Spatio-temporal Analysis And Influencing Factors Of Pediatric Pneumonia In Zheng Zhou

Pneumonia refers to inflammatory lesions of lung parenchyma and(or)pulmonary interstitium caused by various pathogens or other factors(such as inhalation,allergy,etc.),which is a common infectious diseases of lower respiratory tract.Pneumonia is the largest single infectious cause of death among children worldwide and the first cause of death among hospitalized children in China,making it a hot topic of concern for scholars.The existing literature mainly focuses on descriptive statistical analysis of cases,influencing factors and lag effects of childhood pneumonia,etc.The factors that affect the incidence of childhood pneumonia mainly include meteorological factors,atmospheric pollutants,and ground environmental factors.Zhengzhou is the capital of Henan Province,located in the central northern part of Henan Province,and is one of the areas with a high incidence of childhood pneumonia.This study used data on hospitalized cases of pneumonia in children aged 18 and under from a tertiary hospital in Zhengzhou City from January 1,2016 to December 30,2019.The spatiotemporal rearrangement scan statistical method was used to analyze the spatiotemporal clustering characteristics of pediatric pneumonia hospitalization,Next,the Distributed Lag Nonlinear Models(DLNM)were used to explore the exposure response relationship between meteorological factors(daily high temperature,daily low temperature,relative humidity)and air pollutant factors(PM2.5,PM10,SO2,NO2,CO,and O3)on pediatric pneumonia hospitalization.Finally,Geodetector was used to analyze the impact of land types on the spatial distribution of pediatric pneumonia hospitalization.The main results are as follows:(1)From 2016 to 2019,there were spatio-temporal differences in hospitalization of pneumonia among children in Zhengzhou.The results of spatio-temporal aggregation analysis show that the largest gathering area is from May 31,2019 to August 30,2019,with Zhongyuan District covering high-tech development District,Erqi District and Jinshui District.The expected number of hospitalizations in the region is 613.87 and the actual number of hospitalizations is 1087.Jinshui District,Zhengdong New District and Economic and technological Development District also have aggregation phenomenon in other years,but the scope is very small.Time and space aggregation were not detected in Huiji District and Guancheng District.(2)Temperature and all air pollutants have an impact on the admission of children with pneumonia,but no effect of relative humidity has been found on the admission of children with pneumonia.The lower the temperature,the greater the risk of hospital admission for children with pneumonia on the same day.With the increase of the lag days,the risk of daily high temperature for hospitalization of children with pneumonia decreased,while the daily low temperature showed a trend of increasing first and then decreasing.When the concentration of SO2 exceeds 50μg/m3,the higher the concentration,the greater the risk of hospital admission,and the risk lag days will also increase.The higher the concentration of PM2.5,PM10 and NO2,the higher the admission risk of children with pneumonia,and the lag days of admission risk caused by NO2 will also increase,but the delayed effect of PM2.5 and PM10 only exists for 3-4 days.The admission risk of pneumonia caused by CO and O3 fluctuated greatly with the lag day.The study did not find that relative humidity had an effect on hospitalization of children with pneumonia.(3)The impact of different levels of substance types on the admission of children with pneumonia is relatively small.The results of factor detector showed that impervious water(0.0432),cropland(0.0331)and grassland(0.0205)were the main influencing factors of hospitalization of children with pneumonia.It is worth noting that different structures of green space have different explanatory power for hospital admission of children with pneumonia: grassland(0.0205)> forest(0.0004)> shrubland(0).The results of interactive detector showed that the interaction between impervious water and other landscape could significantly increase the hospitalization risk of pneumonia in children.(4)The type of land indirectly affects children’s pneumonia by affecting temperature and air pollutants.Therefore,when the level of urban air pollution is high,the indirect impact of land object type on children’s pneumonia hospitalization is not significant.This study can provide reference basis for children’s health institutions and provide suggestions for preventing pediatric pneumonia.In extreme weather conditions,pay attention to prevention and scientifically set the range of activities for children.At the same time,the government and relevant institutions should also take action to reduce air pollution and plan for continuous and large-scale urban green spaces.