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Seasonality in hospital admissions of Crimean-Congo hemorrhagic fever and its dependence on ambient temperature—empirical evidence from Pakistan

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Abstract

Crimean-Congo hemorrhagic fever (CCHF) has been reported from all provinces of Pakistan. Little is known about the seasonal variations in the disease and its association with weather conditions. In this study, we explored time-series data about monthly number of CCHF admissions (2007–2010) in three public sector hospitals of Quetta—the capital city of Baluchistan province of Pakistan. Cosinor analysis was carried out to investigate seasonality in the data. To assess the effect of average monthly ambient temperature (°C) on disease, a distributed lag nonlinear model (DLNM) was applied. Cosinor model revealed statistically significant seasonality in monthly number of CCHF patients admitted to the study hospitals. The estimated amplitude was 3.24 cases per month with phase in mid-June and low point in mid-December. DLNM confirmed nonlinear and delayed effect of temperature on hospital admissions. At a lag of 2 months, the cumulative relative risk was more than 1 at temperature at 18.37 °C and above. In addition, relative risk was significantly high at 60th (21.98 °C), 70th (24.50 °C), 80th (27.33 °C), and 90th (29.25 °C) percentiles of temperature (relative to median value, 18.37 °C). Inclusion of Eid-al-Adha as a predictor did not improve the fitness of DLNM. Based on our analysis, we concluded significant seasonality in CCHF hospital admissions. Our findings also suggested average monthly ambient temperature (°C) as a significant predictor of CCHF hospitalizations. DLNM presented in this study may be improved with inclusion of other possible time-varying predictors particularly meteorological conditions of this region.

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References

  • Abbas T, Younus M, Muhammad SA (2015) Spatial cluster analysis of human cases of Crimean Congo hemorrhagic fever reported in Pakistan. Infectious diseases of poverty 4:9. doi:10.1186/2049-9957-4-9

    Article  Google Scholar 

  • Alam MM, Khurshid A, Sharif S, Shaukat S, Suleman RM, Angez M, Zaidi SS (2013) Crimean-Congo hemorrhagic fever Asia-2 genotype, Pakistan. Emerg Infect Dis 19(6):1017–1019. doi:10.3201/eid1906.120771

    Article  Google Scholar 

  • Appannanavar SB, Mishra B (2011) An update on Crimean Congo hemorrhagic fever. J Global Infect Dis 3(3):285–292. doi:10.4103/0974-777x.83537

    Article  Google Scholar 

  • Aslam S, Latif MS, Daud M, Rahman ZU, Tabassum B, Riaz MS, Khan A, Tariq M, Husnain T (2016) Crimean-Congo hemorrhagic fever: risk factors and control measures for the infection abatement. Biomedical reports 4(1):15–20. doi:10.3892/br.2015.545

    Article  Google Scholar 

  • Athar KM, Dawood KM, Ahmed M, Saleem M (2014) Epidemiological trends, clinical profile and geographical distribution of Crimean Congo hemorrhagic fever in Quetta, Baluchistan. Pakistan Journal of Science 66(1)

  • Bai L, Cirendunzhu WA, Dawa Z, Chen B, Liu Q (2014) Temperature, hospital admissions and emergency room visits in Lhasa, Tibet: a time-series analysis. Sci Total Environ 490:838–848. doi:10.1016/j.scitotenv.2014.05.024

    Article  CAS  Google Scholar 

  • Banu S, Guo Y, Hu W, Dale P, Mackenzie JS, Mengersen K, Tong S (2015) Impacts of El Niño Southern Oscillation and Indian Ocean Dipole on dengue incidence in Bangladesh. Scientific reports 5:16105. doi:10.1038/srep16105

    Article  Google Scholar 

  • Bhavan KA (1987) The Indian Hyalomma ticks. krishikoshegranthacin/bitstream/1/2048965/1/32_28pdf

  • Estrada-Pena A, Ayllon N, de la Fuente J (2012) Impact of climate trends on tick-borne pathogen transmission. Front Physiol 3:64. doi:10.3389/fphys.2012.00064

    Article  Google Scholar 

  • Estrada-Pena A, Ruiz-Fons F, Acevedo P, Gortazar C, de la Fuente J (2013) Factors driving the circulation and possible expansion of Crimean-Congo haemorrhagic fever virus in the western Palearctic. J Appl Microbiol 114(1):278–286. doi:10.1111/jam.12039

    Article  CAS  Google Scholar 

  • Estrada-Pena A, de la Fuente J, Latapia T, Ortega C (2015) The impact of climate trends on a tick affecting public health: a retrospective modeling approach for Hyalomma marginatum (Ixodidae). PLoS One 10(5):e0125760. doi:10.1371/journal.pone.0125760

