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Saadene Y, Salhi A, Mliki F, Bouslama Z. Climate change and cutaneous leishmaniasis in the province of Ghardaïa in Algeria: A model-based approach to predict disease outbreaks. Ann Saudi Med 2023; 43:263-276. [PMID: 37805813 PMCID: PMC10560365 DOI: 10.5144/0256-4947.2023.263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 08/03/2023] [Indexed: 10/09/2023] Open
Abstract
BACKGROUND Cutaneous leishmaniasis (CL) is a vector-borne disease prevalent in Algeria since 2000. The disease has significant impacts on affected communities, including morbidity and social stigma. OBJECTIVE Investigate the association between environmental factors and the incidence of CL in the province of Ghardaïa and assess the predictive capacity of these factors for disease occurrence. DESIGN Retrospective SETTING: The study area included both urban and rural communities. METHODS We analyzed a dataset on CL in the province of Ghardaïa, Algeria, spanning from 2000 to 2020. The dataset included climatic variables such as temperature, average humidity, wind speed, rainfall, and the normalized difference vegetation index (NDVI). Using generalized additive models, we examined the relationships and interactions between these variables to predict the emergence of CL in the study area. MAIN OUTCOME MEASURES The identification of the most significant environmental factors associated with the incidence and the predicted incidence rates of CL in the province of Ghardaïa, Algeria. SAMPLE SIZE AND CHARACTERISTICS 252 monthly observations of both climatic and epidemiological variables. RESULTS Relative humidity and wind speed were the primary climatic factors influencing the occurrence of CL epidemics in Ghardaïa, Algeria. Additionally, NDVI was a significant environmental factor associated with CL incidence. Surprisingly, temperature did not show a strong effect on CL occurrence, while rainfall was not statistically significant. The final fitted model predictions were highly correlated with real cases. CONCLUSION This study provides a better understanding of the long-term trend in how environmental and climatic factors contribute to the emergence of CL. Our results can inform the development of effective early warning systems for preventing the transmission and emergence of vector-borne diseases. LIMITATIONS Incorporating additional reservoir statistics such as rodent density and a human development index in the region could improve our understanding of disease transmission.
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Affiliation(s)
- Yasmine Saadene
- From the Laboratory of Ecology of Earth and Aquatic Systems, University of Badji Mokhtar, Annaba, Algeria
| | - Amina Salhi
- From the Laboratory of Ecology of Earth and Aquatic Systems, University of Badji Mokhtar, Annaba, Algeria
| | - Feriel Mliki
- From the Laboratory of Ecology of Earth and Aquatic Systems, University of Badji Mokhtar, Annaba, Algeria
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Wibawa BSS, Maharani AT, Andhikaputra G, Putri MSA, Iswara AP, Sapkota A, Sharma A, Syafei AD, Wang YC. Effects of Ambient Temperature, Relative Humidity, and Precipitation on Diarrhea Incidence in Surabaya. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20032313. [PMID: 36767679 PMCID: PMC9916310 DOI: 10.3390/ijerph20032313] [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: 12/12/2022] [Revised: 01/17/2023] [Accepted: 01/25/2023] [Indexed: 05/08/2023]
Abstract
BACKGROUND Diarrhea remains a common infectious disease caused by various risk factors in developing countries. This study investigated the incidence rate and temporal associations between diarrhea and meteorological determinants in five regions of Surabaya, Indonesia. METHOD Monthly diarrhea records from local governmental health facilities in Surabaya and monthly means of weather variables, including average temperature, precipitation, and relative humidity from Meteorology, Climatology, and Geophysical Agency were collected from January 2018 to September 2020. The generalized additive model was employed to quantify the time lag association between diarrhea risk and extremely low (5th percentile) and high (95th percentile) monthly weather variations in the north, central, west, south, and east regions of Surabaya (lag of 0-2 months). RESULT The average incidence rate for diarrhea was 11.4 per 100,000 during the study period, with a higher incidence during rainy season (November to March) and in East Surabaya. This study showed that the weather condition with the lowest diarrhea risks varied with the region. The diarrhea risks were associated with extremely low and high temperatures, with the highest RR of 5.39 (95% CI 4.61, 6.17) in the east region, with 1 month of lag time following the extreme temperatures. Extremely low relative humidity increased the diarrhea risks in some regions of Surabaya, with the highest risk in the west region at lag 0 (RR = 2.13 (95% CI 1.79, 2.47)). Extremely high precipitation significantly affects the risk of diarrhea in the central region, at 0 months of lag time, with an RR of 3.05 (95% CI 2.09, 4.01). CONCLUSION This study identified a high incidence of diarrhea in the rainy season and in the deficient developed regions of Surabaya, providing evidence that weather magnifies the adverse effects of inadequate environmental sanitation. This study suggests the local environmental and health sectors codevelop a weather-based early warning system and improve local sanitation practices as prevention measures in response to increasing risks of infectious diseases.
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Affiliation(s)
- Bima Sakti Satria Wibawa
- Department of Environmental Engineering, College of Engineering, Chung Yuan Christian University, 200 Chung-Pei Road, Zhongli, Taoyuan City 320314, Taiwan
| | | | - Gerry Andhikaputra
- Department of Environmental Engineering, College of Engineering, Chung Yuan Christian University, 200 Chung-Pei Road, Zhongli, Taoyuan City 320314, Taiwan
| | - Marsha Savira Agatha Putri
- Department of Environmental Health, Faculty of Health Science, Universitas Islam Lamongan, Lamongan 62211, Indonesia
| | - Aditya Prana Iswara
- Department of Environmental Engineering, College of Engineering, Chung Yuan Christian University, 200 Chung-Pei Road, Zhongli, Taoyuan City 320314, Taiwan
- Department of Civil Engineering, College of Engineering, Chung Yuan Christian University, 200 Chung-Pei Road, Zhongli, Taoyuan City 320314, Taiwan
| | - Amir Sapkota
- Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, Maryland, MD 20742, USA
| | - Ayushi Sharma
- Department of Environmental Engineering, College of Engineering, Chung Yuan Christian University, 200 Chung-Pei Road, Zhongli, Taoyuan City 320314, Taiwan
- Department of Civil Engineering, College of Engineering, Chung Yuan Christian University, 200 Chung-Pei Road, Zhongli, Taoyuan City 320314, Taiwan
| | - Arie Dipareza Syafei
- Department of Environmental Engineering, Institut Teknologi Sepuluh Nopember, Surabaya 60111, Indonesia
| | - Yu-Chun Wang
- Department of Environmental Engineering, College of Engineering, Chung Yuan Christian University, 200 Chung-Pei Road, Zhongli, Taoyuan City 320314, Taiwan
- Research Center for Environmental Changes, Academia Sinica, 128 Academia Road, Section 2, Nankang, Taipei 11529, Taiwan
- Correspondence:
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Huang LJ, Zha JJ, Cao NW, Zhou HY, Chu XJ, Wang H, Li XB, Li BZ. Temperature might increase the hospital admission risk for rheumatoid arthritis patients in Anqing, China: a time-series study. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2022; 66:201-211. [PMID: 34718869 PMCID: PMC8557265 DOI: 10.1007/s00484-021-02207-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 10/13/2021] [Accepted: 10/13/2021] [Indexed: 05/20/2023]
Abstract
Temperature has been studied in relation to many health outcomes. However, few studies have explored its effect on the risk of hospital admission for rheumatoid arthritis (RA). A distributed lag non-linear model (DLNM) was used to analyze associations between mean temperature, diurnal temperature range (DTR), temperature change between neighboring days (TCN), and daily admissions for RA from 2015 to 2019 in Anqing, China. Subgroup analyses based on age, gender, rheumatoid factors, and admission route were performed. In total, 1456 patients with RA were hospitalized. Regarding the cumulative-lag effects of extreme cold temperature (5th percentile = 3℃), the risks of admissions for RA were increased and highest at lag 0-11 (RR = 2.68, 95% CI: 1.23-5.86). Exposing to low (5th percentile = 1.9℃) and high (95th percentile = 14.2℃) DTRs both had increased risks of RA admission, with highest RRs of 1.40 (95% CI: 1.03-1.91) and 1.24 (95% CI: 1.0-1.53) at lag 0 day, respectively. As for TCN, the marginal risk of admission in RA patients was found when exposed to high TCN (95th percentile = 2.9℃) with the largest single-day effect at lag 10 (RR = 1.11, 95% CI: 1.01-1.23). In subgroup analyses, females were more susceptible to extreme cold temperature, low and high DTRs, and high TCN. In regard to extreme cold temperature, significant risk of hospital admission in females only appeared at lag 2 (RR = 1.48, 95% CI: 1.02-2.15) and lag 0-2 (RR = 2.35, 95% CI: 1.11-4.95). It is clear that RA patients exposed to changing temperature may increase risks of admission.
