Journal of Shandong University (Health Sciences) ›› 2025, Vol. 63 ›› Issue (3): 110-116.doi: 10.6040/j.issn.1671-7554.0.2024.1044

• Public Health & Preventive Medicine • Previous Articles    

Association between heat waves and other infectious diarrhea among school-aged children in Shandong Province from May to October, 2018 to 2022

LI Xinyi1, ZHANG Xiaochi1, LI Wen1, GAO Shanshan2,3, ZHAO Qi1, ZHANG Wei4   

  1. 1. Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Jinan 250012, Shandong, China;
    2. Department of Gastroenterology, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Jinan 250014, Shandong, China;
    3. Department of Occupational and Environmental Health, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong, China;
    4. Dezhou Center for Disease Control and Prevention, Dezhou 253016, Shandong, China
  • Published:2025-04-08

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Abstract: Objective To provide evidence for the development of targeted other infectious diarrhea(OID)prevention and control measures for individuals aged 6-18 years(school-aged individuals)by examining the association between heat waves(HW)and OID in Shandong Province, and explore the potential modifying effect of urbanization. Methods Data from 2018 to 2022 in Shandong Province were collected, including daily OID cases among school-aged individuals, meteorological data, and urbanization indicators(per capita GDP, urbanization rate, and per capita medical institution beds). The study period was set from May to October each year. Two definitions of HW(HW1 and HW2)were established based on the 90th and 95th percentiles of daily average temperature for each city, with a minimum duration of three consecutive days. A time-series analysis was conducted using a quasi-Poisson regression model combined with distributed lag non-linear models to explore the association between HW and OID incidence. Interaction terms were added to quantify the modifying effects of urbanization indicators. Results A total of 35,929 cases of OID were reported among school-aged individuals in Shandong Province during the study period. Compared to non-HW days, the effects of HW1 and HW2 peaked on the current day of exposure(lag 0 day)and the lag 2 days, with relative risks(RRs)being 1.05(95%CI: 1.02-1.09)and 1.08(95%CI: 1.05-1.11), respectively. Over the entire lag period(lag 0-15 days), the cumulative RR values were 1.62(95%CI: 1.37-1.92)for HW1 and 1.93(95%CI: 1.47-2.53)for HW2. Areas with lower urbanization rate and per capita GDP showed a higher risk of HW-related OID. Conclusion HW are associated with an increased incidence of OID among school-aged individuals, with urbanization considered as strong effect modifiers.

Key words: Heat wave, Other infectious diarrhea, School-aged individuals, Time series analysis, Distributed lag nonlinear model, Urbanization

CLC Number: 

  • R122
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