山东日照市2009—2012年手足口病与气象因素的时间序列分析

Time series analysis of weather and hand,foot,and mouth disease in Rizhao,Shandong,2009-2012

目的探讨气象因素对日照市儿童手足口病疫情的影响。方法从气象部门获得日照市2009年1月1日至2012年12月31日每日平均气温、日均相对湿度、日均气压、降水量和日均日照时间等气象资料,以及从"中国疾病预防控制信息系统"收集同时期该市手足口病每日发病人数。利用广义相加时间序列模型对每日气象因素与儿童手足口病发病的关系进行分析,在模型中对可能的混杂因素进行控制,包括长期和季节趋势、星期效应、公众假期效应等。结果日照市2009—2012年共报告26 827例手足口病病例,其中26 619例为10岁以下儿童,男女性别比为1.63∶1。时间序列的多因素分析结果发现,日均气温在滞后4~8 d时,日均气温越高,手足口病发病越多,以滞后6 d时风险最大[每升高1℃,其超额发病危险度(ER)为1.54%,95%CI:0.69%~2.40%];在滞后5~7 d时,日均相对湿度越高,该病发病风险越高,其中滞后7 d时相对湿度每升高1%时对应的ER为0.19%(95%CI:0.07%~0.31%);在滞后4~7 d时,日均日照时间越多对应的发病风险越低,其中滞后4 d时,日均日照时间每增加1 h,对应的ER为-0.53%(95%CI:-0.93%^-0.13%)。结论该研究提示气象因素可能是日照市儿童手足口病的一个重要影响因素,在以后的疾病防控工作中应该予以考虑。

Objective To examine the short-term effects of meteorological factors on occurrence of hand, foot, and mouth disease （HFMD） in children in Rizhao. Methods A generalized additive Poisson model was applied to estimate the effects of meteorological factors on occurrence of HFMD in children in 2009 -2012. Results During the study period, there were 26 827 HFMD cases, among which 26 619 were children under 10 years old, and the sex ratio was 1.63： 1. A positive effect of temperature was ob- served on lag 4 - 8 days （ Excess risk [ ER ] = 1.54% , 95% CI： 0. 69% to 2.40% for 1 ℃ increase on lag 6 days）. A positive effect of relative humidity was found on lag 5 -7 days with the ER being 0. 19% （95% CI： 0. 07% -0. 31% ） for 1% of increase in relative humidity on lag 7 days. An adverse effect was observed for sunshine onlag4-7 days （ER= -0.53%, 95% CI： -0.93% to -0.13% on lag 4 days）. Conclusion This study suggests that meteorological factors might be important predictor of HFMD occurrence in children in Rizhao and should be considered in future disease control and prevention.