Wang Yao, Duan Qing, Pang Bo, Tian Xueying, Ma Jing, Ma Wei, Kou Zengqiang, Wen Hongling
Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China.
Department of Microbiological Laboratory Technology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China.
Transbound Emerg Dis. 2023 Sep 20;2023:5572334. doi: 10.1155/2023/5572334. eCollection 2023.
Hemorrhagic fever with renal syndrome (HFRS) is a climate-sensitive infectious disease. The effect of climatic drivers might predict and prevent HFRS, and understanding their relationship is urgently needed in the face of climate change. This study aimed to investigate the effect of meteorological factors on HFRS incidence. The random forest regression model, generalized additive model, and distributed lag nonlinear model (DLNM) were constructed to predict the importance, nonlinear trend and interaction effect, and exposure-lag effect of meteorological factors on HFRS incidence based on the data obtained in Shandong Province, China, 2013-2022. The most crucial meteorological factor was the weekly mean temperature. Interaction results showed that relative humidity affected HFRS incidence only under high or low-temperature conditions, and the effect of relative humidity with high and low pressure was the opposite. Using the median value as the reference, DLNM indicated that extremely low temperature had significant associations with HFRS at a lag of 3-5 weeks. Under extremely high temperatures, relative risks (RRs) became significantly high from a lag of 11 weeks, with the lowest value of 1.07 (95% CI: 1.00-1.13). RRs increased and then decreased with increasing mean temperature at lag 4 and 8 weeks, whereas at lag 12 and 16 weeks, the RRs gradually increased as the mean temperature climbed. This study demonstrates the complex relationship between meteorological factors and HFRS incidence. Our findings provide implications for the development of weather-based HFRS early warning systems.
肾综合征出血热(HFRS)是一种对气候敏感的传染病。气候驱动因素的影响可能有助于预测和预防HFRS,面对气候变化,迫切需要了解它们之间的关系。本研究旨在调查气象因素对HFRS发病率的影响。基于2013 - 2022年在中国山东省获得的数据,构建了随机森林回归模型、广义相加模型和分布滞后非线性模型(DLNM),以预测气象因素对HFRS发病率的重要性、非线性趋势和交互作用以及暴露滞后效应。最关键的气象因素是周平均温度。交互作用结果表明,相对湿度仅在高温或低温条件下影响HFRS发病率,且相对湿度在高压和低压条件下的影响相反。以中位数为参考,DLNM表明极低温度在滞后3 - 5周时与HFRS有显著关联。在极高温度下,从滞后11周起相对风险(RRs)显著升高,最低值为1.07(95%CI:1.00 - 1.13)。在滞后4周和8周时,RRs随平均温度升高先增加后降低,而在滞后12周和16周时,RRs随着平均温度升高逐渐增加。本研究证明了气象因素与HFRS发病率之间的复杂关系。我们的研究结果为基于天气的HFRS早期预警系统的开发提供了启示。