广东省、安徽省和吉林省体感温度与手足口病发病的关系及其空间异质性分析

目的分析广东省、安徽省和吉林省(3个省份)共46个城市体感温度与手足口病发病的关系、空间异质性及其影响因素,为手足口病早期预警提供科学依据。方法收集广东省2009-2018年、安徽省2009-2015年和吉林省2013-2018年的手足口病发病资料及同期气象数据。构建分布滞后非线性模型,分析46个城市体感温度与手足口病发病的关系,通过Meta分析合并不同城市的结果,采用Meta回归方法分析空间异质性的影响因素。结果3个省份46个城市的每日体感温度与手足口病发病总体上呈非线性关系,广东省和吉林省的发病风险关系相似,即随体感温度升高而增加,而安徽省的发病风险随体感温度上升先增加,在18.1℃达峰值后下降。不同体感温度的滞后作用不同,较高体感温度的影响更大、持续时间更久。经纬度、平均气温和平均日照时数可能是体感温度与手足口病关系存在空间异质性的原因。结论体感温度是一个同时评估气温、相对湿度和风速3种气象因素与手足口病发病关系的综合指标,其升高会增加手足口病的发病风险,体感温度与手足口病关系的空间异质性与所处地理位置和当地气象因素有关。

The association between apparent temperature and hand, foot, and mouth disease and its spatial heterogeneity in Guangdong, Anhui and Jilin provinces

Objective To study the association between apparent temperature(AT)and the incidence of hand,foot,and mouth disease(HFMD)and its spatial heterogeneity in 46 cities in Guangdong,Anhui and Jilin provinces,and provide scientific evidence for the early warning of HFMD.Methods The data of HFMD incidence and meteorological factors from 2009 to 2018 in Guangdong province,2009 to 2015 in Anhui province,and 2013 to 2018 in Jilin province were collected.Distributed lag non-linear models were constructed to investigate the association between AT and the incidence of HFMD in 46 cities from three provinces in China.Meta-analysis was used to pool the city-specific estimates,and Meta-regression was applied to analyze the factors that may cause spatial heterogeneity.Results The relationship between daily AT and the incidence of HFMD in 46 cities appeared nonlinear.The association in Guangdong was similar to that in Jilin,and the risk of HFMD increased with the increase of AT.While the risk of HFMD in Anhui first increased with the increase of AT,and peaked at 18.1℃and then went down.AT on different levels showed different lag impacts and the higher AT showed greater and longer lag impact.The spatial heterogeneity of associations may have been caused by latitude,longitude,average temperature,and average sunshine hours.Conclusions AT is a comprehensive index to evaluate the association between temperature,relative humidity and wind speed and the incidence of HFMD.Higher AT may increase the risk of HFMD.The AT and HFMD relationship across spatial heterogeneity varies depending on geographic location and meteorological conditions.