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Cao H, Xu R, Liang Y, Li Q, Jiang W, Jin Y, Wang W, Yuan J. Effects of extreme meteorological factors and high air pollutant concentrations on the incidence of hand, foot and mouth disease in Jining, China. PeerJ 2024; 12:e17163. [PMID: 38766480 PMCID: PMC11102053 DOI: 10.7717/peerj.17163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 03/06/2024] [Indexed: 05/22/2024] Open
Abstract
Background The evidence on the effects of extreme meteorological conditions and high air pollution levels on incidence of hand, foot and mouth disease (HFMD) is limited. Moreover, results of the available studies are inconsistent. Further investigations are imperative to elucidate the specific issue. Methods Data on the daily cases of HFMD, meteorological factors and air pollution were obtained from 2017 to 2022 in Jining City. We employed distributed lag nonlinear model (DLNM) incorporated with Poisson regression to explore the impacts of extreme meteorological conditions and air pollution on HFMD incidence. Results We found that there were nonlinear relationships between temperature, wind speed, PM2.5, SO2, O3 and HFMD. The cumulative risk of extreme high temperature was higher at the 95th percentile (P95th) than at the 90th percentile(P90th), and the RR values for both reached their maximum at 10-day lag (P95th RR = 1.880 (1.261-2.804), P90th RR = 1.787 (1.244-2.569)), the hazardous effect of extreme low temperatures on HFMD is faster than that of extreme high temperatures. The cumulative effect of extreme low wind speeds reached its maximum at 14-day lag (P95th RR = 1.702 (1.389-2.085), P90th RR = 1.498(1.283-1.750)). The cumulative effect of PM2.5 concentration at the P90th was largest at 14-day lag (RR = 1.637 (1.069-2.506)), and the cumulative effect at the P95th was largest at 10-day lag (RR = 1.569 (1.021-2.411)). High SO2 concentration at the P95th at 14-day lag was associated with higher risk for HFMD (RR: 1.425 (1.001-2.030)). Conclusion Our findings suggest that high temperature, low wind speed, and high concentrations of PM2.5 and SO2 are associated with an increased risk of HFMD. This study not only adds insights to the understanding of the impact of extreme meteorological conditions and high levels of air pollutants on HFMD incidence but also holds practical significance for the development and enhancement of an early warning system for HFMD.
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Affiliation(s)
- Haoyue Cao
- School of Public Health, North China University of Science and Technology, Tangshan, Hebei Province, China
| | - Rongrong Xu
- State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing, China
| | - Yongmei Liang
- Business Management Department, Jining Center For Disease Control And Prevention, Jining, Shandong, China
| | - Qinglin Li
- School of Public Health, North China University of Science and Technology, Tangshan, Hebei Province, China
| | - Wenguo Jiang
- Infectious Disease Prevention and Control Department, Jining Center For Disease Control And Prevention, Jining, Shandong, China
| | - Yudi Jin
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Wenjun Wang
- Weifang Nursing Vocational College, Weifang, Shandong, China
| | - Juxiang Yuan
- School of Public Health, North China University of Science and Technology, Tangshan, Hebei Province, China
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Yang X, Wang J, Zhang G, Yu Z. Short-Term Effects of Extreme Meteorological Factors on Hand, Foot, and Mouth Disease Infection During 2010-2017 in Jiangsu, China: A Distributed Lag Non-Linear Analysis. GEOHEALTH 2024; 8:e2023GH000942. [PMID: 38562664 PMCID: PMC10982542 DOI: 10.1029/2023gh000942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 01/30/2024] [Accepted: 03/13/2024] [Indexed: 04/04/2024]
Abstract
Hand, Foot, and Mouth Disease (HFMD) is an infectious disease that primarily affects young children. In densely populated Jiangsu Province in China, the impact of extreme meteorological factors on HFMD is a concern. We aimed to examine the association between extreme meteorological variables and HFMD infection risk using daily HFMD infections and meteorological data from 2010 to 2017 in Jiangsu Province. We used distributed lag non-linear model (DLNM) to analyze the data, which can effectively capture the nuanced non-linear dynamics and lag effects in the relationship between HFMD and extreme meteorological factors. Comparing the 10th and 90th percentiles of meteorological variables with their respective median values, our results showed that extremely low temperatures and high humidity were significantly associated with increased HFMD infection risk. The greatest effect of extremely low temperatures was observed at a lag of 1-2 days, elevating the risk by 18 ∼ 33% (RR = 1.18 ∼ 1.33). Extremely high humidity was found to increase the risk of infection, starting at a lag of 4 days. In contrast, extremely high temperatures, low humidity, and high wind speed were associated with reduced risk of infection at lag of 0-12 days, with the range of RR values being 0.60-0.98 for extremely high temperatures, 0.69-0.89 for extremely low humidity, and 0.84-0.98 for extremely high wind speed respectively. Our findings suggest that extreme meteorological factors can significantly impact the incidence of HFMD in Jiangsu Province, and highlight the need for effective public health protection measures during the periods of extreme meteorological condition, particularly for vulnerable populations.
