Zhang Yazhen, Zhang Juan, Zhang Xuefeng, Jin Hui
Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, Jiangsu, China.
Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, Jiangsu, China.
Int J Infect Dis. 2025 May;154:107845. doi: 10.1016/j.ijid.2025.107845. Epub 2025 Feb 18.
This study analyzed the influence of urbanization on the effectiveness of school closures in controlling hand, foot, and mouth disease (HFMD).
Data were collected from 31 provinces in mainland China between 2010 and 2019. The effect of school closures on HFMD was estimated and synthesized for high and low urbanization groups. Discrepancies in effectiveness were hypothesized to be explained by transmission potential, which was estimated with its influencing factors identified. Considering time lags or seasons, system dynamics models were constructed to verify this hypothesis.
The relative risk of school closures on HFMD epidemics was 0.68, with a negative correlation between urbanization and the effectiveness of school closures. Urbanization and human mobility significantly increased the transmission potential of HFMD. Controlling for the positive effects of specific humidity, school closures reduced the effective reproductive number of HFMD by 10.52% and 17.07% in the high and low urbanization groups, respectively (P < 0.0001). Timely response or school closures in autumn led to a notable decline in the number of HFMD cases.
Increased urbanization reduced the effectiveness of school closures in controlling HFMD by greater transmission potential, highlighting the need for additional public health interventions.
本研究分析了城市化对学校停课防控手足口病（HFMD）效果的影响。
收集了2010年至2019年中国大陆31个省份的数据。对高城市化组和低城市化组评估并综合了学校停课对手足口病的影响。假设防控效果的差异可通过传播潜力来解释，对传播潜力及其影响因素进行了估计。考虑到时间滞后或季节因素，构建了系统动力学模型来验证这一假设。
学校停课对手足口病流行的相对风险为0.68，城市化与学校停课效果呈负相关。城市化和人口流动显著增加了手足口病的传播潜力。在控制了比湿的积极影响后，学校停课分别使高城市化组和低城市化组手足口病的有效再生数降低了10.52%和17.07%（P < 0.0001）。秋季及时响应或学校停课导致手足口病病例数显著下降。
城市化加剧通过更大的传播潜力降低了学校停课防控手足口病的效果，凸显了采取额外公共卫生干预措施的必要性。
