广义相加模型在气象因素对手足口发病影响研究中的应用

分析气象因素对手足口病发病的影响,为传染病预防控制提供科学依据.方法 利用广义相加Quasi-Poisson模型,对北京市海淀区2008-2014年手足口周发病数的时间序列和同期气象因素的关系进行分析.结果 北京市海淀区2008年1月1日至2014年12月31日手足口病共报告33 704例,平均周报92例,发病率为143.8/10万.其中男性20 718例,女性12 986例,男女性别比为1.60:1.全年各月均有报告,发病高峰主要出现在5-8月,共发病24 460例,占发病总数的72.57%.2008-2014年发病率总体呈现上升趋势,其中2009年发病率最低,为94.2/10万(2 904例);2010年发病率最高,为216.9/10万(7 115例).发病呈现明显的季节性,发病高峰主要集中在夏、秋季.当平均温度、相对湿度、日照时数分别超过阈值(9.1℃,40.2%,7.7 h)时,每增加1个单位,手足口发病人数分别增加4.81% (95%CI=3.99%~5.64%)、0.30% (95%CI=0.10%~ 0.50%)、2.02%(95% CI=0.63%~ 3.43%),且趋势均有统计学意义(P值均<0.05).当大气气压低于阈值(1 014.5 kPa)时,大气气压每降低1 kPa导致手足口发病人数增加5.76% (95%CI=4.52%~ 7.01%).结论 气象因素可能是手足口发病的一个重要影响因素,在今后的疾病防控工作中应予以考虑.广义相加模型可应用于分析手足口病与气候因素的相互关系.

Application of Generalized Additive Model in the research of influence of meteorological factors and hand foot and mouth disease

Objective To investigate the influence of meteorological factors on the incidence of hand,foot and mouth disease (HFMD),and to provide scientific basis for the prevention and control strategies of HFMD.Methods Generalized additive model (GAM) with Quasi-Poisson function to analyze the relationship between the weekly cases of HFMD and meteorological factors in Haidian District of Beijing from 2008 to 2014.Results There were reported 33 704 cases of HFMD in Haidian District during 2008-2014,the weekly average was 92 cases,the incidence rate was 143.8/10 million people.And there were 20 718 males and 12 986 females,the sex ratio of male to female was 1.60:1.There were no one month without cases of HFMD in every year.The peak incidence was mainly concentrated in the 5-8 months,and there were 24 460 cases totally,accounting for 72.57% of the total incidence.The overall trend of the incidence showed an increase 2008-2014,the lowest was 94.2/10 million people (2 904 cases)in 2009,and the highest was 216.9/10 million people (7 115 cases) in 2010.The incidence of HFMD showed significant seasonality,mainly concentrated in summer and autumn.With one unit increasing exceed the threshold of average temperature,relative humidity and sunshine hours (9.1 ℃,40.2%,7.7 h),the incidence of HFMD significantly increased 4.81%(3.99%-5.64%),0.30% (0.10%-0.50%),2.02%(0.63%-3.43%).And with one unit decreasing below 1 014.5 kPa of air pressure,the incidence of HFMD significantly increased 5.76%(4.52%-7.01%).Conclusion This study suggests that meteorological factors may be an important factor for the incidence of HFMD,which should be considered in prevention and control frameworks of HFMD in the future.Furthermore,GAM can be used to examine the relationship between HFMD and meteorological factors.