Department of Social and Preventive Medicine, Sungkyunkwan University School of Medicine, Suwon 16419, Korea.
Department of Preventive Medicine, Dankook University College of Medicine, Cheonan 31116, Korea.
Int J Environ Res Public Health. 2020 Dec 30;18(1):211. doi: 10.3390/ijerph18010211.
Shigellosis is a major diarrheal disease in low- and middle-income countries. Although the incidence of such diseases in South and Southeast Asia has been associated with climate fluctuations linked to the El Niño-Southern Oscillation (ENSO), the impact of ENSO on shigellosis infections remains unknown. Data reported to being infected with shigellosis while traveling abroad from 2004 to 2017 were obtained from the Korea Centers for Disease Control and Prevention. We investigated the relationship between the Oceanic Niño Index (ONI) and Indian Ocean Dipole Mode Index and the relative risk of shigellosis in outbound travelers using distributed lag linear and non-linear models. From 2004 to 2017, 87.1% of imported shigellosis was infected in South and Southeast Asian countries. The relative risk of imported shigellosis infection in outbound travelers increased as the ONI decreased. In the association with the five-month cumulative ONI, the relative risk of infection continuously increased as the La Niña index gained strength. Climate fluctuations associated with the La Niña phenomenon in South and Southeast Asian countries can lead to issues in sanitation and water safety. Our findings suggest that the decreasing trend in the ONI is associated with an increased incidence of shigellosis in these countries.
志贺菌病是中低收入国家的一种主要腹泻病。尽管南亚和东南亚的此类疾病发病率与与厄尔尼诺-南方涛动（ENSO）相关的气候波动有关，但 ENSO 对志贺菌病感染的影响尚不清楚。从 2004 年到 2017 年，从国外旅行归来时报告感染志贺菌病的数据来自韩国疾病控制和预防中心。我们使用分布式滞后线性和非线性模型调查了海洋尼诺指数（ONI）和印度洋偶极子模式指数与出国旅行者志贺菌病相对风险之间的关系。2004 年至 2017 年，87.1%的输入性志贺菌病感染发生在南亚和东南亚国家。随着 ONI 的降低，出国旅行者感染输入性志贺菌病的相对风险增加。在与五个月累积 ONI 的关联中，随着拉尼娜指数的增强，感染的相对风险持续增加。与拉尼娜现象相关的气候波动可能会导致南亚和东南亚国家的卫生和水安全问题。我们的研究结果表明，ONI 的下降趋势与这些国家志贺菌病发病率的增加有关。
