Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, 210009, China.
Department of Environmental Health, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, China.
Curr Med Sci. 2021 Apr;41(2):211-218. doi: 10.1007/s11596-021-2338-x. Epub 2021 Apr 20.
The association between meteorological factors and infectious diarrhea has been widely studied in many countries. However, investigation among children under 5 years old in Jiangsu, China remains quite limited. Data including infectious diarrhea cases among children under five years old and daily meteorological indexes in Jiangsu, China from 2015 to 2019 were collected. The lag-effects up to 21 days of daily maximum temperature (Tmax) on infectious diarrhea were explored using a quasi-Poisson regression with a distributed lag non-linear model (DLNM) approach. The cases number of infectious diarrhea was significantly associated with seasonal variation of meteorological factors, and the burden of disease mainly occurred among children aged 0-2 years old. Moreover, when the reference value was set at 16.7°C, Tmax had a significant lag-effect on cases of infectious diarrhea among children under 5 years old in Jiangsu Province, which was increased remarkably in cold weather with the highest risk at 8°C. The results of DLNM analysis implicated that the lag-effect of Tmax varied among the 13 cities in Jiangsu and had significant differences in 8 cities. The highest risk of Tmax was presented at 5 lag days in Huaian with a maximum RR of 1.18 (95% CI: 1.09, 1.29). Suzhou which had the highest number of diarrhea cases (15830 cases), had a maximum RR of 1.04 (95% CI:1.03, 1.05) on lag 15 days. Tmax is a considerable indicator to predict the epidemic of infectious diarrhea among 13 cities in Jiangsu, which reminds us that in cold seasons, more preventive strategies and measures should be done to prevent infectious diarrhea.
气象因素与感染性腹泻之间的关系在许多国家都有广泛研究。然而，在中国江苏，针对 5 岁以下儿童的调查仍相当有限。收集了 2015 年至 2019 年期间中国江苏 5 岁以下儿童感染性腹泻病例和每日气象指标的数据。采用分布滞后非线性模型（DLNM）方法，使用拟泊松回归分析了日最高温度（Tmax）对感染性腹泻的滞后效应，滞后时间达 21 天。感染性腹泻病例数与气象因素的季节性变化显著相关，疾病负担主要发生在 0-2 岁儿童中。此外，当参考值设定为 16.7°C 时，Tmax 对江苏省 5 岁以下儿童感染性腹泻病例有显著的滞后效应，在寒冷天气下，Tmax 显著升高，风险最高为 8°C。DLNM 分析结果表明，Tmax 的滞后效应在江苏省 13 个城市之间存在差异，在 8 个城市之间存在显著差异。Tmax 的最高风险出现在淮安的 5 个滞后日，RR 值最高为 1.18（95%CI：1.09，1.29）。苏州腹泻病例数最多（15830 例），在第 15 天的滞后期 RR 值最高为 1.04（95%CI：1.03，1.05）。Tmax 是预测江苏省 13 个城市感染性腹泻流行的一个重要指标，这提醒我们，在寒冷季节，应采取更多的预防策略和措施来预防感染性腹泻。
