Department of Biostatistics,School of Public Health,Shandong University,Jinan,Shandong,China.
School of Medicine & Centre for Environment and Population Health,Griffith University,Bristol city,Queensland,Australia.
Epidemiol Infect. 2018 Oct;146(13):1671-1679. doi: 10.1017/S095026881800184X. Epub 2018 Jul 6.
Haemorrhagic fever with renal syndrome (HFRS) is transmitted to humans mainly by rodents and this transmission could be easily influenced by meteorological factors. Given the long-term changes in climate associated with global climate change, it is important to better identify the effects of meteorological factors of HFRS in epidemic areas. Shandong province is one of the most seriously suffered provinces of HFRS in China. Daily HFRS data and meteorological data from 2007 to 2012 in Shandong province were applied. Quasi-Poisson regression with the distributed lag non-linear model was used to estimate the influences of mean temperature and Diurnal temperature range (DTR) on HFRS by sex, adjusting for the effects of relative humidity, precipitation, day-of-the-week, long-term trends and seasonality. A total of 6707 HFRS cases were reported in our study. The two peaks of HFRS were from March to June and from October to December, particularly, the latter peak in 2012. The estimated effects of mean temperature and DTR on HFRS were non-linear. The immediate and strong effect of low temperature and high DTR on HFRS was found. The lowest temperature -8.86°C at lag 0 days indicated the largest related relative risk (RRs) with the reference (14.85 °C), respectively, 1.46 (95% CI 1.11-1.90) for total cases, 1.33 (95% CI 1.00-1.78) for the males and 1.76 (95% CI 1.12-2.79) for the females. Highest DTR was associated with a higher risk on HFRS, the largest RRs (95% CI) were obtained when DTR = 15.97 °C with a reference at 8.62 °C, with 1.26 (0.96-1.64) for total cases and 1.52 (0.97-2.38) for the female at lag 0 days, 1.22 (1.05-1.41) for the male at lag 5 days. Non-linear lag effects of mean temperature and DTR on HFRS were identified and there were slight differences for different sexes.
肾综合征出血热（HFRS）主要通过啮齿动物传播给人类，这种传播很容易受到气象因素的影响。鉴于与全球气候变化相关的长期气候变化，有必要更好地确定疫区气象因素对 HFRS 的影响。山东省是中国 HFRS 受灾最严重的省份之一。应用了山东省 2007 年至 2012 年的每日 HFRS 数据和气象数据。采用分布滞后非线性模型的拟泊松回归来估计平均温度和日较差（DTR）对 HFRS 的影响，按性别调整相对湿度、降水、星期几、长期趋势和季节性的影响。本研究共报告了 6707 例 HFRS 病例。HFRS 的两个高峰分别出现在 3 月至 6 月和 10 月至 12 月，尤其是 2012 年的后一个高峰。平均温度和 DTR 对 HFRS 的影响是非线性的。低温和高 DTR 对 HFRS 的即时和强烈影响。滞后 0 天的最低温度-8.86°C 表明与参考值（14.85°C）的最大相关相对风险（RRs）分别为 1.46（95%CI 1.11-1.90），总病例数为 1.33（95%CI 1.00-1.78）男性和女性分别为 1.76（95%CI 1.12-2.79）。最高 DTR 与 HFRS 风险较高相关，当 DTR = 15.97°C 且参考值为 8.62°C 时，RRs（95%CI）最大，滞后 0 天的总病例数为 1.26（0.96-1.64），女性为 1.52（0.97-2.38），男性为 1.22（1.05-1.41），滞后 5 天。确定了平均温度和 DTR 对 HFRS 的非线性滞后效应，不同性别之间存在细微差异。
