Wang Y T, Peng W J, Su H L, Wang Weibing
Department of Epidemiology, Key Laboratory of Public Health Safety of Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China.
Minhang District Center for Disease Control and Prevention, Shanghai 201101, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2022 Oct 10;43(10):1562-1567. doi: 10.3760/cma.j.cn112338-20220416-00307.
To analyze the spatiotemporal characteristics of hand,foot and mouth disease (HFMD) in China, explore the association of socioeconomic, population and health services factors with the incidence of HFMD in China, and provide information for the prevention and control of HFMD. Bayesian spatiotemporal model was used to fit the data of HFMD, evaluate the spatiotemporal variation of HFMD, and identify the potential association between the risk of HFMD and social, economic, population and health services. From 2011 to 2018, a total of 17 118 050 HFMD cases, including 2 283 deaths, were reported in China. The reported incidence showed a fluctuating increase trend from 2011 to 2014, and a fluctuating decrease trend from 2014 to 2018. Meanwhile, there was a fluctuating decrease trend of mortality rate. The incidence of HFMD had spatial clustering, with the highest incidence in southern China with hot spot and high risk areas, and the lowest incidence in northwestern China where cold spot and low risk areas were found. The risk for HFMD was associated with GDP per capita (=3.54), number of industrial enterprises above designated size of 10 000 people (=1.61), urbanization rate (=3.00), birth rate (=2.36), number of beds in medical institutions per 10 000 people (=3.40), and green area in parks per capita (=0.57). The hotspot area for HFMD prevention and control in China was in the southeast coastal provinces from 2011 to 2018. In order to reduce the incidence of HFMD, it is necessary to increase the green area in parks per capita while accelerating urbanization process.
分析中国手足口病（HFMD）的时空特征，探讨社会经济、人口和卫生服务因素与中国手足口病发病率的关联，为手足口病的预防控制提供信息。采用贝叶斯时空模型拟合手足口病数据，评估手足口病的时空变化，识别手足口病风险与社会、经济、人口和卫生服务之间的潜在关联。2011年至2018年，中国共报告手足口病病例17118050例，其中死亡2283例。报告发病率在2011年至2014年呈波动上升趋势，在2014年至2018年呈波动下降趋势。同时，死亡率呈波动下降趋势。手足口病发病率存在空间聚集性，中国南方发病率最高，为热点和高风险地区，中国西北发病率最低，为冷点和低风险地区。手足口病风险与人均国内生产总值（=3.54）、每万人规模以上工业企业数（=1.61）、城市化率（=3.00）、出生率（=2.36）、每万人医疗机构床位数（=3.40）和人均公园绿地面积（=0.57）有关。2011年至2018年中国手足口病防控的热点地区位于东南沿海省份。为降低手足口病发病率，有必要在加快城市化进程的同时增加人均公园绿地面积。
