Contributions of ambient temperature and relative humidity to the risk of tuberculosis admissions: A multicity study in Central China

Huang, Kai; Hu, Chengyang; Yang, Xiyao; Zhang, Yunquan; Wang, Xinqiang; Zhang, Kang-Di; Li, Ying-Qing; Wang, Jie; Yu, Weijie; Cheng, Xin; Cao, Jiyu; Zhang, Tao; Kan, Xiao-Hong; Zhang, Xiu-Jun

doi:10.1016/j.scitotenv.2022.156272

Cited by 13 publications

(14 citation statements)

References 56 publications

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“…Low humidex could increase the risk of TB incidence. This finding is consistent with some previous reports in China, although most of these studies explored temperature and relative humidity separately [7,26,27]. For instance, studies in Jiangsu [9] and Hong Kong [7] found that low humidity and low temperature increase the risk of TB.…”

Section: Discussionsupporting

confidence: 91%

The association between humidex and tuberculosis: a two-stage modelling nationwide study in China

Li,

Wang,

Huang

et al. 2024

BMC Public Health

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Background Under a changing climate, the joint effects of temperature and relative humidity on tuberculosis (TB) are poorly understood. To address this research gap, we conducted a time-series study to explore the joint effects of temperature and relative humidity on TB incidence in China, considering potential modifiers. Methods Weekly data on TB cases and meteorological factors in 22 cities across mainland China between 2011 and 2020 were collected. The proxy indicator for the combined exposure levels of temperature and relative humidity, Humidex, was calculated. First, a quasi-Poisson regression with the distributed lag non-linear model (DLNM) was constructed to examine the city-specific associations between humidex and TB incidence. Second, a multivariate meta-regression model was used to pool the city-specific effect estimates, and to explore the potential effect modifiers. Results A total of 849,676 TB cases occurred in the 22 cities between 2011 and 2020. Overall, a conspicuous J-shaped relationship between humidex and TB incidence was discerned. Specifically, a decrease in humidex was positively correlated with an increased risk of TB incidence, with a maximum relative risk (RR) of 1.40 (95% CI: 1.11–1.76). The elevated RR of TB incidence associated with low humidex (5th humidex) appeared on week 3 and could persist until week 13, with a peak at approximately week 5 (RR: 1.03, 95% CI: 1.01–1.05). The effects of low humidex on TB incidence vary by Natural Growth Rate (NGR) levels. Conclusion A J-shaped exposure-response association existed between humidex and TB incidence in China. Humidex may act as a better predictor to forecast TB incidence compared to temperature and relative humidity alone, especially in regions with higher NGRs.

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Section: Discussionsupporting

confidence: 91%

The association between humidex and tuberculosis: a two-stage modelling nationwide study in China

Li,

Wang,

Huang

et al. 2024

BMC Public Health

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“…Huang et al used DLNM to study the relationship between daily TB hospitalizations and meteorological factors and air pollutants in 16 cities in Anhui Province and found that low temperature exposure increased the risk of TB hospitalizations at lags of 0 and 1 day, and that associations between temperature and TB admissions varied according to air pollution, latitude and healthcare resources. The overall exposure–response curve between relative humidity and TB was almost a flat line with 78% of the reference relative humidity 15 . Wang et al found short-term lag and cumulative lag effects in the development of TB using the DLNM 16 .…”

Section: Introductionmentioning

confidence: 85%

An investigation of the effects of meteorological factors on the incidence of tuberculosis

Chang,

Emam,

Chen

et al. 2024

Sci Rep

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To explore the influence of meteorological factors on the incidence of tuberculosis (TB) in Yingjisha County, Kashgar Region, Xinjiang, and to provide a scientific basis for the prevention and control of TB. The Spearman correlation analysis and distribution lag nonlinear model analysis were conducted on the number of daily reported cases of TB from 2016 to 2023 to study the association effect of various meteorological factors and the daily incidence number of TB in Yingjisha County. A total of 13,288 TB cases were reported from January 2016 to June 2023, and June to October is the peak period of annual TB incidence. Spearman correlation analysis revealed that average daily temperature (AT) and average daily wind speed (WS) were positively correlated with TB incidence (rAT = 0.110, rWS = 0.090); and average daily relative humidity (RH) and TB incidence was negatively correlated (rRH = − 0.093). When AT was − 15 °C, the RR reached a maximum of 2.20 (95% CI: 0.77–6.29) at a lag of 21 days. When RH was 92%, the RR reached a maximum of 1.05 (95% CI: 0.92–1.19) at a lag of 6 days. When WS was 5.2 m/s, the RR reached a maximum of 1.30 (95% CI: 0.78–2.16) at a lag of 16 days. There is a non-linearity and a certain lag between meteorological factors and the occurrence and prevalence of TB in the population, which is mainly manifested in the fact that the risk of incidence of TB decreases with the increase of the daily AT, has a hazardous effect within a certain range of humidity as the average daily RH rises, and gradually increases with the increase of the average daily WS. Local residents are advised to pay attention to climate change so as to take appropriate preventive measures, especially women and middle and old age group should pay close attention to climate change and add more clothes in time, minimise travelling in hazy weather and windy and sandy weather, maintain good nutrition, adequate sleep and moderate exercise in daily life to enhance their immunity, wash hands frequently and ventilate the air, and try to avoid staying in humid and confined spaces in order to reduce the risk of latent TB patients developing the disease.