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Affiliation(s)
- Xu Yang
- Key Laboratory of Virtual Geographic EnvironmentNanjing Normal UniversityMinistry of EducationNanjingChina
- Jiangsu Center for Collaborative Innovation in Geographical Information Resource Development and ApplicationNanjingChina
| | - Junshu Wang
- Key Laboratory of Virtual Geographic EnvironmentNanjing Normal UniversityMinistry of EducationNanjingChina
- Jiangsu Center for Collaborative Innovation in Geographical Information Resource Development and ApplicationNanjingChina
| | - Guoming Zhang
- Health Information Center of Jiangsu ProvinceNanjingChina
| | - Zhaoyuan Yu
- Key Laboratory of Virtual Geographic EnvironmentNanjing Normal UniversityMinistry of EducationNanjingChina
- Jiangsu Center for Collaborative Innovation in Geographical Information Resource Development and ApplicationNanjingChina
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Yang L, Liu T, Tian D, Zhao H, Xia Y, Wang J, Li T, Li Q, Qi L. Non-linear association between daily mean temperature and children's hand foot and mouth disease in Chongqing, China. Sci Rep 2023; 13:20355. [PMID: 37990138 PMCID: PMC10663521 DOI: 10.1038/s41598-023-47858-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 11/19/2023] [Indexed: 11/23/2023] Open
Abstract
Chongqing was seriously affected by hand, foot, and mouth disease (HFMD), but the relationships between daily mean temperature and the incidence of HFMD remain unclear. This study used distributed lag nonlinear model to evaluate the effect of daily mean temperature on the incidence of HFMD in children aged < 5 years in Chongqing. Daily HFMD data from 2012 to 2019 in Chongqing were retrieved from the notifiable infectious disease surveillance system. A total of 413,476 HFMD cases aged < 5 years were reported in Chongqing from 2012 to 2019. The exposure-response curve of daily mean temperature and daily HFMD cases was wavy-shaped. The relative risks (RRs) increased as daily mean temperature below 5.66 °C or above 9.43 °C, with two peaks at 16.10 °C and 26.68 °C. The RRs reached the highest when the daily mean temperature at 26.68 °C on the current day (RR = 1.20, 95% CI 1.09-1.32), followed by the daily mean temperature at 16.10 °C at lag 5 days (RR = 1.07, 95% CI 1.05-1.08). The RRs for girls and daycare children were much higher than those for boys and scattered children, respectively. Taken together, daily mean temperature has strong effect on HFMD in children aged < 5 years old in Chongqing, particularly for girls and daycare children.
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Affiliation(s)
- Lin Yang
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, 400042, China
| | - Tian Liu
- Jingzhou Center for Disease Control and Prevention, Hubei, 434000, China
| | - Dechao Tian
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-Sen University, Shenzhen, 518107, Guangdong, China
| | - Han Zhao
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, 400042, China
| | - Yu Xia
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, 400042, China
| | - Ju Wang
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, 400042, China
| | - Tingting Li
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, 400042, China
| | - Qin Li
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, 400042, China.
| | - Li Qi
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, 400042, China.
