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Stručni rad UDK 616.831.9-002 Medicus 2006; 7(1): 29-31
CORRELATION BETWEEN CLIMATE AND BACTERIAL
MENINGITIS
Ljupka D. Jankovic, Vesna R. Pantovic, Vlasta D. Damjanov
Institute of Public Health of Serbia „Dr Milan Jovanovic – Batut“, Belgrade, Serbia and Montenegro
KORELACIJA IZMEĐU KLIME I BAKTERIJSKOG MENINGITISA
Ljupka D. Janković, Vesna R. Pantović, Vlasta D. Damjanov
Institut za zaštitu zdravlja Srbije „Dr Milan Jovanović – Batut“, Beograd
Received/Primljen: 10. 06. 2005. Accepted/Prihvaćen: 03. 02. 2006.
SAŽETAK ABSTRACT
Bakterijski meningitisi predstavljaju oboljenja vrlo teškog toka, sa Bacterial meningitis are diseases with severe form and often long-la-
čestim trajnim sekvelama i smrtnim ishodom i do 20% obolelih. U sting sequel and with high case-fatality rate up to 20%. Neonates, pa-
većem riziku da obole su odojčad, bolesnici sa oslabljenim imunitetom tients with impaired immunity and consequences of head trauma are
i osobe koje su imale traumu glave. Cilj ovog istraživanja je da se utvrdi on higher risk for disease. The subject of this study is investigation of
povezanost nekih klimatskih faktora sa kretanjem bakterijskih meni correlation between climate and bacterial meningitis in order to point
ngitisa radi sprovođenja adekvatnih mera zaštite. U radu je korišćen to application of adequate preventive measures. Descriptive and eco-
deskriptivni metod i korelaciona studija. Izvor podataka su bili zvanični logical studies were used to analyze data from Annual statistical report
podaci Statističkih godišnjaka grada Beograda i Statističkih prikaza of Belgrade and Annual Report of Institute of Public Health of Belgrade,
zdravstvene delatnosti GZZZ Beograda za period 1989–2003. godine. for period 1989–2003. The data were statistically analyzed and results
Obrada podataka je rađena uobičajenim statističkim alatima i Pir- of Pirson’s test of linear correlation were tested by Student’s t-test.
sonovim testom linearne korelacije, a statistička značajnost dobijenih Thirty-two climate variables (temperature, precipitations, windiness, air
korelacija je testirana Studentovim t-testom. U studiji je analizirano kre- pressure, cloudiness, solar radiation and visibility) have been analyzed
tanje 32 varijable klimatskih faktora (temperature, padavina, vetrovitosti, in this study. Annual and seasonal climate differences are correlated
vazdušnog pritiska, oblačnosti, osunčavanja i vidljivosti). Ispitano je with bacterial meningitis. Correlation between solar radiation and
godišnje i sezonsko kretanje varijabli i njihova korelacija sa kretanjem bacterial meningitis is negative with very high significance (P< 0.01),
bakterijskih meningitisa, za isti period. Korelacija između osunčavanja i while correlation between strong windy days and bacterial meningitis
bakterijskih meningitisa je bila negativna visoko statistički značajna (P< is positive with high significance (P< 0.05). Statistically positive but
0,01), dok je korelacija dana sa jakim vetrom bila statistički značajno not significant correlation was found with the number of days with fog.
pozitivna sa obolevanjem od bakterijskih meningitisa (P<0,05). Dani Changes in humidity, precipitations, temperature and cloudiness have
sa maglom su bili u pozitivnoj korelacionoj vezi, na granici statističke no influence on the diseases. Preventive measures, based on obtained
značajnosti. Kretanje relativne vlažnosti vazduha, padavina, tempera- results, are suggested to persons on high risk to go to the countryside
ture vazduha i oblačnosti nisu pokazali statistički značajnu povezanost on sunny days without winds.
sa kretanjem bakterijskih meningitisa. Na osnovu dobijenih rezultata Key words: bacterial meningitis, climate, correlation, preventive me-
osobama u povećanom riziku da obole od bakterijskih meningitisa asures
preporučuje se češći boravak u prirodi, u toku sučanih dana bez vetra.
Važna preventivna mera je i vakcinacija osoba sa oslabljenim imu-
nitetom protiv invazivnog hemofilusa B, pneumokoka i meningokoka.
