长沙市气象因素与手足口病发病的关联研究:基于分布滞后非线性模型

Study on the Association between Meteorological Factors and Incidence of Hand Foot and Mouth Disease in Changsha City based on the Distributed Lag Non-linear Model

目的分析长沙市气象因素与手足口病发病的关联及其滞后效应。方法收集2016-2019年长沙市手足口病日发病数据及同期气象数据,对其进行关联性分析,采用分布滞后非线性模型分析气象因素对手足口病发病的滞后效应。结果2016-2019年长沙市共报告手足口病122788例,年平均发病率为395.09/10万,4~7月和11~12月是每年手足口病发病高峰期。以中位数18.2℃为参考值,日均气温在28.5℃时对手足口病发病的总体效应最高(RR=2.70,95%CI:2.04~3.58),低温(P_(5)=3.2℃)情况下滞后2d时RR最大,为1.19(95%CI:1.09~1.30),高温(P_(95)=30.7℃)情况下滞后0d时RR最大,为1.14(95%CI:1.04~1.26)。以中位数1002.10hPa为参考值,日均气压在991hPa时对手足口病发病的总体效应最高(RR=2.35,95%CI:1.84~3.02),低压(P_(5)=988.7hPa)情况下滞后5d时RR最大,为1.10(95%CI:1.06~1.13),高压(P_(95)=1015.8hPa)情况下滞后2d时RR最大,为1.10(95%CI:1.05~1.16)。结论日均气温、日均气压与手足口病发病呈非线性关系,并存在明显的滞后效应,高温、低压对手足口病发病的影响更为显著。

Objective To analyze the association between meteorological factors and the incidence of HFMD in Changsha city and its lag effect.Methods The daily incidence data of HFMD and the data of meteorological factors in Changsha during 2016-2019 were collected to describe their characteristics and to analyze their association.The distributed lag non-linear model was performed to estimate the lag effect of meteorological factors on the incidence of HFMD.Results A total of 122788 cases of HFMD were reported in Changsha from 2016 to 2019,with an annual average incidence rate of 395.09/100000.The rate among the period from April to July and from November to December are the peak of the incidence of HFMD each year.Taking the median daily average temperature of 18.2℃as reference,the overall effect of the incidence of HFMD was the highest at 28.5℃(RR=2.70,95%CI:2.04~3.58).The maximum RR was 1.19(95%CI:1.09~1.30)at the lag of 2 days in low temperature(P_(5)=3.2℃),and the maximum RR was 1.14(95%CI:1.04~1.26)at the lag of 0 days in high temperature(P_(95)=30.7℃).Compared to the median daily average air pressure of 1002.10hPa,the overall effect of the incidence of HFMD was the highest at 991hPa(RR=2.35,95%CI:1.84~3.02).The maximum RR was 1.10(95%CI:1.06~1.13)at the lag of 5 days in low pressure(P_(5)=988.7hPa),and the maximum RR was 1.10(95%CI:1.05~1.16)at the lag of 2 days in high pressure(P_(95)=1015.8hPa).Conclusion Daily average temperature and daily average air pressure show a non-linear relationship with the incidence of HFMD,and there is an obvious lag effect,and the impact of high temperature and low pressure is more significant associated with the incidence of HFMD.