Shandong Center for Disease Control and Prevention, Jinan, China.
Department of Acute Infectious Disease, Qingdao Centre for Disease Control and Prevention, Qingdao Institute of Prevention Medicine, Qingdao, Shandong, China.
PLoS One. 2020 Jun 5;15(6):e0233914. doi: 10.1371/journal.pone.0233914. eCollection 2020.
Hand, foot, and mouth disease (HFMD) has become one of the most important infectious diseases recent years. Qingdao City has suffered from serious HFMD epidemic. This study aimed to describe epidemiological characteristics and investigate spatial-temporal distribution at town level in Qingdao City.
The surveillance data of HFMD during 2013-2018 were collected from the National Notifiable Disease Surveillance System. The global Moran's I statistic was used to detect the spatial autocorrelation of HFMD cases by ArcGis 10.0 software. Purely spatial and spatial-temporal analysis was used to detect epidemic clusters by SatScanTM v9.6 software.
The annual average incidence of HFMD cases in Qingdao City from 2013 to 2018 was 123.16 per 100000, while the incidence rate of children≤5years old was 2879.80 per 100000. The majority (88.97%) of HFMD cases were aged within 0-5 years old and the males were 60.20%. Other enterovirus (EV), enteriovirus 71(EV71), and Coxsackievirus A16 (CA16) accounted for 48.75%, 30.91% and 20.34%. The seasonal peak was between May and October. HFMD had positive spatial autocorrelation at town level with global Moran's I from 0.19 to 0.31(P<0.001). Spatial-temporal cluster analysis detected six most likely clusters and three secondary clusters from 2013 to 2018. The most likely cluster was located in urban and urban-rural fringe areas.
Urban and urban-rural fringe areas were the major locations of the clusters with other EV as the dominant pathogen between May and October. The findings suggested that the prevention and control of HFMD in Qingdao City should be focus on these high-risk periods and locations which had important public health significance for the allocation of public health resources.
手足口病（HFMD）已成为近年来最重要的传染病之一。青岛市遭受了严重的 HFMD 疫情。本研究旨在描述青岛市手足口病的流行病学特征，并调查乡镇级别的时空分布。
从国家法定传染病监测系统收集 2013-2018 年手足口病监测数据。使用 ArcGis 10.0 软件的全局 Moran's I 统计量检测手足口病病例的空间自相关。使用 SatScanTM v9.6 软件检测纯空间和时空分析的疫情聚集。
2013-2018 年，青岛市手足口病年平均发病率为 123.16/10 万，0-5 岁儿童发病率为 2879.80/10 万。大多数（88.97%）手足口病病例年龄在 0-5 岁之间，男性占 60.20%。其他肠道病毒（EV）、肠道病毒 71（EV71）和柯萨奇病毒 A16（CA16）分别占 48.75%、30.91%和 20.34%。发病高峰期为 5 月至 10 月。乡镇级手足口病呈正空间自相关，全局 Moran's I 为 0.19-0.31（P<0.001）。2013-2018 年时空聚类分析检测到 6 个最可能的集群和 3 个二级集群。最可能的集群位于城市和城乡结合部。
城市和城乡结合部是聚集的主要地点，5 月至 10 月以其他 EV 为主要病原体。研究结果表明，青岛市手足口病的防控应重点关注这些高风险时期和地点，这对分配公共卫生资源具有重要的公共卫生意义。
