Rastriya Bal Swasthya Karyakram, Ministry of Health, Government of India, NIHFW Campus, Munirka, New Delhi 110067, India.
Department of Neonatology, All India Institute of Medical Sciences, Jodhpur 342005, Rajasthan, India.
J Trop Pediatr. 2022 Jan 7;68(1). doi: 10.1093/tropej/fmab111.
Despite periodic outbreaks, the causes and risk factors of acute encephalitis syndrome (AES) in children of Muzaffarpur, Bihar, India, remain unknown. We explored the correlation between AES caseload and the climate parameters.
Data for 1318 hospitalized children with AES during 2012-20 were used. The correlation between AES cases and daily climate parameters (temperature, sunshine, rainfall, humidity and wind speed) for the previous 24, 48 and 72 h were examined using Pearson's and Spearman's rank-order correlation and Poisson regression or negative binomial regression analyses.
Most (91.8%) of the AES cases occurred during the summer season (May-July months), especially June month. Pearson's and Spearman's rank-order correlation analyses revealed that AES caseload had positive correlations with maximum (r = 0.275, ρ = 0.293) and minimum (r = 0.306, ρ = 0.306) temperatures during past 24 h and heat index (r = 0.325, ρ = 0.325) and negative correlation with humidity (r = -0.222, ρ = -0.222) and rainfall (r = -0.183, ρ = -0.183) (all p < 0.05). The correlation was consistent for the climate parameters for the past 24, 48 and 72 h. Regression analysis also documented a significant association of AES cases with daily maximum (β: 0.32-0.36) and minimum (β: 0.53-0.62) temperatures and heat index (β: 0.92-1.03) over past 24, 48 and 72 h (all p < 0.01). The number of AES cases exponentially increased when the daily maximum and minimum temperatures crossed 40°C and 31°C, respectively.
The climate parameters, especially temperature appears to be a risk factor for AES in children. The definite aetiological role of heat for AES in children needs further exploration.
尽管周期性爆发，但印度比哈尔邦穆扎法尔布尔儿童急性脑炎综合征（AES）的病因和危险因素仍不清楚。我们探讨了 AES 发病率与气候参数之间的相关性。
使用了 2012-20 年期间 1318 名住院 AES 儿童的数据。使用 Pearson 和 Spearman 等级相关以及泊松回归或负二项回归分析，检验了 AES 病例与过去 24、48 和 72 小时内的每日气候参数（温度、阳光、降雨、湿度和风速）之间的相关性。
大多数（91.8%）AES 病例发生在夏季（5-7 月），尤其是 6 月。Pearson 和 Spearman 等级相关分析表明，AES 发病率与过去 24 小时内的最高（r = 0.275，ρ = 0.293）和最低温度（r = 0.306，ρ = 0.306）以及热指数（r = 0.325，ρ = 0.325）呈正相关，与湿度（r = -0.222，ρ = -0.222）和降雨量（r = -0.183，ρ = -0.183）呈负相关（均 p < 0.05）。过去 24、48 和 72 小时的气候参数相关性一致。回归分析还记录了 AES 病例与过去 24、48 和 72 小时内每日最高（β：0.32-0.36）和最低（β：0.53-0.62）温度和热指数（β：0.92-1.03）显著相关（均 p < 0.01）。当每日最高和最低温度分别超过 40°C 和 31°C 时，AES 病例数量呈指数级增加。
气候参数，尤其是温度，似乎是儿童 AES 的危险因素。需要进一步探索热对儿童 AES 的明确病因作用。