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Ji Y, Xiong J, Yuan Z, Huang Z, Li L. Risk assessment and disease burden of extreme precipitation on hospitalizations for acute aortic dissection in a subtropical coastal Chinese city. Front Public Health 2023; 11:1216847. [PMID: 37457244 PMCID: PMC10343949 DOI: 10.3389/fpubh.2023.1216847] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 06/14/2023] [Indexed: 07/18/2023] Open
Abstract
Background Extreme precipitation events are becoming more frequent due to climate change. The present study aimed to explore the impacts of extreme precipitation on hospitalizations for acute aortic dissection (AAD) and to identify susceptible populations and quantify the corresponding disease burden. Methods The present study used a distributed lag nonlinear model (DLNM) with a quasi-Poisson function to investigate the association between extreme precipitation (≥95th percentile) and the risk of hospitalizations for AAD from 2015 to 2020 in Shantou, Guangdong Province, China. Results The significant adverse effects of extreme precipitation (relative to no precipitation) on daily AAD hospitalizations lasted from lag 5 [relative risk (RR): 1.0318, 95% confidence interval (CI): 1.0067-1.0575] to lag 9 (RR: 1.0297, 95% CI: 1.0045-1.0555) and reached its maximum at lag 7 (RR: 1.0382, 95% CI: 1.0105-1.0665). Males and older adult individuals (≥60 years) were more susceptible to extreme precipitation. A total of 3.68% (118 cases) of AAD hospitalizations were due to extreme precipitation. Conclusion Extreme precipitation was significantly correlated with AAD hospitalizations. Government departments should actively implement extreme precipitation intervention measures to strengthen the protection of males and the older adult (≥60 years) and effectively reduce AAD hospitalizations.
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Affiliation(s)
- Yanhu Ji
- School of Public Health, Shantou University, Shantou, China
| | - Jianping Xiong
- The First Affiliated Hospital of Shantou University Medical College, Shantou, China
| | | | - Zepeng Huang
- The Second Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Liping Li
- School of Public Health, Shantou University, Shantou, China
- Injury Prevention Research Center, Shantou University Medical College, Shantou, China
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Wang W, Rosenberg MW, Chen H, Gong S, Yang M, Deng D. Epidemiological characteristics and spatiotemporal patterns of hand, foot, and mouth disease in Hubei, China from 2009 to 2019. PLoS One 2023; 18:e0287539. [PMID: 37352281 PMCID: PMC10289314 DOI: 10.1371/journal.pone.0287539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 06/07/2023] [Indexed: 06/25/2023] Open
Abstract
BACKGROUND Hand, foot, and mouth disease (HFMD) is a public health issue in Hubei and studies of- spatiotemporal clustering at a fine scale are limited. The purpose of this research was to analyze the epidemiological characteristics, temporal variation characteristics, and spatiotemporal clustering of HFMD cases at the town level from 2009 to 2019 to improve public health outcomes. METHODS Mathematical statistics, a seasonal index, wavelet analysis, and spatiotemporal scans were used to analyze epidemiological characteristics, time series trends, and spatiotemporal clusters of HFMD in Hubei. RESULTS EV-A71 (Enterovirus A71) and CVA16 (Coxsackievirus A16) constitute the two primary pathogens of the HFMD epidemic in Hubei, among which EV-A71 is the dominant pathogen, especially in 2016. In terms of age distribution, a major peak occurred at 0-5 years and a very small increase appeared at 25-35 years, with the former having a higher incidence among males than females and the latter having the opposite difference between males and females. The number/rate of HFMD cases exhibited a considerable increase followed by a moderate decline from 2009 to 2019, with the first large peak in April-July and a smaller peak in November-December. HFMD in Hubei exhibited the characteristics of a 270-day cycle with multiscale nesting, which was similar to the periodicity of HFMD cases caused by EV-A71 (9 months). Cities with a higher incidence of HFMD formed a part of an "A-shaped urban skeleton". Subdistricts had the highest incidence of HFMD, followed by towns and villages. The spatiotemporal scan results showed one most likely cluster and 22 secondary clusters, which was consistent with the geographic location of railways and rivers in Hubei. CONCLUSIONS These findings may be helpful in the prevention and control of HFMD transmission and in implementing effective measures in Hubei Province.
