Abstract / Summary
Abstract Background. Ambient temperature is one of the most consistently reported drivers of diarrhoeal disease, but the relationship has not been quantified for Central Asia. Using national surveillance data and validated reanalysis climate data, we examined whether acute intestinal infection (AII) morbidity in Uzbekistan is statistically associated with ambient air temperature. Methods. We analysed routine national surveillance records for AIIs: monthly counts by territory for 2021, multi-year monthly counts for the capital (2021 and 2023–2025), annual counts and etiologic structure for all 14 territories, and the national age distribution. Monthly mean air temperature for 2015–2025 was obtained from NASA POWER reanalysis and validated against in-country measurements. The temperature–AII association was quantified with Spearman correlation at the national and regional level and with negative-binomial regression across regions; a multi-year, season-adjusted model for the capital served as a sensitivity analysis. Results. AII morbidity was strongly seasonal, peaking in summer alongside temperature. Reanalysis temperature agreed closely with measurements (Pearson r = 0.99). Ambient temperature was positively and significantly associated with AII incidence: nationally (Spearman r = 0.73, p = 0.007) and in 6 of 10 territories (r from 0.59 to 0.94). In the cross-regional model, each 1°C higher monthly temperature corresponded to a 3.4% higher case count (incidence rate ratio 1.034, 95% confidence interval 1.017–1.051; p < 0.001), close to the global meta-analytic estimate. In a multi-year sensitivity analysis in the capital, the association attenuated after adjustment for the annual cycle, indicating that it is substantially seasonal. The burden fell mainly on children under five (67.4% of cases). Conclusions. Ambient temperature is positively and significantly associated with acute intestinal infection morbidity in Uzbekistan, consistent with global evidence. The association is closely tied to the summer season, and separating a direct thermal effect from seasonal co-variation will require multi-year monthly analysis. These findings establish a climate–health signal for enteric disease in Central Asia and a baseline for temperature-attributable assessment and seasonally timed prevention.