1
|
Wang H, Geng M, Schikowski T, Areal AT, Hu K, Li W, Coelho MDSZS, Saldiva PHN, Sun W, Zhou C, Lu L, Zhao Q, Ma W. Increased Risk of Influenza Infection During Cold Spells in China: National Time Series Study. JMIR Public Health Surveill 2024; 10:e55822. [PMID: 39140274 DOI: 10.2196/55822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Revised: 05/13/2024] [Accepted: 06/01/2024] [Indexed: 08/15/2024] Open
Abstract
Background Studies have reported the adverse effects of cold events on influenza. However, the role of critical factors, such as characteristics of cold spells, and regional variations remain unresolved. Objective We aimed to systematically evaluate the association between cold spells and influenza incidence in mainland China. Methods This time series analysis used surveillance data of daily influenza from 325 sites in China in the 2014-2019 period. A total of 15 definitions of cold spells were adopted based on combinations of temperature thresholds and days of duration. A distributed lag linear model was used to estimate the short-term effects of cold spells on influenza incidence during the cool seasons (November to March), and we further explored the potential impact of cold spell characteristics (ie, intensity, duration, and timing during the season) on the estimated associations. Meta-regressions were used to evaluate the modification effect of city-level socioeconomic indicators. Results The overall effect of cold spells on influenza incidence increased with the temperature threshold used to define cold spells, whereas the added effects were generally small and not statistically significant. The relative risk of influenza-associated with cold spells was 3.35 (95% CI 2.89-3.88), and the estimated effects were stronger during the middle period of cool seasons. The health effects of cold spells varied geographically and residents in Jiangnan region were vulnerable groups (relative risk 7.36, 95% CI 5.44-9.95). The overall effects of cold spells were positively correlated with the urban population density, population size, gross domestic product per capita, and urbanization rate, indicating a sterner response to cold spells in metropolises. Conclusions Cold spells create a substantial health burden on seasonal influenza in China. Findings on regional and socioeconomic differences in the health effects of cold spells on seasonal influenza may be useful in formulating region-specific public health policies to address the hazardous effects of cold spells.
Collapse
Affiliation(s)
- Haitao Wang
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- Shandong University Climate Change and Health Center, Jinan, China
| | - Mengjie Geng
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Tamara Schikowski
- Department of Epidemiology, IUF-Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany
| | - Ashtyn Tracey Areal
- Department of Epidemiology, IUF-Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany
| | - Kejia Hu
- Department of Big Data in Health Science, School of Public Health, Zhejiang University, Hangzhou, China
| | - Wen Li
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- Shandong University Climate Change and Health Center, Jinan, China
| | | | | | - Wei Sun
- Taierzhuang Center for Disease Control and Prevention, Zaozhuang, China
| | - Chengchao Zhou
- Management and Policy, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- National Health Commission of China Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Liang Lu
- Shandong University Climate Change and Health Center, Jinan, China
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Qi Zhao
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- Shandong University Climate Change and Health Center, Jinan, China
| | - Wei Ma
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- Shandong University Climate Change and Health Center, Jinan, China
| |
Collapse
|
2
|
Sun J, Zhang W, Yao G, Gu J, Wu W, Wang D, Du Z, Hao Y. Assessing the modification impact of vaccination on the relationship of the Discomfort Index with hand, foot, and mouth disease in Guizhou: A multicounty study. PLoS Negl Trop Dis 2024; 18:e0012008. [PMID: 38949988 PMCID: PMC11216560 DOI: 10.1371/journal.pntd.0012008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 06/02/2024] [Indexed: 07/03/2024] Open
Abstract
BACKGROUND Hand, foot, and mouth disease (HFMD) is a major public health issue in China while temperature and humidity are well-documented predictors. However, evidence on the combined effect of temperature and humidity is still limited. It also remains unclear whether such an effect could be modified by the enterovirus 71 (EV71) vaccination. METHODS Based on 320,042 reported HFMD cases during the summer months between 2012 and 2019, we conducted a study utilizing Distributed Lag Non-Linear Models (DLNM) and time-varying DLNM to examine how China's HFMD EV71 vaccine strategy would affect the correlation between meteorological conditions and HFMD risk. RESULTS The incidence of HFMD changed with the Discomfort Index in an arm-shaped form. The 14-day cumulative risk of HFMD exhibited a statistically significant increase during the period of 2017-2019 (following the implementation of the EV71 vaccine policy) compared to 2012-2016 (prior to the vaccine implementation). For the total population, the range of relative risk (RR) values for HFMD at the 75th, 90th, and 99th percentiles increased from 1.082-1.303 in 2012-2016 to 1.836-2.022 in 2017-2019. In the stratified analyses, Han Chinese areas show stronger relative growth, with RR values at the 75th, 90th, and 99th percentiles increased by 14.3%, 39.1%, and 134.4% post-vaccination, compared to increases of 22.7%, 41.6%, and 38.8% in minority areas. Similarly, boys showed greater increases (24.4%, 47.7%, 121.5%) compared to girls (8.1%, 28.1%, 58.3%). Additionally, the central Guizhou urban agglomeration displayed a tendency for stronger relative growth compared to other counties. CONCLUSIONS Although the EV71 vaccine policy has been implemented, it hasn't effectively controlled the overall risk of HFMD. There's been a shift in the main viral subtypes, potentially altering population susceptibility and influencing HFMD occurrences. The modulating effects of vaccine intervention may also be influenced by factors such as race, sex, and economic level.
Collapse
Affiliation(s)
- Jie Sun
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
- Institute for the Control of Infectious Diseases, Guizhou Center for Disease Control and Prevention, Guiyang, Guizhou, China
| | - Wangjian Zhang
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Guanghai Yao
- Institute for the Control of Infectious Diseases, Guizhou Center for Disease Control and Prevention, Guiyang, Guizhou, China
| | - Jing Gu
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Wenjing Wu
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Dan Wang
- Institute for the Control of Infectious Diseases, Guizhou Center for Disease Control and Prevention, Guiyang, Guizhou, China
| | - Zhicheng Du
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
- Guangzhou Joint Research Center for Disease Surveillance and Risk Assessment, Sun Yat-sen University & Guangzhou Center for Disease Control and Prevention, Guangzhou, China
| | - Yuantao Hao
- Peking University Center for Public Health and Epidemic Preparedness & Response, Peking University, Beijing, China
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing, China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Peking University, Beijing, China
| |
Collapse
|
3
|
Cao H, Xu R, Liang Y, Li Q, Jiang W, Jin Y, Wang W, Yuan J. Effects of extreme meteorological factors and high air pollutant concentrations on the incidence of hand, foot and mouth disease in Jining, China. PeerJ 2024; 12:e17163. [PMID: 38766480 PMCID: PMC11102053 DOI: 10.7717/peerj.17163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 03/06/2024] [Indexed: 05/22/2024] Open
Abstract
Background The evidence on the effects of extreme meteorological conditions and high air pollution levels on incidence of hand, foot and mouth disease (HFMD) is limited. Moreover, results of the available studies are inconsistent. Further investigations are imperative to elucidate the specific issue. Methods Data on the daily cases of HFMD, meteorological factors and air pollution were obtained from 2017 to 2022 in Jining City. We employed distributed lag nonlinear model (DLNM) incorporated with Poisson regression to explore the impacts of extreme meteorological conditions and air pollution on HFMD incidence. Results We found that there were nonlinear relationships between temperature, wind speed, PM2.5, SO2, O3 and HFMD. The cumulative risk of extreme high temperature was higher at the 95th percentile (P95th) than at the 90th percentile(P90th), and the RR values for both reached their maximum at 10-day lag (P95th RR = 1.880 (1.261-2.804), P90th RR = 1.787 (1.244-2.569)), the hazardous effect of extreme low temperatures on HFMD is faster than that of extreme high temperatures. The cumulative effect of extreme low wind speeds reached its maximum at 14-day lag (P95th RR = 1.702 (1.389-2.085), P90th RR = 1.498(1.283-1.750)). The cumulative effect of PM2.5 concentration at the P90th was largest at 14-day lag (RR = 1.637 (1.069-2.506)), and the cumulative effect at the P95th was largest at 10-day lag (RR = 1.569 (1.021-2.411)). High SO2 concentration at the P95th at 14-day lag was associated with higher risk for HFMD (RR: 1.425 (1.001-2.030)). Conclusion Our findings suggest that high temperature, low wind speed, and high concentrations of PM2.5 and SO2 are associated with an increased risk of HFMD. This study not only adds insights to the understanding of the impact of extreme meteorological conditions and high levels of air pollutants on HFMD incidence but also holds practical significance for the development and enhancement of an early warning system for HFMD.
Collapse
Affiliation(s)
- Haoyue Cao
- School of Public Health, North China University of Science and Technology, Tangshan, Hebei Province, China
| | - Rongrong Xu
- State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing, China
| | - Yongmei Liang
- Business Management Department, Jining Center For Disease Control And Prevention, Jining, Shandong, China
| | - Qinglin Li
- School of Public Health, North China University of Science and Technology, Tangshan, Hebei Province, China
| | - Wenguo Jiang
- Infectious Disease Prevention and Control Department, Jining Center For Disease Control And Prevention, Jining, Shandong, China
| | - Yudi Jin
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Wenjun Wang
- Weifang Nursing Vocational College, Weifang, Shandong, China
| | - Juxiang Yuan
- School of Public Health, North China University of Science and Technology, Tangshan, Hebei Province, China
| |
Collapse
|
4
|
Wang W, Yang K, Li J, Jiang H, Zhang S, Lin Y, Zhang X, Jin M, Wang J, Tang M, Chen K. Association between ambient temperature and risk of notifiable infectious diseases in China from 2011 to 2019. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2024:1-13. [PMID: 38713481 DOI: 10.1080/09603123.2024.2350609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Accepted: 04/26/2024] [Indexed: 05/08/2024]
Abstract
Previous studies on temperature and infectious diseases primarily focused on individual disease types, yielding inconsistent conclusions. This study collected monthly data on notifiable infectious disease cases and meteorological variables across 7 provinces in China from 2011 to 2019. A distributed lag nonlinear model was used to evaluate the association between ambient temperature and infectious diseases within each province, and random meta-analysis was applied to evaluate the pooled effect. Extreme hot temperature (the 97.5th percentile) was positively associated with the risk of respiratory infectious diseases with the relative risk (RR) of 1.45 (95%CI: 1.01-2.08). Conversely, extreme cold temperature (the 2.5th percentile) was negatively associated with intestinal infectious diseases and zoonotic diseases and vector-borne diseases, reporting RRs of 0.43 (95%CI: 0.30-0.60) and 0.46 (95%CI: 0.38-0.57), respectively. This study described the nonlinear association between ambient temperature and infectious diseases with different transmission routes, informing comprehensive prevention and control strategies for temperature-related infectious diseases.
Collapse
Affiliation(s)
- Wenqing Wang
- Department of Public Health, the Fourth Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Kaixuan Yang
- Department of Public Health, The Fourth Affiliated Hospital, International Institutes of Medicine, Zhejiang University School of Medicine, Yiwu, China
| | - Jiayi Li
- Department of Public Health, the Fourth Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Haiyan Jiang
- Department of Public Health, the Fourth Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Simei Zhang
- Department of Public Health, the Fourth Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yaoyao Lin
- Department of Public Health, the Fourth Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xinhan Zhang
- Department of Public Health, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Mingjuan Jin
- Department of Public Health, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jianbing Wang
- Department of Public Health, National Clinical Research Center for Child Health of Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Mengling Tang
- Department of Public Health, the Fourth Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Kun Chen
- Department of Public Health, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| |
Collapse
|
5
|
Huang S, Wang H, Li Z, Wang Z, Ma T, Song R, Lu M, Han X, Zhang Y, Wang Y, Zhen Q, Shui T. Risk effects of meteorological factors on human brucellosis in Jilin province, China, 2005-2019. Heliyon 2024; 10:e29611. [PMID: 38660264 PMCID: PMC11040064 DOI: 10.1016/j.heliyon.2024.e29611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 04/10/2024] [Accepted: 04/10/2024] [Indexed: 04/26/2024] Open
Abstract
Background The impact of climate on zoonotic infectious diseases (or can be referred to as climate-sensitive zoonotic diseases) is confirmed. Yet, research on the association between brucellosis and climate is limited. We aim to understand the impact of meteorological factors on the risk of brucellosis, especially in northeastern China. Methods Monthly incidence data for brucellosis from 2005 to 2019 in Jilin province was obtained from the China Information System for Disease Control and Prevention (CDC). Monthly meteorological data (average temperature (°C), wind velocity (m/s), relative humidity (%), sunshine hours (h), air pressure (hPa), and rainfall (mm)) in Jilin province, China, from 2005 to 2019 were collected from the China Meteorological Information Center (http://data.cma.cn/). The Spearman's correlation was used to choose among the several meteorological variables. A distributed lag non-linear model (DLNM) was used to estimate the lag and non-linearity effect of meteorological factors on the risk of brucellosis. Results A total of 24,921 cases of human brucellosis were reported in Jilin province from 2005 to 2019, with the peak epidemic period from April to June. Low temperature and low sunshine hours were protective factors for the brucellosis, where the minimum RR values were 0.50 (95 % CI = 0.31-0.82) for -13.7 °C with 1 month lag and 0.61 (95 % CI = 0.41-0.91) for 110.5h with 2 months lag, respectively. High temperature, high sunshine hours, and low wind velocity were risk factors for brucellosis. The maximum RR values were 2.91 (95 % CI = 1.43-5.92, lag = 1, 25.7 °C), 1.85 (95 % CI = 1.23-2.80, lag = 2, 332.6h), and 1.68 (95 % CI = 1.25-2.26, lag = 2, 1.4 m/s). The trends in the impact of extreme temperature and extreme sunshine hours on the transmission of brucellosis were generally consistent. Conclusion High temperature, high sunshine hours, and low wind velocity are more conducive to the transmission of brucellosis with an obvious lag effect. The results will deepen the understanding of the relationship between climate and brucellosis and provide a reference for formulating relevant public health policies.
Collapse
Affiliation(s)
- Shanjun Huang
- Department of Epidemiology and Biostatistics, Key Laboratory of Zoonosis, Ministry of Education, School of Public Health, Jilin University, Changchun, Jilin, PR China
- State Key Laboratory for Diagnosis and Treatment of Severe Zoonotic Infectious Diseases, Key Laboratory for Zoonoses Research of the Ministry of Education, Changchun, PR China
| | - Hao Wang
- Department of Epidemiology and Biostatistics, Key Laboratory of Zoonosis, Ministry of Education, School of Public Health, Jilin University, Changchun, Jilin, PR China
| | - Zhuo Li
- Department of Epidemiology and Biostatistics, Key Laboratory of Zoonosis, Ministry of Education, School of Public Health, Jilin University, Changchun, Jilin, PR China
| | - Zhaohan Wang
- Department of Epidemiology and Biostatistics, Key Laboratory of Zoonosis, Ministry of Education, School of Public Health, Jilin University, Changchun, Jilin, PR China
| | - Tian Ma
- Department of Epidemiology and Biostatistics, Key Laboratory of Zoonosis, Ministry of Education, School of Public Health, Jilin University, Changchun, Jilin, PR China
| | - Ruifang Song
- Department of Epidemiology and Biostatistics, Key Laboratory of Zoonosis, Ministry of Education, School of Public Health, Jilin University, Changchun, Jilin, PR China
| | - Menghan Lu
- Department of Epidemiology and Biostatistics, Key Laboratory of Zoonosis, Ministry of Education, School of Public Health, Jilin University, Changchun, Jilin, PR China
| | - Xin Han
- Department of Epidemiology and Biostatistics, Key Laboratory of Zoonosis, Ministry of Education, School of Public Health, Jilin University, Changchun, Jilin, PR China
| | - Yiting Zhang
- Department of Epidemiology and Biostatistics, Key Laboratory of Zoonosis, Ministry of Education, School of Public Health, Jilin University, Changchun, Jilin, PR China
| | - Yingtong Wang
- Department of Epidemiology and Biostatistics, Key Laboratory of Zoonosis, Ministry of Education, School of Public Health, Jilin University, Changchun, Jilin, PR China
| | - Qing Zhen
- Department of Epidemiology and Biostatistics, Key Laboratory of Zoonosis, Ministry of Education, School of Public Health, Jilin University, Changchun, Jilin, PR China
- State Key Laboratory for Diagnosis and Treatment of Severe Zoonotic Infectious Diseases, Key Laboratory for Zoonoses Research of the Ministry of Education, Changchun, PR China
| | - Tiejun Shui
- Yunnan Center for Disease Control and Prevention, Kunming, Yunnan, PR China
| |
Collapse
|
6
|
Yu HW, Kuan CH, Tseng LW, Chen HY, Tsai MY, Chen YS. Investigation of the Correlation between Enterovirus Infection and the Climate Factor Complex Including the Ping-Year Factor and El Niño-Southern Oscillation in Taiwan. Viruses 2024; 16:471. [PMID: 38543836 PMCID: PMC10975746 DOI: 10.3390/v16030471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 03/14/2024] [Accepted: 03/18/2024] [Indexed: 05/23/2024] Open
Abstract
Enterovirus infection and enterovirus infection with severe complications (EVSC) are critical issues in several aspects. However, there is no suitable predictive tool for these infections. A climate factor complex (CFC) containing several climate factors could provide more effective predictions. The ping-year factor (PYF) and El Niño-Southern Oscillation (ENSO) are possible CFCs. This study aimed to determine the relationship between these two CFCs and the incidence of enterovirus infection. Children aged 15 years and younger with enterovirus infection and/or EVSC were enrolled between 2007 and 2022. Each year was categorized into a ping-year or non-ping-year according to the PYF. Poisson regression was used to evaluate the associations between the PYF, ENSO, and the incidence of enterovirus infection. Compared to the ping-year group, the incidence rate of enterovirus infection, the incidence rate of EVSC, and the ratio of EVSC in the non-ping-year group were 1.24, 3.38, and 2.73 times higher, respectively (p < 0.001). For every one-unit increase in La Niña, the incidence rate of enterovirus infection decreased to 0.96 times (p < 0.001). Our study indicated that CFCs could be potential predictors for enterovirus infection, and the PYF was more suitable than ENSO. Further research is needed to improve the predictive model.