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Affiliation(s)
- Li-Juan Huang
- Medical Department, The Affiliated Anqing Hospital of Anhui Medical University, Anqing, Anhui, China
| | - Jun-Jing Zha
- Medical Department, The Affiliated Anqing Hospital of Anhui Medical University, Anqing, Anhui, China
| | - Nv-Wei Cao
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, China
| | - Hao-Yue Zhou
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, China
| | - Xiu-Jie Chu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, China
| | - Hua Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, China
| | - Xian-Bao Li
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, China
| | - Bao-Zhu Li
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, China.
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Zhu W, Wei X, Zhang L, Shi Q, Shi G, Zhang X, Wang M, Yin C, Kang F, Bai Y, Nie Y, Zheng S. The effect and prediction of diurnal temperature range in high altitude area on outpatient and emergency room admissions for cardiovascular diseases. Int Arch Occup Environ Health 2021; 94:1783-1795. [PMID: 33900441 DOI: 10.1007/s00420-021-01699-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 02/18/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE Diurnal temperature range (DTR) is a meteorological indicator closely associated with global climate change. Thus, we aim to explore the effects of DTR on the outpatient and emergency room (O&ER) admissions for cardiovascular diseases (CVDs), and related predictive research. METHODS The O&ER admissions data for CVDs from three general hospitals in Jinchang of Gansu Province were collected from 2013 to 2016. A generalized additive model (GAM) with Poisson regression was employed to analyze the effect of DTR on the O&ER admissions for all cardiovascular diseases, hypertension, ischemic heart disease (IHD) and stoke. GAM was also used to preform predictive research of the effect of DTR on the O&ER admissions for CVDs. RESULTS There were similar positive linear relationships between DTR and the O&ER visits with the four cardiovascular diseases. And the cumulative lag effects were higher than the single lag effects. A 1 °C increase in DTR corresponded to a 1.30% (0.99-1.62%) increase in O&ER admissions for all cardiovascular diseases. Males and elderly were more sensitivity to DTR. The estimates in non-heating season were higher than in heating season. The trial prediction accuracy rate of CVDs based on DTR was between 59.32 and 74.40%. CONCLUSIONS DTR has significantly positive association with O&ER admissions for CVDs, which can be used as a prediction index of the admissions of O&ER with CVDs.
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Affiliation(s)
- Wenzhi Zhu
- Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, 730000, China
| | - Xingfu Wei
- Gansu Provincial Maternity and Child-Care Hospital, Lanzhou, 730000, China
| | - Li Zhang
- Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, 730000, China
| | - Qin Shi
- Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, 730000, China
| | - Guoxiu Shi
- Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, 730000, China
| | - Xiaofei Zhang
- Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, 730000, China
| | - Minzhen Wang
- Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, 730000, China
| | - Chun Yin
- Workers' Hospital of Jinchuan Group Co., Ltd., Jinchang, 737102, China
| | - Feng Kang
- Workers' Hospital of Jinchuan Group Co., Ltd., Jinchang, 737102, China
| | - Yana Bai
- Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, 730000, China
| | - Yonghong Nie
- Jinchang Center for Disease Prevention and Control, Jinchang, 737100, China.
| | - Shan Zheng
- Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, 730000, China.
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Wang L, Xu C, Xiao G, Qiao J, Zhang C. Spatial heterogeneity of bacillary dysentery and the impact of temperature in the Beijing-Tianjin-Hebei region of China. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2021; 65:1919-1927. [PMID: 34050434 DOI: 10.1007/s00484-021-02148-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 12/29/2020] [Accepted: 05/15/2021] [Indexed: 06/12/2023]
Abstract
Previous studies indicate that the incidence of bacillary dysentery is closely related to meteorological factors. However, the impact of temperature and the spatial heterogeneity of the disease in regions of unbalanced socioeconomic development remains unclear. Therefore, this research collected data for 29,639 daily bacillary dysentery cases in children under 5 years of age, as well as the meteorological variables from China's Beijing-Tianjin-Hebei region, to analyze the spatial pattern of bacillary dysentery and reveal its nonlinear association with temperature. The SatScan method was employed first, to detect the spatial heterogeneity of the disease risk, and then the distributed lag nonlinear model (DLNM) was used to analyze the relationships between the daily minimum, mean, and maximum temperatures and bacillary dysentery in the stratified heterogeneous regions. The results indicated that bacillary dysentery incidence presented statistically significant spatial heterogeneity. The area of highest risk was found to be Beijing and its neighboring regions, which have high population densities. There was also a positive association between bacillary dysentery and temperature. Hotter temperatures were accompanied by higher relative risks. In the most likely spatial cluster region, the excess risk (ER) values for a 1°C rise in minimum, mean, and maximum temperatures above the median were 4.65%, 11.30%, and 19.21%, respectively. The effect of temperature on bacillary dysentery peaked at a lag of 3 to 4 days. The findings of this study will aid risk assessments and early warning systems for bacillary dysentery.
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Affiliation(s)
- Li Wang
- College of Environment and Planning, Henan University, Kaifeng, 475001, China
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Science and Natural Resource Research, Chinese Academy of Sciences, Beijing, 100101, China
- Key Laboratory of Geospatial Technology for the Middle and Lower Yellow River Regions (Henan University), Ministry of Education, Kaifeng, 475001, China
| | - Chengdong Xu
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Science and Natural Resource Research, Chinese Academy of Sciences, Beijing, 100101, China
- University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Gexin Xiao
- National Institute of Hospital Administration, Beijing, 100044, China.
