Phung D, Huang C, Rutherford S, Chu C, Wang X, Nguyen M, Nguyen N H, Do C M, Nguyen T H
Centre for Environment and Population Health (CEPH),Griffith University,Queensland,Australia.
Commonwealth Scientific and Industrial Research Organisation (CSIRO),Melbourne,Victoria,Australia.
Epidemiol Infect. 2015 Dec;143(16):3488-97. doi: 10.1017/S0950268815000709. Epub 2015 Apr 16.
This study examined the temporal and spatial patterns of diarrhoea in relation to hydro-meteorological factors in the Mekong Delta area in Vietnam. A time-series design was applied to examine the temporal pattern of the climate-diarrhoea relationship using Poisson regression models. Spatial analysis was applied to examine the spatial clusters of diarrhoea using Global Moran's I and local indicators of spatial autocorrelation (LISA). The temporal pattern showed that the highest peak of diarrhoea was from weeks 30-42 corresponding to August-October annually. A 1 cm increase in river water level at a lag of 1 week was associated with a small [0·07%, 95% confidence interval (CI) 0·01-0·1] increase in the diarrhoeal rate. A 1 °C increase in temperature at lag of 2 and 4 weeks was associated with a 1·5% (95% CI 0·3-2·7) and 1·1% (95% CI 0·1-2·3) increase in diarrhoeal risk, respectively. Relative humidity and diarrhoeal risk were in nonlinear relationship. The spatial analysis showed significant clustering of diarrhoea, and the LISA map shows three multi-centred diarrhoeal clusters and three single-centred clusters in the research location. The findings suggest that climatic conditions projected to be associated with climate change have important implication for human health impact in the Mekong Delta region.
本研究调查了越南湄公河三角洲地区腹泻的时空模式及其与水文气象因素的关系。采用时间序列设计,运用泊松回归模型研究气候与腹泻关系的时间模式。应用空间分析方法,使用全局莫兰指数(Global Moran's I)和局部空间自相关指标(LISA)研究腹泻的空间聚集情况。时间模式显示,腹泻的最高峰出现在每年8 - 10月对应的第30 - 42周。滞后1周时河流水位每升高1厘米,腹泻率小幅上升[0.07%,95%置信区间(CI)0.01 - 0.1]。滞后2周和4周时温度每升高1℃,腹泻风险分别上升1.5%(95% CI 0.3 - 2.7)和1.1%(95% CI 0.1 - 2.3)。相对湿度与腹泻风险呈非线性关系。空间分析显示腹泻存在显著聚集,LISA地图显示研究区域有三个多中心腹泻聚集区和三个单中心聚集区。研究结果表明,预计与气候变化相关的气候条件对湄公河三角洲地区的人类健康影响具有重要意义。