Collapse
Affiliation(s)
- Hsueh-Wen Yu
- Department of Chinese Acupuncture and Traumatology, Center for Traditional Chinese Medicine, Chang Gung Memorial Hospital, No. 123, Dinghu Rd., Gueishan Dist., Taoyuan City 333423, Taiwan; (H.-W.Y.); (C.-H.K.); (L.-W.T.)
- Taiwan Huangdi-Neijing Medical Practice Association (THMPA), Taoyuan City 330032, Taiwan
| | - Chia-Hsuan Kuan
- Department of Chinese Acupuncture and Traumatology, Center for Traditional Chinese Medicine, Chang Gung Memorial Hospital, No. 123, Dinghu Rd., Gueishan Dist., Taoyuan City 333423, Taiwan; (H.-W.Y.); (C.-H.K.); (L.-W.T.)
- Taiwan Huangdi-Neijing Medical Practice Association (THMPA), Taoyuan City 330032, Taiwan
| | - Liang-Wei Tseng
- Department of Chinese Acupuncture and Traumatology, Center for Traditional Chinese Medicine, Chang Gung Memorial Hospital, No. 123, Dinghu Rd., Gueishan Dist., Taoyuan City 333423, Taiwan; (H.-W.Y.); (C.-H.K.); (L.-W.T.)
- Taiwan Huangdi-Neijing Medical Practice Association (THMPA), Taoyuan City 330032, Taiwan
| | - Hsing-Yu Chen
- Department of Chinese Internal Medicine, Center for Traditional Chinese Medicine, Chang Gung Memorial Hospital, No. 123, Dinghu Rd., Gueishan Dist., Taoyuan City 333423, Taiwan;
| | - Meg-Yen Tsai
- Pingzhen Fengze Chinese Medicine Clinic, No. 65, Sec. 2, Yanping Rd., Pingzhen Dist., Taoyuan City 324005, Taiwan;
| | - Yu-Sheng Chen
- Department of Chinese Acupuncture and Traumatology, Center for Traditional Chinese Medicine, Chang Gung Memorial Hospital, No. 123, Dinghu Rd., Gueishan Dist., Taoyuan City 333423, Taiwan; (H.-W.Y.); (C.-H.K.); (L.-W.T.)
- Taiwan Huangdi-Neijing Medical Practice Association (THMPA), Taoyuan City 330032, Taiwan
- School of Traditional Chinese Medicine, Chang Gung University, No. 259, Wen-Hwa 1st Rd., Gueishan Dist., Taoyuan City 333323, Taiwan
| |
Collapse
|
7
|
Zhang C, Wang X, Sun D, Li Y, Feng Y, Zhang R, Zheng Y, Kou Z, Liu Y. Modification effects of long-term air pollution levels on the relationship between short-term exposure to meteorological factors and hand, foot, and mouth disease: A distributed lag non-linear model-based study in Shandong Province, China. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2024; 272:116060. [PMID: 38310825 DOI: 10.1016/j.ecoenv.2024.116060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 01/28/2024] [Accepted: 01/29/2024] [Indexed: 02/06/2024]
Abstract
The occurrence of hand, foot, and mouth disease (HFMD) is closely related to meteorological factors. However, location-specific characteristics, such as persistent air pollution, may increase the complexity of the impact of meteorological factors on HFMD, and studies across different areas and populations are largely lacking. In this study, a two-stage multisite time-series analysis was conducted using data from 16 cities in Shandong Province from 2015 to 2019. In the first stage, we obtained the cumulative exposure-response curves of meteorological factors and the number of HFMD cases for each city. In the second stage, we merged the estimations from the first stage and included city-specific air pollution variables to identify significant effect modifiers and how they modified the short-term relationship between HFMD and meteorological factors. High concentrations of air pollutants may reduce the risk effects of high average temperature on HFMD and lead to a distinct peak in the cumulative exposure-response curve, while lower concentrations may increase the risk effects of high relative humidity. Furthermore, the effects of average wind speed on HFMD were different at different levels of air pollution. The differences in modification effects between subgroups were mainly manifested in the diversity and quantity of significant modifiers. The modification effects of long-term air pollution levels on the relationship between sunshine hours and HFMD may vary significantly depending on geographical location. The people in age<3 and male groups were more susceptible to long-term air pollution. These findings contribute to a deepening understanding of the relationship between meteorological factors and HFMD and provide evidence for relevant public health decision-making.
Collapse
Affiliation(s)
- Chao Zhang
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China; Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250000, China
| | - Xianjun Wang
- Shandong Center for Disease Control and Prevention, Jinan, China
| | - Dapeng Sun
- Shandong Center for Disease Control and Prevention, Jinan, China
| | - Yan Li
- Shandong Center for Disease Control and Prevention, Jinan, China
| | - Yiping Feng
- Shandong Center for Disease Control and Prevention, Jinan, China
| | - Rongguo Zhang
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China; Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250000, China
| | - Yongxiao Zheng
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China; Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250000, China
| | - Zengqiang Kou
- Shandong Center for Disease Control and Prevention, Jinan, China.
| | - Yunxia Liu
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China; Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250000, China; Climate Change and Health Center, Shandong University, Jinan, Shandong 250012, China.
| |
Collapse
|
8
|
Wang W, Li S, Zhang T, Yin F, Ma Y. Detecting the spatial clustering of exposure-response relationships with estimation error: a novel spatial scan statistic. Biometrics 2023; 79:3522-3532. [PMID: 36964947 DOI: 10.1111/biom.13861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 02/25/2023] [Accepted: 03/15/2023] [Indexed: 03/27/2023]
Abstract
Detecting the spatial clustering of the exposure-response relationship (ERR) between environmental risk factors and health-related outcomes plays important roles in disease control and prevention, such as identifying highly sensitive regions, exploring the causes of heterogeneous ERRs, and designing region-specific health intervention measures. However, few studies have focused on this issue. A possible reason is that the commonly used cluster-detecting tool, spatial scan statistics, cannot be used for multivariate spatial datasets with estimation error, such as the ERR, which is often defined by a vector with its covariance estimated by a regression model. Such spatial datasets have been produced in abundance in the last decade, which suggests the importance of developing a novel cluster-detecting tool applicable for multivariate datasets with estimation error. In this work, by extending the classic scan statistic, we developed a novel spatial scan statistic called the estimation-error-based scan statistic (EESS), which is applicable for both univariate and multivariate datasets with estimation error. Then, a two-stage analytic process was proposed to detect the spatial clustering of ERRs in practical studies. A published motivating example and a simulation study were used to validate the performance of EESS. The results show that the clusters detected by EESS can efficiently reflect the clustering heterogeneity and yield more accurate ERR estimates by adjusting for such heterogeneity.
Collapse
Affiliation(s)
- Wei Wang
- West China School of Public Health and West China Fourth hospital, Sichuan University, Chengdu, China
| | - Sheng Li
- West China School of Public Health and West China Fourth hospital, Sichuan University, Chengdu, China
| | - Tao Zhang
- West China School of Public Health and West China Fourth hospital, Sichuan University, Chengdu, China
| | - Fei Yin
- West China School of Public Health and West China Fourth hospital, Sichuan University, Chengdu, China
| | - Yue Ma
- West China School of Public Health and West China Fourth hospital, Sichuan University, Chengdu, China
- Institute of Systems Epidemiology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| |
Collapse
|
9
|
Yang L, Liu T, Tian D, Zhao H, Xia Y, Wang J, Li T, Li Q, Qi L. Non-linear association between daily mean temperature and children's hand foot and mouth disease in Chongqing, China. Sci Rep 2023; 13:20355. [PMID: 37990138 PMCID: PMC10663521 DOI: 10.1038/s41598-023-47858-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 11/19/2023] [Indexed: 11/23/2023] Open
Abstract
Chongqing was seriously affected by hand, foot, and mouth disease (HFMD), but the relationships between daily mean temperature and the incidence of HFMD remain unclear. This study used distributed lag nonlinear model to evaluate the effect of daily mean temperature on the incidence of HFMD in children aged < 5 years in Chongqing. Daily HFMD data from 2012 to 2019 in Chongqing were retrieved from the notifiable infectious disease surveillance system. A total of 413,476 HFMD cases aged < 5 years were reported in Chongqing from 2012 to 2019. The exposure-response curve of daily mean temperature and daily HFMD cases was wavy-shaped. The relative risks (RRs) increased as daily mean temperature below 5.66 °C or above 9.43 °C, with two peaks at 16.10 °C and 26.68 °C. The RRs reached the highest when the daily mean temperature at 26.68 °C on the current day (RR = 1.20, 95% CI 1.09-1.32), followed by the daily mean temperature at 16.10 °C at lag 5 days (RR = 1.07, 95% CI 1.05-1.08). The RRs for girls and daycare children were much higher than those for boys and scattered children, respectively. Taken together, daily mean temperature has strong effect on HFMD in children aged < 5 years old in Chongqing, particularly for girls and daycare children.
Collapse
Affiliation(s)
- Lin Yang
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, 400042, China
| | - Tian Liu
- Jingzhou Center for Disease Control and Prevention, Hubei, 434000, China
| | - Dechao Tian
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-Sen University, Shenzhen, 518107, Guangdong, China
| | - Han Zhao
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, 400042, China
| | - Yu Xia
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, 400042, China
| | - Ju Wang
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, 400042, China
| | - Tingting Li
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, 400042, China
| | - Qin Li
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, 400042, China.
| | - Li Qi
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, 400042, China.
| |
Collapse
|
10
|
Guo Z, Wang Y, Li Y, Zhou L. Impact of meteorological factors on the incidence of hand-foot-mouth disease in Yangzhou from 2017 to 2022: a time series study. Front Public Health 2023; 11:1278516. [PMID: 37881347 PMCID: PMC10597706 DOI: 10.3389/fpubh.2023.1278516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 09/26/2023] [Indexed: 10/27/2023] Open
Abstract
Background Hand, foot, and mouth disease (HFMD) is a significant public health issue in China, and numerous studies have indicated a close association between HFMD incidence and meteorological factors. This study aims to investigate the relationship between meteorological factors and HFMD in Yangzhou City, Jiangsu Province, China. Methods HFMD case reports and meteorological data from Yangzhou City between 2017 and 2022 were extracted from the National Notifiable Infectious Disease Surveillance System and the Meteorological Data Sharing Service System, respectively. A generalized additive model (GAM) was employed to assess the exposure-response relationship between meteorological factors and HFMD. Subsequently, a distributed lag nonlinear model (DLNM) was used to explore the exposure-lag-effect of meteorological factors on HFMD. Results HFMD in Yangzhou City exhibits obvious seasonality and periodicity. There is an inverted "U" shaped relationship between average temperature and the risk of HFMD, with the maximum lag effect observed at a temperature of 25°C with lag 0 day (RR = 2.07, 95% CI: 1.74-2.47). As the duration of sunshine and relative humidity increase, the risk of HFMD continuously rises, with the maximum lag effect observed at a sunshine duration of 12.4 h with a lag of 14 days (RR = 2.10, 95% CI: 1.17-3.77), and a relative humidity of 28% with a lag of 14 days (RR = 1.21, 95% CI: 1.01-1.64). There is a "U" shaped relationship between average atmospheric pressure and the risk of HFMD, with the maximum effect observed at an atmospheric pressure of 989 hPa with no lag (RR = 1.45, 95% CI: 1.25-1.69). As precipitation increases, the risk of HFMD decreases, with the maximum effect observed at a precipitation of 151 mm with a lag of 14 days (RR = 1.45, 95% CI: 1.19-2.53). Conclusion Meteorological factors including average temperature, average atmospheric pressure, relative humidity, precipitation, and sunshine duration significantly influenced the risk of HFMD in Yangzhou City. Effective prevention measures for HFMD should be implemented, taking into account the local climate conditions.
Collapse
Affiliation(s)
- Zaijin Guo
- Clinical Medical College, Yangzhou University, Yangzhou, China
- Northern Jiangsu People’s Hospital, Yangzhou, China
| | - Yin Wang
- Department of Acute Infectious Disease Control and Prevention, Yangzhou Centre for Disease Control and Prevention, Yangzhou, China
| | - Yunshui Li
- Clinical Medical College, Yangzhou University, Yangzhou, China
- Northern Jiangsu People’s Hospital, Yangzhou, China
| | - Luojing Zhou
- Clinical Medical College, Yangzhou University, Yangzhou, China
- Northern Jiangsu People’s Hospital, Yangzhou, China
| |
Collapse
|
11
|
Tan C, Li S, Li Y, Peng Z. Dynamic modeling and data fitting of climatic and environmental factors and people's behavior factors on hand, foot, and mouth disease (HFMD) in Shanghai, China. Heliyon 2023; 9:e18212. [PMID: 37576260 PMCID: PMC10412780 DOI: 10.1016/j.heliyon.2023.e18212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 07/08/2023] [Accepted: 07/11/2023] [Indexed: 08/15/2023] Open
Abstract
Background Hand, foot, and mouth disease (HFMD) appear to be a multi-wave outbreak with unknown mechanisms. We investigate the effects of climatic and environmental factors and changes in people's behavior factors that may be caused by external factors: temperature, relative humidity, and school opening and closing. Methods Distributed lag nonlinear model (DLNM) and dynamic model are used to research multi-wave outbreaks of HFMD. Climatic and environmental factors impact on transmission rate β ( t ) is modeled through DLNM and then substituted into this relationship to establish the dynamic model with reported case data to test for validity. Results Relative risk (RR) of HFMD infection increases with increasing temperature. The RR of infection first increases and then decreases with the increase of relative humidity. For the model fitting HFMD dynamic, time average basic reproduction number [ R 0 ] of Stage I (without vaccine) and Stage II (with EV71 vaccine) are 1.9362 and 1.5478, respectively. Temperature has the highest explanatory power, followed by school opening and closing, and relative humidity. Conclusion We obtain three conclusions about the prevention and control of HFMD. 1) According to the temperature, relative humidity and school start time, the outbreak peak of HFMD should be warned and targeted prevention and control measures should be taken. 2) Reduce high indoor temperature when more than 31.5 oC, and increase low relative humidity when less than 77.5% by opening the window for ventilation, adding houseplants, using air conditioners and humidifiers, reducing the incidence of HFMD and the number of infections. 3) The risk of HFMD transmission during winter vacations is higher than during summer vacations. It is necessary to strengthen the publicity of HFMD prevention knowledge before winter vacations and strengthen the disinfection control measures during winter vacations in children's hospitals, school classrooms, and other places where children gather to reduce the frequency of staff turnover during winter vacations.
Collapse
Affiliation(s)
- Changlei Tan
- School of Information and Mathematics, Yangtze University, Jingzhou, 434023, Hubei, PR China
- Information Engineering College, Hunan Applied Technology University, Changde, 415100, Hunan, PR China
| | - Shuang Li
- College of Mathematics and Information Science, Henan Normal University, Xinxiang, 453000, Henan, PR China
| | - Yong Li
- School of Information and Mathematics, Yangtze University, Jingzhou, 434023, Hubei, PR China
| | - Zhihang Peng
- School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, PR China
| |
Collapse
|
12
|
Cai W, Luo C, Geng X, Zha Y, Zhang T, Zhang H, Yang C, Yin F, Ma Y, Shui T. City-level meteorological conditions modify the relationships between exposure to multiple air pollutants and the risk of pediatric hand, foot, and mouth disease in the Sichuan Basin, China. Front Public Health 2023; 11:1140639. [PMID: 37601186 PMCID: PMC10433208 DOI: 10.3389/fpubh.2023.1140639] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 06/26/2023] [Indexed: 08/22/2023] Open
Abstract
Background Several studies have examined the effects of city-level meteorological conditions on the associations between meteorological factors and hand, foot, and mouth disease (HFMD) risk. However, evidence that city-level meteorological conditions modify air pollutant-HFMD associations is lacking. Methods For each of the 17 cities in the Sichuan Basin, we obtained estimates of the relationship between exposures to multiple air pollutants and childhood HFMD risk by using a unified distributed lag nonlinear model (DLNM). Multivariate meta-regression models were used to identify the effects of city-level meteorological conditions as effect modifiers. Finally, we conducted subgroup analyses of age and sex to explore whether the modification effects varied in different subgroups. Results The associations between PM2.5/CO/O3 and HFMD risk showed moderate or substantial heterogeneity among cities (I 2 statistics: 48.5%, 53.1%, and 61.1%). Temperature conditions significantly modified the PM2.5-HFMD association, while relative humidity and rainfall modified the O3-HFMD association. Low temperatures enhanced the protective effect of PM2.5 exposure against HFMD risk [PM2.5 <32.7 μg/m3 or PM2.5 >100 μg/m3, at the 99th percentile: relative risk (RR) = 0.14, 95% CI: 0.03-0.60]. Low relative humidity increased the adverse effect of O3 exposure on HFMD risk (O3 >128.7 μg/m3, at the 99th percentile: RR = 2.58, 95% CI: 1.48-4.50). However, high rainfall decreased the risk of HFMD due to O3 exposure (O3: 14.1-41.4 μg/m3). In addition, the modification effects of temperature and relative humidity differed in the female and 3-5 years-old subgroups. Conclusion Our findings revealed moderate or substantial heterogeneity in multiple air pollutant-HFMD relationships. Temperature, relative humidity, and rainfall modified the relationships between PM2.5 or O3 exposure and HFMD risk.
