河北省日平均气温对其他感染性腹泻发病的影响

Effects of daily mean temperature on the incidence of other infectious diarrhea in Hebei Province

目的探讨河北省四大区域日平均气温与其他感染性腹泻发病的滞后效应与关联性。方法通过中国传染病网络报告系统收集2017年至2020年河北省张家口市、承德市、唐山市、秦皇岛市、保定市、廊坊市、沧州市、石家庄市、衡水市、邢台市、邯郸市其他感染性腹泻的日发病数据和同期气象资料,包括气温、日平均气温等,将11个地级市分为北、东、中、南部四大区域,构建分布滞后非线性模型评估四大区域日平均气温对其他感染性腹泻发病的非线性关系和滞后效应,应用冷热效应分析其对感染性腹泻发病影响的滞后效应关系。结果2017年至2020年河北省11个市共报告其他感染性腹泻231008例,季节分布明显,呈现夏季大高峰、冬季小高峰双峰分布。河北省日平均气温与其他感染性腹泻发病风险的累积相对危险度呈现反"S"型暴露反应关系,低温(<13.67℃)和高温(>27.50℃)均会增加其他感染性腹泻的发病风险。当气温<13.00℃时,滞后时间与相对危险度呈"U"型趋势(滞后4~7 d,23~30 d);高于13.00℃时,呈倒"U"型趋势(滞后5~21 d)。4个不同区域比较显示,低温效应时(P5=-7.24℃),由南向北滞后时间由6 d延长到30 d;高温效应(P95=28.25℃)在滞后0 d危险因素就会出现,滞后时间由北向南逐渐变短,高温效应起效快、持续时间短。结论河北省日平均气温与其他感染性腹泻发病呈现反"S"非线性关系,低温和高温均可增加其他感染性腹泻的发病风险,低温的效应较高温的效应更显著、持续时间更长。

Objective To explore the lag effect and correlation between daily average temperature and the incidence of other infectious diarrhea in Hebei Province.Methods The data of meteorological factors(including temperature and average daily temperature)and the daily incidence of other infectious diarrhea in Zhangjiakou City,Chengde City,Tangshan City,Qinhuangdao City,Baoding City,Langfang City,Cangzhou City,Shijiazhuang City,Hengshui City,Xingtai City,and Handan City in Hebei Province from 2017 to 2020 were collected.Eleven prefecture-level cities were divided into four regions,including east,north,middle and south regions.Distributed lag non-linear model was applied to examine the non-linear associations and the lag effect of daily mean temperature on daily incidence of other infectious diarrhea.Meanwhile,the cold and hot effects were used to estinuate the lag-response relationship on the incidence of other infectious diarrhea.Results A total of 231008 cases of other infectious diarrhea were reported in Hebei Province.The seasonal distribution was obvious,showing a bimodal distribution of large peaks in summer and small peaks in winter.An inverse S-shaped association between average daily temperature and cumulative risk ratio(RR)of other infectious diarrhea was observed in Hebei Province.Both high temperature(higher than 27.50℃)and low temperature(less than 13.67℃)could increase the risk of other infectious diarrhea.When the temperature was lower than 13.00℃,the lag time and RR had a U-shaped association(lag four to seven days,23 to 30 days).Meanwhile,when it was higher than 13.00℃,it had an inverted U-shaped association(lag 5 to 21 days).A comparison of four regions of Hebei Province showed that the lag time from south to north was extended from six days to 30 days at low temperature effects with temperature P5=-7.24℃.When the temperature getting hot(P95=28.25℃),the risk occurred at lag 0 days,and the lag time gradually got short from north to south.Thus,the high temperature effect reached maximum quickly with a relative short duration.Conclusions The inverse S-shaped non-linear association between daily average temperature and the incidence of other infectious diarrhea in Hebei Province is observed.Both low temperature and high temperature are associated with increased risk of other infectious diarrhea.But the impact of low temperature is more notable,which has a relative long duration.