Abstract:
Diarrhea contributes significantly to global morbidity and mortality. There is evidence that diarrhea prevalence is associated with ambient temperature. This study aimed to determine if there was an association between ambient temperature and diarrhea at a rural site in South Africa. Daily diarrheal hospital admissions (2007 to 2016) at two large district hospitals in Mopani district, Limpopo province were compared to average daily temperature and apparent temperature (Tapp, \'real-feel\' temperature that combined temperature, relative humidity, and wind speed). Linear regression and threshold regression, age-stratified to participants ≤5 years and >5 years old, considered changes in daily admissions by unit °C increase in Tapp. Daily ranges in ambient temperature and Tapp were 2-42 °C and -5-34 °C, respectively. For every 1 °C increase in average daily temperature, there was a 6% increase in hospital admissions for diarrhea for individuals of all ages (95% CI: 0.04-0.08; p < 0.001) and a 4% increase in admissions for individuals older than 5 years (95% CI: 0.02-0.05; p < 0.001). A positive linear relationship between average daily Tapp and all daily diarrheal admissions for children ≤5 years old was not statistically significant (95% CI: -0.00-0.03; p = 0.107). Diarrhea is common in children ≤5 years old, however, is more likely triggered by factors other than temperature/Tapp, while it is likely associated with increased temperature in individuals >5 years old. We are limited by lack of data on confounders and effect modifiers, thus, our findings are exploratory. To fully quantify how temperature affects hospital admission counts for diarrhea, future studies should include socio-economic-demographic factors as well as WASH-related data such as personal hygiene practices and access to clean water.
摘要:
腹泻是全球发病率和死亡率的重要原因。有证据表明,腹泻的患病率与环境温度有关。这项研究旨在确定南非农村地区的环境温度与腹泻之间是否存在关联。Mopani区两家大型地区医院的每日腹泻医院(2007年至2016年),林波波省与日平均温度和表观温度(Tapp,\'真实感觉\'温度,结合温度,相对湿度,和风速)。线性回归和阈值回归,年龄分层为≤5岁和>5岁的参与者,考虑通过Tapp的单位°C增加每日入院率的变化。环境温度和Tapp的每日范围为2-42°C和-5-34°C,分别。每日平均气温每升高1°C,所有年龄段的患者因腹泻住院率增加了6%(95%CI:0.04-0.08;p<0.001),5岁以上患者住院率增加了4%(95%CI:0.02-0.05;p<0.001).≤5岁儿童的平均每日Tapp与所有每日腹泻入院之间的正线性关系无统计学意义(95%CI:-0.00-0.03;p=0.107)。腹泻常见于≤5岁的儿童,然而,更有可能是由温度/Tapp以外的因素触发的,而这可能与>5岁个体的温度升高有关。我们由于缺乏关于混杂因素和效应修饰符的数据而受到限制,因此,我们的发现是探索性的.为了全面量化温度如何影响腹泻的入院计数,未来的研究应包括社会经济人口因素以及与WASH相关的数据,例如个人卫生习惯和清洁水的获取。