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“…The short sunshine duration could reduce the UV rays, increasing the degree of low temperature and high relatively humidity, which contribute to Mtb survive in the environment. Also the specific meteorological conditions may influence the human body function and immunity [ 34 , 36 ]. We found extreme low wind speed decrease the risk of TB incidence.…”

Section: Discussionmentioning

confidence: 99%

Epidemiological characteristics of tuberculosis incidence and its macro-influence factors in Chinese mainland during 2014–2021

Deng,

Zhao,

et al. 2024

Infect Dis Poverty

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Background Tuberculosis (TB) remains a pressing public health issue, posing a significant threat to individuals' well-being and lives. This study delves into the TB incidence in Chinese mainland during 2014–2021, aiming to gain deeper insights into their epidemiological characteristics and explore macro-level factors to enhance control and prevention. Methods TB incidence data in Chinese mainland from 2014 to 2021 were sourced from the National Notifiable Disease Reporting System (NNDRS). A two-stage distributed lag nonlinear model (DLNM) was constructed to evaluate the lag and non-linearity of daily average temperature (℃, Atemp), average relative humidity (%, ARH), average wind speed (m/s, AWS), sunshine duration (h, SD) and precipitation (mm, PRE) on the TB incidence. A spatial panel data model was used to assess the impact of demographic, medical and health resource, and economic factors on TB incidence. Results A total of 6,587,439 TB cases were reported in Chinese mainland during 2014–2021, with an average annual incidence rate of 59.17/100,000. The TB incidence decreased from 67.05/100,000 in 2014 to 46.40/100,000 in 2021, notably declining from 2018 to 2021 (APC = -8.87%, 95% CI: -11.97, -6.85%). TB incidence rates were higher among males, farmers, and individuals aged 65 years and older. Spatiotemporal analysis revealed a significant cluster in Xinjiang, Qinghai, and Xizang from March 2017 to June 2019 (RR = 3.94, P < 0.001). From 2014 to 2021, the proportion of etiologically confirmed cases increased from 31.31% to 56.98%, and the time interval from TB onset to diagnosis shortened from 26 days (IQR: 10–56 days) to 19 days (IQR: 7–44 days). Specific meteorological conditions, including low temperature (< 16.69℃), high relative humidity (> 71.73%), low sunshine duration (< 6.18 h) increased the risk of TB incidence, while extreme low wind speed (< 2.79 m/s) decreased the risk. The spatial Durbin model showed positive associations between TB incidence rates and sex ratio (β = 1.98), number of beds in medical and health institutions per 10,000 population (β = 0.90), and total health expenses (β = 0.55). There were negative associations between TB incidence rates and population (β = -1.14), population density (β = -0.19), urbanization rate (β = -0.62), number of medical and health institutions (β = -0.23), and number of health technicians per 10,000 population (β = -0.70). Conclusions Significant progress has been made in TB control and prevention in China, but challenges persist among some populations and areas. Varied relationships were observed between TB incidence and factors from meteorological, demographic, medical and health resource, and economic aspects. These findings underscore the importance of ongoing efforts to strengthen TB control and implement digital/intelligent surveillance for early risk detection and comprehensive interventions. Graphical Abstract

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Contributions of ambient temperature and relative humidity to the risk of tuberculosis admissions: A multicity study in Central China

Cited by 13 publications

References 56 publications

The association between humidex and tuberculosis: a two-stage modelling nationwide study in China

The association between humidex and tuberculosis: a two-stage modelling nationwide study in China

An investigation of the effects of meteorological factors on the incidence of tuberculosis

Epidemiological characteristics of tuberculosis incidence and its macro-influence factors in Chinese mainland during 2014–2021

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