基于分布滞后非线性模型探讨上海市诺如病毒感染性腹泻的发病与气象因素的关联  

Exploration of the association between meteorological factors and positive rate of norovirus infectious diarrhea based on the distributed lag non-linear model in Shanghai

作　　者：周士夏 张海洋 王丽萍[3] 刘玮 方立群 国家科技重大专项腹泻症候群监测团队 ZHOU Shi-xia;ZHANG Hai-yang;WANG Li-ping;LIU Wei;FANG Li-qun;National Science and Technology Major Project Etiology of Diarrhea Surveillance Study Team(School of Public Health,Anhui Medical University,Hefei 230032,China;State Key Laboratory of Pathogen and Biosecurity,Beijing Institute of Microbiology and Epidemiology,Beijing 100071,China;Division of Infectious Disease,Key Laboratory of Surveillance and Early-warning on Infectious Disease,Chinese Center for Disease Control and Prevention,Beijing 102206,China;Department of Laboratorial Science and Technology,School of Public Health,Peking University,Beijing 100191,China;不详)

机构地区：[1]安徽医科大学公共卫生学院,合肥230032 [2]军事医学研究院微生物流行病研究所病原微生物生物安全国家重点实验室,北京100071 [3]中国疾病预防控制中心传染病预防控制处传染病监测预警重点实验室,北京102206 [4]北京大学公共卫生学院卫生检验学系,北京100191 [5]不详

出　　处：《中华疾病控制杂志》2021年第10期1180-1185,1193,共7页Chinese Journal of Disease Control & Prevention

基　　金：国家科技重大专项(2018ZX10713001,2018ZX10713002,2018ZX10201001)。

摘　　要：目的探讨上海市腹泻患者中诺如病毒感染与气象因素的关联,为诺如病毒感染性腹泻的防控提供科学依据。方法收集上海市2012—2019年腹泻病例与上海市各气象监测点逐日气象资料,利用分布滞后非线性模型(distributed lag non-linear model,DLNM)分析诺如病毒感染性腹泻的发病与气象因素的关联。结果在21148名腹泻入院的就诊患者中,诺如病毒检出率为18.75%。其中45~<60岁人群的检出率最高(22.72%)。DLNM结果显示,相对于日平均气温18℃(P50),当日平均气温为-6℃时对诺如病毒感染的影响最大(RR=3.06,95%CI:1.49~6.30);日平均气温在滞后2 d时对诺如病毒感染产生最大影响(RR=1.15,95%CI:1.02~1.29)。相对于日降水量0 mm(P50),当日降水量195 mm时出现最大负效应(RR=0.31,95%CI:0.06~1.66)。结论上海市腹泻入院就诊患者的诺如病毒感染率较高,低温增加诺如病毒感染性腹泻发病风险,应根据诺如病毒流行特征针对性地开展防控工作。Objective To explore the association between norovirus among diarrheal patients and meteorological factors in Shanghai,and to provide a scientific basis for the prevention and control of norovirus infectious diarrhea.Methods We collected the data of diarrhea in Shanghai from 2012 to 2019 and the daily meteorological data of all meteorological monitoring points in Shanghai.A distributed lag non-linear model(DLNM)was constructed to analyze the relationship between norovirus infections diarrhea and meteorological factors.Results 18.75%of the 21148 diarrheal patients were found norovirus.Age group of 45~<60 years old patients were found with the highest positive percentage(22.72%).Compared with the daily average temperature of 18℃(P50),the daily average temperature of-6℃had the greatest impact on norovirus infection(RR=3.06,95%CI:1.49-6.30);the average daily temperature lagging by 2 days has a maximum impact on norovirus infection(RR=1.15,95%CI:1.02-1.29).Compared with the daily precipitation of 0 mm(P50),the highest negative effect was associated with daily precipitation of 195 mm(RR=0.31,95%CI:0.06-1.66).Conclusions The rate of norovirus infection in patients in Shanghai is high,and low temperature increases the risk of norovirus infectious diarrhea.Targeted prevention and control work should be carried out according to the characteristics of norovirus epidemic.

关 键 词：诺如病毒 哨点监测 分布滞后非线性模型 腹泻 

分 类 号：R183.4[医药卫生—流行病学]