Collapse
Affiliation(s)
- Wennian Cai
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Caiying Luo
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Xiaoran Geng
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Yuanyi Zha
- Graduate School of Kunming Medical University, Kunming, China
| | - Tao Zhang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Huadong Zhang
- Chongqing Center for Disease Control and Prevention, Chongqing, China
| | - Changhong Yang
- Sichuan Center for Disease Control and Prevention, Chengdu, China
| | - Fei Yin
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Yue Ma
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Tiejun Shui
- Yunnan Center for Disease Control and Prevention, Kunming, China
| |
Collapse
|
13
|
Jiang X, Ma Y, Lv Q, Liu Y, Zhang T, Yin F, Shui T. Influence of social and meteorological factors on hand, foot, and mouth disease in Sichuan Province. BMC Public Health 2023; 23:849. [PMID: 37165358 PMCID: PMC10170695 DOI: 10.1186/s12889-023-15699-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 04/18/2023] [Indexed: 05/12/2023] Open
Abstract
BACKGROUND Hand, foot and mouth disease (HFMD) caused by a variety of enteroviruses remains a major public health problem in China. Previous studies have found that social factors may contribute to the inconsistency of the relationship patterns between meteorological factors and HFMD, but the conclusions are inconsistent. The influence of social factors on the association between meteorology and HFMD is still less well understood. We aimed to analyze whether social factors affected the effect of meteorological factors on HFMD in Sichuan Province. METHOD We collected daily data on HFMD, meteorological factors and social factors in Sichuan Province from 2011 to 2017. First, we used a Bayesian spatiotemporal model combined with a distributed lag nonlinear model to evaluate the exposure-lag-response association between meteorological factors and HFMD. Second, by constructing the interaction of meteorological factors and social factors in the above model, the changes in the relative risk (RR) under different levels of social factors were evaluated. RESULTS The cumulative exposure curves for average temperature, relative humidity, and HFMD were shaped like an inverted "V" and a "U" shape. As the average temperature increased, the RR increased and peaked at 19 °C (RR 1.020 [95% confidence interval CI 1.004-1.050]). The urbanization rate, per capita gross domestic product (GDP), population density, birth rate, number of beds in health care centers and number of kindergartens interacted with relative humidity. With the increase in social factors, the correlation curve between relative humidity and HFMD changed from an "S" shape to a "U" shape. CONCLUSIONS Relative humidity and average temperature increased the risk of HFMD within a certain range, and social factors enhanced the impact of high relative humidity. These results could provide insights into the combined role of environmental factors in HFMD and useful information for regional interventions.
Collapse
Affiliation(s)
- Xiaohong Jiang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yue Ma
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Qiang Lv
- Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan, China
| | - Yaqiong Liu
- Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan, China
| | - Tao Zhang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Fei Yin
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China.
| | - Tiejun Shui
- Yunnan Center for Disease Control and Prevention, Kunming, Yunnan, China.
| |
Collapse
|
14
|
Associations between ambient air pollutants and childhood hand, foot, and mouth disease in Sichuan, China: a spatiotemporal study. Sci Rep 2023; 13:3993. [PMID: 36899026 PMCID: PMC10006415 DOI: 10.1038/s41598-023-31035-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 03/06/2023] [Indexed: 03/12/2023] Open
Abstract
Hand, foot, and mouth disease (HFMD) is a major public health concern in the Asia-Pacific region. Previous studies have implied that ambient air pollution may affect the incidence of HFMD, but the results among different regions are inconsistent. We aimed to deepen the understanding of the associations between air pollutants and HFMD by conducting a multicity study. Daily data on childhood HFMD counts and meteorological and ambient air pollution (PM2.5, PM10, NO2, CO, O3, and SO2) concentrations in 21 cities in Sichuan Province from 2015 to 2017 were collected. A spatiotemporal Bayesian hierarchical model framework was established, and then a distributed lag nonlinear models (DLNMs) was constructed to reveal exposure-lag-response relationships between air pollutants and HFMD while controlling for spatiotemporal effects. Furthermore, given the differences in the levels and seasonal trends of air pollutants between the basin region and plateau region, we explored whether these associations varied between different areas (basin and plateau). The associations between air pollutants and HFMD were nonlinear, with different lag responses. Low NO2 concentrations and both low and high PM2.5 and PM10 concentrations were associated with a decreased risk of HFMD. No significant associations between CO, O3, and SO2 and HFMD were found. The associations between air pollutant concentrations and HFMD were different between the basin and plateau regions. Our study revealed associations between PM2.5, PM10, and NO2 concentrations and HFMD, deepening the understanding of the relationships between air pollutants and HFMD. These findings provide evidence to support the formulation of relevant prevention measures and the establishment of an early warning system.
Collapse
|
15
|
Li Y, Li J, Zhu Z, Zeng W, Zhu Q, Rong Z, Hu J, Li X, He G, Zhao J, Yin L, Quan Y, Zhang Q, Li M, Zhang L, Zhou Y, Liu T, Ma W, Zeng S, Chen Q, Sun L, Xiao J. Exposure-response relationship between temperature, relative humidity, and varicella: a multicity study in South China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:7594-7604. [PMID: 36044136 DOI: 10.1007/s11356-022-22711-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 08/21/2022] [Indexed: 06/15/2023]
Abstract
Varicella is a rising public health issue. Several studies have tried to quantify the relationships between meteorological factors and varicella incidence but with inconsistent results. We aim to investigate the impact of temperature and relative humidity on varicella, and to further explore the effect modification of these relationships. In this study, the data of varicella and meteorological factors from 2011 to 2019 in 21 cities of Guangdong Province, China were collected. Distributed lag nonlinear models (DLNM) were constructed to explore the relationship between meteorological factors (temperature and relative humidity) and varicella in each city, controlling in school terms, holidays, seasonality, long-term trends, and day of week. Multivariate meta-analysis was applied to pool the city-specific estimations. And the meta-regression was used to explore the effect modification for the spatial heterogeneity of city-specific meteorological factors and social factors (such as disposable income per capita, vaccination coverage, and so on) on varicella. The results indicated that the relationship between temperature and varicella in 21 cities appeared nonlinear with an inverted S-shaped. The relative risk peaked at 20.8 ℃ (RR = 1.42, 95% CI: 1.22, 1.65). The relative humidity-varicella relationship was approximately L-shaped, with a peaking risk at 69.5% relative humidity (RR = 1.25, 95% CI: 1.04, 1.50). The spatial heterogeneity of temperature-varicella relationships may be caused by income or varicella vaccination coverage. And varicella vaccination coverage may contribute to the spatial heterogeneity of the relative humidity-varicella relationship. The findings can help us deepen the understanding of the meteorological factors-varicella association and provide evidence for developing prevention strategy for varicella epidemic.
Collapse
Affiliation(s)
- Yihan Li
- School of Public Health, Southern Medical University, Guangzhou, 510515, Guangdong, China
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, Guangdong, China
| | - Jialing Li
- Institute of Immunization Program, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, Guangdong, China
| | - Zhihua Zhu
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, Guangdong, China
| | - Weilin Zeng
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, Guangdong, China
| | - Qi Zhu
- Institute of Immunization Program, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, Guangdong, China
| | - Zuhua Rong
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, Guangdong, China
| | - Jianxiong Hu
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, Guangdong, China
| | - Xing Li
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, Guangdong, China
| | - Guanhao He
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, Guangdong, China
| | - Jianguo Zhao
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, Guangdong, China
| | - Lihua Yin
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, Guangdong, China
| | - Yi Quan
- School of Public Health, Southern Medical University, Guangzhou, 510515, Guangdong, China
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, Guangdong, China
| | - Qian Zhang
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, Guangdong, China
| | - Manman Li
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, Guangdong, China
| | - Li Zhang
- School of Public Health, Southern Medical University, Guangzhou, 510515, Guangdong, China
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, Guangdong, China
| | - Yan Zhou
- School of Public Health, Southern Medical University, Guangzhou, 510515, Guangdong, China
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, Guangdong, China
| | - Tao Liu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, 510632, Guangdong, China
| | - Wenjun Ma
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, 510632, Guangdong, China
| | - Siqing Zeng
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, Guangdong, China
| | - Qing Chen
- School of Public Health, Southern Medical University, Guangzhou, 510515, Guangdong, China
| | - Limei Sun
- Institute of Immunization Program, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, Guangdong, China
| | - Jianpeng Xiao
- School of Public Health, Southern Medical University, Guangzhou, 510515, Guangdong, China.
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, Guangdong, China.
| |
Collapse
|
16
|
Meng L, Zhou C, Xu Y, Liu F, Zhou C, Yao M, Li X. The lagged effect and attributable risk of apparent temperature on hand, foot, and mouth disease in Changsha, China: a distributed lag non-linear model. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:11504-11515. [PMID: 36094702 DOI: 10.1007/s11356-022-22875-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 08/31/2022] [Indexed: 06/15/2023]
Abstract
Hand, foot, and mouth disease (HFMD) is the leading Category C infectious disease affecting millions of children in China every year. In the context of global climate change, the understanding and quantification of the impact of weather factors on human health are particularly critical to the development and implementation of climate change adaptation and mitigation strategies. The aim of this study was to quantify the attributable burden of a combined bioclimatic indicator (apparent temperature) on HFMD and to identify temperature-specific sensitive populations. A total of 123,622 HFMD cases were included in the study. The non-linear relationship between apparent temperature and the incidence of HFMD was approximately M-shaped, with hot weather being more likely to be attributable than cold conditions, of which moderately hot accounting for the majority of cases (21,441, 17.34%). Taking the median apparent temperature (19.2 °C) as reference, the cold effect showed a short acute effect with the highest risk on the day of lag 0 (RR = 1.086, 95% CI: 1.024 ~ 1.152), whereas the hot effect lasted longer with the greatest risk at a lag of 7 days (RR = 1.081, 95% CI: 1.059 ~ 1.104). Subgroup analysis revealed that males, children under 3 years old, and scattered children tended to be more vulnerable to HFMD in hot weather, while females, those aged 3 ~ 5 years, and nursery children were sensitive to cold conditions. This study suggests that high temperatures have a greater impact on HFMD than low temperatures as well as lasting longer, of particular concern being moderately high temperatures rather than extreme temperatures. Early intervention takes on greater importance during cold days, while the duration of HFMD intervention must be longer during hot days.
Collapse
Affiliation(s)
- Lijun Meng
- Department of Epidemiology and Health Statistics, Xiang Ya School of Public Health, Central South University, Changsha, 410078, Hunan, China
| | - Chunliang Zhou
- Hunan Provincial Center for Disease Control and Prevention, Changsha, 410005, Hunan, China
| | - Yiqing Xu
- Hunan Provincial Center for Disease Control and Prevention, Changsha, 410005, Hunan, China
| | - Fuqiang Liu
- Hunan Provincial Center for Disease Control and Prevention, Changsha, 410005, Hunan, China
| | - Cui Zhou
- Department of Epidemiology and Health Statistics, Xiang Ya School of Public Health, Central South University, Changsha, 410078, Hunan, China
| | - Meng Yao
- Department of Epidemiology and Health Statistics, Xiang Ya School of Public Health, Central South University, Changsha, 410078, Hunan, China
| | - Xingli Li
- Department of Epidemiology and Health Statistics, Xiang Ya School of Public Health, Central South University, Changsha, 410078, Hunan, China.
| |
Collapse
|
17
|
How neighborhood environment modified the effects of power outages on multiple health outcomes in New York state? HYGIENE AND ENVIRONMENTAL HEALTH ADVANCES 2022; 4. [PMID: 36777309 PMCID: PMC9914544 DOI: 10.1016/j.heha.2022.100039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Background Although power outage (PO) is one of the most important consequences of increasing weather extremes and the health impact of POs has been reported previously, studies on the neighborhood environment underlying the population vulnerability in such situations are limited. This study aimed to identify dominant neighborhood environmental predictors which modified the impact of POs on multiple health outcomes in New York State. Methods We applied a two-stage approach. In the first stage, we used time series analysis to determine the impact of POs (versus non-PO periods) on multiple health outcomes in each power operating division in New York State, 2001-2013. In the second stage, we classified divisions as risk-elevated and non-elevated, then developed predictive models for the elevation status based on 36 neighborhood environmental factors using random forest and gradient boosted trees. Results Consistent across different outcomes, we found predictors representing greater urbanization, particularly, the proportion of residents having access to public transportation (importance ranging from 4.9-15.6%), population density (3.3-16.1%), per capita income (2.3-10.7%), and the density of public infrastructure (0.8-8.5%), were associated with a higher possibility of risk elevation following power outages. Additionally, the percent of minority (-6.3-27.9%) and those with limited English (2.2-8.1%), the percent of sandy soil (6.5-11.8%), and average soil temperature (3.0-15.7%) were also dominant predictors for multiple outcomes. Spatial hotspots of vulnerability generally were located surrounding New York City and in the northwest, the pattern of which was consistent with socioeconomic status. Conclusion Population vulnerability during power outages was dominated by neighborhood environmental factors representing greater urbanization.
Collapse
|
18
|
Huang J, Ma Y, Lv Q, Liu Y, Zhang T, Yin F, Shui T. Interactive effects of meteorological factors and air pollutants on hand, foot, and mouth disease in Chengdu, China: a time-series study. BMJ Open 2022; 12:e067127. [PMID: 36450433 PMCID: PMC9716848 DOI: 10.1136/bmjopen-2022-067127] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES Hand, foot, and mouth disease (HFMD) is a viral infectious disease that poses a substantial threat in the Asia-Pacific region. It is widely reported that meteorological factors are associated with HFMD. However, the relationships between air pollutants and HFMD are still controversial. In addition, the interactive effects between meteorological factors and air pollutants on HFMD remain unknown. To fill this research gap, we conducted a time-series study. DESIGN A time-series study. SETTING AND PARTICIPANTS Daily cases of HFMD as well as meteorological and air pollution data were collected in Chengdu from 2011 to 2017. A total of 184 610 HFMD cases under the age of 15 were included in our study. OUTCOME MEASURES Distributed lag nonlinear models were used to investigate the relationships between HFMD and environmental factors, including mean temperature, relative humidity, SO2, NO2, and PM10. Then, the relative excess risk due to interaction (RERI) and the proportion attributable to interaction were calculated to quantitatively evaluate the interactions between meteorological factors and air pollutants on HFMD. Bivariate response surface models were used to visually display the interactive effects. RESULTS The cumulative exposure-response curves of SO2 and NO2 were inverted 'V'-shaped and 'M'-shaped, respectively, and the risk of HFMD gradually decreased with increasing PM10 concentrations. We found that there were synergistic interactions between mean temperature and SO2, relative humidity and SO2, as well as relative humidity and PM10 on HFMD, with individual RERIs of 0.334 (95% CI 0.119 to 0.548), 0.428 (95% CI 0.214 to 0.642) and 0.501 (95% CI 0.262 to 0.741), respectively, indicating that the effects of SO2 and PM10 on HFMD were stronger under high temperature (>17.3°C) or high humidity (>80.0%) conditions. CONCLUSIONS There were interactive effects between meteorological factors and air pollutants on HFMD. Our findings could provide guidance for targeted and timely preventive and control measures for HFMD.
Collapse
Affiliation(s)
- Jiaqi Huang
- Department of Epidemiology and Health Statistics, West China School of Public Health, Sichuan University, Chengdu, China
| | - Yue Ma
- Department of Epidemiology and Health Statistics, West China School of Public Health, Sichuan University, Chengdu, China
| | - Qiang Lv
- Department of Acute Infectious Disease Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan, China
| | - Yaqiong Liu
- Department of Acute Infectious Disease Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan, China
| | - Tao Zhang
- Department of Epidemiology and Health Statistics, West China School of Public Health, Sichuan University, Chengdu, China
| | - Fei Yin
- Department of Epidemiology and Health Statistics, West China School of Public Health, Sichuan University, Chengdu, China
| | - Tiejun Shui
- Department of Leprosy Control and Prevention, Yunnan Center for Disease Control and Prevention, Kunming, Yunnan, China
| |
Collapse
|
19
|
Huang K, Hu CY, Yang XY, Zhang Y, Wang XQ, Zhang KD, Li YQ, Wang J, Yu WJ, Cheng X, Cao JY, Zhang T, Kan XH, Zhang XJ. Contributions of ambient temperature and relative humidity to the risk of tuberculosis admissions: A multicity study in Central China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 838:156272. [PMID: 35644395 DOI: 10.1016/j.scitotenv.2022.156272] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 05/08/2022] [Accepted: 05/23/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND As a communicable disease and major public health issue, many studies have quantified the associations between tuberculosis (TB) and meteorological factors with inconsistent results. The purpose of this multicenter study was to characterize the associations between ambient temperature, humidity and the risk of TB hospitalizations and to investigate potential heterogeneity. METHOD Data on daily hospitalizations for TB, meteorological factors and ambient air pollutants for 16 cities in Anhui Province were collected from 2015 to 2020. A distributed lag nonlinear model (DLNM) was performed to obtain the estimates of meteorological-TB relationships by cities. Then, we used the multivariate meta-regression model to pool the city-specific estimates with air pollution, demographic indicators, medical resource and latitude as potential modifiers to explore the sources of heterogeneity. Finally, we divided the whole province into three regions to validate the meteorological-TB relationships by regions. RESULTS The overall pooled temperature-TB association presented an approximate S-shaped curve, with relative risk (RR) peaking at 5 °C (RR = 1.536, 95% CI: 1.303-1.811) compared to the reference temperature (27 °C). Lag-response curve suggested that low temperature exposure increased the risk of TB hospitalizations at lag 0 and 1 day (lag0 day: RR = 1.136, 95% CI: 1.048-1.231, lag1 day: RR = 1.052, 95% CI: 1.023-1.082). However, the overall exposure-response curve between relative humidity and TB showed almost horizontal line with reference relative humidity to 78%. The residual heterogeneity ranged from 27.1% to 36.9%, with air pollution, latitude and medical resource explained the largest proportion. CONCLUSION We found that low temperature exposure is associated with an acute increased risk of TB hospitalizations in Anhui Province. The association between temperature and TB admission varies depending on air pollution, latitude, and medical resources. Since the effect of short-term exposure to humidity is not significant, further studies are supposed to focus on the long-term effect of humidity.