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Affiliation(s)
- Wuwei Wang
- Institute of China Rural Studies, Central China Normal University, Wuhan, Hubei, China
- Institute of Sustainable Development & Department of Geography, Central China Normal University, Wuhan, Hubei, China
- Department of Geography and Planning, Queen’s University, Kingston, Ontario, Canada
| | - Mark W. Rosenberg
- Department of Geography and Planning, Queen’s University, Kingston, Ontario, Canada
| | - Hongying Chen
- Center for Disease Control and Prevention of Hubei Province, Wuhan, Hubei, China
| | - Shengsheng Gong
- Institute of Sustainable Development & Department of Geography, Central China Normal University, Wuhan, Hubei, China
| | - Mengmeng Yang
- Institute of Sustainable Development & Department of Geography, Central China Normal University, Wuhan, Hubei, China
| | - Dacai Deng
- Institute of China Rural Studies, Central China Normal University, Wuhan, Hubei, China
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Zheng H, Liu D, Zhao X, Zhao X, Liu Y, Li D, Shi T, Ren X. Influence and prediction of meteorological factors on brucellosis in a northwest region of China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:9962-9973. [PMID: 36064850 DOI: 10.1007/s11356-022-22831-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 08/29/2022] [Indexed: 06/15/2023]
Abstract
This paper aims to study the cumulative lag effect of meteorological factors on brucellosis incidence and the prediction performance based on Random Forest model. The monthly number of brucellosis cases and meteorological data from 2015 to 2019 in Yongchang of Gansu Province, northwest China, were used to build distributed lag nonlinear model (DLNM). The number of brucellosis cases of lag 1 month and meteorological data from 2015 to 2018 were used to build RF model to predict the brucellosis incidence in 2019. Meanwhile, SARIMA model was established to compare the prediction performance with RF model according to R2 and RMSE. The results indicated that the population had a high incidence risk at temperature between 5 and 13 °C and lag between 0 and 18 days, sunshine duration between 225 and 260 h and lag between 0 and 1 month, and atmosphere pressure between 789 and 793.5 hPa and lag between 0 and 18 days. The R2 and RMSE of train set and test set in RF model were 0.903, 1.609, 0.824, and 2.657, respectively, and the R2 and RMSE in SARIMA model were 0.530 and 7.008. This study found significant nonlinear and lag associations between meteorological factors and brucellosis incidence. The prediction performance of RF model was more accurate and practical compared with SARIMA model.
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Affiliation(s)
- Hongmiao Zheng
- School of Public Health, Lanzhou University, Gansu, China
| | - Dongpeng Liu
- Gansu Provincial Center for Disease Control and Prevention, Gansu, China
| | - Xin Zhao
- School of Public Health, Lanzhou University, Gansu, China
| | - Xiangkai Zhao
- School of Public Health, Lanzhou University, Gansu, China
| | - Yanchen Liu
- School of Public Health, Lanzhou University, Gansu, China
| | - Donghua Li
- School of Public Health, Lanzhou University, Gansu, China
| | - Tianshan Shi
- School of Public Health, Lanzhou University, Gansu, China
| | - Xiaowei Ren
- School of Public Health, Lanzhou University, Gansu, China.
