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目的探讨气象因素对日照市儿童手足口病疫情的影响。方法从气象部门获得日照市2009年1月1日至2012年12月31日每日平均气温、日均相对湿度、日均气压、降水量和日均日照时间等气象资料,以及从“中国疾病预防控制信息系统”收集同时期该市手足口病每日发病人数。利用广义相加时间序列模型对每日气象因素与儿童手足口病发病的关系进行分析,在模型中对可能的混杂因素进行控制,包括长期和季节趋势、星期效应、公众假期效应等。结果日照市2009—2012年共报告26 827例手足口病病例,其中26 619例为10岁以下儿童,男女性别比为1.63∶1。时间序列的多因素分析结果发现,日均气温在滞后4~8 d时,日均气温越高,手足口病发病越多,以滞后6 d时风险最大[每升高1℃,其超额发病危险度(ER)为1.54%,95%CI:0.69%~2.40%];在滞后5~7 d时,日均相对湿度越高,该病发病风险越高,其中滞后7 d时相对湿度每升高1%时对应的ER为0.19%(95%CI:0.07%~0.31%);在滞后4~7 d时,日均日照时间越多对应的发病风险越低,其中滞后4 d时,日均日照时间每增加1 h,对应的ER为-0.53%(95%CI:-0.93%~-0.13%)。结论该研究提示气象因素可能是日照市儿童手足口病的一个重要影响因素,在以后的疾病防控工作中应该予以考虑。
Objective To explore the influence of meteorological factors on the outbreak of HFMD in children in Rizhao. Methods The daily average air temperature, average daily relative humidity, average daily air pressure, precipitation and daily average sunshine time of Rizhao from January 1, 2009 to December 31, 2012 were obtained from the meteorological department, Disease Prevention and Control Information System "collected during the same period the city’s HFMD daily incidence. The generalized additive time series model is used to analyze the relationship between daily meteorological factors and the incidence of hand, foot and mouth disease in children and to control possible confounding factors in the model, including long-term and seasonal trends, the week effect and public holiday effects. Results A total of 26 827 HFMD cases were reported in Rizhao from 2009 to 2012, of which 26 619 were children under 10 years old with a sex ratio of 1.63:1. The multivariate analysis of time series showed that when the average daily temperature was between 4 and 8 days, the average daily temperature was higher, the incidence of hand-foot-mouth disease was more, and the risk was the highest at 6-day lag Risk (ER) was 1.54%, 95% CI: 0.69% ~ 2.40%]. When lag 5 ~ 7 d, the higher the relative daily humidity was, the higher the risk was. The relative humidity The corresponding ER was 0.19% (95% CI: 0.07% -0.31%) at 1% increase. At 4 to 7 days of lag, the more the daily sunshine duration was, the lower the risk of the corresponding ER was. On the 4th day of lag, The corresponding ER was -0.53% (95% CI: -0.93% -0.13%) for every 1 h increase in daily average sunshine duration. Conclusion The study suggests that meteorological factors may be an important influencing factor for hand-foot-mouth disease in children in Rizhao City and should be considered in future disease prevention and control work.