Collapse
Affiliation(s)
- Kai Huang
- Department of Hospital Infection Prevention and Control, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei 230601, China; Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, China
| | - Cheng-Yang Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, China
| | - Xi-Yao Yang
- Department of Hospital Infection Prevention and Control, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei 230601, China
| | - Yunquan Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College, Wuhan University of Science and Technology, Wuhan 430065, China
| | - Xin-Qiang Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, China
| | - Kang-Di Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, China
| | - Ying-Qing Li
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, China
| | - Jie Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, China
| | - Wen-Jie Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, China
| | - Xin Cheng
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, China
| | - Ji-Yu Cao
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, Anhui, China
| | - Tao Zhang
- Anhui Chest Hospital, 397 Jixi Road, Hefei 230022, China
| | - Xiao-Hong Kan
- Anhui Chest Hospital, 397 Jixi Road, Hefei 230022, China; Anhui Medical University Clinical College of Chest, 397 Jixi Road, Hefei 230022, China.
| | - Xiu-Jun Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, China.
| |
Collapse
|
20
|
Qin T, Hao Y, Wu Y, Chen X, Zhang S, Wang M, Xiong W, He J. Association between averaged meteorological factors and tuberculosis risk: A systematic review and meta-analysis. ENVIRONMENTAL RESEARCH 2022; 212:113279. [PMID: 35561834 DOI: 10.1016/j.envres.2022.113279] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 04/07/2022] [Accepted: 04/07/2022] [Indexed: 06/15/2023]
Abstract
Inconsistencies were discovered in the findings regarding the effects of meteorological factors on tuberculosis (TB). This study conducted a systematic review of published studies on the relationship between TB and meteorological factors and used a meta-analysis to investigate the pooled effects in order to provide evidence for future research and policymakers. The literature search was completed by August 3rd, 2021, using three databases: PubMed, Web of Science and Embase. Relative risks (RRs) in included studies were extracted and all effect estimates were combined together using meta-analysis. Subgroup analyses were carried out based on the resolution of exposure time, regional climate, and national income level. A total of eight studies were included after screening for inclusion and exclusion criteria. Our results show that TB risk was positively correlated with precipitation (RR = 1.32, 95% CI: 1.14, 1.51), while temperature (RR = 1.15, 95% CI: 1.00, 1.32), humidity (RR = 1.05, 95% CI: 0.99, 1.10), air pressure (RR = 0.89, 95% CI: 0.69, 1.14) and sunshine duration (RR = 0.95, 95% CI: 0.80, 1.13) all had no statistically significant correlation. Subgroup analysis shows that quarterly measure resolution, low and middle Human Development Index (HDI) level and subtropical climate increase TB risk not only in precipitation, but also in temperature and humidity. Moreover, less heterogeneity was observed in "high and extremely high" HDI areas and subtropical areas than that in other subgroups (I2 = 0%). Precipitation, a subtropical climate, and a low HDI level are all positive influence factors to tuberculosis. Therefore, residents and public health managers should take precautionary measures ahead of time, especially in extreme weather conditions.
Collapse
Affiliation(s)
- Tianyu Qin
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing 100029, China
| | - Yu Hao
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing 100029, China
| | - You Wu
- Key Laboratory of Health Cultivation of the Ministry of Education, Beijing University of Chinese Medicine, Beijing 100029, China
| | - Xinli Chen
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing 100029, China
| | - Shuwen Zhang
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing 100029, China
| | - Mengqi Wang
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing 100029, China
| | - Weifeng Xiong
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing 100029, China
| | - Juan He
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing 100029, China.
| |
Collapse
|
21
|
Luo C, Qian J, Liu Y, Lv Q, Ma Y, Yin F. Long-term air pollution levels modify the relationships between short-term exposure to meteorological factors, air pollution and the incidence of hand, foot and mouth disease in children: a DLNM-based multicity time series study in Sichuan Province, China. BMC Public Health 2022; 22:1484. [PMID: 35927638 PMCID: PMC9351082 DOI: 10.1186/s12889-022-13890-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 07/26/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Epidemiological studies have investigated the short-term effects of meteorological factors and air pollution on the incidence of hand, foot, and mouth disease (HFMD). Several meteorological indicators, such as relative humidity and the diurnal temperature range (DTR), significantly modify the relationship between short-term exposure to temperature and HFMD incidence. However, it remains unclear whether (and how) long-term air pollution levels modify the short-term relationships of HFMD incidence with meteorological factors and air pollution. METHODS We obtained daily data on meteorological factors, air pollutants, and HFMD counts in children from 21 prefecture-level cities in Sichuan Province in Southwest China from 2015 to 2017. First, we constructed a distributed lag nonlinear model (DLNM) at each prefecture-level site to evaluate the short-term impacts of meteorological variables and air pollutants on HFMD incidence. Then, we assessed the pooled effects of the exposures and incorporated long-term city-specific air pollutant indicators as meta-predictors to examine their potential modification effects by performing multivariate meta-regression models. RESULTS We found that long-term SO2 and CO concentrations significantly modified the short-term relationships between climatic variables and HFMD incidence. Specifically, high concentrations of CO (P = 0.027) and SO2 (P = 0.039) reduced the risk of HFMD at low temperatures. The relationship between relative humidity and HFMD incidence was weakened at high SO2 concentrations (P = 0.024), especially when the relative humidity was below the median level. When the minimum relative humidity (32%) was compared to the median relative humidity (77%), the risk ratio (RR) was 0.77 (95% CI: 0.51-1.17) in the 90th percentile of SO2 (19.6 μg/m3) and 0.41 (95% CI: 0.27-0.64) in the 10th percentile of SO2 (10.6 μg/m3). CONCLUSION Our results indicated that long-term SO2 and CO levels modified the short-term associations between HFMD incidence in children and meteorological variables. These findings may inform health authorities to optimize targeted public health policies including reducing ambient air pollution and reinforcing self-protective actions to weaken the adverse health impacts of environmental factors on HFMD incidence.
Collapse
Affiliation(s)
- Caiying Luo
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Sichuan, Chengdu, China
| | - Jian Qian
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Sichuan, Chengdu, China
| | - Yaqiong Liu
- Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan, China
| | - Qiang Lv
- Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan, China
| | - Yue Ma
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Sichuan, Chengdu, China.
| | - Fei Yin
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Sichuan, Chengdu, China.
| |
Collapse
|
22
|
Fu X, Ge M, Xu W, Yu M, Ju J, Zhong Y, Huang H. Epidemiological features and sociodemographic factors associated with mumps in mainland China from 2004 to 2018. J Med Virol 2022; 94:4850-4859. [PMID: 35739613 PMCID: PMC9546204 DOI: 10.1002/jmv.27955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 06/20/2022] [Accepted: 06/21/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND Mumps is an acute infectious disease that spreads widely around the world. The aim of this study was to investigate the epidemiological features and sociodemographic factors associated with mumps in mainland China from 2004 to 2018. METHODS Incidence data for mumps during the period 2004-2018 were collected from the Public Health Sciences Data Center of China. Joinpoint regression analysis was performed to explore the trends of mumps. Space-time clustering analysis was conducted to spatial and temporal aggregation areas of mumps. A generalized linear model was used to explore sociodemographic factors associated with the incidence of mumps. RESULTS Average annual incidence of mumps was 21.44/100,000 in mainland China. It was increased dramatically during 2004-2012 (APC = 7.51, 95%CI: 2.28 to 13.00). After 2012, it remained stable, however, significantly increased in intermediately developed regions from 2015 to 2018 (APC = 25.84, 95%CI: 3.59 to 52.86). The first-level spatial and temporal aggregation areas were distributed in Xinjiang, Gansu, Qinghai, Ningxia and Shaanxi, Tibet, Sichuan, Yunnan, Chongqing, Guizhou, Guangxi, with gathering times from Jan 1, 2006 to Dec 31, 2012 (RR = 1.87, P < 0.001). The percentage of the population aged 0-14 years, number of health workers per capital, and number of passengers were found to be positively associated with the incidence of mumps. CONCLUSIONS Overall, after 2012, the incidence of mumps in mainland China remained stable. High-risk periods, clusters of regions and sociodemographic factors for mumps were identified, which will help the government develop disease- and location-specific interventive measures. This article is protected by copyright. All rights reserved.
Collapse
Affiliation(s)
- Xiaofang Fu
- Linping Campus, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Minjie Ge
- Linping Campus, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Wucheng Xu
- Linping Campus, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Min Yu
- Linping Campus, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Jiangang Ju
- Linping Campus, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Yonghong Zhong
- Linping Campus, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Huaqiong Huang
- Key Laboratory of Respiratory Disease of Zhejiang Province, Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| |
Collapse
|
23
|
Du Z, Zhang W, Yu S, Lin S, Hao Y. Assessing the impact of ambient temperature on the risk of hand, foot, and mouth disease in Guangdong, China: New insight from the disease severity and burden. PLoS Negl Trop Dis 2022; 16:e0010470. [PMID: 35737664 PMCID: PMC9223337 DOI: 10.1371/journal.pntd.0010470] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 05/05/2022] [Indexed: 11/19/2022] Open
Abstract
Background The association between the incidence of hand, foot, and mouth disease (HFMD) and ambient temperature has been well documented. Although the severity of symptoms is an important indicator of disease burden and varies significantly across cases, it usually was ignored in previous studies, potentially leading to biased estimates of the health impact of temperature. Methods We estimated the disability-adjusted life year (DALY) by considering the severity of symptoms for each HFMD case reported during 2010–2012 in Guangdong and used distributed lag-nonlinear models to estimate the association between the daily average temperature and daily DALY of HFMD cases at the city-level. We investigated the potential effect modifiers on the pathway between temperature and DALY and pooled city-specific estimates to a provincial association using a meta-regression. The overall impact of temperature was further evaluated by estimates of DALYs that could be attributed to HFMD. Results The overall cumulative effect of daily mean temperature on the DALY of HFMD showed an inverse-U shape, with the maximum effect estimated to be β = 0.0331 (95%CI: 0.0199–0.0463) DALY at 23.8°C. Overall, a total of 6.432 (95%CI: 3.942–8.885) DALYs (attributable fraction = 2.721%, 95%CI: 1.660–3.759%) could be attributed to temperature exposure. All the demographic subgroups had a similar trend as the main analysis, while the magnitude of the peak of the temperature impact tended to be higher among the males, those aged ≥3yrs or from the Pear-River Delta region. Additionally, the impact of temperature on DALY elevated significantly with the increasing population density, per capita GDP, and per capita green space in parks. Conclusions Temperature exposure was associated with increased burden of HFMD nonlinearly, with certain groups such as boys and those from areas with greater population density being more vulnerable. Hand, foot, and mouth disease (HFMD) is a contagious viral infection common in young children. Although the association between ambient temperature and the risk of HFMD has been well documented, existing studies were solely based on the reported number of cases, failing to differentiate cases of different severity. This study improves the estimation of disease burden by additionally accounting for the severity of symptoms. Our major findings included that (1) we identified an inverse-U shaped association between the ambient temperature and the daily DALY (i.e. an established indicator for disease burden) associated with HFMD, with 2.7% DALY could be attributed to the temperature exposure; (2) the peak impact of temperature on DALY was estimated to be β = 0.0331 (95%CI: 0.0199–0.0463) DALY and identified at 23.8°C; (3) the trends were generally consistent across different demographic and geographic subgroups, with the peak effect identified to be greater among the males, those aged ≥3yrs or from the Pear-River Delta region; (4) the impact of temperature on DALY elevated more apparently in areas with a greater population density, per capita GDP, or per capita green space in parks.
Collapse
Affiliation(s)
- Zhicheng Du
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
- Center for Health Information Research, Sun Yat-sen University, Guangzhou, China
- Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Wangjian Zhang
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
- Center for Health Information Research, Sun Yat-sen University, Guangzhou, China
- Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Shicheng Yu
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Shao Lin
- Department of Environmental Health Sciences, School of Public Health, University at Albany, the State University of New York, Albany, New York, USA
| | - Yuantao Hao
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
- Center for Health Information Research, Sun Yat-sen University, Guangzhou, China
- Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
- Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing, China
- * E-mail:
| |
Collapse
|
24
|
Peng H, Chen Z, Cai L, Liao J, Zheng K, Li S, Ren X, Duan X, Tang X, Wang X, Long L, Yang C. Relationship between meteorological factors, air pollutants and hand, foot and mouth disease from 2014 to 2020. BMC Public Health 2022; 22:998. [PMID: 35581574 PMCID: PMC9112249 DOI: 10.1186/s12889-022-13365-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 05/04/2022] [Indexed: 11/10/2022] Open
Abstract
Background Meteorological factors and air pollutants have been reported to be associated with hand, foot, and mouth disease (HFMD) epidemics before the introduction of vaccine. However, there is limited evidence for studies with long-term dimensions. Methods We collected the daily HFMD counts, weather and air pollution data from 2014 to 2020 in Chengdu. Distributed lag non-linear models (DLNM) were used to assess the associations of meteorological factors and air pollutants on HFMD cases. Results From 2014–2020, high relative humidity and precipitation and extremely high and low levels of PM10, O3, SO2 and CO increased the risk of HFMD. In pre-vaccination period, extreme high and low temperatures, PM10 and NO2, low precipitation and high concentrations of PM2.5 and O3 significantly increase the risk of HFMD; In post-vaccination period, high relative humidity and low level of CO can significantly increase the incidence of HFMD; During the period of COVID-19, only low temperature will significantly increase the risk of HFMD; Low concentration of air pollutants has the greatest impact on the 6–14 age group, while the high concentration of air pollutants has the greatest impact on the 0–1 age group. Conclusions Our study suggest that high relative humidity and precipitation and extremely high and low levels of PM10, O3, SO2 and CO increased the risk of HFMD from 2014 to 2020. The results of this study provide a reference for local authorities to formulate intervention measures and establish an environment-based disease early warning system. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13365-9.
Collapse
Affiliation(s)
- Hongxia Peng
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, No.16, Section 3, Renmin south road, Wuhou District, Chengdu, Sichuan, China
| | - Zhenhua Chen
- Department of Microbiology Laboratory, Chengdu Municipal Center for Disease Control and Prevention, Chengdu, Sichuan, China
| | - Lin Cai
- Department of Gastroenterology, West China School of Public Health and West China Forth Hospital, Sichuan University, Chengdu, Sichuan, China.,Non-Communicable Diseases Research Center, West China-PUMC C.C. Chen Institute of Health, Sichuan University, Chengdu, Sichuan, China
| | - Juan Liao
- Department of Gastroenterology, West China School of Public Health and West China Forth Hospital, Sichuan University, Chengdu, Sichuan, China.,Non-Communicable Diseases Research Center, West China-PUMC C.C. Chen Institute of Health, Sichuan University, Chengdu, Sichuan, China
| | - Ke Zheng
- Department of Immunization Planning, Chengdu Municipal Center for Disease Control and Prevention, Chengdu, Sichuan, China
| | - Shuo Li
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, No.16, Section 3, Renmin south road, Wuhou District, Chengdu, Sichuan, China
| | - Xueling Ren
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, No.16, Section 3, Renmin south road, Wuhou District, Chengdu, Sichuan, China
| | - Xiaoxia Duan
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, No.16, Section 3, Renmin south road, Wuhou District, Chengdu, Sichuan, China
| | - Xueqin Tang
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, No.16, Section 3, Renmin south road, Wuhou District, Chengdu, Sichuan, China
| | - Xiao Wang
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, No.16, Section 3, Renmin south road, Wuhou District, Chengdu, Sichuan, China
| | - Lu Long
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, No.16, Section 3, Renmin south road, Wuhou District, Chengdu, Sichuan, China.
| | - Chunxia Yang
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, No.16, Section 3, Renmin south road, Wuhou District, Chengdu, Sichuan, China.
| |
Collapse
|
25
|
Li P, Rui J, Niu Y, Xie F, Wang Y, Li Z, Liu C, Yu S, Huang J, Luo L, Deng B, Liu W, Yang T, Li Q, Chen T. Analysis of HFMD Transmissibility Among the Whole Population and Age Groups in a Large City of China. Front Public Health 2022; 10:850369. [PMID: 35480581 PMCID: PMC9035867 DOI: 10.3389/fpubh.2022.850369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 03/02/2022] [Indexed: 11/29/2022] Open
Abstract
Background Hand-Foot-and-Mouth-Disease (HFMD) has been widely spread in Asia, and has result in a high disease burden for children in many countries. However, the dissemination characteristics intergroup and between different age groups are still not clear. In this study, we aim to analyze the differences in the transmissibility of HFMD, in the whole population and among age groups in Shenzhen city, by utilizing mathematical models. Methods A database that reports HFMD cases in Shenzhen city from January 2010 to December 2017 was collected. In the first stage, a Susceptive-Infected-Recovered (SIR) model was built to fit data of Shenzhen city and its districts, and Reff was used to assess transmissibility in each district. In the second stage, a cross-age groups SIR model was constructed to calculate the difference in transmissibility of reported cases among three age groups of EV71 virus: 0–3 years, 3–5 years, and over 5 years which was denoted as age group 1, 2, and 3, respectively. Results From 2010 to 2017, 345,807 cases of HFMD were reported in Shenzhen city, with peak incidence in spring and autumn in Shenzhen city and most of its districts each year. Analysis of the EV71 incidence data by age group revealed that age Group 1 have the highest incidence (3.13 ×10−7–2.31 ×10−4) while age group 3 had the lowest incidence (0–3.54 ×10−5). The differences in weekly incidence of EV71 between age groups were statistically significant (t12 = 7.563, P < 0.0001; t23 = 12.420, P < 0.0001; t13 = 16.996, P < 0.0001). The R2 of the SIR model Shenzhen city population-wide HFMD fit for each region was >0.5, and P < 0.001. Reff values were >1 for the vast majority of time and regions, indicating that the HFMD virus has the ability to spread in Shenzhen city over the long-term. Differences in Reff values between regions were judged by using analysis of variance (ANOVA) (F = 0.541, P = 0.744). SiIiRi-SjIjRj models between age groups had R2 over 0.7 for all age groups and P <0.001. The Reff values between groups show that the 0–2 years old group had the strongest transmissibility (median: 2.881, range: 0.017–9.897), followed by the over 5 years old group (median: 1.758, range: 1.005–5.279), while the 3–5 years old group (median: 1.300, range: 0.005–1.005) had the weakest transmissibility of the three groups. Intra-group transmissibility was strongest in the 0–2 years age group (median: 1.787, range: 0–9.146), followed by Group 1 to Group 2 (median: 0.287, range: 0–1.988) and finally Group 1 to Group 3 (median: 0.287, range: 0–1.988). Conclusion The incidence rate of HFMD is high in Shenzhen city. In the data on the incidence of EV71 in each age group, the highest incidence was in the 0–2 years age group, and the lowest incidence was in the over 5 years age group. The differences in weekly incidence rate of EV71 among age groups were statistically significant. Children with the age of 0–2 years had the highest transmissibility.
