Abstract
BackgroundThe incidence of hand, foot and mouth disease (HFMD) varies over space and time and this variability is related to climate and social-economic factors. Majority of studies on HFMD were carried out in humid regions while few have focused on the disease in arid/semi-arid regions, more research in such climates would potentially make the mechanism of HFMD transmission clearer under different climate conditions.MethodsIn this paper, we explore spatial-temporal distribution of HFMD in Ningxia province, which has an arid/semi-arid climate in northwest China. We first employed a Bayesian space-time hierarchy model (BSTHM) to assess the spatial-temporal heterogeneity of the HFMD cases and its relationship with meteorological factors in Ningxia from 2009 to 2013, then used a novel spatial statistical software package GeoDetector to test the spatial-temporal heterogeneity of HFMD risk.ResultsThe results showed that the spatial relative risks in northern part of Ningxia were higher than those in the south. The highest temporal risk of HFMD incidence was in fall season, with a secondary peak in spring. Meteorological factors, such as average temperature, relative humidity, and wind speed played significant roles in the spatial-temporal distribution of HFMD risk.ConclusionsThe study provide valuable information on HFMD distribution in arid/semi-arid areas in northwest China and facilitate understanding of the concentration of HFMD.
Highlights
The incidence of hand, foot and mouth disease (HFMD) varies over space and time and this variability is related to climate and social-economic factors
Spatial-temporal analysis Between 1st January 2009 to 31st December 2013, 28, 446 HFMD cases were reported in Ningxia Province in
In southern Ningxia, the risk was relatively low except Yuanzhou county, which was a hot spot surrounded by neighboring cold spots
Summary
The incidence of hand, foot and mouth disease (HFMD) varies over space and time and this variability is related to climate and social-economic factors. Foot and mouth disease (HFMD) is a common infectious disease, affecting mainly children under 5 years of age, which is caused by a group of enteroviruses, in particular Coxsackievirus A16 and Enterovirus 71. The occurrence of HFMD showed apparent seasonality in countries or regions with distinct climate conditions. Previous studies demonstrated that HFMD incidence showed apparent seasonal variation across China, while HFMD cases were prevalent throughout the year. Peaks of HFMD were observed in spring and summer (March to July) in Henan province (located in eastern central China) [9]. In Yixing city (one of the biggest cities in southern China in Jiangsu province) HFMD were found to be most prevalent in summer [10]
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