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Chen NT, Chen YC, Wu CD, Chen MJ, Guo YL. The impact of heavy precipitation and its impact modifiers on shigellosis occurrence during typhoon season in Taiwan: A case-crossover design. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 848:157520. [PMID: 35882342 DOI: 10.1016/j.scitotenv.2022.157520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 07/07/2022] [Accepted: 07/16/2022] [Indexed: 06/15/2023]
Abstract
Because of climate change, heavy precipitation is likely to become frequent and intense, thereby increasing the risk of shigellosis occurrence. However, few studies examined the impact of heavy precipitation on shigellosis and its impact modifiers in developed countries. This study aims to analyze the association between heavy precipitation and shigellosis in Taiwan, and to identify the vulnerable population and impact modifiers. We adopted a case-crossover design, and used conditional logistic regression to estimate odds ratios (ORs) for shigellosis occurrence. Information were collected on the daily shigellosis cases, precipitation, temperature, and typhoons from 1994 to 2015, and yearly data of medical resources and environmental factors were obtained at the city level from 1998 to 2015. Stratification analyses were performed by age, sex, medical resource, and environmental factors. We discovered that heavy precipitation ≥80 mm/day considerably increased the risk of shigellosis occurrence. The ORs of heavy rain (80 to <200 mm/day) were 2.08-2.26 at lags 0-1. The ORs of extremely heavy rain (≥200 mm/day) increased to 2.17-4.73 at lags 5-8. Moreover, the effect of heavy precipitation was greater under high temperature condition (≥23.6 °C). Adults were more susceptible to heavy-precipitation-associated shigellosis, especially the elderly. Males experienced marginally higher effects than females did. Moreover, cities with more medical resources and forest cover and higher percentage of completed storm sewers had lower effects; however, dense population and higher pig density were the risk factors. Although the high water-supply penetration rate did not decrease Shigella infection after heavy precipitation, it did lower the risk of typhoon-related shigellosis. In conclusion, hot temperature could enhance the impact of heavy precipitation on shigellosis. Public health interventions should be introduced according to the lag period after heavy precipitation, particularly in areas with high population density, proportion of elderly people, and pig density. The improvement of medical resources and tree cover as well as the construction of storm sewers and piped water systems might be mitigation measures that can be considered.
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Affiliation(s)
- Nai-Tzu Chen
- National Institute of Environmental Health Sciences, National Health Research Institutes, 35 Keyan Road, Zhunan Town, Miaoli 35053, Taiwan; Research Center of Environmental Trace Toxic Substances, National Cheng Kung University, Tainan 704302, Taiwan
| | - Yu-Cheng Chen
- National Institute of Environmental Health Sciences, National Health Research Institutes, 35 Keyan Road, Zhunan Town, Miaoli 35053, Taiwan; Department of Occupational Safety and Health, China Medical University, 91 Hsueh-Shih Road, Taichung 40402, Taiwan
| | - Chih-Da Wu
- National Institute of Environmental Health Sciences, National Health Research Institutes, 35 Keyan Road, Zhunan Town, Miaoli 35053, Taiwan; Department of Geomatics, National Cheng Kung University, Tainan 70101, Taiwan
| | - Mu-Jean Chen
- National Institute of Environmental Health Sciences, National Health Research Institutes, 35 Keyan Road, Zhunan Town, Miaoli 35053, Taiwan
| | - Yue-Liang Guo
- National Institute of Environmental Health Sciences, National Health Research Institutes, 35 Keyan Road, Zhunan Town, Miaoli 35053, Taiwan; Department of Environmental and Occupational Medicine, College of Medicine, National Taiwan University (NTU) and NTU Hospital, Taipei 10051, Taiwan; Institute of Occupational Medicine and Industrial Hygiene, College of Public Health, National Taiwan University, Taipei 10055, Taiwan.
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Chen Y, Chang Z, Zhao Y, Liu Y, Fu J, Liu Y, Liu X, Kong D, Han Y, Tang S, Fan Z. Association of extreme precipitation with hospitalizations for acute myocardial infarction in Beijing, China: A time-series study. Front Public Health 2022; 10:1024816. [PMID: 36238253 PMCID: PMC9551252 DOI: 10.3389/fpubh.2022.1024816] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 09/13/2022] [Indexed: 01/28/2023] Open
Abstract
Background In the context of global climate changes, increasing extreme weather events have aroused great public concern. Limited evidence has focused on the association between extreme precipitation and hospitalizations for acute myocardial infarction (AMI). Our study aimed to examine the effect of extreme precipitation on AMI hospitalizations. Methods Daily AMI hospitalizations, weather variables and air pollution data in Beijing from 2013 to 2018 were obtained. We used a time-series analysis with a distributed lag model to evaluate the association of extreme precipitation (≥95th percentile of daily precipitation) with AMI hospitalizations. Subgroup analysis was conducted to identify the vulnerable subpopulations and further assessed the attributable burden. Results Extreme precipitation increased the risk of AMI hospitalizations with significant single-day effects from Lag 4 to Lag 11, and the maximum cumulative effects at Lag 0-14 (CRR = 1.177, 95% CI: 1.045, 1.326). Older people (≥65 years) and females were more vulnerable to extreme precipitation. The attributable fraction and numbers of extreme precipitation on AMI hospitalizations were 0.68% (95% CI: 0.20%, 1.12%) and 854 (95% CI: 244, 1,395), respectively. Conclusion Extreme precipitation is correlated with a higher risk of AMI hospitalizations. The elderly (≥65 years) and females are more susceptible to AMI triggered by extreme precipitation.
