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目的对2010~2014年海口市台风月份与无台风月份感染性腹泻发病情况进行比较,判断极端天气事件台风对感染性腹泻流行的影响。通过对台风“威马逊”、“海鸥”的两次现场调查资料分析,进一步阐明海口市感染性腹泻在台风月份的流行情况。筛选出台风环境下导致感染性腹泻发病、流行的危险因素,为感染性腹泻的防控提供基础资料。方法收集、整理2010~2014年海南省海口市历年平均常住人口、台风、其他气象因素、感染性腹泻病例以及现场流调等数据资料。根据不同资料的性质,采用配对t检验、分层卡方检验,分析台风对海口市感染性腹泻流行的影响;采用线性回归和Logistic回归,分析台风与感染性腹泻发病之间的关系。结果 2010~2014年海口市台风月份感染性腹泻病发病率显著高于无台风月份(P<0.01)。由最高温度、相对湿度与感染性腹泻发病数建立的线性回归模型差异有统计学意义(P<0.05)。当最高气温界于28.2~33.6℃,相对湿度界于74%~84%时:当相对湿度一定,最高气温每升高1℃,感染性腹泻发病数相应地增加约:5人;在最高温度一定时,相对湿度每增加1℃,感染性腹泻发病数相应地增加约:353人。台风“威马逊”和“海鸥”对调查地区感染性腹泻流行的影响具有统计学意义(P<0.01)。台风过后,感染性腹泻在人群中流行的概率较高(OR=3.750,95%CI:1.266~11.102)。居民患感染性腹泻与否和经历台风(OR=2.783,95%CI:1.135~6.823)、病媒生物增多(OR=2.403,95%CI:1.052~5.486)、饭前便后不洗手(OR=24.151,95%CI:5.653~103.182)和吃隔夜饭菜(OR=40.591,95%CI:5.483~300.496)等4个危险因素有关。结论海口市感染性腹泻在台风月份的发病率较无台风月份升高。感染性腹泻发病数的增多与台风过后气象因素(最高气温、相对湿度)的上升有关,最高气温和相对湿度的变化与感染性腹泻发病数呈线性关系。台风对感染性腹泻在人群中是否流行与居民居住地(城市或乡村)无相关关系。台风过后,决定感染性腹泻发病的危险因素包括:高温、高湿天气、居住环境中病媒生物增多、饭前便后不洗手和吃隔夜饭菜。
Objective To compare the incidence of infectious diarrhea between typhoon in Haikou in 2010-2014 and the month without typhoon and determine the influence of typhoon on the prevalence of infectious diarrhea in extreme weather events. Through the analysis of field survey data of typhoon “Wimaxon ” and “Seagull ”, we further clarify the epidemic situation of infectious diarrhea in Haikou in the typhoon month. Screening out the typhoon environment leading to the incidence of infectious diarrhea, the prevalence of risk factors for the prevention and control of infectious diarrhea provide the basic information. Methods The data of average resident population, typhoon, other meteorological factors, cases of infectious diarrhea and epidemic diseases on site in Haikou City, Hainan Province from 2010 to 2014 were collected and sorted out. According to the nature of different data, the influence of typhoon on the epidemic of infectious diarrhea in Haikou was analyzed by paired t-test and stratified chi-square test. The relationship between typhoon and infectious diarrhea was analyzed by linear regression and Logistic regression. Results The incidence of infectious diarrhea in the typhoon months from 2010 to 2014 in Haikou was significantly higher than that in the absence of typhoon (P <0.01). The linear regression model established by the maximum temperature, relative humidity and the number of infectious diarrhea was significantly different (P <0.05). When the highest temperature is between 28.2 and 33.6 ℃ and the relative humidity is between 74% and 84%, when the relative humidity is constant and the maximum temperature is increased by 1 ℃, the number of infectious diarrhea increases by about 5, When a certain relative humidity is increased by 1 ℃, the number of infectious diarrhea increased by about 353. The effects of typhoon “威马逊 ” and “海鸥 ” were statistically significant (P <0.01) on the prevalence of infectious diarrhea in the survey area. After the typhoon, infectious diarrhea has a higher prevalence in the population (OR = 3.750, 95% CI: 1.266 to 11.102). Residents infected with infectious diarrhea or not and experienced typhoon (OR = 2.783,95% CI: 1.135-6.823), vector increased (OR = 2.403,95% CI: 1.052 ~ 5.486) = 24.151, 95% CI: 5.653 ~ 103.182) and eating overnight meals (OR = 40.591,95% CI: 5.483 ~ 300.496) and other 4 risk factors. Conclusion The incidence of infectious diarrhea in Haikou in the typhoon month is higher than that in the absence of typhoon. The increased incidence of infectious diarrhea was related to the increase of meteorological factors (maximum temperature and relative humidity) after typhoon. The change of maximum temperature and relative humidity was linear with the incidence of infectious diarrhea. Typhoon has no correlation with the prevalence of infectious diarrhea among the population and the place of residence (city or village). After the typhoon, the risk factors for determining the incidence of infectious diarrhea include: high temperature and high humidity, increased living vectors in the living environment, no washing of hands before meals and eating overnight meals.