    Article  Google Scholar 

  • Gray JS, Dautel H, Estrada-Pena A, Kahl O, Lindgren E (2009) Effects of climate change on ticks and tick-borne diseases in Europe. Interdisciplinary perspectives on infectious diseases 2009:593232. doi:10.1155/2009/593232

    Article  CAS  Google Scholar 

  • Khurshid A, Hassan M, Alam MM, Aamir UB, Rehman L, Sharif S, Shaukat S, Rana MS, Angez M, Zaidi SS (2015) CCHF virus variants in Pakistan and Afghanistan: emerging diversity and epidemiology. Journal of clinical virology: the official publication of the Pan American Society for Clinical Virology 67:25–30. doi:10.1016/j.jcv.2015.03.021

    Article  CAS  Google Scholar 

  • Leblebicioglu H, Sunbul M, Memish ZA, Al-Tawfiq JA, Bodur H, Ozkul A, Gucukoglu A, Chinikar S, Hasan Z (2015) Consensus report: preventive measures for Crimean-Congo hemorrhagic fever during Eid-al-Adha festival. International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases 38:9–15. doi:10.1016/j.ijid.2015.06.029

    Article  Google Scholar 

  • Leblebicioglu H, Ozaras R, Irmak H, Sencan I (2016) Crimean-Congo hemorrhagic fever in Turkey: current status and future challenges. Antivir Res 126:21–34. doi:10.1016/j.antiviral.2015.12.003

    Article  CAS  Google Scholar 

  • Messina JP, Pigott DM, Golding N, Duda KA, Brownstein JS, Weiss DJ, Gibson H, Robinson TP, Gilbert M, William Wint GR, Nuttall PA, Gething PW, Myers MF, George DB, Hay SI (2015) The global distribution of Crimean-Congo hemorrhagic fever. Trans R Soc Trop Med Hyg 109(8):503–513. doi:10.1093/trstmh/trv050

    Article  Google Scholar 

  • Mostafavi E, Chinikar S, Bokaei S, Haghdoost A (2013) Temporal modeling of Crimean-Congo hemorrhagic fever in eastern Iran. International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases 17(7):e524–528. doi:10.1016/j.ijid.2013.01.010

  • Rai MA, Khanani MR, Warraich HJ, Hayat A, Ali SH (2008) Crimean-Congo hemorrhagic fever in Pakistan. J Med Virol 80(6):1004–1006. doi:10.1002/jmv.21159

    Article  Google Scholar 

  • Sheikh AS, Sheikh AA, Sheikh NS, Rafi US, Asif M, Afridi F, Malik MT (2005) Bi-annual surge of Crimean-Congo haemorrhagic fever (CCHF): a five-year experience. International journal of infectious diseases: IJID: official publication of the International Society for Infectious Diseases 9(1):37–42

    Article  Google Scholar 

  • Talagala T (2015) Distributed lag nonlinear modelling approach to identify relationship between climatic factors and dengue incidence in Colombo District, Sri Lanka. Epidemiology, Biostatistics and Public Health 12 (4)

  • Vescio FM, Busani L, Mughini-Gras L, Khoury C, Avellis L, Taseva E, Rezza G, Christova I (2012) Environmental correlates of Crimean-Congo haemorrhagic fever incidence in Bulgaria. BMC Public Health 12:1116. doi:10.1186/1471-2458-12-1116

    Article  Google Scholar 

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Authors and Affiliations

  1. University College of Veterinary & Animal Sciences, Islamia University of Bahawalpur, Baghdad-ul-Jadeed Campus, Bahawalpur, Pakistan

    Tariq Abbas & Abdul Qayyum

  2. School of Public Health, Institute of Health and Biomedical Innovation, Queensland University of Technology, Victoria Park Road, Kelvin Grove, QLD, 4059, Australia

    Zhiwei Xu

  3. University of Veterinary & Animal Sciences, Lahore, Pakistan

    Muhammad Younus

  4. Livestock & Dairy Development Department, Government of Punjab, Lahore, Pakistan

    Muhammad T. Riaz

Authors
  1. Tariq Abbas
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  2. Zhiwei Xu
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  3. Muhammad Younus
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  4. Abdul Qayyum
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  5. Muhammad T. Riaz
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Correspondence to Tariq Abbas.

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Abbas, T., Xu, Z., Younus, M. et al. Seasonality in hospital admissions of Crimean-Congo hemorrhagic fever and its dependence on ambient temperature—empirical evidence from Pakistan. Int J Biometeorol 61, 1893–1897 (2017). https://doi.org/10.1007/s00484-017-1359-4

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  • DOI: https://doi.org/10.1007/s00484-017-1359-4

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