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Peng H, Chen Z, Cai L, Liao J, Zheng K, Li S, Ren X, Duan X, Tang X, Wang X, Long L, Yang C. Relationship between meteorological factors, air pollutants and hand, foot and mouth disease from 2014 to 2020. BMC Public Health 2022; 22:998. [PMID: 35581574 PMCID: PMC9112249 DOI: 10.1186/s12889-022-13365-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 05/04/2022] [Indexed: 11/10/2022] Open
Abstract
Background Meteorological factors and air pollutants have been reported to be associated with hand, foot, and mouth disease (HFMD) epidemics before the introduction of vaccine. However, there is limited evidence for studies with long-term dimensions. Methods We collected the daily HFMD counts, weather and air pollution data from 2014 to 2020 in Chengdu. Distributed lag non-linear models (DLNM) were used to assess the associations of meteorological factors and air pollutants on HFMD cases. Results From 2014–2020, high relative humidity and precipitation and extremely high and low levels of PM10, O3, SO2 and CO increased the risk of HFMD. In pre-vaccination period, extreme high and low temperatures, PM10 and NO2, low precipitation and high concentrations of PM2.5 and O3 significantly increase the risk of HFMD; In post-vaccination period, high relative humidity and low level of CO can significantly increase the incidence of HFMD; During the period of COVID-19, only low temperature will significantly increase the risk of HFMD; Low concentration of air pollutants has the greatest impact on the 6–14 age group, while the high concentration of air pollutants has the greatest impact on the 0–1 age group. Conclusions Our study suggest that high relative humidity and precipitation and extremely high and low levels of PM10, O3, SO2 and CO increased the risk of HFMD from 2014 to 2020. The results of this study provide a reference for local authorities to formulate intervention measures and establish an environment-based disease early warning system. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13365-9.
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Affiliation(s)
- Hongxia Peng
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, No.16, Section 3, Renmin south road, Wuhou District, Chengdu, Sichuan, China
| | - Zhenhua Chen
- Department of Microbiology Laboratory, Chengdu Municipal Center for Disease Control and Prevention, Chengdu, Sichuan, China
| | - Lin Cai
- Department of Gastroenterology, West China School of Public Health and West China Forth Hospital, Sichuan University, Chengdu, Sichuan, China.,Non-Communicable Diseases Research Center, West China-PUMC C.C. Chen Institute of Health, Sichuan University, Chengdu, Sichuan, China
| | - Juan Liao
- Department of Gastroenterology, West China School of Public Health and West China Forth Hospital, Sichuan University, Chengdu, Sichuan, China.,Non-Communicable Diseases Research Center, West China-PUMC C.C. Chen Institute of Health, Sichuan University, Chengdu, Sichuan, China
| | - Ke Zheng
- Department of Immunization Planning, Chengdu Municipal Center for Disease Control and Prevention, Chengdu, Sichuan, China
| | - Shuo Li
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, No.16, Section 3, Renmin south road, Wuhou District, Chengdu, Sichuan, China
| | - Xueling Ren
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, No.16, Section 3, Renmin south road, Wuhou District, Chengdu, Sichuan, China
| | - Xiaoxia Duan
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, No.16, Section 3, Renmin south road, Wuhou District, Chengdu, Sichuan, China
| | - Xueqin Tang
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, No.16, Section 3, Renmin south road, Wuhou District, Chengdu, Sichuan, China
| | - Xiao Wang
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, No.16, Section 3, Renmin south road, Wuhou District, Chengdu, Sichuan, China
| | - Lu Long
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, No.16, Section 3, Renmin south road, Wuhou District, Chengdu, Sichuan, China.
| | - Chunxia Yang
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, No.16, Section 3, Renmin south road, Wuhou District, Chengdu, Sichuan, China.