Collapse
Affiliation(s)
- Peihua Li
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Jia Rui
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Yan Niu
- Chinese Center for Disease Control and Prevention, Public Health Emergency Center, Beijing, China
| | - Fang Xie
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Yifang Wang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Zhuoyang Li
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Chan Liu
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Shanshan Yu
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Jiefeng Huang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Li Luo
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Bin Deng
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Weikang Liu
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Tianlong Yang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Qun Li
- Chinese Center for Disease Control and Prevention, Public Health Emergency Center, Beijing, China
- Qun Li
| | - Tianmu Chen
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
- *Correspondence: Tianmu Chen ;
| |
Collapse
|
26
|
Xu M, Hu P, Chen R, Liu B, Chen H, Hou J, Ke L, Huang J, Ren H, Hu H. Association of long-term exposure to ambient air pollution with the number of tuberculosis cases notified: a time-series study in Hong Kong. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:21621-21633. [PMID: 34767173 DOI: 10.1007/s11356-021-17082-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Accepted: 10/13/2021] [Indexed: 05/25/2023]
Abstract
To analyze the association of long-term exposure to air pollution and its attributable risks with the number of tuberculosis (TB) cases notified, a quasi-Poisson regression model combined with a distributed lag nonlinear model (DLNM) was constructed using monthly data on air pollution and TB cases notified in Hong Kong from 1999 to 2018. Nonlinear relationships between PM10, PM2.5, and CO and TB cases notified were identified. The concentrations of PM10, PM2.5, and CO corresponding to the minimum numbers of TB cases notified (the minimum TB notification concentrations, MTNCs) were 58.3 μg/m3, 41.7 μg/m3, and 0.1 mg/m3, respectively. Compared with the MTNCs, the overall cumulative numbers of TB cases notified increased by 76.93% (95% CI: 13.08%, 176.83%), 88.81% (95% CI: 26.09%, 182.71%), and 233.43% (95% CI: 13.56%, 879.03%) for the 95th percentiles of PM10 and PM2.5 and for the 97.5th percentiles of CO, respectively. The TB notification rate attributed to concentration ranges above the 97.5th percentile of PM10, PM2.5, and CO was 3.38% (95% empirical confidence intervals [eCI]: 0.93%, 5.61%), 4.73% (95% eCI: 1.87%, 7.15%), and 3.34% (95% eCI: 0.29%, 5.83%), respectively. Long-term exposure to high concentrations of air pollution in Hong Kong may be associated with increases in the number of TB cases notified for this area.
Collapse
Affiliation(s)
- Man Xu
- School of Nursing, Hubei University of Chinese Medicine, 16 Huangjiahu West Road, Hongshan District, Wuhan City, 430065, Hubei Province, China
| | - Ping Hu
- Key Laboratory of Environment and Health (HUST), Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Ruoling Chen
- Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton, UK
| | - Bing Liu
- Center of Health Administration and Development Studies, Hubei University of Medicine, Shiyan, 442000, Hubei, China
| | - Hongying Chen
- Biological Products Management Office, Hubei Provincial Center for Disease Control and Prevention, Wuhan, Hubei, China
| | - Jian Hou
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, 450052, Henan, China
| | - Li Ke
- Center of Health Administration and Development Studies, Hubei University of Medicine, Shiyan, 442000, Hubei, China
| | - Jiao Huang
- Center for Evidence-Based and Translational Medicine, Wuhan University Zhongnan Hospital, Wuhan, 430030, Hubei, China
| | - Hairong Ren
- School of Nursing, Hubei University of Chinese Medicine, 16 Huangjiahu West Road, Hongshan District, Wuhan City, 430065, Hubei Province, China.
| | - Hui Hu
- School of Nursing, Hubei University of Chinese Medicine, 16 Huangjiahu West Road, Hongshan District, Wuhan City, 430065, Hubei Province, China.
| |
Collapse
|
27
|
Liu R, Cai J, Guo W, Guo W, Wang W, Yan L, Ma N, Zhang X, Zhang S. Effects of temperature and PM 2.5 on the incidence of hand, foot, and mouth in a heavily polluted area, Shijiazhuang, China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:11801-11814. [PMID: 34550518 DOI: 10.1007/s11356-021-16397-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 09/03/2021] [Indexed: 06/13/2023]
Abstract
The influence of weather and air pollution factors on hand, foot, and mouth disease (HFMD) has received widespread attention. However, most of the existing studies came from lightly polluted areas and the results were inconsistent. There was a lack of relevant evidence of heavily polluted areas. This study aims to quantify the relationship between weather factors and air pollution with HFMD in heavily polluted areas. We collected the daily number of hand, foot, and mouth disease in Shijiazhuang, China from 2014 to 2018, as well as meteorological and air pollutant data over the same period. The generalized linear model combined with the distributed lag model was used to study the effect of meteorological factors and air pollutants on the daily cases of HFMD and its hysteresis effect. We found that the dose-response relationship between temperature, PM2.5, and the risk of hand-foot-mouth disease was non-linear. Both low temperature and high temperature increased the risk of hand-foot-mouth disease. The cumulative effect of high temperature reached the maximum at 0-10 lag days, and the cumulative effect of low temperature reached the maximum at 0-3 lag days. The concentration of PM2.5 between 76 and 200 μg/m3 has a certain risk of the onset of hand, foot, and mouth disease, but the extreme PM2.5 concentration has a certain protective effect. In addition, low humidity, low wind speed, and low-O3 can increase the risk of HFMD. Risks of humidity and low concentration of O3 increased as lag days extended. In conclusion, our study found that climate factors and air pollutants exert varying degrees of impact on HFMD. Our research provided the scientific basis for establishing an early warning system so that medical staff and parents can take corresponding measures to prevent HFMD.
Collapse
Affiliation(s)
- Ran Liu
- Department of Epidemiology and Statistics, School of Public Health, Hebei Medical University, Hebei Province Key Laboratory of Environment and Human Health, 361 Zhongshan East Road, Shijiazhuang, 050017, China
| | - Jianning Cai
- The Department of Epidemic Treating and Preventing, Center for Disease Prevention and Control of Shijiazhuang City, Likang Road 3#, Shijiazhuang, 050011, China
| | - Weiheng Guo
- Department of Epidemiology and Statistics, School of Public Health, Hebei Medical University, Hebei Province Key Laboratory of Environment and Human Health, 361 Zhongshan East Road, Shijiazhuang, 050017, China
| | - Wei Guo
- Department of Epidemiology and Statistics, School of Public Health, Hebei Medical University, Hebei Province Key Laboratory of Environment and Human Health, 361 Zhongshan East Road, Shijiazhuang, 050017, China
| | - Wenjuan Wang
- Department of Epidemiology and Statistics, School of Public Health, Hebei Medical University, Hebei Province Key Laboratory of Environment and Human Health, 361 Zhongshan East Road, Shijiazhuang, 050017, China
| | - Lina Yan
- Department of Epidemiology and Statistics, School of Public Health, Hebei Medical University, Hebei Province Key Laboratory of Environment and Human Health, 361 Zhongshan East Road, Shijiazhuang, 050017, China
| | - Ning Ma
- Department of Epidemiology and Statistics, School of Public Health, Hebei Medical University, Hebei Province Key Laboratory of Environment and Human Health, 361 Zhongshan East Road, Shijiazhuang, 050017, China
| | - Xiaolin Zhang
- Department of Epidemiology and Statistics, School of Public Health, Hebei Medical University, Hebei Province Key Laboratory of Environment and Human Health, 361 Zhongshan East Road, Shijiazhuang, 050017, China.
| | - Shiyong Zhang
- The Department of Epidemic Treating and Preventing, Center for Disease Prevention and Control of Shijiazhuang City, Likang Road 3#, Shijiazhuang, 050011, China.
| |
Collapse
|
28
|
Chua PL, Ng CFS, Madaniyazi L, Seposo X, Salazar MA, Huber V, Hashizume M. Projecting Temperature-Attributable Mortality and Hospital Admissions due to Enteric Infections in the Philippines. ENVIRONMENTAL HEALTH PERSPECTIVES 2022; 130:27011. [PMID: 35188405 PMCID: PMC8860302 DOI: 10.1289/ehp9324] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 10/29/2021] [Accepted: 01/21/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Enteric infections cause significant deaths, and global projection studies suggest that mortality from enteric infections will increase in the future with warmer climate. However, a major limitation of these projection studies is the use of risk estimates derived from nonmortality data to project excess enteric infection mortality associated with temperature because of the lack of studies that used actual deaths. OBJECTIVE We quantified the associations of daily temperature with both mortality and hospital admissions due to enteric infections in the Philippines. These associations were applied to projections under various climate and population change scenarios. METHODS We modeled nonlinear temperature associations of mortality and hospital admissions due to enteric infections in 17 administrative regions of the Philippines using a two-stage time-series approach. First, we quantified nonlinear temperature associations of enteric infections by fitting generalized linear models with distributed lag nonlinear models. Second, we combined regional estimates using a meta-regression model. We projected the excess future enteric infections due to nonoptimal temperatures using regional temperature-enteric infection associations under various combinations of climate change scenarios according to representative concentration pathways (RCPs) and population change scenarios according to shared socioeconomic pathways (SSPs) for 2010-2099. RESULTS Regional estimates for mortality and hospital admissions were significantly heterogeneous and had varying shapes in association with temperature. Generally, mortality risks were greater in high temperatures, whereas hospital admission risks were greater in low temperatures. Temperature-attributable excess deaths in 2090-2099 were projected to increase over 2010-2019 by as little as 1.3% [95% empirical confidence intervals (eCI): -3.1%, 6.5%] under a low greenhouse gas emission scenario (RCP 2.6) or as much as 25.5% (95% eCI: -3.5%, 48.2%) under a high greenhouse gas emission scenario (RCP 8.5). A moderate increase was projected for temperature-attributable excess hospital admissions, from 0.02% (95% eCI: -2.0%, 1.9%) under RCP 2.6 to 5.2% (95% eCI: -12.7%, 21.8%) under RCP 8.5 in the same period. High temperature-attributable deaths and hospital admissions due to enteric infections may occur under scenarios with high population growth in 2090-2099. DISCUSSION In the Philippines, futures with hotter temperatures and high population growth may lead to a greater increase in temperature-related excess deaths than hospital admissions due to enteric infections. Our results highlight the need to strengthen existing primary health care interventions for diarrhea and support health adaptation policies to help reduce future enteric infections. https://doi.org/10.1289/EHP9324.
Collapse
Affiliation(s)
- Paul L.C. Chua
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Department of Global Health, School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
- Alliance for Improving Health Outcomes, Inc., Quezon City, Philippines
| | - Chris Fook Sheng Ng
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Department of Global Health, School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Lina Madaniyazi
- Department of Global Health, School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
- Department of Pediatric Infectious Diseases, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Xerxes Seposo
- Department of Global Health, School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Miguel Antonio Salazar
- Alliance for Improving Health Outcomes, Inc., Quezon City, Philippines
- Institute of Global Health, University of Heidelberg, Heidelberg, Germany
| | - Veronika Huber
- Department of Physical, Chemical and Natural Systems, Universidad Pablo de Olavide, Sevilla, Spain
| | - Masahiro Hashizume
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Department of Global Health, School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
- Department of Pediatric Infectious Diseases, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| |
Collapse
|
29
|
Du Z, Yang B, Jalaludin B, Knibbs L, Yu S, Dong G, Hao Y. Association of neighborhood greenness with severity of hand, foot, and mouth disease. BMC Public Health 2022; 22:38. [PMID: 34991526 PMCID: PMC8739664 DOI: 10.1186/s12889-021-12444-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 12/20/2021] [Indexed: 11/24/2022] Open
Abstract
Background Hand, foot, and mouth disease (HFMD) is an epidemic infectious disease in China. Relationship of neighborhood greenness with human health has been widely studied, yet its association with severe HFMD has not yet been established. Methods Individual HFMD cases that occurred in Guangdong province in 2010 were recruited and were categorised into mild and severe cases. Residential greenness was assessed using global land cover data. We used a case-control design (i.e., severe versus mild cases) with logistic regression models to assess the association between neighborhood greenness and HFMD severity. Effect modification was also examined. Results A total of 131,606 cases were included, of whom 130,840 were mild cases and 766 were severe cases. In an unadjusted model, HFMD severity increased with higher proportion of neighborhood greenness (odds ratio, OR = 1.029, 95%CI: 1.009–1.050). The greenness-HFMD severity association remained (OR = 1.031, 95%CI: 1.006–1.057) after adjusting for population density, demographic variables and climate variables. Both population density (Z = 4.148, P < 0.001) and relative humidity (Z = -4.297, P < 0.001) modified the association between neighborhood greenness and HFMD severity. In the stratified analyses, a protective effect (OR = 0.769, 95%CI: 0.687–0.860) of greenness on HFMD severity were found in the subgroup of population density being lower than and equal to 5 ln(no.)/km2. While in both the subgroups of population density being higher than 5, the greenness had hazard effects (subgroup of > 5 & ≤7: OR = 1.071, 95%CI: 1.024–1.120; subgroup of > 7: OR = 1.065, 95%CI: 1.034–1.097) on HFMD severity. As to relative humidity, statistically significant association between greenness and HFMD severity was only observed in the subgroup of being lower than and equal to 76% (OR = 1.059, 95%CI: 1.023–1.096). Conclusions Our study found that HFMD severity is associated with the neighborhood greenness in Guangdong, China. This study provides evidence on developing a prevention strategy of discouraging the high-risk groups from going to the crowded green spaces during the epidemic period. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-12444-7.
Collapse
Affiliation(s)
- Zhicheng Du
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Boyi Yang
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Bin Jalaludin
- School of Public Health and Community Medicine, University of New South Wales, Kensington, NSW, 1871, Australia
| | - Luke Knibbs
- School of Public Health, The University of Sydney, Camperdown, NSW, 2006, Australia
| | - Shicheng Yu
- Chinese Center for Disease Control and Prevention, Beijing, 102206, China
| | - Guanghui Dong
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China.
| | - Yuantao Hao
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China.
| |
Collapse
|
30
|
Deng X, Chen Z, Zou Y, He Y, Chen S, Wang Q, Xing D, Zhang Y. The effect of daily mean temperature on hand, foot and mouth disease and the source of regional heterogeneity in Chongqing, China, 2010-2019. Environ Health Prev Med 2022; 27:47. [PMID: 36517013 PMCID: PMC9792571 DOI: 10.1265/ehpm.22-00133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Hand, foot and mouth disease (HFMD) is a serious infectious disease which has become a public health problem. A multi-regional study was conducted in this study to explore the relationship between temperature and HFMD in different regions and the source of heterogeneity, and further detect the effect modifiers such as socio-economic factors, medical and health factors and meteorological factors. METHODS The data on daily reported HFMD cases and meteorological data from 2010 to 2019 in Chongqing were collected. Thirty-eight districts and counties of Chongqing were divided into 6 regions. The distributed lag nonlinear model (DLNM) was applied to assess the effect of daily mean temperature on HFMD at region level with the pooled effect estimates from multivariate meta-regression model analysis. Stratified analyses by gender, age and children's type were also conducted. Potential modifiers were considered in meta regression to explore the source of heterogeneity. RESULTS There were nonlinear relationships with an inverted V-shape between temperature and HFMD. A maximum cumulative relative risk (CRR) of 1.22 (95% confidence interval (CI): 1.12-1.34) peaked at 23.8 °C, and the risk appeared immediately and lasted for the whole 14 days. Compared with other groups, warm temperature had a stronger effect on children aged 0-1 and scattered children, while cold temperature had a stronger effect on female, children aged 3-6 and childcare children with an M-shape. We found that socio-economic factors, medical health factors and meteorological factors were significantly associated with heterogeneity. Density of medical technical personnel, urbanization rate and density of health care institutions were the main modifiers for explaining heterogeneity of 26.10%, 24.90% and 24.86% respectively which were revealed by meta-analysis. CONCLUSIONS There was a significant nonlinear correlation between temperature and HFMD. Compared with other groups, children aged 0-1 and scattered children were more susceptible to warm temperature, while female, children aged 3-6 and childcare children were more susceptible to cold temperature. Socio-economic factors, medical health factors and meteorological factors may be the source of the heterogeneity. Therefore, local governments should consider different temperature-HFMD relationships between different regions and populations when formulating appropriate preventive measures.
