School of Public Health, Southern Medical University, Guangzhou, China.
Department of Communicable Disease Control and Prevention, Guangzhou Center for Disease Control and Prevention, Guangzhou, China.
JMIR Public Health Surveill. 2024 Aug 2;10:e58821. doi: 10.2196/58821.
In the past 10 years, the number of hand, foot, and mouth disease (HFMD) cases reported in Guangzhou, China, has averaged about 60,000 per year. It is necessary to conduct an in-depth analysis to understand the epidemiological pattern and related influencing factors of HFMD in this region.
This study aims to describe the epidemiological characteristics and spatiotemporal distribution of HFMD cases in Guangzhou from 2013 to 2022 and explore the relationship between sociodemographic factors and HFMD incidence.
The data of HFMD cases in Guangzhou come from the Infectious Disease Information Management System of the Guangzhou Center for Disease Control and Prevention. Spatial analysis and space-time scan statistics were used to visualize the spatiotemporal distribution of HFMD cases. Multifactor ordinary minimum regression model, geographically weighted regression, and geographically and temporally weighted regression were used to analyze the influencing factors, including population, economy, education, and medical care.
From 2013 to 2022, a total of 599,353 HFMD cases were reported in Guangzhou, with an average annual incidence rate of 403.62/100,000. Children aged 5 years and younger accounted for 93.64% (561,218/599,353) of all cases. HFMD cases showed obvious bimodal distribution characteristics, with the peak period from May to July and the secondary peak period from August to October. HFMDs in Guangzhou exhibited a spatial aggregation trend, with the central urban area showing a pattern of low-low aggregation and the peripheral urban area demonstrating high-high aggregation. High-risk areas showed a dynamic trend of shifting from the west to the east of peripheral urban areas, with coverage first increasing and then decreasing. The geographically and temporally weighted regression model results indicated that population density (β=-0.016) and average annual income of employees (β=-0.007) were protective factors for HFMD incidence, while the average number of students in each primary school (β=1.416) and kindergarten (β=0.412) was a risk factor.
HFMD cases in Guangzhou were mainly infants and young children, and there were obvious differences in time and space. HFMD is highly prevalent in summer and autumn, and peripheral urban areas were identified as high-risk areas. Improving the economic level of peripheral urban areas and reducing the number of students in preschool education institutions are key strategies to controlling HFMD.
过去 10 年，中国广州市手足口病（HFMD）报告病例数平均每年约为 6 万例。有必要深入分析了解该地区 HFMD 的流行病学模式和相关影响因素。
本研究旨在描述 2013 年至 2022 年广州市 HFMD 病例的流行病学特征和时空分布，并探讨社会人口因素与 HFMD 发病率之间的关系。
广州市 HFMD 病例数据来源于广州市疾病预防控制中心传染病信息管理系统。采用空间分析和时空扫描统计方法可视化 HFMD 病例的时空分布。采用多因素普通最小二乘法回归模型、地理加权回归和地理时空加权回归分析人口、经济、教育和医疗等影响因素。
2013 年至 2022 年，广州市共报告 HFMD 病例 599353 例，年均发病率为 403.62/10 万。所有病例中，5 岁及以下儿童占 93.64%（561218/599353）。HFMD 病例呈明显双峰分布特征，高峰期为 5 月至 7 月，次高峰为 8 月至 10 月。广州市 HFMD 呈空间集聚趋势，中心城区呈低-低集聚模式，外围城区呈高-高集聚模式。高危地区呈由外围城区西部向东部动态转移趋势，覆盖范围先增后减。地理时空加权回归模型结果表明，人口密度（β=-0.016）和职工年平均收入（β=-0.007）是 HFMD 发病率的保护因素，而每所小学（β=1.416）和幼儿园（β=0.412）的平均学生数是危险因素。
广州市 HFMD 病例主要为婴幼儿，时间和空间分布差异明显。HFMD 高发于夏秋季，外围城区为高风险地区。提高外围城区经济水平，减少学前教育机构学生人数是控制 HFMD 的关键策略。