| | - Jiajun Qiao
- College of Environment and Planning, Henan University, Kaifeng, 475001, China
| | - Chaozheng Zhang
- China National Center for Food Safety Risk Assessment, Beijing, 100022, China
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Huang X, Ma W, Law C, Luo J, Zhao N. Importance of applying Mixed Generalized Additive Model (MGAM) as a method for assessing the environmental health impacts: Ambient temperature and Acute Myocardial Infarction (AMI), among elderly in Shanghai, China. PLoS One 2021; 16:e0255767. [PMID: 34383808 PMCID: PMC8360529 DOI: 10.1371/journal.pone.0255767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 07/23/2021] [Indexed: 11/18/2022] Open
Abstract
Association between acute myocardial infarction (AMI) morbidity and ambient temperature has been examined with generalized linear model (GLM) or generalized additive model (GAM). However, the effect size by these two methods might be biased due to the autocorrelation of time series data and arbitrary selection of degree of freedom of natural cubic splines. The present study analyzed how the climatic factors affected AMI morbidity for older adults in Shanghai with Mixed generalized additive model (MGAM) that addressed these shortcomings mentioned. Autoregressive random effect was used to model the relationship between AMI and temperature, PM10, week days and time. The degree of freedom of time was chosen based on the seasonal pattern of temperature. The performance of MGAM was compared with GAM on autocorrelation function (ACF), partial autocorrelation function (PACF) and goodness of fit. One-year predictions of AMI counts in 2011 were conducted using MGAM with the moving average. Between 2007 and 2011, MGAM adjusted the autocorrelation of AMI time series and captured the seasonal pattern after choosing the degree of freedom of time at 5. Using MGAM, results were well fitted with data in terms of both internal (R2 = 0.86) and external validity (correlation coefficient = 0.85). The risk of AMI was relatively high in low temperature (Risk ratio = 0.988 (95% CI 0.984, 0.993) for under 12°C) and decreased as temperature increased and speeded up within the temperature zone from 12°C to 26°C (Risk ratio = 0.975 (95% CI 0.971, 0.979), but it become increasing again when it is 26°C although not significantly (Risk ratio = 0.999 (95% CI 0.986, 1.012). MGAM is more appropriate than GAM in the scenario of response variable with autocorrelation and predictors with seasonal variation. The risk of AMI was comparatively higher when temperature was lower than 12°C in Shanghai as a typical representative location of subtropical climate.
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Affiliation(s)
- Xiaoqian Huang
- Department of Biostatistics, School of Public Health, Fudan University, Shanghai, China
- NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Weiping Ma
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
- Icahn Institute of Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Chikin Law
- NHMRC Clinical Trials Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Jianfeng Luo
- Department of Biostatistics, School of Public Health, Fudan University, Shanghai, China
- NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
- * E-mail:
| | - Naiqing Zhao
- Department of Biostatistics, School of Public Health, Fudan University, Shanghai, China
- NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
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Ma Y, Wen T, Xing D, Zhang Y. Associations between floods and bacillary dysentery cases in main urban areas of Chongqing, China, 2005-2016: a retrospective study. Environ Health Prev Med 2021; 26:49. [PMID: 33874880 PMCID: PMC8056597 DOI: 10.1186/s12199-021-00971-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 04/05/2021] [Indexed: 11/16/2022] Open
Abstract
Background Understanding the association between floods and bacillary dysentery (BD) incidence is necessary for us to assess the health risk of extreme weather events. This study aims at exploring the association between floods and daily bacillary dysentery cases in main urban areas of Chongqing between 2005 and 2016 as well as evaluating the attributable risk from floods. Methods The association between floods and daily bacillary dysentery cases was evaluated by using distributed lag non-linear model, controlling for meteorological factors, long-term trend, seasonality, and day of week. The fraction and number of bacillary dysentery cases attributable to floods was calculated. Subgroup analyses were conducted to explore the association across age, gender, and occupation. Results After controlling the impact of temperature, precipitation, relative humidity, long-term trend, and seasonality, a significant lag effect of floods on bacillary dysentery cases was found at 0-day, 3-day, and 4-day lag, and the cumulative relative risk (CRR) over a 7-lag day period was 1.393 (95%CI 1.216–1.596). Male had higher risk than female. People under 5 years old and people aged 15–64 years old had significantly higher risk. Students, workers, and children had significantly higher risk. During the study period, based on 7-lag days, the attributable fraction of bacillary dysentery cases due to floods was 1.10% and the attributable number was 497 persons. Conclusions This study confirms that floods can increase the risk of bacillary dysentery incidence in main urban areas of Chongqing within an accurate time scale, the risk of bacillary dysentery caused by floods is still serious. The key population includes male, people under 5 years old, students, workers, and children. Considering the lag effect of floods on bacillary dysentery, the government and public health emergency departments should advance to the emergency health response in order to minimize the potential risk of floods on public. Supplementary Information The online version contains supplementary material available at 10.1186/s12199-021-00971-z.
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Affiliation(s)
- Yang Ma
- School of Public Health and Management, Research Center for Medicine and Social Development, Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Yixueyuan Road, Yuzhong District, Chongqing, 400016, China
| | - Tong Wen
- School of Public Health and Management, Research Center for Medicine and Social Development, Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Yixueyuan Road, Yuzhong District, Chongqing, 400016, China
| | - Dianguo Xing
- Office of Health Emergency, Chongqing Municipal Health Commission, No.6, Qilong Road, Yubei District, Chongqing, 401147, China
| | - Yan Zhang
- School of Public Health and Management, Research Center for Medicine and Social Development, Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Yixueyuan Road, Yuzhong District, Chongqing, 400016, China.
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Liu Z, Tong MX, Xiang J, Dear K, Wang C, Ma W, Lu L, Liu Q, Jiang B, Bi P. Daily Temperature and Bacillary Dysentery: Estimated Effects, Attributable Risks, and Future Disease Burden in 316 Chinese Cities. ENVIRONMENTAL HEALTH PERSPECTIVES 2020; 128:57008. [PMID: 32452706 PMCID: PMC7266621 DOI: 10.1289/ehp5779] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 04/29/2020] [Accepted: 05/01/2020] [Indexed: 05/27/2023]
Abstract
BACKGROUND Bacillary dysentery (BD) remains a significant public health issue, especially in developing countries. Evidence assessing the risk of BD from temperature is limited, particularly from national studies including multiple locations with different climatic characteristics. OBJECTIVES We estimated the effect of temperature on BD across China, assessed heterogeneity and attributable risks across cities and regions, and projected the future risk of BD under climate change. METHODS Daily BD surveillance and meteorological data over 2014-2016 were collected from the Chinese Center for Disease Control and Prevention and the China Meteorology Administration, respectively. A two-stage statistical model was used to estimate city-specific temperature-BD relationships that were pooled to derive regional and national estimates. The risk of BD attributable to temperature was estimated, and the future burden of BD attributable to temperature was projected under different climate change scenarios. RESULTS A positive linear relationship for the pooled effect was estimated at the national level. Subgroup analyses indicate that the estimated effect of temperature on BD was similar by age (≤5y or >5y) and gender. At baseline, estimated attributable risks for BD due to average daily mean temperatures above the 50th percentile were highest for the Inner Mongolia (16%), Northeast China (14%), and Northern China (13%). Most of the individual cities in the same regions and most of the cities in the Northwest, Southern, and Southwest regions, had high attributable risks (≥5%). The Northern, Northeast, Inner Mongolia, Northwest, and Southern China regions were identified as high risk for future BD, with estimated increases by the 2090s compared with baseline of 20% (95% confidence interval: 11%, 27%), 15% (6%, 20%), 15% (-1%, 22%), 12% (1%, 19%), and 11% (5%, 15%), respectively, under Representative Concentration Pathway 8.5. CONCLUSIONS The positive association between temperature and BD in different climatic regions of China, and the projection for increased risk due to climate change, support efforts to mitigate future risks. https://doi.org/10.1289/EHP5779.
