here, as the peak in rainfall occurs several months prior to the peak in reported cases of diarrheal disease in present-day Kiribati ( s e e F i g u r e 2 ) .

No. of reported cases of diarrhea

Mean Rainfail 1995 (1992-95) (inches)

647 684

NR 732 565

NR 856

Aug 5 1 6 2 1 105 '1045 9sB 9 3 1

Oct 1 105 825 817

745 Dec

This corrtrasts with the sigrrificant positive correlation for rainfallarrd rnonthly reported cases of salrnonellosis in Cuarn.ra'l The difference between Cuarn and Kiribati with regard to the relationship between rainfall and diarrheal disease probably has to do with the disparate ecologies, ways of using water a n d w a y s o f g e t t i n g r i d o f w a s t e . C u a m , b e i n g a h i g h is l a n d with an attached lirnestone plateau, has at least two natural sources of fresh water - a water lens in the north and rivers in the south. For some time now, Cuam has enjoyed modern, and for the most part reliable, water-purification ano sewer systerns. On the other hand, the people of Kiribati have only one source of water, this being the water lens, which is supplemented with man-made water-catchment systems. I so Further, their water systems are constantly subjected to high l e v e l s o f p o l l u t i o n . l 5 r

(!

=

t u fo o5

P .3 0 p

=

o r + ( D

a

(!

o

€ 15m

F

o

n

a(g o

E 10m

E o t

5m

N o v Dec

sep

Oct May Aug

Mar Apr Feb

Jan J u n J u l

Month

M o n t h 1 9 9 2 1 9 9 3 1 994 721 '13

8 . 5 Feb

6 . 5 9 1 4

971 Apr

5 . 5 648 946

NR 1244 M a y

1292 2151 4 5 677 807

794 NR 9 5 1 Mar

1 964 753

NR

9 1 6 1 130 804

Sep 1261 _{4 4}

906 A E

1 004

7 5 9'19 783

i

6 1