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10
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Wu Y, Yao Z, Ma G, Cheng J, Xu H, Qin W, Yi W, Pan R, Wei Q, Tang C, Liu X, He Y, Yan S, Li Y, Jin X, Liang Y, Sun X, Mei L, Song J, Song S, Su H. Effects of extreme precipitation on hospitalization risk and disease burden of schizophrenia in urban and rural Lu'an, China, from 2010 to 2019. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:19176-19184. [PMID: 34713403 DOI: 10.1007/s11356-021-16913-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 10/03/2021] [Indexed: 06/13/2023]
Abstract
With the increasing frequency of extreme events caused by global climate change, the association between extreme precipitation (EP) and disease has aroused concern currently. However, no study has examined the relationship between EP and schizophrenia. Our study aimed to explore the relationship between EP and schizophrenia, and to further examine the difference between urban and rural areas. This study used quasi-Poisson generalized linear regression model combined with distributed lag non-linear model (DLNM) to estimate the association between EP (≥ 95th percentile) and hospitalization for schizophrenia from 2010 to 2019 in the city of Lu'an, China. EP could significantly increase the risk of hospitalization for schizophrenia. The effect firstly appeared at lag1 [relative risk (RR): 1.056, 95% confidence interval (95%CI): 1.003-1.110] and continued until lag17 (RR: 1.039, 95%CI: 1.004-1.075). Our research showed that EP had a significant effect on the hospitalization for schizophrenia in both urban and rural areas, and no significant difference was found (p>0.05). EP exerted more acute effects on schizophrenia living in rural areas than those in urban areas in the cold season. Further studies on the burden of schizophrenia found that patients who are male, aged ≤ 39 years or less, and living in urban areas are a priority for future warnings. We should pay more attention to the impact of EP on burden of schizophrenia, especially during the cold season, targeting those vulnerable groups, thereby implementing more accurate and timely preventive measures.
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Affiliation(s)
- Yudong Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
- Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, 230032, Anhui, China
| | - Zhenghai Yao
- Anhui Public Meteorological Service Center, Hefei, Anhui, China
| | - Gongyan Ma
- Lu'an Municipal Center for Disease Control and Prevention, Lu'an, Anhui, China
| | - Jian Cheng
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
- Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, 230032, Anhui, China
| | - Huabin Xu
- Affiliated Hospital of West Anhui Health Vocational College, Lu'an, China
| | - Wei Qin
- Lu'an Municipal Center for Disease Control and Prevention, Lu'an, Anhui, China
| | - Weizhuo Yi
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
- Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, 230032, Anhui, China
| | - Rubing Pan
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
- Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, 230032, Anhui, China
| | - Qiannan Wei
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
- Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, 230032, Anhui, China
| | - Chao Tang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
- Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, 230032, Anhui, China
| | - Xiangguo Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
- Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, 230032, Anhui, China
| | - Yangyang He
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
- Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, 230032, Anhui, China
| | - Shuangshuang Yan
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
- Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, 230032, Anhui, China
| | - Yuxuan Li
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
- Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, 230032, Anhui, China
| | - Xiaoyu Jin
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
- Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, 230032, Anhui, China
| | - Yunfeng Liang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
- Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, 230032, Anhui, China
| | - Xiaoni Sun
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
- Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, 230032, Anhui, China
| | - Lu Mei
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
- Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, 230032, Anhui, China
| | - Jian Song
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
- Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, 230032, Anhui, China
| | - Shasha Song
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
- Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, 230032, Anhui, China
| | - Hong Su
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China.
- Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, 230032, Anhui, China.