Ključne reči: bakterijski meningitisi, klimatski faktori, korelacije, mere
prevencije
INTRODUCTION them temperature, precipitations, windiness, air pressure,
Bacterial meningitis are diseases with severe form and cloudiness, solar radiation, and visibility. Reported cases
often long-lasting sequel and with high case-fatality rate of bacterial meningitis were also analyzed for the same
up to 20%. Neonates, patients with impaired immunity period in Belgrade. Statistical data were processed in
and consequences of head trauma are on higher risk for tables and graphs of yearly and seasonal frequency distri-
the disease. Bacteria such as Neisseria meningitidis, Strep bution. Linear correlations were made by Pearson and
tococcus pneumoniae (Pneumococcus) and invasive serotype results were tested by Student’s ttest (4).
of bacteria Haemophylus influenzae type b (Hib) constitute
more then 75% of all cases of bacterial meningitis, and RESULTS
90% of bacterial meningitis in children under 5 years Seven hundred and seventeen cases of bacterial menin-
of age (1, 2). gitis were reported Belgrade in period 1989–2003. The
The subject of this study is investigation of correlation least number of cases, only four, was registered in 1990.
between climate and bacterial meningitis and significan- The highest number of 133 cases was registered in 1997.
ce of these correlations, in order to point to adequate Average frequencies for monthly distribution of bacterial
primary preventive measures against bacterial meningitis meningitis cases in Belgrade in period 1989–2003 shows
through improving life style (3). that the lowest number was in February and May (22
cases) and the highest number was in November with
PATIENTS AND METHODS 117 cases.
Descriptive method and correlation study were used in The highest strong winds days with number of 135 were
this research. All data were analyzed yearly and seaso- in 1999, and the lowest strong windy days of 6 were in
nally (monthly) for the period of 15 years (1989–2003). 1990. Monthly distribution shows that the highest num
Annual statistical report of Belgrade and Annual report ber of the days with strong wind was in March (18 days),
of Institute of Public Health of Belgrade were data sour- and the lowest number of the days with strong wind was
ces. Thirty-two climate variables were analyzed, among in December (1 day). Correlation between strong windy
Correspondence:
Ljupka Jankovic, MSc
Institute of Public Helth of Serbia, Dr Subotica 5, Belgrade
Serbia and Montenegro
tel: +381 11 2684–566, fax: +381 11 684–566
home tel: +381 11 400–953 ; + 381 64 22 405 22
e-mail: ljulju@beotel.yu
Medicus 2006; 7(1): 29-31
days and bacterial meningitis is positive R = 0.69, with At the end of twentieth century epidemiologists have
high significance (P<0.05) (Figure 1). expanded Gordon’s trials to network of causality that
includes many factors, often specific for particular dise-
Correlation between winds days and bacterial meningitis ase. According to those theories, environmental factors
140 160
are connected with the health disorders, raising issue
120 140
of including ecological analysis in complex concept of
100
120 health (68).
100 Important part of the environment is climate, that is
defined as a wholeness of weather conditions of the
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80
60
60
lowest stratosphere stratum. Climate has positive or
40
40
negative influence on the human organism. Climate
20
influence on the human health was often studied in the
field of noncommunicable diseases (9). Significance of
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0 0
microclimate condition is especially emphasized in cities.
Some quantity of different mineral and organic particles
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03
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02
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№ of cases № of windy days (aerosol) that pollutes air hangs in the air in cities very
Figure 1. Correlation between winds days and bacterial meningitis
often. Air in big cities is very often polluted with lot of
viruses and bacteria (10, 11). The wind causes coldness
Solar radiation in hours (h) had the highest value of of organism and speeding up the breathing. Negative
2433.3 hours in 2000, and the lowest value in 2003 influence of winds is that they raise dust, bacteria and
(1,714.9 hours). Average monthly distribution shows viruses that may come up into human respiratory tract
the highest value of solar radiation in August (284.4h), (12). The presence of aerosol in the air makes fog curtain
and the lowest value in December (43 hours). Correla above towns that cause the reduction of solar radiation
tion between solar radiation and bacterial meningitis is and shortening of sunshine period. It reduces influence
negative R= 0.81, with high significance (P<0.01), of UV radiation and increases risk for spread of respira-
see (Figure 2). tory diseases. City’s air fog (smog) hinders vertical mo
Correlation between solar radiation and bacterial meningitis vement of the air and removal of particles, harmful for
140 2500
human health, from the city’s atmosphere. During fog
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2200
human body has a higher sense of coldness because of
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110 1900
water droplets condensation on the skin. Higher amount
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1600
of aerosol in city’s air causes increased condensation of
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80 1300
humidity and more cloudiness above towns then above
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60 1000 its’ surrounding. This microclimate makes higher risk
50 700 for spread of respiratory diseases (13).
