湖南省暴雨洪涝对细菌性痢疾的滞后效应及脆弱地区

目的 研究湖南省暴雨洪涝对细菌性痢疾(菌痢)的滞后效应,找出脆弱地区。 方法 收集2004~2011年菌痢周发病资料及同期气象资料。采用两阶段模型,首先建立基于时间序列的分布滞后非线性模型,分析洪水对菌痢发病的滞后效应;然后利用分层线性模型筛选脆弱地区。 结果 研究期间湖南省总共上报菌痢患者53 439例。在全省水平上,暴雨洪涝发生后2周其累积效应有统计学意义(RR=1.19, 95%CI: 1.05~1.36),效应值在滞后1周时达到最大(RR=1.12, 95%CI: 1.05~1.20)。西部地区(RR=1.66, 95%CI: 1.09~2.55)、经济发展水平低的地区(RR=1.43, 95%CI: 1.02~2.02)相较于其他地区更加脆弱。 结论 暴雨洪涝可以增加菌痢的发病风险,相应的干预措施应至少持续2周;针对经济发展水平较低的脆弱地区,应加大救灾力度,降低菌痢的发病风险。

Lag effect and vulnerable areas of floods on bacillary dysentery in Hunan Province

Objective To study the lag effect and vulnerable areas of floods on bacillary dysentery in Hunan Province. Methods The meteorological data and weekly data of bacillary dysentery in 2004-2011 were obtained. The two-stage model was conducted. Firstly, a distributed lag non-linear model was developed to assess the relationship between floods and bacillary dysentery. Secondly, a hierarchical linear model was used to find the vulnerable areas. Results A total of 53 439 cases of bacillary dysentery were notified over the study period. At the province level, the cumulative effect of floods on bacillary dysentery at lag 0-1 week was statistically significant(RR=1.19, 95%CI: 1.05-1.36), and the effect reached maximum at lag 1 week(RR=1.12, 95%CI: 1.05-1.20). Western Hunan(RR=1.66, 95%CI: 1.09-2.55)and regions with low level of economic development(RR=1.43, 95%CI: 1.02-2.02)were more vulnerable than other areas. Conclusion Floods have significantly increased the risk of bacillary dysentery in study area. The intervention measures should be last at least two weeks. Disaster relief work must be intensified especially in regions with low level of economic development to control a potential risk of bacillary dysentery after floods.