Short Term Effects of Weather on Hand, Foot and Mouth Disease
Short Term Effects of Weather on Hand, Foot and Mouth Disease
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DOI：
10.1371/journal.pone.0016796
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发表时间：
2011-02-11
期刊：
影响因子：
3.7
通讯作者：
Ng, Nawi
中科院分区：
文献类型：
--
作者：
Hii, Yien Ling;Rocklov, Joacim;Ng, Nawi
背景：自20世纪90年代末以来，手足口病(HFMD)暴发导致的临床和致命并发症有所增加；特别是在亚太地区。手足口病的暴发高峰在一年中较温暖的季节，但这种年度模式的潜在因素和最近激增趋势的原因尚未确定。这项研究分析了短期天气变化对新加坡手足口病发病率的影响。方法：使用考虑过度分散的时间序列泊松回归模型估计20012008年间手足口病每周病例与温度和降雨量之间的相对风险。平滑被用来允许天气和每周手足口病病例之间的非线性关系，并根据季节性和长期时间趋势进行调整。此外，控制了自相关性，并允许天气对手足口病发病率产生滞后影响，最长可达2周。结果：每周气温和降雨量与手足口病发病率在1-2周时的滞后时间具有统计学意义。最高气温每升高1摄氏度，手足口病发病风险增加36%(95%CI=1.341-1.389)。同时，每周累积降雨量每增加1毫米，手足口病发病风险增加0.3个百分点(CI=1.002~1.003)。大于75 mm的降雨量则相反，降雨量每增加1 mm，发病率降低0.5%(CI=0.995~0.996)。我们还发现，最低气温和最高气温之间的差异超过7摄氏度，手足口病的风险增加了41%(CI=1.388-1.439)。结论：我们的发现表明手足口病与天气有很强的相关性。然而，这种联系的确切原因还有待研究。在手足口病发病前提供32摄氏度以上的最高气温和中等降雨量的信息，有助于控制和遏制手足口病的上升趋势。
Background: Hand, foot, and mouth disease (HFMD) outbreaks leading to clinical and fatal complications have increased since late 1990s; especially in the Asia Pacific Region. Outbreaks of HFMD peaks in the warmer season of the year, but the underlying factors for this annual pattern and the reasons to the recent upsurge trend have not yet been established. This study analyzed the effect of short-term changes in weather on the incidence of HFMD in Singapore.Methods: The relative risks between weekly HFMD cases and temperature and rainfall were estimated for the period 20012008 using time series Poisson regression models allowing for over-dispersion. Smoothing was used to allow non-linear relationship between weather and weekly HFMD cases, and to adjust for seasonality and long-term time trend. Additionally, autocorrelation was controlled and weather was allowed to have a lagged effect on HFMD incidence up to 2 weeks.Results: Weekly temperature and rainfall showed statistically significant association with HFMD incidence at time lag of 1-2 weeks. Every 1 degrees C increases in maximum temperature above 32 degrees C elevated the risk of HFMD incidence by 36% (95% CI = 1.341-1.389). Simultaneously, one mm increase of weekly cumulative rainfall below 75 mm increased the risk of HFMD by 0.3% (CI = 1.002-1.003). While above 75 mm the effect was opposite and each mm increases of rainfall decreased the incidence by 0.5% (CI = 0.995-0.996). We also found that a difference between minimum and maximum temperature greater than 7 degrees C elevated the risk of HFMD by 41% (CI = 1.388-1.439).Conclusion: Our findings suggest a strong association between HFMD and weather. However, the exact reason for the association is yet to be studied. Information on maximum temperature above 32 degrees C and moderate rainfall precede HFMD incidence could help to control and curb the up-surging trend of HFMD.