Haque Farhana, Lampe Fiona C, Hajat Shakoor, Stavrianaki Katerina, Hasan S M Tafsir, Faruque A S G, Ahmed Tahmeed, Jubayer Shamim, Kelman Ilan
Institute for Global Health (IGH), University College London (UCL), London, United Kingdom.
UK Public Health Rapid Support Team (UK-PHRST), Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine (LSHTM), London, United Kingdom.
PLOS Glob Public Health. 2024 Sep 3;4(9):e0003629. doi: 10.1371/journal.pgph.0003629. eCollection 2024.
While numerous studies have assessed the association between temperature and diarrhoea in various locations, evidence of relationship between heat wave and diarrhoea is scarce. We defined elevated daily mean and maximum temperature over the 95th and 99th percentiles lasting for at least one day between March to October 1981-2010 as TAV95 and TAV99 and D95 and D99 heat wave, respectively. We investigated the association between heat wave and daily counts of hospitalisations for all-cause diarrhoea in Dhaka, Bangladesh using time series regression analysis employing constrained distributed lag-linear models. Effects were assessed for all ages and children aged under 5 years of age. Diarrhoea hospitalisation increased by 6.7% (95% CI: 4.6%- 8.9%), 8.3% (3.7-13.1), 7.0 (4.8-9.3) and 7.4 (3.1-11.9) in all ages on a TAV95, TAV99, D95 and D99 heat wave day, respectively. These effects were more pronounced for under-5 children with an increase of 13.9% (95% CI: 8.3-19.9), 24.2% (11.3-38.7), 17.0 (11.0-23.5) and 19.5 (7.7-32.6) in diarrhoea hospitalisations on a TAV95, TAV99, D95 and D99 heat wave day, respectively. At lags of 3 days, we noticed a negative association indicating a 'harvesting' effect. Our findings suggest that heat wave was a significant risk factor for diarrhoea hospitalisation in Dhaka. Further research is needed to elucidate the causal pathways and identify the preventive measures necessary to mitigate the impacts of heat waves on diarrhoea. Given that no heat wave definitions exist for Dhaka, these results may help to define heat waves for Dhaka and trigger public health interventions including heat alerts to prevent heat-related morbidity in Dhaka, Bangladesh.
虽然众多研究评估了不同地点温度与腹泻之间的关联，但热浪与腹泻之间关系的证据却很稀少。我们将1981 - 2010年3月至10月期间日平均温度和最高温度超过第95和第99百分位数且持续至少一天分别定义为TAV95和TAV99热浪以及D95和D99热浪。我们采用受限分布滞后线性模型的时间序列回归分析，研究了孟加拉国达卡热浪与全因腹泻住院日数之间的关联。对所有年龄段以及5岁以下儿童的影响进行了评估。在TAV95、TAV99、D95和D99热浪日，所有年龄段的腹泻住院率分别增加了6.7%（95%置信区间：4.6% - 8.9%）、8.3%（3.7 - 13.1）、7.0（4.8 - 9.3）和7.4（3.1 - 11.9）。这些影响在5岁以下儿童中更为明显，在TAV95、TAV99、D95和D99热浪日，腹泻住院率分别增加了13.9%（95%置信区间：8.3 - 19.9）、24.2%（11.3 - 38.7）、17.0（11.0 - 23.5）和19.5（7.7 - 32.6）。在滞后3天的时候，我们注意到一种负相关，表明存在“收获”效应。我们的研究结果表明，热浪是达卡腹泻住院的一个重要风险因素。需要进一步研究以阐明因果途径，并确定减轻热浪对腹泻影响所需的预防措施。鉴于达卡不存在热浪定义，这些结果可能有助于为达卡定义热浪，并引发包括热警报在内的公共卫生干预措施，以预防孟加拉国达卡与热相关的发病情况。
