摘要
目的分析北京市手足口病的流行特征,探讨日均气温对手足口病发病的短期滞后效应。方法收集2009年1月至2018年12月北京市西城区、朝阳区以及昌平区手足口病的病例资料以及同期气象数据,利用分布滞后模型探索北京市气温与手足口病发病的累计相对危险度与短期滞后效应。结果2009至2018年北京市西城区、朝阳区以及昌平区累计确诊手足口病97210例。手足口病年发病率在各区存在差异,西城区的年均发病率最低,为71.83/10万;三区合计年均发病率为146.89/10万,病例集中于每年5~7月,并在10~11月出现小高峰。男女发病比例为1.49∶1,患者年龄为3.08(1.89,4.39)岁,6岁以下患儿占比呈逐年下降趋势(Z=-30.11,P<0.01)。分布滞后模型显示日均气温对手足口病发病的累计相对危险度曲线呈双峰分布,峰值出现在4℃和26℃,累计RR值分别为1.36(95%CI:1.05~1.76)和1.35(95%CI:1.10~1.66)。结论北京市手足口病年发病率在各区存在差异,西城区的年均发病率最低;此外,手足口病发病存在季节性,春夏季发病高于秋冬季;日均气温对手足口病的发病存在滞后效应,且高温和低温对手足口病发病的影响存在差异。
Objective To analyze the epidemic characteristics of hand,foot and mouth disease(HFMD)in Beijing and explore the short-term lag effect of daily average temperature on HFMD.Methods The incidence data and meteorological data of HFMD were collected from Xicheng District,Chaoyang District,and Changping District of Beijing between January 2009 and December 2018.The dose-response relationship and short-term lag effect of temperature and HFMD incidence were explored by the distributed lag non-linear model(DNLM).Results From 2009 to 2018,a total of 97210 cases of HFMD were confirmed in Xicheng District,Chaoyang District,and Changping District of Beijing.The incidence rate of HFMD in Xicheng district was 71.83/100000,which was the lowest in three districts.The total annual average incidence was 146.89/100000 in the three districts.The cases were concentrated from May to July,with a small peak in October to November.The ratio of male to female was 1.49∶1,and the median age of the patients was 3.08(1.89,4.39)years old,which showed a decreasing trend in children under 6 years old(Z=-30.11,P<0.01).The DNLM showed that the cumulative relative risk(RR)curve had a bimodal distribution,with RR of 1.36(95%CI:1.05-1.76)and 1.35(95%CI:1.10-1.66),and the peak values appeared at 4℃and 26℃,respectively.Conclusions The incidence rate of HFMD in Xicheng was the lowest in three districts of Beijing.In addition,the incidence of HFMD is seasonal,and the incidence is higher in spring and summer than that in autumn and winter.Daily average temperature had a lag effect on HFMD,which was different between high temperature and low temperature.
作者
李昆
武泽昊
刘国涛
李宏通
王红增
彭亚光
Li Kun;Wu Zehao;Liu Guotao;Li Hongtong;Wang Hongzeng;Peng Yaguang(Center for Clinical Epidemiology and Evidence-based Medicine,Beijing Children′s Hospital,Capital Medical University,National Center for Children Health,Beijing 100045,China;Xicheng District Center for Disease Control and Prevention,Beijing 100120,China;Changping District Center for Disease Control and Prevention,Beijing 102200,China;Department of Prevention and Health Protection,Beijing United Family Hospital,Beijing 100015,China)
出处
《中华医学杂志》
CAS
CSCD
北大核心
2020年第34期2696-2700,共5页
National Medical Journal of China
基金
北京市委组织部优秀人才项目(2017000021469G245)。
关键词
手足口病
流行病学
分布滞后模型
Hand,foot and mouth disease
Epidemiology
Distributed lag non-linear model
