Dukić Vanja, Hayden Mary, Hopson Tom, Monaghan Andrew, Adams Forgor Abudulai, Akweongo Patricia, Hodgson Abraham, Wiedinmyer Christine, Yoksas Tom, Pandya Raj, Thomson Madeleine C, Trzaska Sylwia
Department of Applied Mathematics, University of Colorado, Boulder, CO, USA.
National Center for Atmospheric Research, Boulder, CO, USA.
J Agric Biol Environ Stat. 2012 Sep;17(3):442-460. doi: 10.1007/s13253-012-0095-9. Epub 2012 Aug 3.
Bacterial (meningococcal) meningitis is a devastating infectious disease with outbreaks occurring annually during the dry season in locations within the 'Meningitis Belt', a region in sub-Saharan Africa stretching from Ethiopia to Senegal. Meningococcal meningitis occurs from December to May in the Sahel with large epidemics every 5-10 years and attack rates of up to 1000 infections per 100,000 people. High temperatures coupled with low humidity may favor the conversion of carriage to disease as the meningococcal bacteria in the nose and throat are better able to cross the mucosal membranes into the blood stream. Similarly, respiratory diseases such as influenza and pneumonia might weaken the immune defenses and add to the mucosa damage. Although the transmission dynamics are poorly understood, outbreaks regularly end with the onset of the rainy season and may begin anew with the following dry season. In this paper, we employ a generalized additive modeling approach to assess the association between number of reported meningitis cases and a set of weather variables (relative humidity, rain, wind, sunshine, maximum and minimum temperature). The association is adjusted for air quality (dust, carbon monoxide), as well as varying degrees of unobserved time-varying confounding processes that co-vary with both the disease incidence and weather. We present the analysis of monthly reported meningitis counts in Navrongo, Ghana, from 1998-2008.
细菌性（脑膜炎球菌性）脑膜炎是一种极具破坏性的传染病，在“脑膜炎带”（撒哈拉以南非洲从埃塞俄比亚延伸至塞内加尔的一个地区）内的一些地方，每年旱季都会爆发疫情。在萨赫勒地区，脑膜炎球菌性脑膜炎于12月至次年5月发病，每5至10年就会出现大规模流行，发病率高达每10万人中有1000人感染。高温加上低湿度可能有利于带菌状态转变为发病状态，因为鼻腔和咽喉中的脑膜炎球菌更容易穿过黏膜进入血流。同样，流感和肺炎等呼吸道疾病可能会削弱免疫防御能力，并加剧黏膜损伤。尽管传播动态机制尚不清楚，但疫情通常在雨季开始时结束，并可能在接下来的旱季再次爆发。在本文中，我们采用广义相加模型方法来评估报告的脑膜炎病例数与一组气象变量（相对湿度、降雨、风速、日照、最高气温和最低气温）之间的关联。该关联针对空气质量（灰尘、一氧化碳）以及与疾病发病率和天气共同变化的不同程度的未观察到的随时间变化的混杂过程进行了调整。我们展示了对1998年至2008年加纳纳瓦龙戈每月报告的脑膜炎病例数的分析。
