---
cited_by:
  - publication: /report/usgcrp-climate-human-health-assessment-2016/chapter/water-related-illnesses
    publication_type: chapter
    reference: /reference/646b4f16-bf9b-4ddf-911b-9fa7efaac098
  - publication: /report/usgcrp-climate-human-health-assessment-2016
    publication_type: report
    reference: /reference/646b4f16-bf9b-4ddf-911b-9fa7efaac098
contributors: []
description: 'Background: It has been reported that the El Nino-Southern Oscillation (ENSO) influences the interannual variation of endemic cholera in Bangladesh. There is increased interest in the influence of the Indian Ocean dipole (IOD), a climate mode of coupled ocean-atmosphere variability, on regional ocean climate in the Bay of Bengal and on Indian monsoon rainfall.      Objectives: We explored the relationship between the IOD and the number of cholera patients in Bangladesh, controlling for the effects of ENSO.      Methods: Time-series regression was performed. Negative binomial models were used to estimate associations between the monthly number of hospital visits for cholera in Dhaka and Matlab (1993-2007) and the dipole mode index (DMI) controlling for ENSO index [NINO3, a measure of the average sea surface temperature (SST) in the Nino 3 region], seasonal, and interannual variations. Associations between cholera cases and SST and sea surface height (SSH) of the northern Bay of Bengal were also examined.      Results: A 0.1-unit increase in average DMI during the current month through 3 months before was associated with an increase in cholera incidence of 2.6% [(95% confidence interval (CI), 0.0-5.2; p = 0.05] in Dhaka and 6.9% (95% CI, 3.2-10.8; p < 0.01) in Matlab. Cholera incidence in Dhaka increased by 2.4% (95% CI, 0.0-5.0; p = 0.06) after a 0.1-unit decrease in DMI 4-7 months before. Hospital visits for cholera in both areas were positively associated with SST 0-3 months before, after adjusting for SSH (p < 0.01).      Conclusions: These findings suggest that both negative and positive dipole events are associated with an increased incidence of cholera in Bangladesh with varying time lags. '
display_name: 'The Indian Ocean dipole and cholera incidence in Bangladesh: A time-series analysis'
doi: 10.1289/ehp.1002302
files: []
href: http://52.38.26.42:8080/article/10.1289/ehp.1002302.yaml
identifier: 10.1289/ehp.1002302
journal_identifier: environmental-health-perspectives
journal_pages: 239-244
journal_vol: 119
notes: ~
parents:
  - display_name: "Chapter 6: Climate Impacts on Water-Related Illnesses (in 'The Impacts of Climate Change on Human Health in the United States: A Scientific Assessment')"
    reference: /reference/646b4f16-bf9b-4ddf-911b-9fa7efaac098
    relationship: cito:isCitedBy
    uri: /report/usgcrp-climate-human-health-assessment-2016/chapter/water-related-illnesses
  - display_name: 'The Impacts of Climate Change on Human Health in the United States: A Scientific Assessment'
    reference: /reference/646b4f16-bf9b-4ddf-911b-9fa7efaac098
    relationship: cito:isCitedBy
    uri: /report/usgcrp-climate-human-health-assessment-2016
references: []
title: 'The Indian Ocean dipole and cholera incidence in Bangladesh: A time-series analysis'
type: article
uri: /article/10.1289/ehp.1002302
url: ~
year: 2011