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Affiliation(s)
- Zhidong Liu
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, People's Republic of 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
| | - Jianjun Xiang
- School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia
| | - Keith Dear
- School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia
| | - Changke Wang
- National Climate Center, China Meteorological Administration, Beijing, People's Republic of China
| | - Wei Ma
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, People's Republic of China
- Climate Change and Health Center, Shandong University, Jinan, Shandong Province, People's Republic of China
| | - Liang Lu
- 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, People's Republic of China
| | - Qiyong Liu
- Climate Change and Health Center, Shandong University, Jinan, Shandong Province, People's Republic of 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, People's Republic of China
| | - Baofa Jiang
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, People's Republic of China
- Climate Change and Health Center, Shandong University, Jinan, Shandong Province, People's Republic of China
| | - Peng Bi
- School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia
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Hao Y, Liao W, Ma W, Zhang J, Zhang N, Zhong S, Wang Z, Yang L, Huang C. Effects of ambient temperature on bacillary dysentery: A multi-city analysis in Anhui Province, China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 671:1206-1213. [PMID: 31186130 DOI: 10.1016/j.scitotenv.2019.03.443] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 03/18/2019] [Accepted: 03/28/2019] [Indexed: 05/16/2023]
Abstract
BACKGROUND Rising ambient temperature is expected to increase incidence of bacillary dysentery (BD), but few studies have compared the temperature-BD effects of different age groups and cities in China, especially in a multi-city setting. OBJECTIVES We used city-specific data including BD cases and meteorological variables to determine the relationship between BD incidence and temperature at provincial level. METHODS Weekly BD disease surveillance data and meteorological variables were collected in all 16 prefecture-level cities in Anhui Province of China. Firstly, city-specific weekly mean temperature-BD incidence associations were estimated with Distributed Lag Nonlinear Model (DLNM). Secondly, city-specific estimates were pooled at province-level through multivariate meta-analysis. Also, we conducted subgroup analyses for ages (children <5 years old and population of other ages) and urbanization of cities (high and low level), respectively. RESULTS In Anhui, BD morbidity risk increased with increasing weekly mean temperature. Relative risks (RR) at the 90th percentile (27.5 °C) versus the 50th percentile (17 °C) of weekly mean temperature were 1.42 (95% confidence interval (CI): 1.16, 1.75) and 2.02 (95% CI: 1.76, 2.32) for children <5 and population of other ages, respectively. The relative risk of high temperature on other ages group was higher than that of children under five years old (p = 0.006). Children under 5 in high urbanized cities appeared to be more vulnerable to the effects of ambient high temperature (RR: 1.56, 95% CI: 1.20, 1.92) than in low urbanized cities (RR: 1.01, 95% CI: 0.70, 1.46), the difference between two intervals was statistically significant (p = 0.044). CONCLUSIONS This study suggests that high temperatures may be an important trigger of BD incidence, and especially lead to a substantial burden of BD for high urbanized cities in Anhui Province of China.
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Affiliation(s)
- Yanbin Hao
- Department of Health Policy and Management, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, Guangdong, China; Department of Preventive Medicine, Gannan Medical University, Ganzhou 341000, Jiangxi, China
| | - Wenmin Liao
- Department of Health Policy and Management, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, Guangdong, China
| | - Wanwan Ma
- Anhui Provincial Center for Disease Control and Prevention, Hefei 230601, Anhui, China
| | - Jin Zhang
- Anhui Provincial Center for Disease Control and Prevention, Hefei 230601, Anhui, China
| | - Na Zhang
- Department of Health Policy and Management, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, Guangdong, China
| | - Shuang Zhong
- Center for Chinese Public Administration Research, School of Government, Sun Yat-Sen University, Guangzhou 510080, Guangdong, China
| | - Zhe Wang
- Chinese Center for Disease Control and Prevention, 102206 Beijing, China.
| | - Lianping Yang
- Department of Health Policy and Management, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, Guangdong, China.
| | - Cunrui Huang
- Department of Health Policy and Management, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, Guangdong, China
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Song YJ, Cheong HK, Ki M, Shin JY, Hwang SS, Park M, Ki M, Lim J. The Epidemiological Influence of Climatic Factors on Shigellosis Incidence Rates in Korea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15102209. [PMID: 30309010 PMCID: PMC6210993 DOI: 10.3390/ijerph15102209] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 10/06/2018] [Accepted: 10/06/2018] [Indexed: 12/03/2022]
Abstract
Research has shown the effects of climatic factors on shigellosis; however, no previous study has evaluated climatic effects in regions with a winter seasonality of shigellosis incidence. We examined the effects of temperature and precipitation on shigellosis incidence in Korea from 2002–2010. The incidence of shigellosis was calculated based on data from the Korean Center for Disease Control and Prevention (KCDC, Cheongju, Korea), and a generalized additive model (GAM) was used to analyze the associations between the incidence and climatic factors. The annual incidence rate of shigellosis was 7.9 cases/million persons from 2002–2010. During 2007–2010, high incidence rates and winter seasonality were observed among those aged ≥65 years, but not among lower age groups. Based on the GAM model, the incidence of shigellosis is expected to increase by 13.6% and 2.9% with a temperature increase of 1 °C and a lag of two weeks and with a mean precipitation increase of 1 mm and a lag of five weeks after adjustment for seasonality, respectively. This study suggests that the incidence of shigellosis will increase with global climate change despite the winter seasonality of shigellosis in Korea. Public health action is needed to prevent the increase of shigellosis incidence associated with climate variations.
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Affiliation(s)
- Yeong-Jun Song
- Department of Preventive Medicine College of Medicine, Eulji University, Daejeon 34824, Korea.
| | - Hae-Kwan Cheong
- Department of Social and Preventive Medicine, Sungkyunkwan University School of Medicine, Suwon 16419, Korea.
| | - Myung Ki
- Department of Preventive Medicine, College of Medicine, Korea University, Seoul 02841, Korea.
| | - Ji-Yeon Shin
- Department of Preventive Medicine, School of Medicine, Kyungpook National University, Daegu 41944, Korea.
| | - Seung-Sik Hwang
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul 08826, Korea.
| | - Mira Park
- Department of Preventive Medicine College of Medicine, Eulji University, Daejeon 34824, Korea.
| | - Moran Ki
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang 10408, Korea.
| | - Jiseun Lim
- Department of Preventive Medicine College of Medicine, Eulji University, Daejeon 34824, Korea.
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Herrera D, Ellis A, Fisher B, Golden CD, Johnson K, Mulligan M, Pfaff A, Treuer T, Ricketts TH. Upstream watershed condition predicts rural children's health across 35 developing countries. Nat Commun 2017; 8:811. [PMID: 28993648 PMCID: PMC5634511 DOI: 10.1038/s41467-017-00775-2] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Accepted: 07/27/2017] [Indexed: 12/02/2022] Open
Abstract
Diarrheal disease (DD) due to contaminated water is a major cause of child mortality globally. Forests and wetlands can provide ecosystem services that help maintain water quality. To understand the connections between land cover and childhood DD, we compiled a database of 293,362 children in 35 countries with information on health, socioeconomic factors, climate, and watershed condition. Using hierarchical models, here we find that higher upstream tree cover is associated with lower probability of DD downstream. This effect is significant for rural households but not for urban households, suggesting differing dependence on watershed conditions. In rural areas, the effect of a 30% increase in upstream tree cover is similar to the effect of improved sanitation, but smaller than the effect of improved water source, wealth or education. We conclude that maintaining natural capital within watersheds can be an important public health investment, especially for populations with low levels of built capital.Globally diarrheal disease through contaminated water sources is a major cause of child mortality. Here, the authors compile a database of 293,362 children in 35 countries and find that upstream tree cover is linked to a lower probability of diarrheal disease and that increasing tree cover may lower mortality.
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Affiliation(s)
- Diego Herrera
- Gund Institute for Environment, University of Vermont, 617 Main Street Burlington, Burlington, VT, 05405, USA.
- Rubenstein School of Environment and Natural Resources, University of Vermont, Aiken Center 81 Carrigan Drive Burlington, Burlington, VT, 05405, USA.
