Short Term Effects of Weather on Hand, Foot and Mouth Disease 英文参考文献.docVIP

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Short Term Effects of Weather on Hand, Foot and Mouth Disease 英文参考文献.doc

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Short Term Effects of Weather on Hand, Foot and Mouth Disease 英文参考文献

ShortTermEffectsofWeatheronHand,FootandMouth Disease YienLingHii1*,JoacimRocklo¨v1,2,NawiNg1 1Umea? Centre for Global Health Research, Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umea? University, Umea?, Sweden, 2OccupationalandEnvironmentalMedicine,DepartmentofPublicHealthandClinicalMedicine,Umea? University,Umea?, Sweden Abstract Background:Hand,foot,andmouthdisease(HFMD)outbreaksleadingtoclinicalandfatalcomplicationshaveincreased sincelate1990s;especiallyintheAsiaPacificRegion.OutbreaksofHFMDpeaksinthewarmerseasonoftheyear,butthe underlyingfactorsforthisannualpatternandthereasonstotherecentupsurgetrendhavenotyetbeenestablished.This studyanalyzedtheeffectofshort-termchangesinweatherontheincidenceofHFMDinSingapore. Methods:TherelativerisksbetweenweeklyHFMDcasesandtemperatureandrainfallwereestimatedfortheperiod2001– 2008 using time series Poisson regression models allowing for over-dispersion. Smoothing was used to allow non-linear relationshipbetweenweatherandweeklyHFMDcases,andtoadjustforseasonalityandlong-termtimetrend.Additionally, autocorrelationwascontrolledandweatherwasallowedtohavealaggedeffectonHFMDincidenceupto2weeks. Results:WeeklytemperatureandrainfallshowedstatisticallysignificantassociationwithHFMDincidenceattimelagof1–2 weeks. Every 1uC increases in maximum temperature above 32uC elevated the risk of HFMD incidence by 36% (95% CI=1.341–1.389).Simultaneously,onemmincreaseofweeklycumulativerainfallbelow75mmincreasedtheriskofHFMD by0.3%(CI=1.002–1.003).Whileabove75mmtheeffectwasoppositeandeachmmincreasesofrainfalldecreasedthe incidence by 0.5% (CI=0.995–0.996). We also found that a difference between minimum and maximum temperature greaterthan7uCelevatedtheriskofHFMDby41%(CI=1.388–1.439). Conclusion: Our findings suggest a strong association between HFMD and weather. However, the exact reason for the associationisyettobestudied.Informationonmaximumtemperatureabove32uCandmoderaterainfallprecedeHFMD incidencec