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      Effect of temperature and its interaction with other meteorological factors on bacillary dysentery in Jilin Province, China

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          Abstract

          Bacterial dysentery (BD) brings a major disease burden to developing countries. Exploring the influence of temperature and its interaction with other meteorological factors on BD is significant for the prevention and early warning of BD in the context of climate change. Daily BD cases and meteorological data from 2008 to 2018 were collected in all nine prefecture-level cities in Jilin Province. A one-stage province-level model and a two-stage city-specific multivariate meta-pooled level distributed lag non-linear model were established to explore the correlation between temperature and BD, then the weather-stratified generalised additive model was used to test the interaction. During the study period, a total of 26 971 cases of BD were developed. The one-stage and two-stage cumulative dose-response ‘J’ curves overlapped, and results showed a positive correlation between temperature and BD with a 1–6 days lag effect. Age group ⩾5 years was found to be more sensitive to the effects. Moreover, there was a significant interaction between temperature, humidity and precipitation ( P = 0.004, 0.002, respectively) on BD under high temperature (>0 °C), reminding residents and policymakers to pay attention to the prevention of BD in situations with both high temperature and humidity, high temperature and precipitation during the temperate monsoon climate.

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          Distributed lag non-linear models

          Environmental stressors often show effects that are delayed in time, requiring the use of statistical models that are flexible enough to describe the additional time dimension of the exposure–response relationship. Here we develop the family of distributed lag non-linear models (DLNM), a modelling framework that can simultaneously represent non-linear exposure–response dependencies and delayed effects. This methodology is based on the definition of a ‘cross-basis’, a bi-dimensional space of functions that describes simultaneously the shape of the relationship along both the space of the predictor and the lag dimension of its occurrence. In this way the approach provides a unified framework for a range of models that have previously been used in this setting, and new more flexible variants. This family of models is implemented in the package dlnm within the statistical environment R. To illustrate the methodology we use examples of DLNMs to represent the relationship between temperature and mortality, using data from the National Morbidity, Mortality, and Air Pollution Study (NMMAPS) for New York during the period 1987–2000. Copyright © 2010 John Wiley & Sons, Ltd.
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            Estimates of global, regional, and national morbidity, mortality, and aetiologies of diarrhoeal diseases: a systematic analysis for the Global Burden of Disease Study 2015

            Summary Background The Global Burden of Diseases, Injuries, and Risk Factors Study 2015 (GBD 2015) provides an up-to-date analysis of the burden of diarrhoeal diseases. This study assesses cases, deaths, and aetiologies spanning the past 25 years and informs the changing picture of diarrhoeal disease worldwide. Methods We estimated diarrhoeal mortality by age, sex, geography, and year using the Cause of Death Ensemble Model (CODEm), a modelling platform shared across most causes of death in the GBD 2015 study. We modelled diarrhoeal morbidity, including incidence and prevalence, using a meta-regression platform called DisMod-MR. We estimated aetiologies for diarrhoeal diseases using a counterfactual approach that incorporates the aetiology-specific risk of diarrhoeal disease and the prevalence of the aetiology in diarrhoea episodes. We used the Socio-demographic Index, a summary indicator derived from measures of income per capita, educational attainment, and fertility, to assess trends in diarrhoeal mortality. The two leading risk factors for diarrhoea—childhood malnutrition and unsafe water, sanitation, and hygiene—were used in a decomposition analysis to establish the relative contribution of changes in diarrhoea disability-adjusted life-years (DALYs). Findings Globally, in 2015, we estimate that diarrhoea was a leading cause of death among all ages (1·31 million deaths, 95% uncertainty interval [95% UI] 1·23 million to 1·39 million), as well as a leading cause of DALYs because of its disproportionate impact on young children (71·59 million DALYs, 66·44 million to 77·21 million). Diarrhoea was a common cause of death among children under 5 years old (499 000 deaths, 95% UI 447 000–558 000). The number of deaths due to diarrhoea decreased by an estimated 20·8% (95% UI 15·4–26·1) from 2005 to 2015. Rotavirus was the leading cause of diarrhoea deaths (199 000, 95% UI 165 000–241 000), followed by Shigella spp (164 300, 85 000–278 700) and Salmonella spp (90 300, 95% UI 34 100–183 100). Among children under 5 years old, the three aetiologies responsible for the most deaths were rotavirus, Cryptosporidium spp, and Shigella spp. Improvements in safe water and sanitation have decreased diarrhoeal DALYs by 13·4%, and reductions in childhood undernutrition have decreased diarrhoeal DALYs by 10·0% between 2005 and 2015. Interpretation At the global level, deaths due to diarrhoeal diseases have decreased substantially in the past 25 years, although progress has been faster in some countries than others. Diarrhoea remains a largely preventable disease and cause of death, and continued efforts to improve access to safe water, sanitation, and childhood nutrition will be important in reducing the global burden of diarrhoea. Funding Bill & Melinda Gates Foundation.
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              Interaction revisited: the difference between two estimates.

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                Author and article information

                Journal
                Epidemiol Infect
                Epidemiol Infect
                HYG
                Epidemiology and Infection
                Cambridge University Press (Cambridge, UK )
                0950-2688
                1469-4409
                2021
                22 April 2021
                : 149
                : e121
                Affiliations
                [1 ]Department of Epidemiology and Biostatistics, School of Public Health, Jilin University , No. 1163 Xinmin Street, Changchun, Jilin 130021, China
                [2 ]Department of Infection Control, The First Hospital of Jilin University , Changchun, Jilin 130021, China
                [3 ]Jilin International Travel Healthcare Center , Changchun, Jilin 130062, China
                [4 ]Emergency Office of Jilin Provincial Center for Disease Control and Prevention , Changchun, Jilin 130062, China
                Author notes
                Authors for correspondence: Qinglong Zhao, E-mail: jlcdczql@ 123456126.com ; Yan Yao, E-mail: yaoyan@ 123456jlu.edu.cn
                [*]

                Yingshuang Wang and Meina Li contributed equally to this article.

                Author information
                https://orcid.org/0000-0002-1823-3684
                Article
                S0950268821000893
                10.1017/S0950268821000893
                8161304
                33883047
                da3a11fd-917d-4290-9df7-cb56daaa8cf5
                © The Author(s) 2021

                This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 22 November 2020
                : 02 February 2021
                : 15 April 2021
                Page count
                Figures: 6, Tables: 2, References: 40, Pages: 8
                Categories
                Original Paper

                Public health
                bacillary dysentery,interaction,meteorological factors,temperature
                Public health
                bacillary dysentery, interaction, meteorological factors, temperature

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