Wang J Y, Li S, Dong J Y, Li S Y, Li P, Jia Q, Wang L Q, Chang X H
School of Basic Medicine, Lanzhou University, Lanzhou 730000, China.
Lanzhou Center for Disease Prevention and Control, Lanzhou 730030, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2018 Oct 18;50(5):861-867.
To discuss the lag effects of daily average temperature on the daily cases of bacillary dysentery in Lanzhou city.
The data of daily cases of bacillary dysentery were collected during 2008 and 2015 in the city, and the meteorological data at the same period was integrated. The distributed lag non-linear model was used to analyze the relevance between daily average temperature and the daily cases of bacillary dysentery.
The exposure response relationship between the daily temperature and the incidence of bacillary dysentery was "J" type, the lowest incidence temperature was 17 °C, and the effect of high temperature on different gender and age groups was higher than that of the intermediate effect. The effect of high temperature and intermediate effect on the male and female groups showed an acute effect, the effect of the day was the highest, followed by fluctuations in temperature, and the greater the impact on women. In different age groups, high temperature effect and the intermediate effect of bacterial dysentery in 0-3 years old groups were the biggest; the effects of high and intermediate temperature on people aged 0-3 and 19-64 year all showed acute effects, which were the maximum value at the day, then decreased volatility; and for people aged over 65 years, the day after the onset, decreases and then increases slowly. There were obviously increasing risks of bacillary dysentery both the high temperature (32 °C) and the middle temperature (26 °C) with respect to 17 °C. The accumulative effects were highest at lag14 days, and the RR (95%CI) values of middle temperature was 2.30 (1.53-3.13), 2.45 (1.65-3.30), 2.41 (1.59-3.28), 2.54 (1.40-3.79), 1.82 (0.41-3.43), 1.98 (1.11-2.93), and 1.73 (0.68-2.88) among the males, females, 0-3 years old, 4-11 years old, 12-18 years old, 19-64 years old and over 65 years old people, respectively; while the high temperature was 2.93 (1.38-4.69), 3.08 (1.48- 4.90), 3.26 (1.60-5.16), 3.12 (1.06-5.56), 1.94 (0.73-5.39), 2.31 (0.54-4.36), and 2.06 (0.02-4.51), respectively.
The high temperature may increase risks of bacillary dysentery, and the females and younger people were the sensitive population. Meteorological factors play an important role in the occurrence and development of bacillary dysentery in Lanzhou. The incidence of bacillary dysentery is affected by multiple meteorological factors, but the primary one is high temperature. The temperature has not a direct effect on the incidence of bacillary dysentery, but an indirect influence in different populations through the impacts of various aspects of the incidence of bacterial dysentery (residents living habits, communication channels and the habits of the susceptible population).
探讨兰州市日平均气温对细菌性痢疾日发病数的滞后效应。
收集兰州市2008年至2015年细菌性痢疾日发病数资料，并整合同期气象数据。采用分布滞后非线性模型分析日平均气温与细菌性痢疾日发病数之间的相关性。
日气温与细菌性痢疾发病率的暴露反应关系呈“J”型，最低发病气温为17℃，高温对不同性别和年龄组的影响高于中间效应。高温和中间效应在男女组中均表现为急性效应，当日效应最高，其次是气温波动，对女性的影响更大。在不同年龄组中，0 - 3岁组细菌性痢疾的高温效应和中间效应最大；高温和中间温度对0 - 3岁和19 - 64岁人群的效应均表现为急性效应，当日为最大值，然后波动下降；对于65岁以上人群，发病后当日下降，然后缓慢上升。相对于17℃，高温（32℃）和中温（26℃）时细菌性痢疾发病风险均明显增加。累积效应在滞后14天最高，男性、女性、0 - 3岁、4 - 11岁、12 - 18岁、19 - 64岁和65岁以上人群中，中温的RR（95%CI）值分别为2.30（1.53 - 3.13）、2.45（1.65 - 3.30）、2.41（1.59 - 3.28）、2.54（1.40 - 3.79）、1.82（0.41 - 3.43）、1.98（1.11 - 2.93）和1.73（0.68 - 2.88）；而高温分别为2.93（1.38 - 4.69）、3.08（1.48 - 4.90）、3.26（1.60 - 5.16）、3.12（1.06 - 5.56）、1.94（0.73 - 5.39）、2.31（0.54 - 4.36）和2.06（0.02 - 4.51）。
高温可能增加细菌性痢疾发病风险，女性和年轻人是敏感人群。气象因素在兰州市细菌性痢疾的发生发展中起重要作用。细菌性痢疾发病率受多种气象因素影响，但首要因素是高温。温度对细菌性痢疾发病率没有直接影响，而是通过对细菌性痢疾发病各方面（居民生活习惯、传播途径和易感人群习性）的影响，对不同人群产生间接影响。