Collapse
Affiliation(s)
- Xinyi Deng
- School of Public Health, Research Center for Medicine and Social Development, Innovation Center for Social Risk Governance in Health, Research Center for Public Health Security, Chongqing Medical University, Chongqing, China
| | - Zhiyi Chen
- School of Public Health, Research Center for Medicine and Social Development, Innovation Center for Social Risk Governance in Health, Research Center for Public Health Security, Chongqing Medical University, Chongqing, China
| | - Yang Zou
- School of Public Health, Research Center for Medicine and Social Development, Innovation Center for Social Risk Governance in Health, Research Center for Public Health Security, Chongqing Medical University, Chongqing, China
| | - Ying He
- School of Public Health, Research Center for Medicine and Social Development, Innovation Center for Social Risk Governance in Health, Research Center for Public Health Security, Chongqing Medical University, Chongqing, China
| | - Saijuan Chen
- School of Public Health, Research Center for Medicine and Social Development, Innovation Center for Social Risk Governance in Health, Research Center for Public Health Security, Chongqing Medical University, Chongqing, China
| | - Qiuting Wang
- School of Public Health, Research Center for Medicine and Social Development, Innovation Center for Social Risk Governance in Health, Research Center for Public Health Security, Chongqing Medical University, Chongqing, China
| | - Dianguo Xing
- Office of Health Emergency, Chongqing Municipal Health Commission, Chongqing, China
| | - Yan Zhang
- School of Public Health, Research Center for Medicine and Social Development, Innovation Center for Social Risk Governance in Health, Research Center for Public Health Security, Chongqing Medical University, Chongqing, China
| |
Collapse
|
31
|
Comparison of different predictive models on HFMD based on weather factors in Zibo city, Shandong Province, China. Epidemiol Infect 2021. [PMCID: PMC8753480 DOI: 10.1017/s0950268821002508] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The early identification and prediction of hand-foot-and-mouth disease (HFMD) play an important role in the disease prevention and control. However, suitable models are different in regions due to the differences in geography, social economy factors. We collected data associated with daily reported HFMD cases and weather factors of Zibo city in 2010~2019 and used the generalised additive model (GAM) to evaluate the effects of weather factors on HFMD cases. Then, GAM, support vectors regression (SVR) and random forest regression (RFR) models are used to compare predictive results. The annual average incidence was 129.72/100 000 from 2010 to 2019. Its distribution showed a unimodal trend, with incidence increasing from March, peaking from May to September. Our study revealed the nonlinear relationship between temperature, rainfall and relative humidity and HFMD cases and based on the predictive result, the performances of three models constructed ranked in descending order are: SVR > GAM> RFR, and SVR has the smallest prediction errors. These findings provide quantitative evidence for the prediction of HFMD for special high-risk regions and can help public health agencies implement prevention and control measures in advance.
Collapse
|
32
|
Wu Y, Qu Z, Xiong R, Yang Y, Liu S, Nie J, Liang C, Huang W, Wang Y, Fan C. A practical method for evaluating the in vivo efficacy of EVA-71 vaccine using a hSCARB2 knock-in mouse model. Emerg Microbes Infect 2021; 10:1180-1190. [PMID: 34044752 PMCID: PMC8205003 DOI: 10.1080/22221751.2021.1934558] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 05/19/2021] [Accepted: 05/20/2021] [Indexed: 01/12/2023]
Abstract
Hand-foot-and-mouth disease is a contagious disease common among children under 5 years old worldwide. It is caused by strains of enterovirus, especially EV-A71, which can lead to severe disease. Vaccines are the only way to fight this disease. Accordingly, it is necessary to establish an efficient and accurate methodology to evaluate vaccine efficacy in vivo. Here, we established a practical method using a hSCARB2 knock-in mouse model, which was susceptible to EV-A71 infection at 5-6 weeks of age, to directly determine the efficacy of vaccines. Unlike traditional approaches, one-week-old hSCARB2 mice were immunized twice with a licensed vaccine, with an interval of a week. The titre of antibodies was measured after 1 week. Mice at 4 weeks of age were challenged with EV-A71 intraperitoneally and intracranially, respectively. The unimmunized hSCARB2 mice displayed systemic clinical symptoms and succumbed to the disease at a rate of approximately 50%. High viral loads were detected in the lungs, brain, and muscles, accompanied by clear pathological changes. The expression of IL-1β, IL-13, IL-17, and TNF-α was significantly upregulated. By contrast, the immunized group was practically normal and indistinguishable from the control mice. These results indicate that the hSCARB2 knock-in mouse is susceptible to infection in adulthood, and the in vivo efficacy of EV-A71 vaccine could be directly evaluated in this mouse model. The method developed here may be used in the development of new vaccines against HFMD or quality control of licensed vaccines.
Collapse
Affiliation(s)
- Yong Wu
- Division of Animal Model Research, Institute for Laboratory Animal Resources, National Institutes for Food and Drug Control (NIFDC), Beijing, People’s Republic of China
| | - Zhe Qu
- National Center for Safety Evaluation of Drugs, Institute for Food and Drug Safety Evaluation, National Institutes for Food and Drug Control (NIFDC), Beijing, People’s Republic of China
| | - Rui Xiong
- Division of Animal Model Research, Institute for Laboratory Animal Resources, National Institutes for Food and Drug Control (NIFDC), Beijing, People’s Republic of China
| | - Yanwei Yang
- National Center for Safety Evaluation of Drugs, Institute for Food and Drug Safety Evaluation, National Institutes for Food and Drug Control (NIFDC), Beijing, People’s Republic of China
| | - Susu Liu
- Division of Animal Model Research, Institute for Laboratory Animal Resources, National Institutes for Food and Drug Control (NIFDC), Beijing, People’s Republic of China
| | - Jianhui Nie
- Division of HIV/AIDS and Sexually Transmitted Virus Vaccines, Institute for Biological Product Control, National Institutes for Food and Drug Control (NIFDC), Beijing, People’s Republic of China
| | - Chunnan Liang
- Division of Animal Model Research, Institute for Laboratory Animal Resources, National Institutes for Food and Drug Control (NIFDC), Beijing, People’s Republic of China
| | - Weijin Huang
- Division of HIV/AIDS and Sexually Transmitted Virus Vaccines, Institute for Biological Product Control, National Institutes for Food and Drug Control (NIFDC), Beijing, People’s Republic of China
| | - Youchun Wang
- Division of HIV/AIDS and Sexually Transmitted Virus Vaccines, Institute for Biological Product Control, National Institutes for Food and Drug Control (NIFDC), Beijing, People’s Republic of China
| | - Changfa Fan
- Division of Animal Model Research, Institute for Laboratory Animal Resources, National Institutes for Food and Drug Control (NIFDC), Beijing, People’s Republic of China
| |
Collapse
|
33
|
Zhao R, Gao Q, Hao Q, Wang S, Zhang Y, Li H, Jiang B. The exposure-response association between humidex and bacillary dysentery: A two-stage time series analysis of 316 cities in mainland China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 797:148840. [PMID: 34303970 DOI: 10.1016/j.scitotenv.2021.148840] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 06/22/2021] [Accepted: 06/30/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Many studies have reported the interactive effects between relative humidity and temperature on infectious diseases. However, evidence regarding the combined effects of relative humidity and temperature on bacillary dysentery (BD) is limited, especially for large-scale studies. To address this research need, humidex was utilized as a comprehensive index of relative humidity and temperature. We aimed to estimate the effect of humidex on BD across mainland China, evaluate its heterogeneity, and identify potential effect modifiers. METHODS Daily meteorological and BD surveillance data from 2014 to 2016 were obtained for 316 prefecture-level cities in mainland China. Humidex was calculated on the basis of relative humidity and temperature. A multicity, two-stage time series analysis was then performed. In the first stage, a common distributed lag non-linear model (DLNM) was established to obtain city-specific estimates. In the second stage, a multivariate meta-analysis was conducted to pool these estimates, assess the significance of heterogeneity, and explore potential effect modifiers. RESULTS The pooled cumulative estimates showed that humidex could promote the transmission of BD. The exposure-response relationship was nearly linear, with a maximum cumulative relative risk (RR) of 1.45 [95% confidence interval (CI): 1.29-1.63] at a humidex value of 40.94. High humidex had an acute adverse effect on BD. The humidex-BD relationship could be modified by latitude, urbanization rate, the natural growth rate of population, and the number of primary school students per thousand persons. CONCLUSIONS High humidex could increase the risk of BD incidence. Thus, it is suitable to incorporate humidex as a predictor into the early warning system of BD and to inform the general public in advance to be cautious when humidex is high. This is especially true for regions with higher latitude, higher urbanization rates, lower natural growth rates of population, and lower numbers of primary school students per thousand persons.
Collapse
Affiliation(s)
- Ran Zhao
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong Province, People's Republic of China; Shandong University Climate Change and Health Center, Jinan 250012, Shandong Province, People's Republic of China
| | - Qi Gao
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong Province, People's Republic of China; Shandong University Climate Change and Health Center, Jinan 250012, Shandong Province, People's Republic of China
| | - Qiang Hao
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong Province, People's Republic of China; Shandong University Climate Change and Health Center, Jinan 250012, Shandong Province, People's Republic of China
| | - Shuzi Wang
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong Province, People's Republic of China; Shandong University Climate Change and Health Center, Jinan 250012, Shandong Province, People's Republic of China
| | - Yiwen Zhang
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong Province, People's Republic of China; Shandong University Climate Change and Health Center, Jinan 250012, Shandong Province, People's Republic of China
| | - Hao Li
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong Province, People's Republic of China; Shandong University Climate Change and Health Center, Jinan 250012, Shandong Province, People's Republic of China
| | - Baofa Jiang
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong Province, People's Republic of China; Shandong University Climate Change and Health Center, Jinan 250012, Shandong Province, People's Republic of China.
| |
Collapse
|
34
|
Qu Y, Zhang W, Ye B, Penta S, Dong G, Liu X, Lin S. Power outage mediates the associations between major storms and hospital admission of chronic obstructive pulmonary disease. BMC Public Health 2021; 21:1961. [PMID: 34715823 PMCID: PMC8556928 DOI: 10.1186/s12889-021-12006-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 10/01/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) is the third-leading cause of death worldwide with continuous rise. Limited studies indicate that COPD was associated with major storms and related power outages (PO). However, significant gaps remain in understanding what PO's role is on the pathway of major storms-COPD. This study aimed to examine how PO mediates the major storms-COPD associations. METHODS In this time-series study, we extracted all hospital admissions with COPD as the principal diagnosis in New York, 2001-2013. Using distributed lag nonlinear models, the hospitalization rate during major storms and PO was compared to non-major storms and non-PO periods to determine the risk ratios (RRs) for COPD at each of 0-6 lag days respectively after controlling for time-varying confounders and concentration of fine particulate matter (PM2.5). We then used Granger mediation analysis for time series to assess the mediation effect of PO on the major storms-COPD associations. RESULTS The RRs of COPD hospitalization following major storms, which mainly included flooding, thunder, hurricane, snow, ice, and wind, were 1.23 to 1.49 across lag 0-6 days. The risk was strongest at lag3 and lasted significantly for 4 days. Compared with non-outage periods, the PO period was associated with 1.23 to 1.61 higher risk of COPD admissions across lag 0-6 days. The risk lasted significantly for 2 days and was strongest at lag2. Snow, hurricane and wind were the top three contributors of PO among the major storms. PO mediated as much as 49.6 to 65.0% of the major storms-COPD associations. CONCLUSIONS Both major storms and PO were associated with increased hospital admission of COPD. PO mediated almost half of the major storms-COPD hospitalization associations. Preparation of surrogate electric system before major storms is essential to reduce major storms-COPD hospitalization.
Collapse
Affiliation(s)
- Yanji Qu
- Guangdong Cardiovascular Institute, WHO Collaborating Center for Research and Training in Cardiovascular Diseases, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
- Department of Environmental Health Sciences, University at Albany, State University of New York, New York, NY, USA
| | - Wangjian Zhang
- Department of Environmental Health Sciences, University at Albany, State University of New York, New York, NY, USA
| | - Bo Ye
- Department of Epidemiology and Biostatistics, University at Albany, State University of New York, New York, NY, USA
| | - Samantha Penta
- College of Emergency Preparedness, Homeland Security and Cybersecurity, University at Albany, State University of New York, New York, NY, USA
| | - Guanghui Dong
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Xiaoqing Liu
- Guangdong Cardiovascular Institute, WHO Collaborating Center for Research and Training in Cardiovascular Diseases, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Shao Lin
- Department of Environmental Health Sciences, University at Albany, State University of New York, New York, NY, USA.
- Department of Epidemiology and Biostatistics, University at Albany, State University of New York, New York, NY, USA.
| |
Collapse
|
35
|
Zhu Y, Zhang D, Hu Y, Li C, Jia Y, She K, Liu T, Xu Q, Zhang Y, Li X. Exploring the Relationship between Mumps and Meteorological Factors in Shandong Province, China Based on a Two-Stage Model. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910359. [PMID: 34639658 PMCID: PMC8508524 DOI: 10.3390/ijerph181910359] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 09/27/2021] [Accepted: 09/28/2021] [Indexed: 12/21/2022]
Abstract
Background: Small-scale studies have identified temperature and other meteorological factors as risk factors for human health. However, only a few have quantified the specific impact of meteorological factors on mumps. A quantitative examination of the exposure–response relationship between meteorological factors and mumps is needed to provide new insights for multi-city analysis. Methods: The daily recorded number of mumps cases and meteorological data in 17 cities of Shandong Province from 2009 to 2017 were collected. A two-stage model was built to explore the relationship between meteorological factors and mumps. Results: A total of 104,685 cases of mumps were recorded from 2009 to 2017. After controlling for seasonality and long-term trends, the effect of low temperature on mumps was significant at the provincial level, with a cumulative RR of 1.035 (95%CI: 1.002–1.069) with a 1-day lagged effect. The proportion of primary and middle school students was determined as an effect modifier, which had a significant impact on mumps (Stat = 8.374, p = 0.039). There was heterogeneity in the combined effect of temperature on mumps (Q = 95.447, p = 0.000), and its size was I2 = 49.7%. Conclusions: We have identified a non-linear relationship between mumps and temperature in Shandong Province. In particular, low temperatures could bring more cases of mumps, with certain lagged effects. More public health measures should be taken to reduce the risks when temperatures are low, especially for cities with a high proportion of primary and secondary school students.
Collapse
Affiliation(s)
- Yuchen Zhu
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China; (Y.Z.); (D.Z.); (C.L.); (Y.J.); (K.S.); (T.L.)
| | - Dandan Zhang
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China; (Y.Z.); (D.Z.); (C.L.); (Y.J.); (K.S.); (T.L.)
- Heze Center for Disease Control and Prevention, Heze 274003, China
| | - Yuchen Hu
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, 90 High Holborn, London WC1V 6LJ, UK;
| | - Chunyu Li
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China; (Y.Z.); (D.Z.); (C.L.); (Y.J.); (K.S.); (T.L.)
| | - Yan Jia
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China; (Y.Z.); (D.Z.); (C.L.); (Y.J.); (K.S.); (T.L.)
| | - Kaili She
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China; (Y.Z.); (D.Z.); (C.L.); (Y.J.); (K.S.); (T.L.)
| | - Tingxuan Liu
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China; (Y.Z.); (D.Z.); (C.L.); (Y.J.); (K.S.); (T.L.)
| | - Qing Xu
- Shandong Center for Disease Control and Prevention, Jinan 250012, China;
| | - Ying Zhang
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW 2006, Australia;
| | - Xiujun Li
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China; (Y.Z.); (D.Z.); (C.L.); (Y.J.); (K.S.); (T.L.)
- Correspondence: ; Tel.: +86-531-8838-2140
| |
Collapse
|
36
|
Li C, Zhao Q, Zhao Z, Liu Q, Ma W. The association between tropical cyclones and dengue fever in the Pearl River Delta, China during 2013-2018: A time-stratified case-crossover study. PLoS Negl Trop Dis 2021; 15:e0009776. [PMID: 34499666 PMCID: PMC8454958 DOI: 10.1371/journal.pntd.0009776] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 09/21/2021] [Accepted: 08/28/2021] [Indexed: 11/23/2022] Open
Abstract
Background Studies have shown that tropical cyclones are associated with several infectious diseases, while very few evidence has demonstrated the relationship between tropical cyclones and dengue fever. This study aimed to examine the potential impact of tropical cyclones on dengue fever incidence in the Pearl River Delta, China. Methods Data on daily dengue fever incidence, occurrence of tropical cyclones and meteorological factors were collected between June and October, 2013–2018 from nine cities in the Pearl River Delta. Multicollinearity of meteorological variables was examined via Spearman correlation, variables with strong correlation (r>0.7) were not included in the model simultaneously. A time-stratified case-crossover design combined with conditional Poisson regression model was performed to evaluate the association between tropical cyclones and dengue fever incidence. Stratified analyses were performed by intensity grades of tropical cyclones (tropical storm and typhoon), sex (male and female) and age-groups (<18, 18–59, ≥60 years). Results During the study period, 20 tropical cyclones occurred and 47,784 dengue fever cases were reported. Tropical cyclones were associated with an increased risk of dengue fever in the Pearl River Delta region, with the largest relative risk of 1.62 with the 95% confidence interval (1.45–1.80) occurring on the lag 5 day. The strength of association was greater and lasted longer for typhoon than for tropical storm. There was no difference in effect estimates between males and females. However, individuals aged over 60 years were more vulnerable than others. Conclusions Tropical cyclones are associated with increased risk of local dengue fever incidence in south China, with the elderly more vulnerable than other population subgroups. Health protective strategies should be developed to reduce the potential risk of dengue epidemic after tropical cyclones. Dengue fever, a mosquito-borne tropical infectious disease, has been increasingly serious in recent decades, causing great healthcare burden in low-latitude regions and countries. Aedes is the vector of dengue fever, particularly sensitive to climatic conditions during all stages of the life cycle. Numerous epidemiological studies have demonstrated the association between dengue fever and meteorological factors (e.g., temperature, precipitation and relative humidity). Tropical cyclones are a common extreme weather events in the low latitude and have been associated with the outbreak of several infectious diseases. However, the impact of tropical cyclones on the incidence of dengue fever has not been well clarified. In this study, we explored the association between tropical cyclones and dengue fever in the Pearl River Delta region, China. The results showed that the local incidence of dengue fever was substantially associated with tropical cyclones over a certain lag period, with the effect estimate greater for stronger tropical cyclones. The elderly was more vulnerable than any other population subgroups. The findings highlighted the importance of developing public health surveillance, preparedness, and response targeting the outbreak of dengue fever during the tropical cyclone season.
