title: Exploration of diarrhoea seasonality and its drivers in China.
abstract: This study investigated the diarrhoea seasonality and its potential drivers as well as potential opportunities for future diarrhoea control and prevention in China. Data on weekly infectious diarrhoea cases in 31 provinces of China from 2005 to 2012, and data on demographic and geographic characteristics, as well as climatic factors, were complied. A cosinor function combined with a Poisson regression was used to calculate the three seasonal parameters of diarrhoea in different provinces. Regression tree analysis was used to identify the predictors of diarrhoea seasonality. Diarrhoea cases in China showed a bimodal distribution. Diarrhoea in children <5 years was more likely to peak in fall-winter seasons, while diarrhoea in persons > = 5 years peaked in summer. Latitude was significantly associated with spatial pattern of diarrhoea seasonality, with peak and trough times occurring earlier at high latitudes (northern areas), and later at low latitudes (southern areas). The annual amplitudes of diarrhoea in persons > = 5 years increased with latitude (r = 0.62, P<0.001). Latitude 27.8° N and 38.65° N were the latitudinal thresholds for diarrhoea seasonality in China. Regional-specific diarrhoea control and prevention strategies may be optimal for China. More attention should be paid to diarrhoea in children <5 years during fall-winter seasons.
authors: 1] School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia [2] Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia.
authors: Zhiwei
authors: Z
authors: Xu
authors: 1] School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia [2] Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia.
authors: Wenbiao
authors: W
authors: Hu
authors: Center for Public Health Surveillance and Information Service, Chinese Center for Disease Control and Prevention, Beijing, China.
authors: Yewu
authors: Y
authors: Zhang
authors: Center for Public Health Surveillance and Information Service, Chinese Center for Disease Control and Prevention, Beijing, China.
authors: Xiaofeng
authors: X
authors: Wang
authors: National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
authors: Maigeng
authors: M
authors: Zhou
authors: School of Public Health, Anhui Medical University, Hefei, Anhui, China.
authors: Hong
authors: H
authors: Su
authors: Centre for Environment and Population Health, School of Environment, Griffith University, Brisbane, Australia.
authors: Cunrui
authors: C
authors: Huang
authors: 1] School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia [2] Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia.
authors: Shilu
authors: S
authors: Tong
authors: Center for Public Health Surveillance and Information Service, Chinese Center for Disease Control and Prevention, Beijing, China.
authors: Qing
authors: Q
authors: Guo
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D003967:Diarrhea / Q000453:epidemiology* / Q000209:etiology*; D005260:Female; D062306:Geography, Medical; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012621:Seasons; D062211:Spatio-Temporal Analysis; D055815:Young Adult
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