Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, People's Republic of China.
School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia.
Environ Health Perspect. 2020 May;128(5):57008. doi: 10.1289/EHP5779. Epub 2020 May 26.
Bacillary dysentery (BD) remains a significant public health issue, especially in developing countries. Evidence assessing the risk of BD from temperature is limited, particularly from national studies including multiple locations with different climatic characteristics.
We estimated the effect of temperature on BD across China, assessed heterogeneity and attributable risks across cities and regions, and projected the future risk of BD under climate change.
Daily BD surveillance and meteorological data over 2014-2016 were collected from the Chinese Center for Disease Control and Prevention and the China Meteorology Administration, respectively. A two-stage statistical model was used to estimate city-specific temperature-BD relationships that were pooled to derive regional and national estimates. The risk of BD attributable to temperature was estimated, and the future burden of BD attributable to temperature was projected under different climate change scenarios.
A positive linear relationship for the pooled effect was estimated at the national level. Subgroup analyses indicate that the estimated effect of temperature on BD was similar by age ( or ) and gender. At baseline, estimated attributable risks for BD due to average daily mean temperatures above the 50th percentile were highest for the Inner Mongolia (16%), Northeast China (14%), and Northern China (13%). Most of the individual cities in the same regions and most of the cities in the Northwest, Southern, and Southwest regions, had high attributable risks (). The Northern, Northeast, Inner Mongolia, Northwest, and Southern China regions were identified as high risk for future BD, with estimated increases by the 2090s compared with baseline of 20% (95% confidence interval: 11%, 27%), 15% (6%, 20%), 15% (, 22%), 12% (1%, 19%), and 11% (5%, 15%), respectively, under Representative Concentration Pathway 8.5.
The positive association between temperature and BD in different climatic regions of China, and the projection for increased risk due to climate change, support efforts to mitigate future risks. https://doi.org/10.1289/EHP5779.
细菌性痢疾（BD）仍然是一个重大的公共卫生问题，特别是在发展中国家。关于温度对 BD 风险影响的证据有限，特别是来自包括具有不同气候特征的多个地点的国家研究。
我们评估了中国各地温度对 BD 的影响，评估了不同城市和地区的异质性和归因风险，并预测了气候变化下 BD 的未来风险。
从中国疾病预防控制中心和中国气象局分别收集了 2014-2016 年的每日 BD 监测和气象数据。使用两阶段统计模型估计了特定城市的温度-BD 关系，这些关系被汇总以得出区域和国家估计值。估计了归因于温度的 BD 风险，并根据不同的气候变化情景预测了归因于温度的未来 BD 负担。
在全国范围内估计了一个正线性关系。亚组分析表明，温度对 BD 的估计影响在年龄（或）和性别上相似。在基线时，由于平均每日平均温度高于第 50 个百分位数而导致的 BD 归因风险最高的是内蒙古（16%）、东北（14%）和华北（13%）。同一地区的大多数个别城市以及西北地区、南部地区和西南地区的大多数城市都具有较高的归因风险（）。北方、东北、内蒙古、西北和中国南方地区被确定为未来 BD 的高风险地区，与基线相比，到 2090 年代的估计增幅分别为 20%（95%置信区间：11%，27%）、15%（6%，20%）、15%（，22%）、12%（1%，19%）和 11%（5%，15%），在代表浓度途径 8.5 下。
中国不同气候地区温度与 BD 之间的正关联，以及气候变化导致风险增加的预测，支持了减轻未来风险的努力。https://doi.org/10.1289/EHP5779.
