基于分布滞后非线性模型探讨日均气温对曲靖市手足口病发病的影响

  目的  探究气象因素对曲靖市手足口病(hand, foot, and mouth disease, HFMD)发病的影响及其滞后效应。  方法  采用分布滞后非线性模型(distributed lag non-linear model, DLNM)分析2017-2019年曲靖市气象因素与HFMD发病的相关性及滞后效应。  结果  2017-2019年曲靖市共报告25 902例HFMD，HFMD日发病数与日均气温、降雨量呈正相关，与日照时数呈负相关，以气温对HFMD发病影响最为明显(r=0.51)；DLNM拟合结果显示，日均温度20 ℃左右时对HFMD发病的影响最大(RR=1.408, 95% CI: 1.064~1.864, P=0.017)；日均温度在无滞后情况下，对HFMD产生的影响最大，随后逐渐降低直至消失。  结论  气温是曲靖市手足口病发病的重要影响因素，其影响有明显的滞后效应；不同温度对不同人群的滞后效应明显不同，高温影响更为显著。

Effect of temperature on hand,foot and mouth disease incidence in QuJing: a distributed lag non-linear model analysis

  Objective  To explore the impact of meteorological factors on the incidence of hand-foot-mouth disease (HFMD) in Qujing and its lag effect.  Methods  The distributed lag non-linear model (DLNM) was used to analyze the delayed and cumulative effects of meteorological factors on incidence of HFMD in Qujing from 2017 to 2019.  Results  A total of 25 902 HFMD cases were reported in Qujing from 2017 to 2019. The daily number of HFMD cases was positively correlated with daily average temperature and rainfall, but negatively correlated with sunshine duration. Temperature was the most significant effect on the incidence of HFMD (r=0.51); The daily average temperature of about 20 ℃ had the greatest impact on HFMD (RR=1.408, 95% CI: 1.064-1.864, P=0.017); The daily average temperature without delay had the greatest influence on HFMD, and then gradually decreased until disappeared.  Conclusions  Temperature is an important influencing factor of HFMD in Qujing, and its influence has obvious lag effect. The lag effect of different temperature on different population is obviously different, and the effect of high temperature is more significant.