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2010 — 2018年甘肃省手足口病季节性流行第二峰气象驱动因素分析

Meteorological drivers of second seasonal peak of hand, foot and mouth disease incidence among children and adolescents in Gansu province, 2010 – 2018: a register-based data analysis

  • 摘要:
    目的 分析甘肃省手足口病(HFMD)季节性流行第二峰出现的气象驱动因素,为HFMD的防控提供科学依据。
    方法 收集甘肃省疾病预防控制中心2010年1月1日 — 2018年12月31日报告的83 462例 ≤ 18岁居民HFMD发病数据和同期时空三极环境大数据平台中报告的气象数据,采用病例对照研究设计方法以出现季节性双峰特征的观察年份为病例组、出现季节性单峰特征的观察年份为对照组,以出现季节性流行第二峰及峰前1 ~ 8周的平均温度、相对湿度、降雨量和风速作为暴露因素构建logistic回归模型,估计气象因素与HFMD流行第二峰出现的关系。
    结果 甘肃省2010 — 2018年最终纳入分析的83 190例HFMD病例以男性50 663例(60.9%)和 ≤ 6岁者77 346例(93.0%)为主,主要集中在兰州市22 553例(27.1%)、天水市9 756 例(11.7%)和定西市7 917 例(9.5%)。在13个市(州)9年合计的117个观察年份中,有111个(94.9%)观察年份存在季节性流行特征,其中92个(78.6%)观察年份的季节性流行为双峰,仅19个(16.2%)观察年份的季节性流行为单峰。logistic回归分析结果显示,暴露窗口为1周时,相对湿度对HFMD季节性流行第二峰出现的影响最大,即相对湿度每增加1%,第二峰出现的风险增加4.2%(95%CI = 1.5%~7.3%);暴露窗口为1~7周时,风速对HFMD季节性流行第二峰出现的影响最大,即风速每增加1 m/s,第二峰出现的风险增加193.0%(95%CI = 21.9%~730.1%)。
    结论 相对湿度和风速是甘肃省HFMD季节性流行第二峰出现的关键气象驱动因素。

     

    Abstract:
    Objective To assess meteorological drivers of the second seasonal peaks in the incidence of hand, foot, mouth disease (HFMD) among children and adolescents in Gansu province.
    Methods Totally 83 462 records of 0 – 18 years old HFMD cases registered during 2010 – 2018 were collected from Gansu Provincial Center for Disease Control and Prevention and the data of same period on ambient temperature, relative humidity, rainfall, and wind speed were extracted from the Big Earth Data Platform for Three Poles. Weekly time series were established for the HFMD incidence and meteorological data. Local maximum filter and locally weighted scatter plot smoothing method were used in the identification of bimodal seasonal peaks of HFMD incidence. Logistic regression model analyses were performed to estimate the association of meteorological factors with the occurrence of second seasonal peaks of HFMD incidence, in which, the years with bimodal seasonal incidence peak were considered as the cases and those in years with monomodal incidence peak as the controls and the mean ambient temperature, relative humidity, rainfall and wind speed for 8 weeks before the identified second seasonal peak were considered as the exposure factors.
    Results Of the 83 190 HFMD cases finally included in the study, 50 663 (60.9%) were male and 77 346 (93.0%) were aged less than 6 years, and more cases were reported in municipality/prefecture of Lanzhou (22 553, 27.1%), Tianshui (9 756, 11.7%), and Dingxi (7 917, 9.5%). Of the 117 observation years for the 13 municipalities/prefecture during the 9 years, 111 (94.9%) of observation years had seasonal peaks of HFMD incidence, of which 92 (78.6%) were with bimodal peak and only 19 (16.2%) were with monomodal peak. The results of logistic regression analysis revealed a strong association between relative humidity of previous one week and the occurrence of second seasonal peak of HFMD, with a 4.2% increase (95% confidence interval 95%CI: 1.5% – 7.3%) in the risk of second seasonal peak occurrence for every 1% increase in weekly average relative humidity; the results also indicated a 193.0% (95%CI: 21.9% – 730.1%) increase in the risk of second seasonal peak occurrence of HFMD incidence for every 1m/s increased average weekly wind during 1 – 7 weeks before the second peak.
    Conclusion Weekly average relative humidity and wind speed are key meteorological factors correlated with the occurrence of the second seasonal peak of HFMD incidence.

     

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