- Environmental Defense Fund, 1875 Connecticut Ave NW # 600, Washington, DC, 20009, USA.
| | - Alicia Ellis
- Duke Clinical Research Institute, Duke University, 2400 Pratt St Durham, Durham, NC, 27705, USA
| | - Brendan Fisher
- Gund Institute for Environment, University of Vermont, 617 Main Street Burlington, Burlington, VT, 05405, USA
- Rubenstein School of Environment and Natural Resources, University of Vermont, Aiken Center 81 Carrigan Drive Burlington, Burlington, VT, 05405, USA
| | - Christopher D Golden
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA, 02115, USA
| | - Kiersten Johnson
- USAID Bureau for Food Security, 1300 Pennsylvania Ave NW, Washington, DC, 20004, USA
| | - Mark Mulligan
- Department of Geography, King's College London, London, WC2R 2LS, UK
| | - Alexander Pfaff
- Sanford School of Public Policy, Duke University, 201 Science Dr, Durham, NC, 27708, USA
| | - Timothy Treuer
- Department of Ecology and Evolutionary Biology, Princeton University, 117 Eno Hall Princeton, Princeton, NJ, 08544, USA
| | - Taylor H Ricketts
- Gund Institute for Environment, University of Vermont, 617 Main Street Burlington, Burlington, VT, 05405, USA
- Rubenstein School of Environment and Natural Resources, University of Vermont, Aiken Center 81 Carrigan Drive Burlington, Burlington, VT, 05405, USA
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Impact of meteorological factors on the incidence of bacillary dysentery in Beijing, China: A time series analysis (1970-2012). PLoS One 2017; 12:e0182937. [PMID: 28796834 PMCID: PMC5552134 DOI: 10.1371/journal.pone.0182937] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2017] [Accepted: 07/20/2017] [Indexed: 11/19/2022] Open
Abstract
Objectives Influence of meteorological variables on the transmission of bacillary dysentery (BD) is under investigated topic and effective forecasting models as public health tool are lacking. This paper aimed to quantify the relationship between meteorological variables and BD cases in Beijing and to establish an effective forecasting model. Methods A time series analysis was conducted in the Beijing area based upon monthly data on weather variables (i.e. temperature, rainfall, relative humidity, vapor pressure, and wind speed) and on the number of BD cases during the period 1970–2012. Autoregressive integrated moving average models with explanatory variables (ARIMAX) were built based on the data from 1970 to 2004. Prediction of monthly BD cases from 2005 to 2012 was made using the established models. The prediction accuracy was evaluated by the mean square error (MSE). Results Firstly, temperature with 2-month and 7-month lags and rainfall with 12-month lag were found positively correlated with the number of BD cases in Beijing. Secondly, ARIMAX model with covariates of temperature with 7-month lag (β = 0.021, 95% confidence interval(CI): 0.004–0.038) and rainfall with 12-month lag (β = 0.023, 95% CI: 0.009–0.037) displayed the highest prediction accuracy. Conclusions The ARIMAX model developed in this study showed an accurate goodness of fit and precise prediction accuracy in the short term, which would be beneficial for government departments to take early public health measures to prevent and control possible BD popularity.
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Talmoudi K, Bellali H, Ben-Alaya N, Saez M, Malouche D, Chahed MK. Modeling zoonotic cutaneous leishmaniasis incidence in central Tunisia from 2009-2015: Forecasting models using climate variables as predictors. PLoS Negl Trop Dis 2017; 11:e0005844. [PMID: 28841642 PMCID: PMC5589266 DOI: 10.1371/journal.pntd.0005844] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Revised: 09/07/2017] [Accepted: 07/31/2017] [Indexed: 11/22/2022] Open
Abstract
Transmission of zoonotic cutaneous leishmaniasis (ZCL) depends on the presence, density and distribution of Leishmania major rodent reservoir and the development of these rodents is known to have a significant dependence on environmental and climate factors. ZCL in Tunisia is one of the most common forms of leishmaniasis. The aim of this paper was to build a regression model of ZCL cases to identify the relationship between ZCL occurrence and possible risk factors, and to develop a predicting model for ZCL's control and prevention purposes. Monthly reported ZCL cases, environmental and bioclimatic data were collected over 6 years (2009-2015). Three rural areas in the governorate of Sidi Bouzid were selected as the study area. Cross-correlation analysis was used to identify the relevant lagged effects of possible risk factors, associated with ZCL cases. Non-parametric modeling techniques known as generalized additive model (GAM) and generalized additive mixed models (GAMM) were applied in this work. These techniques have the ability to approximate the relationship between the predictors (inputs) and the response variable (output), and express the relationship mathematically. The goodness-of-fit of the constructed model was determined by Generalized cross-validation (GCV) score and residual test. There were a total of 1019 notified ZCL cases from July 2009 to June 2015. The results showed seasonal distribution of reported ZCL cases from August to January. The model highlighted that rodent density, average temperature, cumulative rainfall and average relative humidity, with different time lags, all play role in sustaining and increasing the ZCL incidence. The GAMM model could be applied to predict the occurrence of ZCL in central Tunisia and could help for the establishment of an early warning system to control and prevent ZCL in central Tunisia.
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Affiliation(s)
- Khouloud Talmoudi
- National Engineering School of Tunis, ENIT, Tunis El Manar University, Tunis, Tunisia
- Research Unit on Modeling, Statistics and Economic Analysis (MASE, ESSAI), High School of Statistics and Information Analysis (ESSAI), University of Carthage, Tunis, Tunisia
- Department of Epidemiology and Statistics, Abderrahman Mami Hospital, Ariana, Tunisia
- Research Unit "Analysis of the Effects of Environmental and Climate Change on Health", Department of Epidemiology and Statistics, Abderrahmen Mami Hospital, Ariana, Tunisia
| | - Hedia Bellali
- Department of Epidemiology and Statistics, Abderrahman Mami Hospital, Ariana, Tunisia
- Research Unit "Analysis of the Effects of Environmental and Climate Change on Health", Department of Epidemiology and Statistics, Abderrahmen Mami Hospital, Ariana, Tunisia
- Department of Epidemiology and Public Health, Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Nissaf Ben-Alaya
- Department of Epidemiology and Public Health, Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
- National Observatory of New and Emergent Diseases, Tunis, Tunisia
| | - Marc Saez
- Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Girona, Spain
| | - Dhafer Malouche
- Research Unit on Modeling, Statistics and Economic Analysis (MASE, ESSAI), High School of Statistics and Information Analysis (ESSAI), University of Carthage, Tunis, Tunisia
| | - Mohamed Kouni Chahed
- Department of Epidemiology and Statistics, Abderrahman Mami Hospital, Ariana, Tunisia
- Research Unit "Analysis of the Effects of Environmental and Climate Change on Health", Department of Epidemiology and Statistics, Abderrahmen Mami Hospital, Ariana, Tunisia
- Department of Epidemiology and Public Health, Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
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Lee HS, Ha Hoang TT, Pham-Duc P, Lee M, Grace D, Phung DC, Thuc VM, Nguyen-Viet H. Seasonal and geographical distribution of bacillary dysentery (shigellosis) and associated climate risk factors in Kon Tam Province in Vietnam from 1999 to 2013. Infect Dis Poverty 2017. [PMID: 28637484 PMCID: PMC5480122 DOI: 10.1186/s40249-017-0325-z] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background Bacillary dysentery (BD) is an acute bacterial infection of the intestine caused by Shigella spp., with clinical symptoms ranging from fever to bloody diarrhoea to abdominal cramps to tenesmus. In Vietnam, enteric bacterial pathogens are an important cause of diarrhoea and most cases in children under 5 years of age are due to Shigella strains. The serogroups S. flexneri and S. sonnei are considered to be the most common. The main objective of this study was to, for the first time, assess the seasonal patterns and geographic distribution of BD in Vietnam, and to determine the climate risk factors associated with the incidence of BD in Kon Tum Province, where the highest rate of bacillary dysentery was observed from 1999 to 2013. Methods The seasonal patterns and geographic distribution of BD was assessed in Vietnam using a seasonal-trend decomposition procedure based on loess. In addition, negative binomial regression models were used to determine the climate risk factors associated with the incidence of BD in Kon Tum Province, from 1999 to 2013. Results Overall, incidence rates of BD have slightly decreased over time (except for an extremely high incidence in 2012 in the north of Vietnam). The central regions (north/south central coast and central highlands) had relatively high incidence rates, whereas the northwest/east and Red River Delta regions had low incidence rates. Overall, seasonal plots showed a high peak in the mid-rainy reason and a second smaller peak in the early or late rainy season. The incidence rates significantly increased between May and October (“wet season”) across the country. In Kon Tum Province, temperature, humidity, and precipitation were found to be positively associated with the incidence of BD. Conclusions Our findings provide insights into the seasonal patterns and geographic distribution of BD in Vietnam and its associated climate risk factors in Kon Tum Province. This study may help clinicians and the general public to better understand the timings of outbreaks and therefore equip them with the knowledge to plan better interventions (such as improving water, sanitation, and hygiene conditions) during peak seasons. This can, in turn, prevent or reduce outbreaks and onwards transmission during an outbreak. Electronic supplementary material The online version of this article (doi:10.1186/s40249-017-0325-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Hu Suk Lee
- International Livestock Research Institute (ILRI), Room 301-302, B1 Building, Van Phuc Diplomatic Compound, 298 Kim Ma Street, Ba Dinh District, Hanoi, Vietnam.
