孟加拉国的极端温度与婴儿死亡率：较热月份，死亡率较低。
Temperature extremes and infant mortality in Bangladesh: Hotter months, lower mortality.
作者信息
Babalola Olufemi, Razzaque Abdur, Bishai David
机构信息
Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America.
International Centre for Diarrhoeal Disease Research Bangladesh (ICDDR,B), Dhaka, Bangladesh.
出版信息
PLoS One. 2018 Jan 5;13(1):e0189252. doi: 10.1371/journal.pone.0189252. eCollection 2018.
BACKGROUND
Our study aims to obtain estimates of the size effects of temperature extremes on infant mortality in Bangladesh using monthly time series data.
METHODS
Data on temperature, child and infant mortality were obtained for Matlab district of rural Bangladesh for January 1982 to December 2008 encompassing 49,426 infant deaths. To investigate the relationship between mortality and temperature, we adopted a regression with Autoregressive Integrated Moving Average (ARIMA) errors model of seasonally adjusted temperature and mortality data. The relationship between monthly mean and maximum temperature on infant mortality was tested at 0 and 1 month lags respectively. Furthermore, our analysis was stratified to determine if the results differed by gender (boys versus girls) and by age (neonates (≤ 30 days) versus post neonates (>30days and <153days)). Dickey Fuller tests were performed to test for stationarity, and since the time series were non-stationary, we conducted the regression analysis based on the first differences of mortality and temperature.
RESULTS
Hotter months were associated with lower infant mortality in Bangladesh. Each degree Celsius increase in mean monthly temperature reduced monthly mortality by 3.672 (SE 1.544, p<0.05) points. A one degree increase in mean monthly temperature one month prior reduced mortality by 0.767 (SE 0.439, p<0.1) for boys and by -0.0764 (SE 0.366, NS) for girls. Beneficial effects of maximum monthly temperature were on the order of 0.623 to -0.712 and statistically significant for girls and boys respectively. Effect sizes of mean monthly temperature were larger for neonates at 1.126 (SE 0.499, p<0.05) than for post-neonates at 0.880 (SE 0.310, p<0.05) reductions in mortality per degree.
CONCLUSION
There is no evidence that infant survival is adversely affected by monthly temperature extremes in Bangladesh. This may reflect a more heightened sensitivity of infants to hypothermia than hyperthermia in this environment.
背景
我们的研究旨在利用月度时间序列数据，估算极端温度对孟加拉国婴儿死亡率的规模效应。
方法
获取了1982年1月至2008年12月孟加拉国农村地区马特拉布县的温度、儿童及婴儿死亡率数据，其中包括49426例婴儿死亡案例。为了研究死亡率与温度之间的关系，我们采用了带有自回归积分滑动平均（ARIMA）误差模型的回归分析，对经季节性调整的温度和死亡率数据进行分析。分别在滞后0个月和1个月时，检验月平均温度和最高温度与婴儿死亡率之间的关系。此外，我们进行分层分析，以确定结果在性别（男孩与女孩）和年龄（新生儿（≤30天）与非新生儿（>30天且<153天））方面是否存在差异。进行迪基-富勒检验以检验平稳性，由于时间序列是非平稳的，我们基于死亡率和温度的一阶差分进行回归分析。
结果
在孟加拉国，较热的月份与较低的婴儿死亡率相关。月平均温度每升高1摄氏度，月度死亡率降低3.672（标准误1.544，p<0.05）个百分点。前一个月的月平均温度每升高1摄氏度，男孩的死亡率降低0.767（标准误0.439，p<0.1），女孩的死亡率降低-0.0764（标准误0.366，无统计学意义）。月最高温度的有益影响在0.623至-0.712之间，分别对女孩和男孩具有统计学意义。月平均温度对新生儿的效应量更大，每升高1摄氏度死亡率降低1.126（标准误0.499，p<0.05），而非新生儿为0.880（标准误0.310，p<0.05）。
结论
没有证据表明孟加拉国的月度极端温度会对婴儿存活率产生不利影响。这可能反映出在这种环境下，婴儿对体温过低比体温过高更为敏感。
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