Lag effect of humidex on bacillary dysentery and its regional heterogeneity in North China
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摘要:
目的 了解华北地区温湿指数与细菌性痢疾发病的关系,探讨区域间异质性来源。 方法 收集华北地区各地市2014年1月1日 — 2016年12月31日细菌性痢疾的发病数据和同期气象资料。应用分布滞后非线性模型评估各地市平均气温、相对湿度、温湿指数与细菌性痢疾发病之间的关系,应用meta分析合并各地市的效应值,再通过meta回归进一步探讨异质性来源。 结果 平均气温、相对湿度及温湿指数与细菌性痢疾发病数之间均呈“J”形关系。温湿指数对细菌性痢疾发病的危害效应在当天开始出现,滞后3 d时达到最大值(RR = 1.07,95 % CI = 1.05~1.09),持续至第7 d。以温湿指数的中位数为参照,温湿指数为42.4时,细菌性痢疾的累积发病风险最高(RR = 1.96,95 % CI = 1.52~2.53)。高纬度、高经度、人口自然增长率高、人均地区生产总值低的地区,温湿指数对细菌性痢疾发病的效应更强。 结论 高温湿指数会增加华北地区细菌性痢疾的发病风险,应对脆弱地区采取有效的预防措施以减少细菌性痢疾的发病。 Abstract:Objective To study the association of humidex with bacillary dysentery (BD) incidence and its regional heterogeneity in North China. Methods The daily BD incidence and meteorological data from January 1, 2014 through December 31, 2016 in North China were collected from Chinese Center for Disease Control and Prevention and China Meteorological Science Data Sharing Service Network. Distributed lag non-linear model was used to assess associations of average ambient temperature, relative humidity and humidex with BD incidence. Multivariate meta-analysis was employed to pool region-specific analytic estimates and then meta-regression analysis was adopted to explore modifiers of the association between humidex and BD incidence. Results Approximately J-shaped relationships were observed between pooled BD risk and average ambient temperature, relative humidity and humidex. The humidex showed a promotion effect on BD incidence of the same day; the effect was the most obvious for the lag day 3 (relative risk [RR] = 1.07, 95% confidence interval [95% CI]: 1.05 – 1.09) and lasted until the lag day 7. Taking the median humidex as a reference, the humidex of 42.4 manifested a highest promotion effect on BD incidence, with the RR of 1.96 (95% CI: 1.52 – 2.53). The effect of humidex was more obvious in city-level regions at high latitude and longitude, with high natural population growth rate but low gross domestic production per capita. Conclusion The meteorological condition with high humidex may promote bacillary dysentery incidence in North China and the situation needs to be concerned in the control of the disease, especially in some vulnerable cities. -
Key words:
- humidex /
- bacillary dysentery /
- distributed lag non-linear model /
- meta regression
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表 1 不同地市菌痢发病风险差异的异质性来源分析
因素 Q检验 I2 值(%) 信息准则 Wald检验 Q 值 P 值 AIC BIC Stat P 值 截距 153.4 0.000 41.3 303.9 334.7 纬度 132.0 0.003 31.8 289.0 319.8 31.4 0.000 经度 134.1 0.002 32.9 289.5 320.3 25.9 0.000 人口密度 158.9 0.000 43.4 305.4 336.2 0.4 0.936 人口自然增长率 139.5 0.001 35.5 296.0 326.7 18.1 0.000 人均地区生产总值 138.0 0.001 34.8 296.7 327.4 22.1 0.000 注:AIC 赤池信息准则;BIC 贝叶斯信息准则。 -
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