| | - T T Ha Hoang
- Department of Bacteriology, National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | - Phuc Pham-Duc
- Center for Public Health and Ecosystem Research, Hanoi University of Public Health, Hanoi, Vietnam
| | - Mihye Lee
- Medical Microbiology Department, The Royal Bournemouth Hospital, Bournemouth, UK
| | | | | | - Vu Minh Thuc
- Department of Bacteriology, National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | - Hung Nguyen-Viet
- International Livestock Research Institute (ILRI), Room 301-302, B1 Building, Van Phuc Diplomatic Compound, 298 Kim Ma Street, Ba Dinh District, Hanoi, Vietnam. .,Center for Public Health and Ecosystem Research, Hanoi University of Public Health, Hanoi, Vietnam.
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Liu X, Liu Z, Zhang Y, Jiang B. The Effects of Floods on the Incidence of Bacillary Dysentery in Baise (Guangxi Province, China) from 2004 to 2012. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14020179. [PMID: 28208681 PMCID: PMC5334733 DOI: 10.3390/ijerph14020179] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Revised: 02/07/2017] [Accepted: 02/08/2017] [Indexed: 11/29/2022]
Abstract
Research shows potential effects of floods on intestinal infections. Baise, a city in Guangxi Province (China) had experienced several floods between 2004 and 2012 due to heavy and constant precipitation. This study aimed to examine the relationship between floods and the incidence of bacillary dysentery in Baise. A mixed generalized additive model and Spearman correlation were applied to analyze the relationship between monthly incidence of bacillary dysentery and 14 flood events with two severity levels. Data collected from 2004 to 2010 were utilized to estimate the parameters, whereas data from 2011 to 2012 were used to validate the model. There were in total 9255 cases of bacillary dysentery included in our analyses. According to the mixed generalized additive model, the relative risks (RR) of moderate and severe floods on the incidence of bacillary dysentery were 1.40 (95% confidence interval (CI): 1.16–1.69) and 1.78 (95% CI: 1.61–1.97), respectively. The regression analysis also indicated that the flood duration was negatively associated with the incidence of bacillary dysentery (with RR: 0.57, 95% CI: 0.40–0.86). Therfore, this research suggests that floods exert a significant part in enhancing the risk of bacillary dysentery in Baise. Moreover, severe floods have a higher proportional contribution to the incidence of bacillary dysentery than moderate floods. In addition, short-term floods may contribute more to the incidence of bacillary dysentery than a long-term flood. The findings from this research will provide more evidence to reduce health risks related to floods.
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Affiliation(s)
- Xuena Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Shandong University, Jinan 250012, China.
- Center for Climate Change and Health, School of Public Health, Shandong University, Jinan 250012, China.
| | - Zhidong Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Shandong University, Jinan 250012, China.
- Center for Climate Change and Health, School of Public Health, Shandong University, Jinan 250012, China.
| | - Ying Zhang
- School of Public Health, China Studies Centre, the University of Sydney, New South Wales 2006, Australia.
| | - Baofa Jiang
- Department of Epidemiology and Health Statistics, School of Public Health, Shandong University, Jinan 250012, China.
- Center for Climate Change and Health, School of Public Health, Shandong University, Jinan 250012, China.
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Zhang F, Ding G, Liu Z, Zhang C, Jiang B. Association between flood and the morbidity of bacillary dysentery in Zibo City, China: a symmetric bidirectional case-crossover study. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2016; 60:1919-1924. [PMID: 27121465 DOI: 10.1007/s00484-016-1178-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Revised: 03/30/2016] [Accepted: 04/17/2016] [Indexed: 06/05/2023]
Abstract
This study examined the relationship between daily morbidity of bacillary dysentery and flood in 2007 in Zibo City, China, using a symmetric bidirectional case-crossover study. Odds ratios (ORs) and 95 % confidence intervals (CIs) on the basis of multivariate model and stratified analysis at different lagged days were calculated to estimate the risk of flood on bacillary dysentery. A total of 902 notified bacillary dysentery cases were identified during the study period. The median of case distribution was 7-year-old and biased to children. Multivariable analysis showed that flood was associated with an increased risk of bacillary dysentery, with the largest OR of 1.849 (95 % CI 1.229-2.780) at 2-day lag. Gender-specific analysis showed that there was a significant association between flood and bacillary dysentery among males only (ORs >1 from lag 1 to lag 5), with the strongest lagged effect at 2-day lag (OR = 2.820, 95 % CI 1.629-4.881), and the result of age-specific indicated that youngsters had a slightly larger risk to develop flood-related bacillary dysentery than older people at one shorter lagged day (OR = 2.000, 95 % CI 1.128-3.546 in youngsters at lag 2; OR = 1.879, 95 % CI 1.069-3.305 in older people at lag 3). Our study has confirmed that there is a positive association between flood and the risk of bacillary dysentery in selected study area. Males and youngsters may be the vulnerable and high-risk populations to develop the flood-related bacillary dysentery. Results from this study will provide recommendations to make available strategies for government to deal with negative health outcomes due to floods.
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Affiliation(s)
- Feifei Zhang
- Department of Epidemiology, School of Public Health, Shandong University, No. 44 Wenhuaxi Road, Jinan, 250012, China
- Shandong University Climate Change and Health Center, Jinan, Shandong Province, 250012, China
| | - Guoyong Ding
- Department of Epidemiology, School of Public Health, Taishan Medical University, Taian, Shandong Province, 271016, China
| | - Zhidong Liu
- Department of Epidemiology, School of Public Health, Shandong University, No. 44 Wenhuaxi Road, Jinan, 250012, China
- Shandong University Climate Change and Health Center, Jinan, Shandong Province, 250012, China
| | - Caixia Zhang
- Department of Epidemiology, School of Public Health, Shandong University, No. 44 Wenhuaxi Road, Jinan, 250012, China
- Shandong University Climate Change and Health Center, Jinan, Shandong Province, 250012, China
| | - Baofa Jiang
- Department of Epidemiology, School of Public Health, Shandong University, No. 44 Wenhuaxi Road, Jinan, 250012, China.
- Shandong University Climate Change and Health Center, Jinan, Shandong Province, 250012, China.
