AUTHOR=Wang Jianping , Lu Kai , Wei Yuxin , Wang Wei , Zhou Yongming , Zeng Jing , Deng Ying , Zhang Tao , Yin Fei , Ma Yue , Shui Tiejun 

TITLE=Using a Leroux-prior-based conditional autoregression-based strategy to map the short-term association between temperature and bacillary dysentery and its attributable burden in China

JOURNAL=Frontiers in Public Health

VOLUME=Volume 12 - 2024

YEAR=2024

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2024.1297635

DOI=10.3389/fpubh.2024.1297635

ISSN=2296-2565

ABSTRACT=Background: In China, bacillary dysentery (BD) is the third most frequently reported infectious disease, with the greatest annual incidence rate of 38.03 cases per 10,000 person-years. It is well acknowledged that temperature is associated with BD and the previous studies of temperature-BD association in different provinces of China present a considerably heterogeneity which may lead to inaccurate estimation for a regionspecific association and incorrect attributable burdens. Meanwhile, the common 2 / 21 method for multi-city studies, such as stratified strategy and meta analysis, have their own limitations in handling the heterogeneity. So, it is necessary to adopt an appropriate method considering the spatial autocorrelation to accurately characterize the spatial distribution of temperature-BD association and obtain its attributable burden in 31 provinces of China.Methods: a novel three-stage strategy was adopted. In the first stage, we used generalized additive model (GAM) model to independently estimate the provincespecific association between monthly average temperature (MAT) and BD. In the second stage, the Leroux-prior-based conditional autoregression (LCAR) was used to spatially smooth the association and characterize its spatial distribution. In the third stage, we calculate the attribute BD cases based on a more accurate estimation of association.Results: the smoothed association curves generally show a higher relative risk with a higher MAT, but some of them have an inverted "V" shape. Meanwhile, the spatial distribution of association indicates that western provinces have a higher relative risk of MAT than eastern provinces with 0.695 and 0.645 on average, respectively. The maximum and minimum of total attributable number of cases are 224,257 in Beijing and 88,906 in Hainan, respectively. The average value of each province in the eastern, western and central areas are approximately 40,991, 42,025 and 26,947, respectively. Conclusion: based on the LCAR-based three-stage strategy, we can obtain a more accurate spatial distribution of temperature-BD association and attributable BD cases. Furthermore, the results can help relevant institutions to prevent and control the 3 / 21 epidemic of BD efficiently.