Collapse
Affiliation(s)
- Chuanxi Li
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.,Shandong University Climate Change and Health Center, Jinan, China
| | - Qi Zhao
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.,Shandong University Climate Change and Health Center, Jinan, China
| | - Zhe Zhao
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.,Shandong University Climate Change and Health Center, Jinan, China
| | - Qiyong Liu
- Shandong University Climate Change and Health Center, Jinan, China.,State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Wei Ma
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.,Shandong University Climate Change and Health Center, Jinan, China
| |
Collapse
|
37
|
Chua PLC, Ng CFS, Rivera AS, Salva EP, Salazar MA, Huber V, Hashizume M. Association between Ambient Temperature and Severe Diarrhoea in the National Capital Region, Philippines. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:8191. [PMID: 34360484 PMCID: PMC8346076 DOI: 10.3390/ijerph18158191] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Revised: 07/27/2021] [Accepted: 07/28/2021] [Indexed: 11/16/2022]
Abstract
Epidemiological studies have quantified the association between ambient temperature and diarrhoea. However, to our knowledge, no study has quantified the temperature association for severe diarrhoea cases. In this study, we quantified the association between mean temperature and two severe diarrhoea outcomes, which were mortality and hospital admissions accompanied with dehydration and/or co-morbidities. Using a 12-year dataset of three urban districts of the National Capital Region, Philippines, we modelled the non-linear association between weekly temperatures and weekly severe diarrhoea cases using a two-stage time series analysis. We computed the relative risks at the 95th (30.4 °C) and 5th percentiles (25.8 °C) of temperatures using minimum risk temperatures (MRTs) as the reference to quantify the association with high- and low-temperatures, respectively. The shapes of the cumulative associations were generally J-shaped with greater associations towards high temperatures. Mortality risks were found to increase by 53.3% [95% confidence interval (CI): 29.4%; 81.7%)] at 95th percentile of weekly mean temperatures compared with the MRT (28.2 °C). Similarly, the risk of hospitalised severe diarrhoea increased by 27.1% (95% CI: 0.7%; 60.4%) at 95th percentile in mean weekly temperatures compared with the MRT (28.6 °C). With the increased risk of severe diarrhoea cases under high ambient temperature, there may be a need to strengthen primary healthcare services and sustain the improvements made in water, sanitation, and hygiene, particularly in poor communities.
Collapse
Affiliation(s)
- Paul L. C. Chua
- Department of Global Health, School of Tropical Medicine and Global Health, Nagasaki University, 1 Chome-12-4 Sakamoto, Nagasaki 852-8102, Japan; (C.F.S.N.); (M.H.)
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
- Alliance for Improving Health Outcomes, Inc., Rm. 406, Veria I Bldg., 62 West Avenue, Barangay West Triangle, Quezon City 1104, Philippines;
| | - Chris Fook Sheng Ng
- Department of Global Health, School of Tropical Medicine and Global Health, Nagasaki University, 1 Chome-12-4 Sakamoto, Nagasaki 852-8102, Japan; (C.F.S.N.); (M.H.)
| | - Adovich S. Rivera
- Institute for Public Health and Management, Feinberg School of Medicine, Northwestern University, 633 N. St. Clair Street, 20th Floor, Chicago, IL 60611, USA;
| | - Eumelia P. Salva
- San Lazaro Hospital, Quiricada St., Santa Cruz, Manila 1003, Philippines;
| | - Miguel Antonio Salazar
- Alliance for Improving Health Outcomes, Inc., Rm. 406, Veria I Bldg., 62 West Avenue, Barangay West Triangle, Quezon City 1104, Philippines;
- Institute of Global Health, University of Heidelberg, Im Neuenheimer Feld 324, 69120 Heidelberg, Germany
| | - Veronika Huber
- Department of Physical, Chemical and Natural Systems, Universidad Pablo de Olavide, Ctra Utrera km 1, 41013 Sevilla, Spain;
| | - Masahiro Hashizume
- Department of Global Health, School of Tropical Medicine and Global Health, Nagasaki University, 1 Chome-12-4 Sakamoto, Nagasaki 852-8102, Japan; (C.F.S.N.); (M.H.)
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| |
Collapse
|
38
|
Using Geographically Weighted Regression to Study the Seasonal Influence of Potential Risk Factors on the Incidence of HFMD on the Chinese Mainland. ISPRS INTERNATIONAL JOURNAL OF GEO-INFORMATION 2021. [DOI: 10.3390/ijgi10070448] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Hand, foot, and mouth disease (HFMD) is an epidemic infectious disease in China. Its incidence is affected by a variety of natural environmental and socioeconomic factors, and its transmission has strong seasonal and spatial heterogeneity. To quantify the spatial relationship between the incidence of HFMD (I-HFMD) and eight potential risk factors (temperature, humidity, precipitation, wind speed, air pressure, altitude, child population density, and per capita GDP) on the Chinese mainland, we established a geographically weighted regression (GWR) model to analyze their impacts in different seasons and provinces. The GWR model successfully describes the spatial changes of the influence of potential risks, and shows greatly improved estimation performance compared with the ordinary linear regression (OLR) method. Our findings help to understand the seasonally and spatially relevant effects of natural environmental and socioeconomic factors on the I-HFMD, and can provide information to be used to develop effective prevention strategies against HFMD at different locations and in different seasons.
Collapse
|
39
|
Chen K, Li C, Wang Y, Shen Z, Guo Y, Li X, Zhang Y. Optimization of Vero Cells Grown on a Polymer Fiber Carrier in a Disposable Bioreactor for Inactivated Coxsackievirus A16 Vaccine Development. Vaccines (Basel) 2021; 9:vaccines9060613. [PMID: 34200441 PMCID: PMC8229131 DOI: 10.3390/vaccines9060613] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 06/02/2021] [Accepted: 06/03/2021] [Indexed: 11/16/2022] Open
Abstract
At present, there are no vaccines available for hand, foot, and mouth disease, which is caused by Coxsackie virus A16 (CVA16) infection. In the present study, we isolated epidemic strains of CVA16 and optimized the production of the virus in Vero cells. The system comprised growing the infected cells on polymer fiber paper carriers in a serum-free medium containing 0.5% (w/v) lactalbumin hydrolysate a mini bioreactor. Disposable Bioflo310 and AmProtein Current perfusion bioreactors were used to monitor virus infection and Vero cell culture. The total number of cells increased from 1.5 × 109 to 3.0 × 1010. In our optimized culture process, the virus titer reached 7.8 × 107 TCID50/mL at three days after infection. The inactivated CVA16 prepared from our optimized culture procedure elicited a slightly higher neutralizing antibody titer compared with that derived from routine culture procedures. These results will promote the large-scale production of inactivated CVA16 vaccines using nonwoven polymer fiber paper cell cultures.
Collapse
Affiliation(s)
- Keda Chen
- Shulan International Medical College, Zhejiang Shuren University, Hangzhou 310015, China; (K.C.); (C.L.); (Y.W.); (Z.S.); (Y.G.); (X.L.)
| | - Chaonan Li
- Shulan International Medical College, Zhejiang Shuren University, Hangzhou 310015, China; (K.C.); (C.L.); (Y.W.); (Z.S.); (Y.G.); (X.L.)
| | - Ying Wang
- Shulan International Medical College, Zhejiang Shuren University, Hangzhou 310015, China; (K.C.); (C.L.); (Y.W.); (Z.S.); (Y.G.); (X.L.)
| | - Zhenwei Shen
- Shulan International Medical College, Zhejiang Shuren University, Hangzhou 310015, China; (K.C.); (C.L.); (Y.W.); (Z.S.); (Y.G.); (X.L.)
| | - Yikai Guo
- Shulan International Medical College, Zhejiang Shuren University, Hangzhou 310015, China; (K.C.); (C.L.); (Y.W.); (Z.S.); (Y.G.); (X.L.)
| | - Xiaoping Li
- Shulan International Medical College, Zhejiang Shuren University, Hangzhou 310015, China; (K.C.); (C.L.); (Y.W.); (Z.S.); (Y.G.); (X.L.)
| | - Yanjun Zhang
- Department of Virus Inspection, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China
- Correspondence: ; Tel.: +86-138-5811-5856
| |
Collapse
|
40
|
Cheng J, Bambrick H, Yakob L, Devine G, Frentiu FD, Williams G, Li Z, Yang W, Hu W. Extreme weather conditions and dengue outbreak in Guangdong, China: Spatial heterogeneity based on climate variability. ENVIRONMENTAL RESEARCH 2021; 196:110900. [PMID: 33636184 DOI: 10.1016/j.envres.2021.110900] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 12/19/2020] [Accepted: 02/15/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Previous studies have shown associations between local weather factors and dengue incidence in tropical and subtropical regions. However, spatial variability in those associations remains unclear and evidence is scarce regarding the effects of weather extremes. OBJECTIVES We examined spatial variability in the effects of various weather conditions on the unprecedented dengue outbreak in Guangdong province of China in 2014 and explored how city characteristics modify weather-related risk. METHODS A Bayesian spatial conditional autoregressive model was used to examine the overall and city-specific associations of dengue incidence with weather conditions including (1) average temperature, temperature variation, and average rainfall; and (2) weather extremes including numbers of days of extremely high temperature and high rainfall (both used 95th percentile as the cut-off). This model was run for cumulative dengue cases during five months from July to November (accounting for 99.8% of all dengue cases). A further analysis based on spatial variability was used to validate the modification effects by economic, demographic and environmental factors. RESULTS We found a positive association of dengue incidence with average temperature in seven cities (relative risk (RR) range: 1.032 to 1.153), a positive association with average rainfall in seven cities (RR range: 1.237 to 1.974), and a negative association with temperature variation in four cities (RR range: 0.315 to 0.593). There was an overall positive association of dengue incidence with extremely high temperature (RR:1.054, 95% credible interval (CI): 1.016 to 1.094), without evidence of variation across cities, and an overall positive association of dengue with extremely high rainfall (RR:1.505, 95% CI: 1.096 to 2.080), with seven regions having stronger associations (RR range: 1.237 to 1.418). Greater effects of weather conditions appeared to occur in cities with higher economic level, lower green space coverage and lower elevation. CONCLUSIONS Spatially varied effects of weather conditions on dengue outbreaks necessitate area-specific dengue prevention and control measures. Extremes of temperature and rainfall have strong and positive associations with dengue outbreaks.
Collapse
Affiliation(s)
- Jian Cheng
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia; Department of Epidemiology and Biostatistics & Anhui Province Key Laboratory of Major Autoimmune Disease, School of Public Health, Anhui Medical University, Anhui, China
| | - Hilary Bambrick
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| | - Laith Yakob
- Department of Disease Control, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Gregor Devine
- Mosquito Control Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Francesca D Frentiu
- Centre for Immunology and Infection Control, School of Biomedical Sciences, Queensland University of Technology, Brisbane, Australia
| | - Gail Williams
- School of Public Health, University of Queensland, Brisbane, Australia
| | - Zhongjie Li
- Division of Infectious Disease, Key Laboratory of Surveillance and Early Warning of Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Weizhong Yang
- Division of Infectious Disease, Key Laboratory of Surveillance and Early Warning of Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China; School of Population Medicine & Public Health, Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing, China
| | - Wenbiao Hu
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia.
| |
Collapse
|
41
|
Lin S, Zhang W, Sheridan S, Mongillo M, DiRienzo S, Stuart NA, Stern EK, Birkhead G, Dong G, Wu S, Chowdhury S, Primeau MJ, Hao Y, Romeiko XX. The immediate effects of winter storms and power outages on multiple health outcomes and the time windows of vulnerability. ENVIRONMENTAL RESEARCH 2021; 196:110924. [PMID: 33689823 DOI: 10.1016/j.envres.2021.110924] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 02/09/2021] [Accepted: 02/18/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND While most prior research has focused on extreme heat, few assessed the immediate health effects of winter storms and associated power outages (PO), although severe storms have become more frequent. This study evaluates the joint and independent health effects of winter storms and PO, snow versus ice-storm, effects by time window (peak timing, winter/transitional months) and the impacts on critical care indicators including numbers of comorbidity, procedure, length of stay and cost. METHODS We use distributed lag nonlinear models to assess the impacts of winter storm/PO on hospitalizations due to cardiovascular, lower respiratory diseases (LRD), respiratory infections, food/water-borne diseases (FWBD) and injuries in New York State on 0-6 lag days following storm/PO compared with non-storm/non-PO periods (references), while controlling for time-varying factors and PM2.5. The storm-related hospitalizations are described by time window. We also calculate changes in critical care indicators between the storm/PO and control periods. RESULTS We found the joint effects of storm/PO are the strongest (risk ratios (RR) range: 1.01-1.90), followed by that of storm alone (1.02-1.39), but not during PO alone. Ice storms have stronger impacts (RRs: 1.04-3.15) than snowstorms (RRs: 1.03-2.21). The storm/PO-health associations, which occur immediately, and some last a whole week, are stronger in FWBD, October/November, and peak between 3:00-8:00 p.m. Comorbidity and medical costs significantly increase after storm/PO. CONCLUSION Winter storms increase multiple diseases, comorbidity and medical costs, especially when accompanied by PO or ice storms. Early warnings and prevention may be critical in the transitional months and afternoon rush hours.
Collapse
Affiliation(s)
- Shao Lin
- Department of Environmental Health Sciences, University at Albany, State University of New York, Rensselaer, NY, USA.
| | - Wangjian Zhang
- Department of Environmental Health Sciences, University at Albany, State University of New York, Rensselaer, NY, USA
| | - Scott Sheridan
- Department of Geography, Kent State University, Kent, OH, USA
| | - Melanie Mongillo
- Department of Health Policy, Management and Behavior, University at Albany, State University of New York, Rensselaer, NY, USA
| | | | | | - Eric K Stern
- College of Emergency Preparedness, Homeland Security, and Cyber-Security, University at Albany, State University of New York, Albany, NY, USA
| | - Guthrie Birkhead
- Department of Epidemiology and Biostatistics, University at Albany, State University of New York, Rensselaer, NY, USA
| | - Guanghui Dong
- Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Shaowei Wu
- Department of Occupational and Environmental Health Sciences, School of Public Health, Xi'an Jiaotong University, Xi'an, China
| | | | - Michael J Primeau
- Office of Health Emergency Preparedness, New York State Department of Health, Albany, NY, USA
| | - Yuantao Hao
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Xiaobo X Romeiko
- Department of Environmental Health Sciences, University at Albany, State University of New York, Rensselaer, NY, USA
| |
Collapse
|
42
|
Wang H, Liu Z, Xiang J, Tong MX, Lao J, Liu Y, Zhang J, Zhao Z, Gao Q, Jiang B, Bi P. Effect of ambient temperatures on category C notifiable infectious diarrhea in China: An analysis of national surveillance data. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 759:143557. [PMID: 33198999 DOI: 10.1016/j.scitotenv.2020.143557] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 08/20/2020] [Accepted: 11/02/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Many studies have explored the association between meteorological factors and infectious diarrhea (ID) transmission but with inconsistent results, in particular the roles from temperatures. We aimed to explore the effects of temperatures on the transmission of category C ID, to identify its potential heterogeneity in different climate zones of China, and to provide scientific evidence to health authorities and local communities for necessary public health actions. METHODS Daily category C ID counts and meteorological variables were collected from 270 cities in China over the period of 2014-16. Distributed lag non-linear models (DLNMs) were applied in each city to obtain the city-specific temperature-disease associations, then a multivariate meta-analysis was implemented to pool the city-specific effects. Multivariate meta-regression was conducted to explore the potential effect modifiers. Attributable fraction was calculated for both low and high temperatures, defined as temperatures below the 5th percentile of temperature or above the 95th percentile of temperature. RESULTS A total of 2,715,544 category C ID cases were reported during the study period. Overall, a M-shaped curve relationship was observed between temperature and category C ID, with a peak at the 81st percentile of temperatures (RR = 1.723, 95% CI: 1.579-1.881) compared to 50th percentile of temperatures. The pooled associations were generally stronger at high temperatures compared to low ambient temperatures, and the attributable fraction due to heat was higher than cold. Latitude was identified as a possible effect modifier. CONCLUSIONS The overall positive pooled associations between temperature and category C ID in China suggest the increasing temperature could bring about more category C infectious diarrhea cases, which warrants further public health measurements.