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Chang Z, Zhang J, Ran L, Sun J, Liu F, Luo L, Zeng L, Wang L, Li Z, Yu H, Liao Q. The changing epidemiology of bacillary dysentery and characteristics of antimicrobial resistance of Shigella isolated in China from 2004-2014. BMC Infect Dis 2016; 16:685. [PMID: 27863468 PMCID: PMC5116132 DOI: 10.1186/s12879-016-1977-1] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Accepted: 10/26/2016] [Indexed: 12/05/2022] Open
Abstract
Background Bacillary dysentery caused by bacteria of the genus Shigella is a significant public health problem in developing countries such as China. The objective of this study was to analyze the epidemiological pattern of bacillary dysentery, the diversity of the causative agent, and the antimicrobial resistance patterns of Shigella spp. for the purpose of determining the most effective allocation of resources and prioritization of interventions. Methods Surveillance data were acquired from the National Infectious Disease Information Reporting System (2004–2014) and from the sentinel hospital-based surveillance system (2005–2014). We analyzed the spatial and temporal distribution of bacillary dysentery, age and sex distribution, species diversity, and antimicrobial resistance patterns of Shigella spp. Results The surveillance registry included over 3 million probable cases of bacillary dysentery during the period 2004–2014. The annual incidence rate of bacillary dysentery decreased from 38.03 cases per 100,000 person-years in 2004 to 11.24 cases per 100,000 person-years in 2014. The case-fatality rate decreased from 0.028% in 2004 to 0.003% in 2014. Children aged <1 year and 1–4 years were most affected, with higher incidence rates (228.59 cases per 100,000 person-years and 92.58 cases per 100,000 person-years respectively). The annual epidemic season occurred between June and September. A higher incidence rate of bacillary dysentery was found in the Northwest region, Beijing and Tianjin during the study period. Shigella flexneri was the most prevalent species that caused bacillary dysentery in China (63.86%), followed by Shigella sonnei (34.89%). Shigella isolates were highly resistant to nalidixic acid (89.13%), ampicillin (88.90%), tetracycline (88.43%), and sulfamethoxazole (82.92%). During the study period, isolates resistant to ciprofloxacin and cefotaxime increased from 8.53 and 7.87% in 2005 to 44.65 and 29.94% in 2014, respectively. Conclusions The incidence rate of bacillary dysentery has undergone an obvious decrease from 2004 to 2014. Priority interventions should be delivered to populations in northwest China and to individuals aged <5 years. Antimicrobial resistance of Shigella is a serious public health problem and it is important to consider the susceptibility profile of isolates before determining treatment.
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Affiliation(s)
- Zhaorui Chang
- Division of Infectious Diseases, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing, 102206, People's Republic of China
| | - Jing Zhang
- Division of Infectious Diseases, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing, 102206, People's Republic of China
| | - Lu Ran
- Division of Infectious Diseases, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing, 102206, People's Republic of China
| | - Junling Sun
- Division of Infectious Diseases, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing, 102206, People's Republic of China
| | - Fengfeng Liu
- Division of Infectious Diseases, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing, 102206, People's Republic of China
| | - Li Luo
- Division of Infectious Diseases, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing, 102206, People's Republic of China
| | - Lingjia Zeng
- Division of Infectious Diseases, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing, 102206, People's Republic of China
| | - Liping Wang
- Division of Infectious Diseases, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing, 102206, People's Republic of China
| | - Zhongjie Li
- Division of Infectious Diseases, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing, 102206, People's Republic of China
| | - Hongjie Yu
- Division of Infectious Diseases, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing, 102206, People's Republic of China
| | - Qiaohong Liao
- Division of Infectious Diseases, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing, 102206, People's Republic of China.
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Guo C, Yang J, Guo Y, Ou QQ, Shen SQ, Ou CQ, Liu QY. Short-term effects of meteorological factors on pediatric hand, foot, and mouth disease in Guangdong, China: a multi-city time-series analysis. BMC Infect Dis 2016; 16:524. [PMID: 27682137 PMCID: PMC5041518 DOI: 10.1186/s12879-016-1846-y] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Accepted: 09/17/2016] [Indexed: 11/19/2022] Open
Abstract
Background Literature shows inconsistency in meteorological effects on Hand, foot, and mouth disease (HFMD) in different cities. This multi-city study aims to investigate the meteorological effects on pediatric HFMD occurrences and the potential effect modification by geographic factors. Methods Based on daily time-series data in eight major cities in Guangdong, China during 2009–2013, mixed generalized additive models were employed to estimate city-specific meteorological effects on pediatric HFMD. Then, a random-effect multivariate meta-analysis was conducted to obtain the pooled risks and to explore heterogeneity explained by city-level factors. Results There were a total of 400,408 pediatric HFMD cases (children aged 0–14 years old) with an annual incidence rate of 16.6 cases per 1,000 children, clustered in males and children under 3 years old. Daily average temperature was positively associated with pediatric HFMD cases with the highest pooled relative risk (RR) of 1.52 (95 % CI: 1.30–1.77) at the 95th percentile of temperature (30.5 °C) as compared to the median temperature (23.5 °C). Significant non-linear positive effects of high relative humidity were also observed with a 13 % increase (RR = 1.13, 95 % CI: 1.00–1.28) in the risk of HFMD at the 99th percentile of relative humidity (86.9 %) as compared to the median value (78 %). The effect estimates showed geographic variations among the cities which was significantly associated with city’s latitude and longitude with an explained heterogeneity of 32 %. Conclusions Daily average temperature and relative humidity had non-linear and delayed effects on pediatric HFMD and the effects varied across different cities. These findings provide important evidence for comprehensive understanding of the climatic effects on pediatric HFMD and for the authority to take targeted interventions and measures to control the occurrence and transmission of HFMD. Electronic supplementary material The online version of this article (doi:10.1186/s12879-016-1846-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Cui Guo
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, 510515, Guangdong, China
| | - Jun Yang
- State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, China
| | - Yuming Guo
- Division of Epidemiology and Biostatistics, School of Public Health, The University of Queensland, Brisbane, QLD, 4006, Australia
| | - Qiao-Qun Ou
- Department of Pediatrics, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, Guangdong, 510180, China
| | - Shuang-Quan Shen
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, 510515, Guangdong, China
| | - Chun-Quan Ou
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, 510515, Guangdong, China.
| | - Qi-Yong Liu
- State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, China.
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19
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Zhang XJ, Ma WP, Zhao NQ, Wang XL. Time series analysis of the association between ambient temperature and cerebrovascular morbidity in the elderly in Shanghai, China. Sci Rep 2016; 6:19052. [PMID: 26750421 PMCID: PMC4707484 DOI: 10.1038/srep19052] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Accepted: 12/02/2015] [Indexed: 11/24/2022] Open
Abstract
Research on the association between ambient temperature and cerebrovascular morbidity is scarce in China. In this study, we applied mixed generalized additive model (MGAM) to daily counts of cerebrovascular disease of Shanghai residents aged 65 years or older from 2007-2011, stratified by gender. Weighted daily mean temperature up to lags of one week was smoothed by natural cubic spline, and was added into the model to assess both linear and nonlinear effects of temperature. We found that when the mean temperature increased by 1 °C, the male cases of cerebrovascular disease reduced by 0.95% (95% Confidence Interval (CI): 0.80%, 1.10%) or reduced by 0.34% (95% CI: -0.68, 1.36%) in conditions of temperature was below or above 27 °C. However, for every 1 °C increase in temperature, the female cases of cerebrovascular disease increased by 0.34% (95% CI: -0.26%, 0.94%) or decreased by 0.92% (95% CI: 0.72, 1.11%) in conditions of temperature was below or above 8 °C, respectively. Temperature and cerebrovascular morbidity is negatively associated in Shanghai. MGAM is recommended in assessing the association between environmental hazards and health outcomes in time series studies.
