Evaluation of effect of ambient temperature on other infectious diarrhea incidence in children aged 0−6 years in Ninghai by distributed lag non-linear model
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摘要:
目的 利用分布滞后非线性模型(distributed lag non-linearmodel,DLNM)探讨气温对浙江省宁海县0~6岁儿童其他感染性腹泻的发病影响,为科学制定预防控制策略提供帮助。 方法 收集2016-2020年宁海县有关气象资料和0~6岁儿童其他感染性腹泻的发病资料,采用SPSS 20.0软件分析气象因素与发病数的相关性,利用R 4.1.0软件构建DLNM探讨气温对0~6岁儿童其他感染性腹泻的发病影响。 结果 2016-2020年宁海县0~6岁儿童其他感染性腹泻的发病呈一定季节性,每年12月至次年2月为发病高峰。 Spearman分析显示,日平均气温与其他感染性腹泻的相关性最高(r=−0.291)。 DLNM显示,日平均气温为−5 ℃时对其他感染性腹泻的累计发病效应最大(RR=16.601,95%CI:2.667~103.333),在滞后0 d 时,发病风险最小(相对危险度RR=0.815,95%CI:0.730~0.910);滞后30 d时,发病风险最大(RR=1.265,95%CI:1.148~1.395)。−5、5、11.5 ℃的气温条件对其他感染性腹泻的发病影响持续时间长,其累计滞后天数分别可达30、21和30 d。 结论 日平均气温和宁海县0~6岁儿童其他感染性腹泻的发病明显相关,在低温条件下发病风险显著增加且有较长的滞后效应,高温条件下不显著。 Abstract:Objective To evaluate the effect of ambient temperature on the incidence of other infectious diarrhea in children aged 0−6 years in Ninghai county of Zhejiang province by distributed lag non-linear model, and provide evidence for the prevention and control of other infectious diarrhea in children. Methods The relevant meteorological data and the incidence data of other infectious diarrhea in children aged 0–6 years in Ninghai from 2016 to 2020 were collected. Software SPSS 20.0 was used to analyze the correlation between meteorological factors and the incidence of other infectious diarrhea, and software R 4.1.0 was used to construct a distributed lag non-linear model to explore the impact of ambient temperature on the incidence of other infectious diarrhea in children aged 0−6 years in Ninghai. Results The incidence of other infectious diarrhea in children aged 0–6 years in Ninghai showed obvious seasonality during 2016−2020, with the peak from December to February. Spearman analysis showed that the correlation between daily average ambient temperature and the incidence of other infectious diarrhea was strongest (r=−0.291). Distributed lag non-linear model showed that the cumulative effect on the incidence of other infectious diarrhea was greatest when the daily average ambient temperature was −5℃ (RR=16.601, 95% CI: 2.667−103.333). The incidence risk was lowest at lag 0 days (RR=0.815, 95% CI: 0.730−0.910) and the incidence risk was highest at lag 30 days (RR=1.265, 95% CI: 1.148−1.395). The ambient temperature of −5 ℃, 5 ℃ and 11.5 ℃ had long impacts on the incidence of other infectious diarrhea, and the cumulative lag days could reach 30 days, 21 days and 30 days, respectively. Conclusion The daily average ambient temperature was significantly related to the incidence of other infectious diarrhea in children aged 0–6 years in Ninghai. The risk of other infectious diarrhea increased significantly at low ambient temperature and had a long lag effect. But it was not significant at high ambient temperature. -
表 1 2016-2020年宁海县气象因素和0~6岁儿童其他感染性腹泻的基本情况
Table 1. Meteorological factors and other infectious diarrhea in children aged 0−6 years in Ninghai during 2016−2020
指标 均值(n=1 827) 最小值 P5 M(P25~P75) P95 最大值 日发病数(例) 7.07 0.00 1.00 6.00(3.00~9.00) 18.00 41.00 日平均温差(℃) 8.81 0.00 3.00 9.00(7.00~11.00) 14.00 24.00 日平均气温(℃) 18.10 −5.00 5.00 18.50(11.50~24.50) 30.00 34.00 日平均湿度(%) 80.35 0.00 58.00 82.00(75.00~88.00) 95.00 100.00 日平均降水量(mm) 7.00 0.00 0.00 1.45(0.00~8.15) 28.89 282.00 日空气质量指数 53.32 12.00 23.00 47.00(34.00~66.00) 103.00 277.00 注:P5. 第5百分位数;M(P25~P75). 中位数(第25~75百分位数);P95. 第95百分位数 表 2 宁海县内0~6岁儿童其他感染性腹泻发病数与同期气象因素的Spearman相关性
Table 2. Spearman correlation between incidence of other infectious diarrhea and meteorological factors in children aged 0−6 years in Ninghai
指标 日发病数 日平均温差 日平均气温 日平均湿度 日平均降水量 日空气质量指数 日发病数 1.00 日平均温差 −0.118a 1.00 日平均气温 −0.291a 0.295a 1.00 日平均湿度 −0.016 −0.471a 0.092a 1.00 日平均降水量 −0.089a −0.272a 0.301a 0.660a 1.00 日空气质量指数 0.101a 0.194a −0.358a −0.394a −0.345a 1.00 注:a. P<0.05 表 3 日平均气温对宁海县0~6岁儿童其他感染性腹泻发病风险的累积滞后效应
Table 3. Cumulative lag effect of different daily average temperatures on risk of other infectious diarrhea in children aged 0−6 years in Ninghai
日平均气温(℃) 累积滞后天数(d) 相对危险度 95%置信区间 −5 0 0.815a 0.730~0.910 0~1 0.693a 0.563~0.854 0~3 0.567a 0.389~0.826 0~7 0.590 0.311~1.120 0~14 1.405 0.477~4.136 0~21 3.410 0.788~14.755 0~30 16.601a 2.667~103.333 P5=5 0 0.921a 0.880~0.965 0~1 0.856a 0.785~0.933 0~3 0.755a 0.648~0.881 0~7 0.641a 0.495~0.829 0~14 0.565a 0.369~0.866 0~21 0.519a 0.294~0.918 0~30 0.553 0.270~1.132 P25=11.5 0 0.973 0.934~1.013 0~1 0.944 0.875~1.018 0~3 0.882 0.772~1.008 0~7 0.754a 0.605~0.938 0~14 0.559a 0.389~0.803 0~21 0.438a 0.266~0.721 0~30 0.335a 0.173~0.648 P75=24.5 0 1.014 0.970~1.060 0~1 1.030 0.948~1.120 0~3 1.067 0.922~1.235 0~7 1.156 0.914~1.461 0~14 1.232 0.849~1.786 0~21 1.059 0.643~1.745 0~30 0.900 0.477~1.698 P95=30 0 0.996 0.937~1.058 0~1 0.998 0.890~1.118 0~3 1.020 0.837~1.244 0~7 1.132 0.826~1.550 0~14 1.366 0.827~2.255 0~21 1.291 0.649~2.569 0~30 1.165 0.465~2.918 34 0 0.970 0.876~1.075 0~1 0.952 0.787~1.151 0~3 0.948 0.684~1.315 0~7 1.057 0.644~1.735 0~14 1.475 0.703~3.095 0~21 1.712 0.634~4.622 0~30 1.844 0.480~7.075 注:a. P<0.05 -
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