Influence of temperature and precipitation on the incidence of hepatitis A in Seoul, Republic of Korea: a time series analysis using distributed lag linear and non-linear model

Abstract

This study aimed to analyze the association between temperature and precipitation and the incidence of hepatitis A in Seoul, Korea, as meteorological factors may have different effects on specific diseases depending on the lifestyle in each region. Weekly cases of hepatitis A, weekly mean daily precipitation, and temperature data from 2016 to 2020 were analyzed. Quasi-Poisson-generalized linear models with time variable adjusted by spline function were used considering 0-6-week lags. The association of each variable and hepatitis A incidence was assessed by the single lag and the constrained distributed lag model. Multivariable distributed lag linear and non-linear models were used to develop models with significant independent variables. Weekly mean of daily mean temperature (Tmean) and maximum temperature (Tmax) were negatively associated with hepatitis A in the 6-week lag. Precipitation was negatively associated with hepatitis A in the 5- and 6-week lags. The multivariable model showed the negative association of Tmax, precipitation and hepatitis A in the 5- and 6-week lags. In the non-linear models, the incidence rate ratio (IRR) was the highest at a Tmax of 11 degrees C and decreased thereafter. IRR was the highest at 12 mm of precipitation and showed decrease pattern to 25 mm and then gradually increased in the 5- and 6-week lags. Identifying the impact of climate factors on hepatitis A incidence would help in the development of strategies to prevent diseases and indirectly estimate the impact of climate change on hepatitis A epidemiology.