Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia.
Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia; Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
Sci Total Environ. 2022 Nov 25;849:157836. doi: 10.1016/j.scitotenv.2022.157836. Epub 2022 Aug 4.
The burden of gastrointestinal infections related to hot ambient temperature remains largely unexplored in low-to-middle income countries which have most of the cases globally and are experiencing the greatest impact from climate change. The situation is particularly true in Brazil.
Using medical records covering over 78 % of population, we quantify the association between high temperature and risk of hospitalization for gastrointestinal infection in Brazil between 2000 and 2015.
Data on hospitalization for gastrointestinal infection and weather conditions were collected from 1814 Brazilian cities during the 2000-2015 hot seasons. A time-stratified case-crossover design was used to estimate the association. Stratified analyses were performed by region, sex, age-group, type of infection and early/late study period.
For every 5 °C increase in mean daily temperature, the cumulative odds ratio (OR) of hospitalization over 0-9 days was 1.22 [95 % confidence interval (CI): 1.21, 1.23] at the national level, reaching its maximum in the south and its minimum in the north. The strength of association tended to decline across successive age-groups, with infants < 1 year most susceptible. The effect estimates were similar for men and women. Waterborne and foodborne infections were more associated with high temperature than the 'others' and 'idiopathic' groups. There was no substantial change in the association over the 16-year study period.
Our findings indicate that exposure to high temperature is associated with increased risk of hospitalization for gastrointestinal infection in the hot season, with the strength varying by region, population subgroup and infection type. There was no evidence to indicate adaptation to heat over the study duration.
在全球大多数病例发生在中低收入国家，这些国家受到气候变化的影响最大，与高温相关的胃肠道感染负担在这些国家在很大程度上仍未得到充分探索。巴西的情况尤其如此。
利用覆盖超过 78%人口的医疗记录，我们量化了 2000 年至 2015 年期间巴西高温与胃肠道感染住院风险之间的关联。
在 2000-2015 年的热季期间，从巴西的 1814 个城市收集了胃肠道感染住院数据和天气条件数据。采用时间分层病例交叉设计来估计关联。分层分析按地区、性别、年龄组、感染类型和研究早期/晚期进行。
与平均每日温度每升高 5°C 相比，全国范围内 0-9 天住院的累积优势比（OR）为 1.22 [95%置信区间（CI）：1.21, 1.23]，在南部达到最大值，在北部达到最小值。关联的强度随连续的年龄组而下降，婴儿<1 岁的人群最易受影响。男女之间的效应估计值相似。与“其他”和“特发性”感染相比，水源性和食源性感染与高温的相关性更强。在 16 年的研究期间，这种关联没有实质性变化。
我们的研究结果表明，在热季暴露于高温与胃肠道感染住院风险增加相关，其强度因地区、人群亚组和感染类型而异。在研究期间，没有证据表明对高温的适应。
