基于两阶段模型探究平均温度和相对湿度与广西恙虫病的暴露滞后反应关系研究  

Exploring the exposure-lag-response relationship between mean temperature,relative humidity and scrub typhus in Guangxi based on a two-stage model

作　　者：倪志松 李树芬 席睿 梁珂梦 宋思豪 程传龙 左慧 鲁亮[2] 李秀君 NI Zhisong;LI Shufen;XI Rui;LIANG Kemeng;SONG Sihao;CHENG Chuanlong;ZUO Hui;LU Liang;LI Xiujun(l.School of Public Health,Cheeloo College of Medicine,Shandong University,Jinan 250012,China;National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases,National Institute for Communicable Disease Control and Prevention,Chinese Center for Disease Control and Prevention)

机构地区：[1]山东大学齐鲁医院公共卫生学院生物统计学系,山东济南250012 [2]传染病溯源预警与智能决策全国重点实验室,中国疾病预防控制中心传染病预防控制所

出　　处：《中国病原生物学杂志》2025年第5期587-591,596,共6页Journal of Pathogen Biology

基　　金：国家重点研发计划项目(No.2023YFC2604401);国家自然科学基金项目(No.81673238)。

摘　　要：目的探索平均温度及相对湿度对广西恙虫病发病的影响。方法收集2006-2021年广西各城市的恙虫病发病资料、平均温度及相对湿度资料,采用分布滞后非线性模型,并结合多元Meta分析,从各城市水平研究广西整体上平均温度及相对湿度对恙虫病发病的影响,通过Meta回归探索不同年龄和性别人群受到的影响是否显著。结果2006-2021年间,广西共报告恙虫病病例23792例,病例具有一定季节性和周期性,主要发生在每年夏季5~7月,且呈现逐年上升的趋势,主要集中于广西中部地区;各地市间温度和相对湿度效应存在差别,温度和相对湿度对广西整体恙虫病发病都呈现出非线性关联。其中温度呈倒“V”型,当温度处于第61.83百分位数即25℃时发病风险最高(RR=1.79,95%CI:1.30-2.47),在滞后0.6个月时达到峰值(RR=1.47,95%CI:1.47-1.66);而相对湿度的效应呈现不断上升的趋势,在第99.10百分位数即88.20%时出现最高发病风险(RR=2.52,95%CI:1.14-5.57),随着滞后时间增加,危险性会持续上升,在滞后6个月达到峰值(RR=1.34,95%CI:1.04-1.73)。男性对相对湿度的敏感性更大,但不同年龄和性别人群的效应差异无统计学意义。结论高温和高湿均会增加广西整体恙虫病的发病风险,提示有关部门应根据气候信号针对性地监测恙虫病的流行,有效控制恙虫病的发生与传播。Objective To explore the impact of mean temperature and relative humidity on the incidence of scrub typhus in Guangxi.Methods Data on the incidence of scrub typhus,mean temperature and relative humidity were collected from various cities in Guangxi from 2006 to 2021,and distributed lag non-linear model with multivariate Meta-analysis was used to investigate the effects of mean temperature and relative humidity on the incidence of scrub typhus in Guangxi at the level of each city,and to explore the significance of the effects on populations of different ages and genders through Meta-regression.Results From 2006 to 2021,a total of 23792 cases of Scrub typhus were reported in Guangxi,and the cases were seasonal and cyclical,mainly occurring in the summer months of May-July each year and showing a rising trend year by year.The incidence of scrub typhus in Guangxi was mostly concentrated in central regions of Guangxi;the effects of temperature and relative humidity varied among cities,and both temperature and relative humidity showed nonlinear associations on the incidence of scrub typhus in Guangxi.The effect of temperature showed an inverted"V"shape,with the highest risk of incidence at the 61.83rd percentile of 25 C(RR=1.79,95%CI:1.30-2.47),and peaked at a lag of 0.6 months(RR=1.47,95%CI:1.47-1.66).However,the effect of relative humidity showed an increasing trend,with the highest risk of morbidity occurring at the 99.10th percentile of 88.2%(RR=2.52,95%CI:1.14-5.57),and the risk continued to increase with increasing lag time,peaking at a lag of 6 months(RR=1.34,95%CI:1.04-1.73).Men were more sensitive to relative humidity,but the differences in effects across age and sex groups were not statistically significant.Conclusion Both high temperature and high humidity increase the risk of scrub typhus,suggesting that the relevant departments should target the monitoring of the prevalence of scrub typhus according to climatic signals to effectively control the incidence and spread of scrub typhus.

关 键 词：恙虫病 气象因素 分布滞后非线性模型 区域异质性 

分 类 号：R384.3[医药卫生—医学寄生虫学]