成都市暴雨洪涝灾害对其它感染性腹泻发病影响及脆弱人群分析  

Influence of floods on incidence of other infectious diarrhea and vulnerable population in Chengdu city

作　　者：劳家辉 刘志东 刘言玉 张静 姜宝法 LAO Jia-hui;LIU Zhi-dong;LIU Yan-yu(Department of Epidemiology, School of Public Health, Shandong University, Ji'nan, Shandong Province 250012, China)

机构地区：[1]山东大学公共卫生学院流行病学系

出　　处：《中国公共卫生》2019年第8期1046-1049,共4页Chinese Journal of Public Health

基　　金：国家科技基础资源调查专项(2017FY101202)

摘　　要：目的探讨四川省成都市暴雨洪涝灾害对其它感染性腹泻发病的影响,筛查脆弱人群。方法收集成都市2008-2012年其它感染性腹泻旬发病数据、暴雨洪涝数据、气象数据,并整理成时间序列的形式。利用分布滞后非线性模型(DLNM)定量评估暴雨洪涝对其它感染性腹泻的滞后效应。将人群按不同性别、年龄分成亚组进行分析以发现脆弱人群。结果 2008-2012年成都市共发生7次暴雨洪涝灾害。滞后2、3、4旬时,暴雨洪涝灾害可增加其它感染性腹泻的发病风险,RR值分别为1.09 (95%CI=1.01~1.17)、1.11 (95%CI=1.02~1.20)、1.12 (95%CI=1.04~1.21),其他滞后期结果无统计学意义。脆弱人群分别为0~4岁男童(lag4,RR=1.10,95%CI=1.00~1.20)、0~4岁女童(lag5,RR=1.14,95%CI=1.02~1.28)、5~14岁女性(lag3,RR=1.64,95%CI=1.22~2.20)、≥65岁女性(lag2,RR=1.35,95%CI=1.02~1.77)。结论在成都市范围内,暴雨洪涝灾害可增加其它感染性腹泻的发病风险,且具有滞后效应;洪涝灾害发生后,有关部门应针对脆弱人群采取措施以控制其它感染性腹泻的流行。Objective To examine the influence of floods on the incidence of other infectious diarrhea and to identify vulnerable populations in Chengdu city. Methods We collected data on incidence of other infectious diarrhea, floods, and meteorology for Chengdu city from 2008 to 2012 and rearranged the data in time sequence. Then we analyzed the data to quantitatively assess the lag effect of floods on the incidence of other infectious diarrhea using distributed lag nonlinear model(DLNM) and we performed the analysis for people groups of different gender and age to identify populations vulnerable to floods-related incidence of the disease. Results There were 7 floods events in Chengdu city during the 5-year period. Floods events increased the risk of other infectious diarrhea incidence for lag days 20 till lag days 40 among the residents in Chengdu city, with the other infectious diarrhea incidence risk ratio [RR] of 1.09(95% confidence interval[95% CI]: 1.01 – 1.17) at lag day 20, 1.11(95% CI: 1.02 – 1.20) at lag day 30, and 1.12(95% CI: 1.04 – 1.21) at lag day 40,respectively. The people more susceptible to floods-related incidence of other infectious diarrhea were 0 – 4 year old boys and girls with the RR of 1.10(95% CI: 1.00 – 1.20) at lag day 40 and the RR of 1.14(95% CI: 1.02 – 1.28) at lag day 50, 5 –14 year old girls with the RR of 1.64(95% CI: 1.22 – 2.20) at lag day 30, and≥65 years old women with the RR of 1.35(95% CI: 1.02 – 1.77) at lag day 20. Conclusion Floods, with a lagged effect, can increase the risk of other infectious diarrhea incidence among residents in Chengdu city. The results suggest that relevant measures should be implemented after floods events for the prevention of other infectious diarrhea incidence, especially among vulnerable populations.

关 键 词：暴雨洪涝灾害 其它感染性腹泻 脆弱人群 分布滞后非线性模型(DLNM) 成都市 

分 类 号：R181.3[医药卫生—流行病学]