关键词: 结核,肺, 危险因素, 发病率

Abstract:

Objective: The influence of meteorological factors on the incidence of pulmonary tuberculosis(PTB) in Hefei was analyzed to provide the basis for developing tuberculosis control strategies. Methods: The weekly number of cases of PTB in Hefei during 2013-2022 was extracted from the Chinese Disease Prevention and Control Information System, and the meteorological data during the same period were collected from the Hefei Meteorological Bureau. Spearman correlation analysis was used to study their association. A Distributed lag nonlinear model (DLNM) was established using R 4.3.0 software to investigate the exposure-lag effect between meteorological factors and the incidence of PTB. Results: A total of 41366 cases of PTB were reported in Hefei from 2013 to 2022, the reported incidence decreased from 63.2/100000 (4742/7506266) in 2013 to 31.4/100000 (2960/9424437) in 2022, showing a fluctuating decreasing trend ({\chi }_{\mathrm{l}\mathrm{i}\mathrm{n}\mathrm{e}\mathrm{a}\mathrm{r}}^2=1622.439, P<0.001). The effects of temperature, relative humidity and wind speed on the incidence of pulmonary tuberculosis were “M” type, inverted “N” type and approximately “Z” type, respectively. The cumulative effect of temperature at 4.7℃ was the highest (cumulative relative risk (CRR)=2.261,95%CI:1.422-3.594). Low temperature (P₅=2.4℃) induced highest risk of PTB incidence at lag of 16 weeks. The cumulative effect of relative humidity at 46.1% was the highest (CRR=8.666,95%CI:5.452-13.773).Low relative humidity (P₁=54.7%) had the maximum RR at lag of 0 weeks (RR=1.073,95%CI:1.047-1.100). High relative humidity (P₉₉=93.0%) was a protective factor for PTB at lag of 0~15 weeks. The cumulative effect of wind speed on PTB was the highest at 1.2 m/s (CRR=1.563,95%CI:1.203-2.031).Low wind speed (P₁=1.2 m/s) had the maximum RR at lag of 16 weeks (RR=1.042,95%CI:1.011-1.073), and high wind speed (P₉₉=3.5m/s) was a protective factor for PTB at lag of 0-13 weeks. Conclusion: Meteorological factors play an important role in the incidence of PTB, and have hysteretic and non-linear effects. Low temperature, low relative humidity and low wind speed will increase the risk of PTB.

Key words: Tuberculosis, pulmonary, Risk factors, Incidence