Zhan Meirong, Cai Shaojian, Xie Zhonghang, Zheng Senshuang, Huang Zhengqiang, Ou Jianming, Wu Shenggen
Fujian Provincial Center for Disease Control and Prevention, Fuzhou 350001, China.
Trop Med Infect Dis. 2025 Jul 3;10(7):188. doi: 10.3390/tropicalmed10070188.
Hand, foot, and mouth disease (HFMD) typically exhibits spatiotemporal clustering. This study aimed to analyze the spatiotemporal heterogeneity of HFMD in Fujian Province, China, and to identify the associations of air pollutants and socioeconomic factors with the incidence.
Daily reported HFMD case data, daily air pollutant data, and socioeconomic data in Fujian Province from 2014 to 2023 were collected for analysis. A descriptive analysis was used to describe the epidemiological trends of HFMD. Spatial autocorrelation analysis was applied to explore the spatiotemporal clustering characteristics. The associations between risk factors and HFMD incidence were evaluated using the generalized additive model (GAM).
HFMD incidence in Fujian has decreased since 2019, and the peak in each year occurred between May and June. Distinct high-high and low-low clustering areas were identified. The cumulative exposure-response curves for SO, NO, and CO showed a monotonically increasing trend, with relative risks (RRs) < 1 at concentrations lower than the median levels (SO ≈ 4 μg/m, NO ≈ 16 μg/m, CO ≈ 1 mg/m). In contrast, the curves for O and PM showed a decreasing trend, with RR < 1 at concentrations above the median levels (O ≈ 55 μg/m, PM ≈ 20 μg/m). Among socioeconomic factors, only the proportion of the population under 15 years old was found to be associated with HFMD incidence.
HFMD incidence in Fujian exhibited distinct spatiotemporal clustering. The incidence was associated with the concentrations of air pollutants. Targeted interventions should be implemented in high-risk areas to mitigate HFMD transmission, with particular attention given to the environmental and demographic factors.
手足口病（HFMD）通常呈现时空聚集性。本研究旨在分析中国福建省手足口病的时空异质性，并确定空气污染物和社会经济因素与发病率之间的关联。
收集了福建省2014年至2023年每日报告的手足口病病例数据、每日空气污染物数据和社会经济数据进行分析。采用描述性分析来描述手足口病的流行病学趋势。应用空间自相关分析来探索时空聚集特征。使用广义相加模型（GAM）评估风险因素与手足口病发病率之间的关联。
自2019年以来，福建省手足口病发病率有所下降，每年的发病高峰出现在5月至6月之间。识别出了明显的高高聚集区和低低聚集区。SO、NO和CO的累积暴露-反应曲线呈单调上升趋势，在浓度低于中位数水平时相对风险（RRs）<1（SO≈4μg/m³，NO≈16μg/m³，CO≈1mg/m³）。相比之下，O₃和PM₂.₅的曲线呈下降趋势，在浓度高于中位数水平时RR<1（O₃≈55μg/m³，PM₂.₅≈20μg/m³）。在社会经济因素中，仅发现15岁以下人口比例与手足口病发病率有关。
福建省手足口病发病率呈现出明显的时空聚集性。发病率与空气污染物浓度有关。应在高风险地区实施针对性干预措施以减轻手足口病传播，尤其要关注环境和人口因素。
