32 个国家 5 岁以下儿童感染性疾病的降水变异性和风险：利用人口与健康调查数据进行的全球分析。

Precipitation variability and risk of infectious disease in children under 5 years for 32 countries: a global analysis using Demographic and Health Survey data.

机构信息

Scripps Institution of Oceanography, University of California, San Diego, CA, USA.

Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, CA, USA; School of Public Health, San Diego State University, San Diego, CA, USA.

出版信息

Lancet Planet Health. 2022 Feb;6(2):e147-e155. doi: 10.1016/S2542-5196(21)00325-9.

DOI:10.1016/S2542-5196(21)00325-9

PMID:35150623

Abstract

BACKGROUND

Precipitation variability is a potentially important driver of infectious diseases that are leading causes of child morbidity and mortality worldwide. Disentangling the links between precipitation variability and disease risk is crucial in a changing climate. We aimed to investigate the links between precipitation variability and reported symptoms of infectious disease (cough, fever, and diarrhoea) in children younger than 5 years.

METHODS

We used nationally representative survey data collected between 2014 and 2019 from Demographic and Health Survey (DHS) surveys for 32 low-income to middle-income countries in combination with high-resolution precipitation data (via the Climate Hazards Group InfraRed Precipitation with Station dataset). We only included DHS data for which interview dates and GPS coordinates (latitude and longitude) of household clusters were available. We used a regression modelling approach to assess the relationship between different precipitation variability measures and infectious disease symptoms (cough, fever, and diarrhoea), and explored the effect modification of different climate zones and disease susceptibility factors.

FINDINGS

Our global analysis showed that anomalously wet conditions increase the risk of cough, fever, and diarrhoea symptoms in humid, subtropical regions. These health risks also increased in tropical savanna regions as a result of anomalously dry conditions. Our analysis of susceptibility factors suggests that unimproved sanitation and unsafe drinking water sources are exacerbating these effects, particularly for rural populations and in drought-prone areas in tropical savanna.

INTERPRETATION

Weather shifts can affect the survival and transmission of pathogens that are particularly harmful to young children. As our findings show, the health burden of climate-sensitive infectious diseases can be substantial and is likely to fall on populations that are already among the most disadvantaged, including households living in remote rural areas and those lacking access to safe water and sanitation infrastructure.

FUNDING

University of California, San Diego FY19 Center Launch programme.

摘要

背景

降水变率是导致全球儿童发病和死亡的主要传染病的一个潜在重要驱动因素。在气候变化的背景下，厘清降水变率与疾病风险之间的联系至关重要。本研究旨在调查 5 岁以下儿童的传染病（咳嗽、发热和腹泻）报告症状与降水变率之间的联系。

方法

我们使用 2014 年至 2019 年期间在 32 个低收入和中等收入国家进行的人口与健康调查（DHS）调查中收集的全国代表性调查数据，并结合高分辨率降水数据（通过气候危害组红外降水与站数据集）进行分析。我们仅纳入了提供家庭群集访谈日期和 GPS 坐标（纬度和经度）的 DHS 数据。我们使用回归模型方法评估不同降水变率指标与传染病症状（咳嗽、发热和腹泻）之间的关系，并探讨了不同气候带和疾病易感性因素的调节作用。