前期降水条件在安徽省极端降雨对细菌性痢疾发病影响中的调节作用

Moderation effect of antecedent rainfall conditions on incidence of bacillary dysentery following heavy rainfall in Anhui Province

  • 摘要:
    背景 气候变化导致极端降雨事件频发,细菌性痢疾发病率较高且与极端降雨关系较为密切,极端降雨及其前期降水条件对该病发病影响值得关注。

    目的 定量分析前期降水条件在安徽省极端降雨对细菌性痢疾发病影响中的调节作用,并探讨该作用在城乡间的差异。

    方法 收集2006年1月1日—2017年8月31日期间安徽省CN05.1气象数据和细菌性痢疾病例数据。构建安徽省极端降雨事件与当日发病例数的暴露反应泊松回归模型,探讨前期降水条件在极端降雨事件对细菌性痢疾发病影响中的调节作用,并进一步按城乡分层分析。

    结果 本研究共纳入细菌性痢疾病例129459例,日均30.39例。研究发现,与前期干燥且无极端降雨的情况相比,前期干燥且存在极端降雨的情形对全省人群细菌性痢疾发病影响无明显差异(P>0.05),但前期湿润却会显著增加极端降雨后全省人群的细菌性痢疾发病风险(前期湿润却无极端降雨:RR=1.281,95%CI:1.264~1.298;前期湿润且存在极端降雨:RR=1.267,95%CI:1.167~1.376)。城乡分层后,前期降水条件同样显示出在极端降雨事件中对细菌性痢疾发病的调节作用:与前期干燥且无极端降雨的情况相比,前期干燥且存在极端降雨的情形对城市和农村人群细菌性痢疾发病无明显影响(均P>0.05)。但在城市或农村地区,前期湿润且无极端降雨时(城市:RR=1.391,95%CI:1.362~1.421;农村:RR=1.222,95%CI:1.201~1.243)及前期湿润且存在极端降雨时(城市:RR=1.364,95%CI:1.193~1.559;农村:RR=1.218,95%CI:1.098~1.352)细菌性痢疾发病风险均升高。

    结论 在极端降雨对安徽省细菌性痢疾发病影响中,前期降水条件在全省及城市和农村均存在一定调节作用,前期湿润条件下其发病风险升高。

     

    Abstract:
    Background Climate change leads to frequent heavy rainfall events, and higher incidences of bacillary dysentery after heavy rainfall have been observed. The impacts of heavy rainfall and its antecedent rainfall conditions on the disease are worth paying attention to.

    Objective To quantitatively analyze how the relationship between heavy rainfall events and bacillary dysentery occurrence is modified by antecedent rainfall conditions in Anhui Province and explore the different moderation effects in urban and rural contexts.

    Methods CN05.1 meteorological data of Anhui Province and cases of bacillary dysentery of the same area were collected from January 1, 2006 to August 31, 2017. An exposure-response Poisson regression model of heavy rainfall events and the number of daily cases was constructed to explore the moderation effect of antecedent rainfall conditions on the incidence of bacillary dysentery, and further stratified by urban and rural areas.

    Results This study included 129 459 cases of bacillary dysentery, with a daily average of 30.39. Compared with dry antecedent conditions without heavy rainfall, dry antecedent conditions with heavy rainfall had no obvious different effect on the incidence of bacillary dysentery for the whole province (P>0.05). But wet antecedent conditions significantly increased the risk of bacillary dysentery for the whole province after heavy rainfall (wet antecedent conditions without heavy rainfall:RR=1.281, 95%CI: 1.264-1.298; wet antecedent conditions with heavy rainfall: RR=1.267, 95%CI: 1.167-1.376). After urban and rural stratification, antecedent rainfall conditions also showed a significant moderation effect on the incidence of bacillary dysentery following heavy rainfall events. Compared with dry antecedent conditions without heavy rainfall, dry antecedent conditions with heavy rainfall had no obvious effect on the incidence of bacillary dysentery for the urban and the rural populations (P > 0.05). However, wet antecedent conditions without heavy rainfall (urban: RR=1.391, 95%CI: 1.362-1.421; rural: RR=1.222, 95%CI: 1.201-1.243) and wet antecedent conditions with heavy rainfall (urban: RR=1.364, 95%CI: 1.193-1.559; rural: RR=1.218, 95%CI: 1.098-1.352) significantly increased the risk of bacillary dysentery in both rural and urban areas.

    Conclusion In the influence of heavy rainfall on the incidence of bacillary dysentery in Anhui Province, antecedent rainfall conditions have a certain moderation effect in the whole province and in both urban and rural areas, and the risk of bacillary dysentery is increased under wet antecedent conditions.

     

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