Abstract
(1) Background: Inconsistencies were observed in studies on the relationship between short-term exposure to meteorological factors and the risk of hand, foot, and mouth disease (HFMD). This systematic review and meta-analysis was aimed to assess the overall effects of meteorological factors on the incidence of HFMD to help clarify these inconsistencies and serve as a piece of evidence for policy makers to determine relevant risk factors. (2) Methods: Articles published as of 24 October 2020, were searched in the four databases, namely, PubMed, Web of Science, Embase, and MEDLINE. We applied a meta-analysis to assess the impact of ambient temperature, relative humidity, rainfall, wind speed, and sunshine duration on the incidence of HFMD. We conducted subgroup analyses by exposure metrics, exposure time resolution, regional climate, national income level, gender, and age as a way to seek the source of heterogeneity. (3) Results: Screening by the given inclusion and exclusion criteria, a total of 28 studies were included in the analysis. We observed that the incidence of HFMD based on the single-day lag model is significantly associated with ambient temperature, relative humidity, rainfall, and wind speed. In the cumulative lag model, ambient temperature and relative humidity significantly increased the incidence of HFMD as well. Subgroup analysis showed that extremely high temperature and relative humidity significantly increased the risk of HFMD. Temperate regions, high-income countries, and children under five years old are major risk factors for HFMD. (4) Conclusions: Our results suggest that various meteorological factors can increase the incidence of HFMD. Therefore, the general public, especially susceptible populations, should pay close attention to weather changes and take protective measures in advance.
Highlights
Hand, foot, and mouth disease (HFMD) is an airborne disease that causes a huge global disease burden [1]
The inclusion criteria of our literature were as follows: (1) studies were written in English, or in other languages if an English translation was available; (2) studies provided effect estimates of relative risk (RR), incidence rate ratio (IRR), or the excess risk (ER); (3) studies reported cases of HFMD rather than death; (4) the associations were reported as effect estimates calculated based on one unit increase in meteorological factors
We found that the overall effect of ambient temperature on HFMD risk has strengthened, while no obvious trend was observed for relative humidity over time (Table S4)
Summary
Foot, and mouth disease (HFMD) is an airborne disease that causes a huge global disease burden [1]. HFMD was first discovered in New Zealand in 1957, and gradually became known worldwide. In the past 20 years, HFMD outbreaks have become more and more common throughout the Asia-Pacific region [2,3]. But are not limited to, Japan, South Korea, Singapore, Malaysia, Vietnam, and China. The main pathogens of HFMD are Coxsackie virus A16. (CA16) and Enterovirus 71 (EV71) [4]. HFMD is a self-limiting disease, its extensive harm to the human body cannot be ignored. The typical symptoms include fever, skin bursts on hands
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