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Affiliation(s)
- Xian-Jing Zhang
- Shanghai Insurance Medical Center, Shanghai 200032, People’s Republic of China
| | - Wei-Ping Ma
- Department of Biostatistics, School of Public Health and Key Laboratory of Public Health Safety, Fudan University, Shanghai 200032, People’s Republic of China
- Department of Genetics and Genomics Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, US
| | - Nai-Qing Zhao
- Department of Biostatistics, School of Public Health and Key Laboratory of Public Health Safety, Fudan University, Shanghai 200032, People’s Republic of China
| | - Xi-Ling Wang
- Department of Biostatistics, School of Public Health and Key Laboratory of Public Health Safety, Fudan University, Shanghai 200032, People’s Republic of China
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20
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Ma Y, Zhang T, Liu L, Lv Q, Yin F. Spatio-Temporal Pattern and Socio-Economic Factors of Bacillary Dysentery at County Level in Sichuan Province, China. Sci Rep 2015; 5:15264. [PMID: 26469274 PMCID: PMC4606827 DOI: 10.1038/srep15264] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Accepted: 09/21/2015] [Indexed: 11/16/2022] Open
Abstract
Bacillary dysentery (BD) remains a big public health problem in China. Effective spatio-temporal monitoring of BD incidence is important for successful implementation of control and prevention measures. This study aimed to examine the spatio-temporal pattern of BD and analyze socio-economic factors that may affect BD incidence in Sichuan province, China. Firstly, we used space-time scan statistic to detect the high risk spatio-temporal clusters in each year. Then, bivariate spatial correlation and Bayesian spatio-temporal model were utilized to examine the associations between the socio-economic factors and BD incidence. Spatio-temporal clusters of BD were mainly located in the northern-southern belt of the midwest area of Sichuan province. The proportion of primary industry, the proportion of rural population and the rates of BD incidence show statistically significant positive correlation. The proportion of secondary industry, proportion of tertiary Industry, number of beds in hospitals per thousand persons, medical and technical personnel per thousand persons, per capital GDP and the rate of BD incidence show statistically significant negative correlation. The best fitting spatio-temporal model showed that medical and technical personnel per thousand persons and per capital GDP were significantly negative related to the risk of BD.
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Affiliation(s)
- Yue Ma
- West China School of Public Health, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Tao Zhang
- West China School of Public Health, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Lei Liu
- Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan, People's Republic of China
| | - Qiang Lv
- Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan, People's Republic of China
| | - Fei Yin
- West China School of Public Health, Sichuan University, Chengdu, Sichuan, People's Republic of China
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21
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Wang Y, Li J, Gu J, Zhou Z, Wang Z. Artificial neural networks for infectious diarrhea prediction using meteorological factors in Shanghai (China). Appl Soft Comput 2015. [DOI: 10.1016/j.asoc.2015.05.047] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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22
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High mean water vapour pressure promotes the transmission of bacillary dysentery. PLoS One 2015; 10:e0124478. [PMID: 25946209 PMCID: PMC4422751 DOI: 10.1371/journal.pone.0124478] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Accepted: 03/09/2015] [Indexed: 12/02/2022] Open
Abstract
Bacillary dysentery is an infectious disease caused by Shigella dysenteriae, which has a seasonal distribution. External environmental factors, including climate, play a significant role in its transmission. This paper identifies climate-related risk factors and their role in bacillary dysentery transmission. Harbin, in northeast China, with a temperate climate, and Quzhou, in southern China, with a subtropical climate, are chosen as the study locations. The least absolute shrinkage and selectionator operator is applied to select relevant climate factors involved in the transmission of bacillary dysentery. Based on the selected relevant climate factors and incidence rates, an AutoRegressive Integrated Moving Average (ARIMA) model is established successfully as a time series prediction model. The numerical results demonstrate that the mean water vapour pressure over the previous month results in a high relative risk for bacillary dysentery transmission in both cities, and the ARIMA model can successfully perform such a prediction. These results provide better explanations for the relationship between climate factors and bacillary dysentery transmission than those put forth in other studies that use only correlation coefficients or fitting models. The findings in this paper demonstrate that the mean water vapour pressure over the previous month is an important predictor for the transmission of bacillary dysentery.
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23
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Nie C, Li H, Yang L, Zhong G, Zhang L. Socio-economic factors of bacillary dysentery based on spatial correlation analysis in Guangxi Province, China. PLoS One 2014; 9:e102020. [PMID: 25036182 PMCID: PMC4103826 DOI: 10.1371/journal.pone.0102020] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Accepted: 06/14/2014] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND In the past decade, bacillary dysentery was still a big public health problem in China, especially in Guangxi Province, where thousands of severe diarrhea cases occur every year. METHODS Reported bacillary dysentery cases in Guangxi Province were obtained from local Centers for Diseases Prevention and Control. The 14 socio-economic indexes were selected as potential explanatory variables for the study. The spatial correlation analysis was used to explore the associations between the selected factors and bacillary dysentery incidence at county level, which was based on the software of ArcGIS10.2 and GeoDA 0.9.5i. RESULTS The proportion of primary industry, the proportion of younger than 5-year-old children in total population, the number of hospitals per thousand persons and the rates of bacillary dysentery incidence show statistically significant positive correlation. But the proportion of secondary industry, per capital GDP, per capital government revenue, rural population proportion, popularization rate of tap water in rural area, access rate to the sanitation toilets in rural, number of beds in hospitals per thousand persons, medical and technical personnel per thousand persons and the rate of bacillary dysentery incidence show statistically significant negative correlation. The socio-economic factors can be divided into four aspects, including economic development, health development, medical development and human own condition. The four aspects were not isolated from each other, but interacted with each other.
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Affiliation(s)
- Chengjing Nie
- School of Public Administration and Policy, Hebei University of Economics and Business, Shijiazhuang, China; Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Science, Beijing, China
| | - Hairong Li
- Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Science, Beijing, China
| | - Linsheng Yang
- Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Science, Beijing, China
| | - Gemei Zhong
- Institute of Environmental Health and Endemic Disease Prevention, Guangxi Center for Disease Prevention and Control, Nanning, Guangxi
| | - Lan Zhang
- Institute for Environmental Health and Related Product Safety, Chinese Center for Disease Control and Prevention, Beijing, China
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24
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Li Z, Wang L, Sun W, Hou X, Yang H, Sun L, Xu S, Sun Q, Zhang J, Song H, Lin H. Identifying high-risk areas of bacillary dysentery and associated meteorological factors in Wuhan, China. Sci Rep 2013; 3:3239. [PMID: 24257434 PMCID: PMC3836034 DOI: 10.1038/srep03239] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2013] [Accepted: 11/01/2013] [Indexed: 11/18/2022] Open
Abstract
Spatial distribution of bacillary dysentery incidence was mapped at the district level in Wuhan, China. And a generalized additive time series model was used to examine the effect of daily weather factors on bacillary dysentery in the high-risk areas, after controlling for potential confounding factors. Central districts were found to be the high-risk areas. The time series analysis found an acute effect of meteorological factors on bacillary dysentery occurrence. A positive association was found for mean temperature (excess risk (ER) for 1°C increase being 0.94% (95% confidence interval (CI): 0.46% to 1.43% on the lag day 2), while a negative effect was observed for relative humidity and rainfall, the ER for 1% increase in relative humidity was −0.21% (95% CI: −0.34% to −0.08%), and the ER for 1 mm increase in rainfall was −0.23% (95% CI: −0.37% to −0.09%). This study suggests that bacillary dysentery prevention and control strategy should consider local weather variations.
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Affiliation(s)
- Zhenjun Li
- 1] State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention; Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases [2]
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