Spatial patterns of water-borne diseases in relation with climatic conditions in Tashkent Province, Uzbekistan Feruza Alimova and Dilorom Fayzieva (Research Institute of Irrigation and Water Problems, Uzbekistan) Methods: Climate data Monthly precipitation and temperature data for five years ( ) have been obtained from the Agency of Hydrometeorology of the Cabinet Ministers of the Republic of Uzbekistan (Uzhydromet). There are 35 hydro-meteorological posts in Tashkent Region, including 14 which monitor daily meteorology data. Water quality Monthly data on bacteriological indicators of water quality as Total Microbial Counts and Coli-index data in 5 towns and 15 districts of Tashkent Region was obtained from the Regional Centre of Sanitary Epidemiological Surveillance of (TashOblCSES) of the Ministry of Health of the Republic of Uzbekistan for the period of five years ( ). Health data Monthly data for two types of water-borne diseases (acute intestinal infections and bacterial dysentery) in 5 towns and 15 districts were obtained from the Ministry of Health of the Republic of Uzbekistan for the period of five years ( ). Overall data has been transformed into GIS (spatial). The formed database was processed statistically for carry out correlation analyses between climate conditions, water quality and diseases. Background: Climate change has direct influence on the development of various pathogens, including causative agents of acute intestinal diseases. This influence was described in several publications (e.g. Campbell-Lendrum et al., 2003). The level of temperature sensitivity observed in Uzbekistan is consistent with, but somewhat higher than that observed in similar studies in other regions (Checkley et al., 2000; Singh et al., 2001). With the increase in temperatures and relative humidity Uzbekistan faces the risk of increasing microbial and protozoan pathogen replication rates as well as, possibly better survival of enteric viruses in the natural environment. Climate change is adversely affecting the health of populations around the world, with the greatest impacts in low-income countries (Confalonieri et al., 2007; McMichael et al., 2003a; WHO, 2002; WHO, 2009). The first detectable changes in human health may well be alterations in the geographic range (latitude and altitude) and seasonality of certain infectious diseases – including vector-borne infections such as malaria and dengue fever, and water and food-borne infections (e.g. acute intestinal infections, salmonellosis) which peak in the warmer months. Warmer average temperatures combined with increased climatic variability would alter the pattern of exposure to thermal extremes and the resultant health impacts, in both summer and winter. Abstract: Nowadays impact of climatic conditions on water quality and human health is very important issue. Climatic changes over recent decades have probably already affected some health outcomes. According to the World Health Organization Report (2002) climate change was estimated to be responsible in 2000 for approximately 2.4% of worldwide diarrhoea, and 6% of malaria in some middle- income countries. An impact of climate change on population health in Uzbekistan has been done in the Second National Communication (2008), where consideration was given first of all to the dynamics of indicators describing and characterizing thermal and meteotropic diseases, seasonal infections, malaria as well as certain parasitic diseases. It was revealed that intestinal infections belong to indirect climate change after-effects, which can occur through lack of clean drinking water and food. Living conditions represent an additional risk factor. Though Water supply averages 83.8% in Uzbekistan, with 78.5% for rural areas. Rural population usually uses open sources such as ‘aryks’, water reservoirs, rivers and channels for potable. Water quality of these sources significantly deteriorated especially in the downstream areas of the river basins. Periodic droughts causing deterioration of sanitary and epidemiological situation are additional risk factor. Under hot climate conditions hygienic norm of water consumption increases, and toxic effect of harmful substances contained in drinking water grows along with epidemiological role of water sources with low quality water. Due to climate warming this trend will progress. The findings of the study in selected areas of Tashkent Province show high level of correlation between air temperature and acute intestinal infections, including bacterial dysentery. It explains seasonal increasing of this group of diseases in studied territory. Findings of the study carried out in Tashkent Province show that bacterial parameters of water have no associations with precipitation due to absence of heavy rainfall and flooding in selected territories. Figure 1: Location of Tashkent Province Results: The figure 3 shows direct correlation between Coli- index and air temperature in Yangiyul, Parkent, Urtachirchik districts and Angren