40
30 400 According to the Law for prevention of communicable
20 100 diseases in Serbia and Decision for reporting system for
10
0 -200 communicable diseases only cases of Meningococcal di-
sease were reported (according MKB – 10 A 39), and
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03
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№ of cases № of windy days the other cases of bacterial meningitis were reported as
aggregate data. Based on this data it was not possible to
Figure 2. Correlation between solar radiation and bacterial meningitis
present number of bacterial meningitis by specific causes
Statisticaly positive but not significant correlation was (14, 15). Based on different studies, leading cause for
found with the number of foggy days. Analysis of corre- postnatal retardation after bacterial meningitis is invasive
lation between cases of bacterial meningitis and the other Hib infection in children. Invasive Hib has the higher
climate factors as temperature, humidity, precipitations incidence among children aged 3 months to 3 years,
and cloudiness shows statistically insignificance for fre- with peak incidence in children between 6 months and
quencies of monthly and yearly distribution. 18 months. Incidence of Hib meningitis have dropped
Monthly distribution of bacterial meningitis cases did from 0.9 to 0.5 per 100,000 population in France in
not have any statisticaly significant correlation with any period 1987 to 1993 (1, 16).
of the climate factors. It is estimated in USA that 20,000 cases of Hib were
registered every year prior to introduction of vaccine
DISCUSSION against Hib. In England number of Hib cases decreased
In 1960s English and American authors have establis more than 90% after two years of introducing routine im
hed a theory, generally accepted, that the disease is a munization of newborns. Invasive Hib has disappeared
consequence of mutual reacting of antigen (the cause), after less than ten years of routine children immunization
human and environment, socalled as Gordon’s trials. All with conjugate vaccine (17).
chains of Gordon’s trials have the same importance for Meningococcal meningitis cause outbreaks and deaths
emergence of disease (5, 6). among children aged under 5 in Central Africa and Asia
every year (18).
Medicus 2006; 7(1): 29-31
Based on the results of previous investigations of corre- Children and older with compromised immunity should
lation between climate and characteristics of bacterial avoid public meetings in days with peak of causal activi-
meningitis and on above results, conclusion is that risk ties (windy and cold days).
of illness is increased in windy days and decreased in Persons with congenital immuno-compromising con-
days with high solar radiation. Recommendation is that ditions, chronic diseases, immunosuppressive therapy,
children and adults with impaired immunity (congenital children with malnutrition, and elderly and exhausted
immune deficiencies, chronic diseases, immunosuppressi- persons should improve their general immunity with he-
ve therapy, malnutrition), elderly and exausted persons althy living style, consumption of healthy food, walking
could reduce their risk of possibly fatal diseases by avo- and light physical activity in the countryside, through
iding staying in open areas on heavy fog and strong the mild sunshine days, without extreme activities of
windy days. other climate factors.
REFERENCES
1. Heymann DL. Control of communicable diseases, In: Iredell J, 10. Dukić D. Klimatologija. Beograd: Naučna knjiga, 1977. [In
ed. Bacterial meningitis. 18th ed. Washington: American Health Serbian]
Association, 2004: 359–71. 11. Dukić D. Klimatologija sa osnovama meteorologije. Beograd:
2. Plotkin SA. Vaccines. In: Mortimer EA, Wharton MC, eds. Hae Naučna knjiga, 1967. [In Serbian]
mophylus meningitis. 3th ed. Philadelphia: WB Saunders Co, 12. Straser T, Anić B. Prilog poznavanju meteoropatoloških dejstava
1999: 1230. vazdušnog pritiska. Srps Arh Celok Lek 1993; 91: 699–700. [In
3. Janković DLj. Uticaj nekih klimatskih faktora na respiratorne Serbian]
zarazne bolesti. Magistarska teza. Kragujevac: Univerzitet u Kra 13. Vaiut A. La Météorologie »Que saisje?«. Paris: Universitaires de
gujevcu, Medicinski fakultet, 2004. [In Serbian] France, 1965. [In French]
4. Beaghole R, Bonita R. Basic epidemiology. Geneva, World Health 14. Zakon o zaštiti stanovništva od zaraznih bolesti koje ugrožavaju
Organization, 1993. celu zemlju «Službeni list SRJ» br. 46/96, član 2. [In Serbian]
5. MacMahon B, Trichopoleros D. Epidemiology, principles and 15. Odluka o načinu prijavljivanja zaraznih bolesti «Službeni list» br.
methods. 2th ed. Boston: Little Brown and Co, 1996. 27/97, član 2. [In Serbian]
6. Radovanović Z. Savremena epidemiologija, koreni, teoretske 16. INSERM, Les meningités bactérienne. Stratégies de traitement
osnove i pravci razvoja. Beograd: Medicinski fakultet, 2003. [In et de prévention. Paris INSERM, 1996: 167–9.
Serbian] 17. Etimble J. Vaccinations: actualités et perspectives, Paris INSERM,
7. Vetter N, Matthews I. Public health medicine. In: Epidemiology: 1999: 349. [In French]
part of public health. Edinburg: Churchill Livingstone, 1999. 18. Goodman RA, Foster KL, Trowbridge FL, Figueroa JP Global .
8. Susser M. Should the epidemiologist be a social scientist or a mo- disease elimination and eradication as public health strategies. Bull
lecular biologist? Int J Epidemiol 1999; 28: 997–9. WHO 1998; 76: 5–11.
9. .
Todorović P Čovek i vreme. Beograd: NIRO Ekspotpres, 1988.
[In Serbian]
