Checkley W, Epstein L D, Gilman R H, Figueroa D, Cama R I, Patz J A, Black R E
Department of International Health, The Johns Hopkins School of Public Health, Baltimore, MD 21205, USA.
Lancet. 2000 Feb 5;355(9202):442-50. doi: 10.1016/s0140-6736(00)82010-3.
To investigate whether the El Niño phenomenon and ambient temperature had an effect on the epidemiology of childhood diarrhoea, we analysed data on daily number of admissions of children with diarrhoea to the Oral Rehydration Unit of the Instituto de Salud del Niño in Lima, Peru, between January, 1993, and November, 1998.
We obtained daily data on hospital admissions from the Oral Rehydration Unit, and meteorological data from the Peruvian Weather Service, and used time-series linear regression models to assess the effects of the 1997-98 El Niño event on admissions for diarrhoea.
57,331 children under 10 years old were admitted to the unit during the study. During the 1997-98 El Niño episode, mean ambient temperature in Lima increased up to 5 degrees C above normal, and the number of daily admissions for diarrhoea increased to 200% of the previous rate. 6225 excess admissions were attributable to El Niño, and these cost US$277,000. During the period before the El Niño episode, admissions for diarrhoea increased by 8% per 1 degree C increase in mean ambient temperature. The effects of El Niño and ambient temperature on the number of admissions for diarrhoea were greatest during the winter months.
El Niño had an effect on hospital admissions greater than that explained by the regular seasonal variability in ambient temperature. The excess increase in ambient temperature was the main environmental variable affecting admissions. If our findings are reproducible in other regions, diarrhoeal diseases may increase by millions of cases worldwide with each degree of increase in ambient temperature above normal.
为了研究厄尔尼诺现象和环境温度是否对儿童腹泻的流行病学有影响，我们分析了1993年1月至1998年11月期间，秘鲁利马市儿童健康研究所口服补液科每日儿童腹泻入院人数的数据。
我们从口服补液科获取了每日住院数据，并从秘鲁气象局获取了气象数据，使用时间序列线性回归模型评估1997 - 1998年厄尔尼诺事件对腹泻入院人数的影响。
在研究期间，该科室收治了57331名10岁以下儿童。在1997 - 1998年厄尔尼诺事件期间，利马的平均环境温度比正常水平升高了5摄氏度，腹泻每日入院人数增加到之前的200%。因厄尔尼诺现象导致额外增加了6225例入院病例，花费27.7万美元。在厄尔尼诺事件之前，平均环境温度每升高1摄氏度，腹泻入院人数增加8%。厄尔尼诺现象和环境温度对腹泻入院人数的影响在冬季月份最为显著。
厄尔尼诺现象对医院入院人数的影响大于环境温度正常季节性变化所能解释的程度。环境温度的过度升高是影响入院人数的主要环境变量。如果我们的研究结果在其他地区也能得到验证，那么全球环境温度每比正常水平升高1摄氏度，腹泻疾病可能会增加数百万例。