town. High correlation (between and 0.9) has been revealed in the three analysed district and one town analysed. It proves oursuggests that assumption that air temperature has influence on growth of coliform bacterias in water is correct. The figure 4 describes correlation between TMC and air temperature in studied districts. High correlation between analyzing factors presented in this map. Direct correlation in Yangiyul district ( ) higher than in other studied districts ( ) was revealed. These results show point to substantial influence of air temperature to the microbial water quality. The figure 5 illustrates correlation between coli-index and precipitation in studied districts. An inverse correlation between analyzed factors means that in the result of intensive precipitation decreasing the value of coli-index in water. The low correlation has been revealed in Yangiyul, Urtachirchik districts and Angren town ( and ) than in Parkent district (between and 0.286). The figure 6 shows inverse correlation between TMC and precipitation in studied three districts and one town. The lower level of inverse correlation has been revealed in Parkent district ( and ), than in other studied areas. The revealed difference is insignificant. The figure 7 illustrates correlation between three integrated factors: climate, water quality and acute intestinal infections diseases. As figure shows, there is high correlation between climate, water quality, and AII observed in Yangiyul district ( ). There was lower correlation between these three factors in other districts selected for study (among and 0.200). The figure 8 shows low level of correlation between climate, water quality and Bacterial Dysentery (0.101 and 0.2). References: Campbell-Lendrum, Wilkinson, P., D.H. and Bartlett, C.L., Monitoring the health effects of climate change. In: A. McMichael et al. (Editors), Climate Change and Human Health: Risks and Responses. World Health Organization, Geneva, pp WHO, (2000). Figure 2: Average rate of water-borne diseases in districts and towns of Tashkent Province for the five years period from 2006 to Figure 3: Correlation between Coli-index and air temperature Figure 4: Correlation between Total Microbial Count (TMC) and air temperature Figure 5: Correlation between Coli-index and precipitation Figure 6: Correlation between Total Microbial Counts (TMC) and precipitation Figure 7: Correlation between climate, water quality and Acute Intestinal Infections Figure 8: Correlation between climate, water quality and Bacterial Dysentery Figure 9.: Correlation of AII incidence and mean monthly air temperature for 5 years Figure 10: Correlation of Bacterial Dysentery incidence and mean monthly air temperature for 5 years Conclusions: Analyzing of data on climate, water quality and water-borne diseases in the studied districts give grounds to assume that the rates of the above diseases are significantly contributed by microbial growth in potable water under the impact of air temperature. Despite various opinions about the negative impact of polluted water sources aggravated by hot climate on the health of the population the necessity of further extensive research is dictated by insufficiently revealed cause-and-effect relationship in this field. The findings of the study in selected areas of Tashkent Province show high level of correlation between air temperature and acute intestinal infections, including bacterial dysentery. It explains seasonal increasing of this group of diseases in studied territory. Findings of the study carried out in Tashkent Province show that bacterial parameters of water have no associations with precipitation due to absence of heavy rainfall and flooding in selected territories. The strong correlation (R²= 0, 801) was revealed between climate, water quality and Acute Intestinal Infections in Yangiyul district of Tashkent region. The findings of the study in selected areas of Tashkent Province show high level of correlation between air temperature and acute intestinal infections, including bacterial dysentery. It explains seasonal increasing of this group of diseases in studied territory. The rates of acute intestinal infections given for the period of , high rate of disease was revealed in Yangiyul, Akkurgan, Toshkent and Kuyichirchik districts in More cases were registered in Urtachirchik and Akkurgan districts in High rates of acute intestinal infections were revealed in Yangiyul district in 2008, 2009 and Based on the results of the study, it can be concluded that Yangiyul district is the most vulnerable area regarding the incidence of acute intestinal infections. It can be explained, that geographically Yangiyul district is located in downstream area of the Chirchik River basin. This district accepts urban sewerage waters from Tashkent city discharged to the canal Salar after biological treatment. The efficiency of abovementioned treatment plant equals to 55-65%, due to old facility constructed at the beginning of 70s of the last century.