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The association of extreme temperatures and the incidence of tuberculosis in Japan

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Abstract

Seasonal variation in the incidence of tuberculosis (TB) has been widely assumed. However, few studies have investigated the association between extreme temperatures and the incidence of TB. We collected data on cases of TB and mean temperature in Fukuoka, Japan for 2008–2012 and used time-series analyses to assess the possible relationship of extreme temperatures with TB incident cases, adjusting for seasonal and interannual variation. Our analysis revealed that the occurrence of extreme heat temperature events resulted in a significant increase in the number of TB cases (relative risk (RR) 1.20, 95 % confidence interval (CI) 1.01–1.43). We also found that the occurrence of extreme cold temperature events resulted in a significant increase in the number of TB cases (RR 1.23, 95 % CI 1.05–1.45). Sex and age did not modify the effect of either heat or cold extremes. Our study provides quantitative evidence that the number of TB cases increased significantly with extreme heat and cold temperatures. The results may help public health officials predict extreme temperature-related TB incidence and prepare for the implementation of preventive public health interventions.

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Abbreviations

CI:

Confidence interval

RR:

Relative risk

TB:

Tuberculosis

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Acknowledgments

We thank the Fukuoka Prefectural Government, Department of Public Health and Medical Affairs, Division of Public Health for their painstaking efforts in infectious disease surveillance in Fukuoka, Japan.

Financial disclosure

The study was supported by grants from the Ministry of Health, Labour and Welfare, Japan, and budgets for research of the Department of Public Health and Medical Affairs, Fukuoka Prefectural Government. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Author contributions

DO has made substantial contributions to conception and design, analyzed data, and wrote the manuscript. AH was involved in drafting the manuscript and critically revising it for important intellectual content.

Conflict of interest

The authors have declared that no competing interests exist.

Ethics approval

The study was approved by the ethics committee at Fukuoka Prefectural Government. The requirement for written informed consent was waived. Patient records and other patient information were anonymized and de-identified prior to analysis.

Author information

Authors and Affiliations

  1. Department of Health Care Administration and Management, Kyushu University Graduate School of Medical Sciences, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan

    Daisuke Onozuka & Akihito Hagihara

  2. Department of Planning Information and Administration, Fukuoka Institute of Health and Environmental Sciences, 39 Mukaizano, Dazaifu-shi, Fukuoka, 818-0135, Japan

    Daisuke Onozuka

Authors
  1. Daisuke Onozuka
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  2. Akihito Hagihara
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Corresponding author

Correspondence to Daisuke Onozuka.

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Figure S1

Diagnostics of models: (a) plots of model residuals, (b) predicted and observed time-series plots, and (c) partial autocorrelation function of the residuals. (GIF 85 kb)

(TIFF 1631 kb)

Figure S2

Crude relationship between the relative risk (RR) of TB (scaled to the mean weekly number of TB cases) and temperature (shown as a 3 df natural cubic spline): (a) over lag periods of 0 to 3 weeks, and (b) over lag periods of 0 to 5 weeks. The center line in the graph shows the estimated spline curve. (GIF 52 kb)

(TIFF 1444 kb)

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Onozuka, D., Hagihara, A. The association of extreme temperatures and the incidence of tuberculosis in Japan. Int J Biometeorol 59, 1107–1114 (2015). https://doi.org/10.1007/s00484-014-0924-3

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  • DOI: https://doi.org/10.1007/s00484-014-0924-3

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