The effect of rainfall on the incidence of cholera in Bangladesh
The effect of rainfall on the incidence of cholera in Bangladesh
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DOI：
10.1097/ede.0b013e31815c09ea
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发表时间：
2008-01-01
期刊：
影响因子：
5.4
通讯作者：
Sack, David A.
中科院分区：
文献类型：
--
作者：
Hashizume, Masahiro;Armstrong, Ben;Sack, David A.
背景：孟加拉国的霍乱发病率具有明显的季节性，这表明天气因素可能在其流行病学中发挥作用。我们估计了降雨对孟加拉达卡霍乱发病率的影响。方法：我们检验了1996-2002年间每周因霍乱就诊的次数与每周降雨量的时间序列模式。我们使用泊松回归模型，对季节变化、年际变化、公共假期和气温进行了调整。结果：平均降雨量每增加10 mm，平均降雨量每增加10 mm，霍乱病例数增加14%(95%可信区间=10.1%~18.9%)，滞后0~8周。相反，霍乱病例的数量增加了24%(10.7%-38.6%)，因为平均降雨量每减少10毫米，就会滞后0到16周。河流水位在一定程度上解释了高降雨量与霍乱病例数量之间的关系。结论：在就诊前几周，霍乱病例数量随着降雨量的增加而增加。这些结果表明，与河流水位相关的因素在高降雨量和霍乱发病率之间存在因果关系。
Background: The incidence of cholera in Bangladesh shows clear seasonality, suggesting that weather factors could play a role in its epidemiology. We estimated the effects of rainfall on the incidence of cholera in Dhaka, Bangladesh.Methods: We examined time-series patterns of the weekly number of hospital visits due to cholera in relation to weekly rainfall from 1996 to 2002. We used Poisson regression models, adjusted for seasonal variation, between-year variation, public holidays, and temperature. The role of river level on the rainfall-cholera relationship was also examined by incorporating river-level terms into the models.Results: The weekly number of cholera cases increased by 14% (95% confidence interval = 10.1%-18.9%) for each 10-mm increase above the threshold of 45 turn for the average rainfall, over lags 0 to 8 weeks. Conversely, the number of cholera cases increased by 24% (10.7%-38.6%) for a 10-mm decrease below the same threshold of average rainfall, over lags 0 to 16 weeks. River level partly explained the association between high rainfall and the number of cholera cases.Conclusions: The number of cholera cases increased with both high and low rainfall in the weeks preceding hospital visits. These results suggest that factors associated with river level are on the causal pathway between high rainfall and incidence of cholera.