Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui Province, China.
Hefei Center for Disease Control and Prevention, 86 Luan Road, Hefei, 230032, Anhui Province, China.
Environ Sci Pollut Res Int. 2020 Oct;27(28):35618-35625. doi: 10.1007/s11356-020-09878-8. Epub 2020 Jun 29.
We aimed to quantify the relationship between the outpatient visits of hand, foot, and mouth disease (HFMD) and diurnal temperature range (DTR). The data of daily HFMD outpatient visits and meteorological parameters were obtained. A distributed lag nonlinear model combined with generalized linear model was used to estimate simultaneously nonlinear and delayed effects between DTR and daily HFMD outpatient visits after controlling confounding factors. A total of 15,275 HFMD visits were enrolled. DTR was significantly associated with HFMD outpatient visits in children. High DTR (P: 11.4 °C) and extreme DTR (P: 15.3 °C) were compared with 8.5 °C, and HFMD visits increased by a maximum of 3.93% (95% CI: 1.82 to 6.07%) and 4.47% (95% CI: 0.45 to 8.65%) in single-day lag effect, respectively. Furthermore, the extreme DTR effect decreased with the lag time and lasted for 10 days. Cumulative lag effects with markedly increasing percent of visits are over 64.88%. Furthermore, the effects were most pronounced among female children and children aged 0-2 years. Our study suggested that DTR changes were associated with HFMD outpatient visits, and populations of female and aged 0-2 years were more sensitive.
我们旨在量化手足口病（HFMD）门诊就诊次数与日温差（DTR）之间的关系。收集了每日 HFMD 门诊就诊和气象参数数据。在控制混杂因素后，采用分布式滞后非线性模型结合广义线性模型来同时估计 DTR 与每日 HFMD 门诊就诊次数之间的非线性和时滞效应。共纳入 15275 例 HFMD 就诊。DTR 与儿童 HFMD 门诊就诊显著相关。与 8.5°C 相比，高 DTR（P：11.4°C）和极端 DTR（P：15.3°C）时，HFMD 就诊分别最多增加 3.93%（95%CI：1.82 至 6.07%）和 4.47%（95%CI：0.45 至 8.65%）。此外，极端 DTR 效应随滞后时间的增加而降低，持续时间为 10 天。滞后效应累积超过 64.88%，就诊百分比明显增加。此外，女性儿童和 0-2 岁儿童的影响最为显著。本研究表明，DTR 变化与 HFMD 门诊就诊次数有关，女性和 0-2 岁儿童的人群更为敏感。
