Department of Medical Statistic and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhong Shan 2nd Road, Guangzhou 510080, China.
Sun Yat-sen Global Health Institute, Sun Yat-sen University, 135 Xin Gang Xi Road, Guangzhou 510275, China.
Int J Environ Res Public Health. 2019 Apr 3;16(7):1191. doi: 10.3390/ijerph16071191.
: Hand, foot, and mouth disease (HFMD) is a common infectious disease among children. Guangdong Province is one of the most severely affected provinces in south China. This study aims to identify the spatiotemporal distribution characteristics and potential predictors of HFMD in Guangdong Province and provide a theoretical basis for the disease control and prevention. : Case-based HFMD surveillance data from 2009 to 2012 was obtained from the China Center for Disease Control and Prevention (China CDC). The Bayesian spatiotemporal model was used to evaluate the spatiotemporal variations of HFMD and identify the potential association with meteorological and socioeconomic factors. : Spatially, areas with higher relative risk () of HFMD tended to be clustered around the Pearl River Delta region (the mid-east of the province). Temporally, we observed that the risk of HFMD peaked from April to July and October to December each year and detected an upward trend between 2009 and 2012. There was positive nonlinear enhancement between spatial and temporal effects, and the distribution of relative risk in space was not fixed, which had an irregular fluctuating trend in each month. The risk of HFMD was significantly associated with monthly average relative humidity (: 1.015, 95% : 1.006-1.024), monthly average temperature (: 1.045, 95% : 1.021-1.069), and monthly average rainfall (: 1.004, 95% : 1.001-1.008), but not significantly associated with average GDP. : The risk of HFMD in Guangdong showed significant spatiotemporal heterogeneity. There was spatiotemporal interaction in the relative risk of HFMD. Adding a spatiotemporal interaction term could well explain the change of spatial effect with time, thus increasing the goodness of fit of the model. Meteorological factors, such as monthly average relative humidity, monthly average temperature, and monthly average rainfall, might be the driving factors of HFMD.
手足口病（HFMD）是儿童中常见的传染病。广东省是华南地区受影响最严重的省份之一。本研究旨在识别广东省手足口病的时空分布特征和潜在预测因素，为疾病防控提供理论依据。
本研究基于中国疾病预防控制中心（China CDC）的手足口病监测数据，采用贝叶斯时空模型评估手足口病的时空变化，并识别与气象和社会经济因素的潜在关联。
空间上，手足口病相对风险（RR）较高的地区往往集中在珠江三角洲地区（省内中东部）。时间上，我们发现手足口病的风险在每年的 4 月至 7 月和 10 月至 12 月达到高峰，并在 2009 年至 2012 年期间呈上升趋势。空间和时间效应之间存在正非线性增强，相对风险的空间分布并不固定，每月呈不规则波动趋势。手足口病的风险与月平均相对湿度（RR：1.015，95%置信区间：1.006-1.024）、月平均温度（RR：1.045，95%置信区间：1.021-1.069）和月平均降雨量（RR：1.004，95%置信区间：1.001-1.008）显著相关，但与平均 GDP 不显著相关。
广东省手足口病的风险呈现出显著的时空异质性。手足口病的相对风险存在时空相互作用。添加时空相互作用项可以很好地解释空间效应随时间的变化，从而提高模型的拟合优度。气象因素如月平均相对湿度、月平均温度和月平均降雨量可能是手足口病的驱动因素。
