Xinjiang Uighur Autonomous Region Center for Disease Control and Prevention, Urumqi, P. R. China.
Institute of EcoHealth, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, P. R. China.
PLoS Negl Trop Dis. 2021 Mar 24;15(3):e0009210. doi: 10.1371/journal.pntd.0009210. eCollection 2021 Mar.
Hand foot and mouth disease (HFMD) is becoming one of the common human infectious diseases in China. Previous studies have described HFMD in tropical or coastal areas of Asia-Pacific countries. However, limited studies have thoroughly studied the epidemiology and potential risk factors for HFMD in inland areas with complex environmental conditions.
METHODOLOGY/PRINCIPAL FINDINGS: Using the data from 2009 to 2018 on reported cases of Xinjiang Uighur Autonomous Region, we characterized the epidemic features of HFMD. Panel negative binomial model was used to identify climate, geographical and demographic determinants for HFMD incidence. A total of 70856 HFMD cases (average annual incidence: 305 per million persons) were reported in Xinjiang during the 10-year study period, of which 10393 (14.7%) were laboratory-confirmed and 98 (0.1%) were severe. HFMD peaked in summer every year during the study period, and incidence in 2012, 2015, 2016 and 2018 had minor peaks in autumn. After adjusting the school or holiday month, multiple factors were found to affect HFMD epidemiology: urban area being major land cover type (incidence risk ratio, IRR 2.08; 95% CI 1.50, 2.89), higher gross domestic product per capita (IRR 1.14; 95% CI 1.11, 1.16), rise in monthly average temperature (IRR 1.65; 95% CI 1.61, 1.69) and monthly accumulative precipitation (IRR 1.20; 95% CI 1.16, 1.24) predicted increase in the incidence of HFMD; farmland being major land cover type (IRR 0.72; 95% CI 0.64, 0.81), an increase of percentage of the minority (IRR 0.91; 95% CI 0.89, 0.93) and population density (IRR 0.98; 95% CI 0.98, 0.99) were related to a decrease in the incidence of HFMD.
CONCLUSIONS/SIGNIFICANCE: In conclusion, the epidemic status of HFMD in Xinjiang is characterized by low morbidity and fatality. Multiple factors have significant influences on the occurrence and transmission of HFMD in Xinjiang.
手足口病（HFMD）正在成为中国常见的人类传染病之一。先前的研究已经描述了亚太国家热带或沿海地区的 HFMD。然而，有限的研究彻底研究了内陆地区具有复杂环境条件的 HFMD 的流行病学和潜在危险因素。
方法/主要发现：利用 2009 年至 2018 年新疆维吾尔自治区报告病例的数据，我们描述了 HFMD 的流行特征。面板负二项式模型用于确定 HFMD 发病率的气候、地理和人口统计学决定因素。在 10 年的研究期间，新疆共报告了 70856 例 HFMD 病例（平均每年每百万人发病率为 305 例），其中 10393 例（14.7%）为实验室确诊，98 例（0.1%）为重症。HFMD 在研究期间每年夏季达到高峰，2012 年、2015 年、2016 年和 2018 年秋季出现小高峰。在校或假期月份调整后，发现多个因素影响 HFMD 流行病学：城区是主要土地覆盖类型（发病率风险比，IRR 2.08；95%CI 1.50，2.89）、人均国内生产总值较高（IRR 1.14；95%CI 1.11，1.16）、月平均气温升高（IRR 1.65；95%CI 1.61，1.69）和月累积降水量增加（IRR 1.20；95%CI 1.16，1.24）预示着 HFMD 发病率的增加；农田是主要土地覆盖类型（IRR 0.72；95%CI 0.64，0.81）、少数民族比例增加（IRR 0.91；95%CI 0.89，0.93）和人口密度（IRR 0.98；95%CI 0.98，0.99）与 HFMD 发病率下降有关。
结论/意义：总之，新疆 HFMD 的流行状况以发病率和死亡率低为特征。多种因素对新疆 HFMD 的发生和传播有显著影响。
