Shen Li, Sun Minghao, Wei Mengna, Hu Qingwu, Bai Yao, Shao Zhongjun, Liu Kun
School of Remote Sensing and Information Engineering, Wuhan University, Wuhan, Hubei Province, China.
Department of Infection Disease Control and Prevention, Xi'an Center for Disease Control and Prevention, Xi'an, Shaanxi, China.
Infect Dis Model. 2024 Feb 10;9(2):373-386. doi: 10.1016/j.idm.2024.02.005. eCollection 2024 Jun.
The transmission and prevalence of Hand, Foot and Mouth Disease (HFMD) are affected by a variety of natural and socio-economic environmental factors. This study aims to quantitatively investigate the non-stationary and spatially varying associations between various environmental factors and HFMD risk. We collected HFMD surveillance cases and a series of relevant environmental data from 2013 to 2021 in Xi'an, Northwest China. By controlling the spatial and temporal mixture effects of HFMD, we constructed a Bayesian spatiotemporal mapping model and characterized the impacts of different driving factors into global linear, non-stationary and spatially varying effects. The results showed that the impact of meteorological conditions on HFMD risk varies in both type and magnitude above certain thresholds (temperature: 30 °C, precipitation: 70 mm, solar radiation: 13000 kJ/m, pressure: 945 hPa, humidity: 69%). Air pollutants (PM, PM, NO) showed an inverted U-shaped relationship with the risk of HFMD, while other air pollutants (O, SO) showed nonlinear fluctuations. Moreover, the driving effect of increasing temperature on HFMD was significant in the 3-year period, while the inhibitory effect of increasing precipitation appeared evident in the 5-year period. In addition, the proportion of urban/suburban/rural area had a strong influence on HFMD, indicating that the incidence of HFMD firstly increased and then decreased during the rapid urbanization process. The influence of population density on HFMD was not only limited by spatial location, but also varied between high and low intervals. Higher road density inhibited the risk of HFMD, but higher night light index promoted the occurrence of HFMD. Our findings further demonstrated that both ecological and socioeconomic environmental factors can pose multiple driving effects on increasing the spatiotemporal risk of HFMD, which is of great significance for effectively responding to the changes in HFMD epidemic outbreaks.
手足口病（HFMD）的传播和流行受到多种自然和社会经济环境因素的影响。本研究旨在定量调查各种环境因素与手足口病风险之间的非平稳和空间变化关联。我们收集了中国西北西安2013年至2021年手足口病监测病例及一系列相关环境数据。通过控制手足口病的时空混合效应，我们构建了贝叶斯时空映射模型，并将不同驱动因素的影响表征为全局线性、非平稳和空间变化效应。结果表明，气象条件对手足口病风险的影响在超过特定阈值（温度：30℃，降水量：70毫米，太阳辐射：13000千焦/平方米，气压：945百帕，湿度：69%）时，类型和程度都会有所不同。空气污染物（PM、PM、NO）与手足口病风险呈倒U形关系，而其他空气污染物（O、SO）呈非线性波动。此外，气温升高对手足口病的驱动作用在3年期间显著，而降水量增加的抑制作用在5年期间明显。此外，城市/郊区/农村地区的比例对手足口病有很大影响，表明在快速城市化过程中手足口病发病率先上升后下降。人口密度对手足口病的影响不仅受空间位置限制，在高低区间也有所不同。较高的道路密度抑制了手足口病风险，但较高的夜光指数促进了手足口病的发生。我们的研究结果进一步表明，生态和社会经济环境因素都可能对增加手足口病的时空风险产生多种驱动作用，这对于有效应对手足口病疫情爆发的变化具有重要意义。