Collapse
Affiliation(s)
- Haitao Wang
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, Shandong, China
| | - Zhidong Liu
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, Shandong, China
| | - Jianjun Xiang
- School of Public Health, Fujian Medical University, Fuzhou, Fujian, China; School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia
| | - Michael Xiaoliang Tong
- School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia
| | - Jiahui Lao
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, Shandong, China
| | - Yanyu Liu
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, Shandong, China
| | - Jing Zhang
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, Shandong, China
| | - Zhe Zhao
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, Shandong, China
| | - Qi Gao
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, Shandong, China
| | - Baofa Jiang
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, Shandong, China; Shandong University Climate Change and Health Center, Jinan, Shandong, China.
| | - Peng Bi
- School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia
| |
Collapse
|
43
|
Pan Q, Liu F, Zhang J, Zhao X, Hu Y, Fan C, Yang F, Chang Z, Xiao X. Regional-level risk factors for severe hand-foot-and-mouth disease: an ecological study from mainland China. Environ Health Prev Med 2021; 26:4. [PMID: 33419405 PMCID: PMC7792012 DOI: 10.1186/s12199-020-00927-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Accepted: 12/21/2020] [Indexed: 12/27/2022] Open
Abstract
Background Severe hand-foot-and-mouth disease (HFMD) is a life-threatening contagious disease among young children and infants. Although enterovirus A71 has been well acknowledged to be the dominant cause of severe HFMD, there still remain other unidentified risk factors for severe HFMD. Previous studies mainly focused on identifying the individual-level risk factors from a clinical perspective, while rare studies aimed to clarify the association between regional-level risk factors and severe HFMD, which may be more important from a public health perspective. Methods We retrieved the clinical HFMD counts between 2008 and 2014 from the Chinese Center for Disease Control and Prevention, which were used to calculated the case-severity rate in 143 prefectural-level cities in mainland China. For each of those 143 cities, we further obtained city-specific characteristics from the China City Statistical Yearbook (social and economic variables) and the national meteorological monitoring system (meteorological variables). A Poisson regression model was then used to estimate the associations between city-specific characteristics (reduced by the principal component analysis to avoid multicollinearity) and the case-severity rate of HFMD. The above analysis was further stratified by age and gender to examine potential modifying effects and vulnerable sub-populations. Results We found that the case-severity rate of HFMD varied dramatically between cities, ranging from 0 to 8.09%. Cities with high case-severity rates were mainly clustered in Central China. By relating the case-severity rate to city-specific characteristics, we found that both the principal component characterized by a high level of social and economic development (RR = 0.823, 95%CI 0.739, 0.916) and another that characterized by warm and humid climate (RR = 0.771, 95%CI 0.619, 0.960) were negatively associated with the case-severity rate of HFMD. These estimations were consistent across age and gender sub-populations. Conclusion Except for the type of infected pathogen, the case-severity rate of HFMD was closely related to city development and meteorological factor. These findings suggest that social and environmental factors may also play an important role in the progress of severe HFMD. Supplementary Information The online version contains supplementary material available at 10.1186/s12199-020-00927-9.
Collapse
Affiliation(s)
- Qing Pan
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, 610041, PR China
| | - Fengfeng Liu
- Division of Infectious Disease & Key Laboratory of Surveillance and Early Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, 102206, PR China
| | - Juying Zhang
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, 610041, PR China
| | - Xing Zhao
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, 610041, PR China
| | - Yifan Hu
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, 610041, PR China
| | - Chaonan Fan
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, 610041, PR China
| | - Fan Yang
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, 610041, PR China
| | - Zhaorui Chang
- Division of Infectious Disease & Key Laboratory of Surveillance and Early Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, 102206, PR China.
| | - Xiong Xiao
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, 610041, PR China.
| |
Collapse
|
44
|
Leading Enterovirus Genotypes Causing Hand, Foot, and Mouth Disease in Guangzhou, China: Relationship with Climate and Vaccination against EV71. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18010292. [PMID: 33401757 PMCID: PMC7795377 DOI: 10.3390/ijerph18010292] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 12/29/2020] [Accepted: 12/29/2020] [Indexed: 11/17/2022]
Abstract
(1) Background: Assignment of pathogens to the correct genus, species, and type is vital for controlling infectious epidemics. However, the role of different enteroviruses during hand, foot, and mouth disease (HFMD) epidemics and the major contributing factors remain unknown. (2) Methods: HFMD cases from 2016 to 2018 in Guangzhou, China were collected. The relationship between HFMD cases and genotype frequency, as well as the association between genotype frequency and climate factors, were studied using general linear models. We transformed the genotype frequency to the isometric log-ratio (ILR) components included in the model. Additionally, vaccination rates were adjusted in the climate-driven models. (3) Results: We observed seasonal trends in HFMD cases, genotype frequency, and climate factors. The model regressing case numbers on genotype frequency revealed negative associations with both the ILRs of CAV16 (RR = 0.725, p < 0.001) and EV71 (RR = 0.421, p < 0.001). The model regressing genotype frequency on driven factors showed that the trends for EV71 proportions were inversely related to vaccination rate (%, β = -0.152, p = 0.098) and temperature (°C, β = -0.065, p = 0.004). Additionally, the trends for CVA16 proportions were inversely related to vaccination rate (%, β = -0.461, p = 0.004) and temperature (°C, β = -0.068, p = 0.031). The overall trends for genotype frequency showed that EV71 decreased significantly, while the trends for CVA16 increased annually. (4) Conclusions: Our findings suggest a potential pathway for climate factors, genotype frequency, and HFMD cases. Our study is practical and useful for targeted prevention and control, and provides environmental-based evidence.
Collapse
|
45
|
Temperature and humidity associated with increases in tuberculosis notifications: a time-series study in Hong Kong. Epidemiol Infect 2020; 149:e8. [PMID: 33436107 PMCID: PMC8057503 DOI: 10.1017/s0950268820003040] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Previous studies have revealed associations of meteorological factors with tuberculosis (TB) cases. However, few studies have examined their lag effects on TB cases. This study was aimed to analyse nonlinear lag effects of meteorological factors on the number of TB notifications in Hong Kong. Using a 22-year consecutive surveillance data in Hong Kong, we examined the association of monthly average temperature and relative humidity with temporal dynamics of the monthly number of TB notifications using a distributed lag nonlinear models combined with a Poisson regression. The relative risks (RRs) of TB notifications were >1.15 as monthly average temperatures were between 16.3 and 17.3 °C at lagged 13–15 months, reaching the peak risk of 1.18 (95% confidence interval (CI) 1.02–1.35) when it was 16.8 °C at lagged 14 months. The RRs of TB notifications were >1.05 as relative humidities of 60.0–63.6% at lagged 9–11 months expanded to 68.0–71.0% at lagged 12–17 months, reaching the highest risk of 1.06 (95% CI 1.01–1.11) when it was 69.0% at lagged 13 months. The nonlinear and delayed effects of average temperature and relative humidity on TB epidemic were identified, which may provide a practical reference for improving the TB warning system.
Collapse
|
46
|
Yi X, Chang Z, Zhao X, Ma Y, Liu F, Xiao X. The temporal characteristics of the lag-response relationship and related key time points between ambient temperature and hand, foot and mouth disease: A multicity study from mainland China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 749:141679. [PMID: 32836135 DOI: 10.1016/j.scitotenv.2020.141679] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 07/26/2020] [Accepted: 08/11/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Previous studies have thoroughly elucidated the exposure-response relationship between ambient temperature and hand, foot, and mouth disease (HFMD), whereas very little concern has been to the lag-response relationship and related key time points. OBJECTIVES We aimed to clarify the temporal characteristics of the lag-response relationship between ambient temperature and HFMD and how they may vary spatially. METHODS We retrieved the daily time series of meteorological variables and HFMD counts for 143 cities in mainland China between 2009 and 2014. We estimated the city-specific lag-response curve between ambient temperature and HFMD and related key time points by applying common distributed lag nonlinear models (DLNM) and Monte Carlo simulation methods. Then, we pooled the city-specific estimates by performing a meta-regression with the city-specific characteristics as meta-predictors to explain the potential spatial heterogeneity. RESULTS We found a robust lag pattern between temperature and HFMD for different levels of temperatures. The temporal change of risk obtained its maximum value on the current day but dropped sharply thereafter and then rebounded to a secondary peak, which implied the presence of a harvesting effect. By contrast, the estimation of key time points showed substantial heterogeneity, especially at high temperature (the I2 statistics ranged from 47% to 80%). With one unit increase in the geographic index, the secondary peak would arrive 0.37 (0.02, 0.71) days later. With one unit increase in the economic index and climatic index, the duration time of the lag-response curve would be lengthened by 0.36 (0.1, 0.62) and 0.92 (0.54, 1.29) days, respectively. CONCLUSION Our study examined the lag pattern and spatial heterogeneity of the lag-response relationship between temperature and HFMD. Those findings gave us new insights into the complex association and the related mechanisms between weather and HFMD and important information for weather-based disease early warning systems.
Collapse
Affiliation(s)
- Xiaowei Yi
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Zhaorui Chang
- Division of Infectious Disease & Key Laboratory of Surveillance and Early Warning on Infectious Disease, Chinese Centre for Disease Control and Prevention, Beijing, China
| | - Xing Zhao
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Yue Ma
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Fengfeng Liu
- Division of Infectious Disease & Key Laboratory of Surveillance and Early Warning on Infectious Disease, Chinese Centre for Disease Control and Prevention, Beijing, China
| | - Xiong Xiao
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.
| |
Collapse
|
47
|
Zhang W, Sheridan SC, Birkhead GS, Croft DP, Brotzge JA, Justino JG, Stuart NA, Du Z, Romeiko XX, Ye B, Dong G, Hao Y, Lin S. Power Outage: An Ignored Risk Factor for COPD Exacerbations. Chest 2020; 158:2346-2357. [PMID: 32502591 PMCID: PMC7768937 DOI: 10.1016/j.chest.2020.05.555] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Revised: 04/06/2020] [Accepted: 05/03/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND COPD is the third leading cause of death in the United States, with 16 million Americans currently experiencing difficulty with breathing. Power outages could be life-threatening for those relying on electricity. However, significant gaps remain in understanding the potential impact of power outages on COPD exacerbations. RESEARCH QUESTION The goal of this study was to determine how power outages affect COPD exacerbations. STUDY DESIGN AND METHODS Using distributed lag nonlinear models controlling for time-varying confounders, the hospitalization rate during a power outage was compared vs non-outage periods to determine the rate ratio (RR) for COPD and its subtypes at each of 0 to 6 lag days in New York State from 2001 to 2013. Stratified analyses were conducted according to sociodemographic characteristics, season, and clinical severity; changes were investigated in numerous critical medical indicators, including length of stay, hospital cost, the number of comorbidities, and therapeutic procedures between the two periods. RESULTS The RR of COPD hospitalization following power outages ranged from 1.03 to 1.39 across lag days. The risk was strongest at lag0 and lag1 days and lasted significantly for 7 days. Associations were stronger for the subgroup with acute bronchitis (RR, 1.08-1.69) than for cases of acute exacerbation (RR, 1.03-1.40). Compared with non-outage periods, the outage period was observed to be $4.67 thousand greater in hospital cost and 1.38 greater in the number of comorbidities per case. The average cost (or number of comorbidities) was elevated in all groups stratified according to cost (or number of comorbidities). In contrast, changes in the average length of stay (-0.43 day) and the average number of therapeutic procedures (-0.09) were subtle. INTERPRETATION Power outages were associated with a significantly elevated rate of COPD hospitalization, as well as greater costs and number of comorbidities. The average cost and number of comorbidities were elevated in all clinical severity groups.
Collapse
Affiliation(s)
- Wangjian Zhang
- Department of Environmental Health Sciences, University at Albany, State University of New York, Rensselaer, NY
| | | | - Guthrie S Birkhead
- Department of Epidemiology and Biostatistics, University at Albany, State University of New York, Rensselaer, NY
| | - Daniel P Croft
- Department of Medicine, University of Rochester Medical Center, Rochester, NY
| | - Jerald A Brotzge
- New York State Mesonet, College of Arts and Sciences, State University of New York, Albany, NY
| | - John G Justino
- Center for Global Health, University at Albany, State University of New York, Rensselaer, NY
| | | | - Zhicheng Du
- Department of Medical Statistics and Epidemiology, University at Albany, State University of New York, Rensselaer, NY
| | - Xiaobo X Romeiko
- Department of Environmental Health Sciences, University at Albany, State University of New York, Rensselaer, NY
| | - Bo Ye
- Department of Epidemiology and Biostatistics, University at Albany, State University of New York, Rensselaer, NY
| | - Guanghui Dong
- Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yuantao Hao
- Department of Medical Statistics and Epidemiology, University at Albany, State University of New York, Rensselaer, NY
| | - Shao Lin
- Department of Environmental Health Sciences, University at Albany, State University of New York, Rensselaer, NY; Department of Epidemiology and Biostatistics, University at Albany, State University of New York, Rensselaer, NY.
| |
Collapse
|
48
|
Ma Y, Liu K, Hu W, Song S, Zhang S, Shao Z. Epidemiological Characteristics, Seasonal Dynamic Patterns, and Associations with Meteorological Factors of Rubella in Shaanxi Province, China, 2005-2018. Am J Trop Med Hyg 2020; 104:166-174. [PMID: 33241784 DOI: 10.4269/ajtmh.20-0585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Rubella occurs worldwide, causing approximately 100,000 cases annually of congenital rubella syndrome, leading to severe birth defects. Better targeting of public health interventions is needed to achieve rubella elimination goals. To that end, we measured the epidemiological characteristics and seasonal dynamic patterns of rubella and determined its association with meteorological factors in Shaanxi Province, China. Data on rubella cases in Shaanxi Province from 2005 to 2018 were obtained from the Chinese National Notifiable Disease Reporting System. The Morlet wavelet analysis was used to estimate temporal periodicity of rubella incidence. Mixed generalized additive models were used to measure associations between meteorological variables (temperature and relative humidity) and rubella incidence. A total of 17,185 rubella cases were reported in Shaanxi during the study period, for an annual incidence of 3.27 cases per 100,000 population. Interannual oscillations in rubella incidence of 0.8-1.4 years, 3.8-4.8 years, and 0.5 years were detected. Both temperature and relative humidity exhibited nonlinear associations with the incidence of rubella. The accumulative relative risk of transmission for the overall pooled estimates was maximized at a temperature of 0.23°C and relative humidity of 41.6%. This study found that seasonality and meteorological factors have impact on the transmission of rubella; public health interventions to eliminate rubella must consider periodic and seasonal fluctuations as well as meteorological factors.
Collapse
Affiliation(s)
- Yu Ma
- 1Department of Epidemiology, Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, School of Public Health, Air Force Medical University, Xi'an, People's Republic of China.,2Shaanxi Provincial Center for Disease Control and Prevention, Xi'an, People's Republic of China
| | - Kun Liu
- 1Department of Epidemiology, Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, School of Public Health, Air Force Medical University, Xi'an, People's Republic of China
| | - Weijun Hu
- 2Shaanxi Provincial Center for Disease Control and Prevention, Xi'an, People's Republic of China
| | - Shuxuan Song
- 1Department of Epidemiology, Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, School of Public Health, Air Force Medical University, Xi'an, People's Republic of China
| | - Shaobai Zhang
- 2Shaanxi Provincial Center for Disease Control and Prevention, Xi'an, People's Republic of China
| | - Zhongjun Shao
- 1Department of Epidemiology, Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, School of Public Health, Air Force Medical University, Xi'an, People's Republic of China
| |
Collapse
|
49
|
Luo C, Ma Y, Liu Y, Lv Q, Yin F. The burden of childhood hand-foot-mouth disease morbidity attributable to relative humidity: a multicity study in the Sichuan Basin, China. Sci Rep 2020; 10:19394. [PMID: 33173087 PMCID: PMC7656260 DOI: 10.1038/s41598-020-76421-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 10/26/2020] [Indexed: 11/22/2022] Open
Abstract
Hand, foot and mouth disease (HFMD) is a growing threat to children's health, causing a serious public health burden in China. The relationships between associated meteorological factors and HFMD have been widely studied. However, the HFMD burden due to relative humidity from the perspective of attributable risk has been neglected. This study investigated the humidity-HFMD relationship in three comprehensive perspectives, humidity-HFMD relationship curves, effect modification and attributable risks in the Sichuan Basin between 2011 and 2017. We used multistage analyses composed of distributed lag nonlinear models (DLNMs), a multivariate meta-regression model and the calculations of attributable risk to quantify the humidity-HFMD association. We observed a J-shaped pattern for the pooled cumulative humidity-HFMD relationship, which presented significant heterogeneity relating to the geographical region and number of primary school students. Overall, 27.77% (95% CI 25.24–30.02%) of HFMD infections were attributed to humidity. High relative humidity resulted in the greatest burden of HFMD infections. The proportion of high humidity-related HFMD in the southern basin was higher than that in the northern basin. The findings provide evidence from multiple perspectives for public health policy formulation and health resource allocation to develop priorities and targeted policies to ease the HFMD burden associated with humidity.
Collapse
Affiliation(s)
- Caiying Luo
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yue Ma
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yaqiong Liu
- Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan, China
| | - Qiang Lv
- Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan, China
| | - Fei Yin
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China.
| |
Collapse
|
50
|
Abstract
To examine the effects of temperature on the daily cases of hand, foot, and mouth disease (HFMD).Data on the daily cases of HFMD in Lanzhou from 2008 to 2015 were obtained, and meteorological data from the same period were collected. A distributed lag nonlinear model was fitted to reveal the relationship between the daily mean temperature and the daily cases of HFMD.From 2008 to 2015, 25,644 cases were reported, of which children under 5 years of age accounted for 78.68% of cases. The highest peak of HFMD cases was usually reported between April to July each year. An inverse V-shaped relationship was observed between daily mean temperature and HFMD cases; a temperature of 18°C was associated with a maximum risk of HFMD. The relative risk (RR) was 1.57 (95% confidence interval: 1.23-1.23), and boys and children aged 3 to 5 years were populations with the highest risk. The cumulative risks of high temperature (20.2°C and 25.2°C) in the total, age-specific, and gender-specific groups peaked on lag 14 days; RR was higher in girls than in boys and in children aged 1 to 2 years than in other age groups. However, the effects of low temperature (-5.3°C, 2.0°C, and 12.8°C) were not significant for both gender-specific and age-specific patients.High temperature may increase the risk of HFMD, and boys and children aged 3 to 5 years were at higher risks on lag 0 day; however, the cumulative risks in girls and children aged 1 to 2 years increased with the increasing number of lag days.
Collapse
Affiliation(s)
- Jinyu Wang
- School of Basic Medical Science, Lanzhou University
| | - Sheng Li
- The First People's Hospital of Lanzhou City, Lanzhou, PR China
| |
Collapse
|