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Liu R, Cai J, Guo W, Guo W, Wang W, Yan L, Ma N, Zhang X, Zhang S. Effects of temperature and PM 2.5 on the incidence of hand, foot, and mouth in a heavily polluted area, Shijiazhuang, China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:11801-11814. [PMID: 34550518 DOI: 10.1007/s11356-021-16397-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 09/03/2021] [Indexed: 06/13/2023]
Abstract
The influence of weather and air pollution factors on hand, foot, and mouth disease (HFMD) has received widespread attention. However, most of the existing studies came from lightly polluted areas and the results were inconsistent. There was a lack of relevant evidence of heavily polluted areas. This study aims to quantify the relationship between weather factors and air pollution with HFMD in heavily polluted areas. We collected the daily number of hand, foot, and mouth disease in Shijiazhuang, China from 2014 to 2018, as well as meteorological and air pollutant data over the same period. The generalized linear model combined with the distributed lag model was used to study the effect of meteorological factors and air pollutants on the daily cases of HFMD and its hysteresis effect. We found that the dose-response relationship between temperature, PM2.5, and the risk of hand-foot-mouth disease was non-linear. Both low temperature and high temperature increased the risk of hand-foot-mouth disease. The cumulative effect of high temperature reached the maximum at 0-10 lag days, and the cumulative effect of low temperature reached the maximum at 0-3 lag days. The concentration of PM2.5 between 76 and 200 μg/m3 has a certain risk of the onset of hand, foot, and mouth disease, but the extreme PM2.5 concentration has a certain protective effect. In addition, low humidity, low wind speed, and low-O3 can increase the risk of HFMD. Risks of humidity and low concentration of O3 increased as lag days extended. In conclusion, our study found that climate factors and air pollutants exert varying degrees of impact on HFMD. Our research provided the scientific basis for establishing an early warning system so that medical staff and parents can take corresponding measures to prevent HFMD.
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Affiliation(s)
- Ran Liu
- Department of Epidemiology and Statistics, School of Public Health, Hebei Medical University, Hebei Province Key Laboratory of Environment and Human Health, 361 Zhongshan East Road, Shijiazhuang, 050017, China
| | - Jianning Cai
- The Department of Epidemic Treating and Preventing, Center for Disease Prevention and Control of Shijiazhuang City, Likang Road 3#, Shijiazhuang, 050011, China
| | - Weiheng Guo
- Department of Epidemiology and Statistics, School of Public Health, Hebei Medical University, Hebei Province Key Laboratory of Environment and Human Health, 361 Zhongshan East Road, Shijiazhuang, 050017, China
| | - Wei Guo
- Department of Epidemiology and Statistics, School of Public Health, Hebei Medical University, Hebei Province Key Laboratory of Environment and Human Health, 361 Zhongshan East Road, Shijiazhuang, 050017, China
| | - Wenjuan Wang
- Department of Epidemiology and Statistics, School of Public Health, Hebei Medical University, Hebei Province Key Laboratory of Environment and Human Health, 361 Zhongshan East Road, Shijiazhuang, 050017, China
| | - Lina Yan
- Department of Epidemiology and Statistics, School of Public Health, Hebei Medical University, Hebei Province Key Laboratory of Environment and Human Health, 361 Zhongshan East Road, Shijiazhuang, 050017, China
| | - Ning Ma
- Department of Epidemiology and Statistics, School of Public Health, Hebei Medical University, Hebei Province Key Laboratory of Environment and Human Health, 361 Zhongshan East Road, Shijiazhuang, 050017, China
| | - Xiaolin Zhang
- Department of Epidemiology and Statistics, School of Public Health, Hebei Medical University, Hebei Province Key Laboratory of Environment and Human Health, 361 Zhongshan East Road, Shijiazhuang, 050017, China.
| | - Shiyong Zhang
- The Department of Epidemic Treating and Preventing, Center for Disease Prevention and Control of Shijiazhuang City, Likang Road 3#, Shijiazhuang, 050011, China.
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12
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Zhao Z, Zheng C, Qi H, Chen Y, Ward MP, Liu F, Hong J, Su Q, Huang J, Chen X, Le J, Liu X, Ren M, Ba J, Zhang Z, Chang Z, Li Z. Impact of the coronavirus disease 2019 interventions on the incidence of hand, foot, and mouth disease in mainland China. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2022; 20:100362. [PMID: 35005671 PMCID: PMC8720138 DOI: 10.1016/j.lanwpc.2021.100362] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Background In early 2020, non-pharmaceutical interventions (NPIs) were implemented in China to reduce and contain the coronavirus disease 2019 (COVID-19) transmission. These NPIs might have also reduced the incidence of hand, foot, and mouth disease (HFMD). Methods The weekly numbers of HFMD cases and meteorological factors in 31 provincial capital cities and municipalities in mainland China were obtained from Chinese Center for Disease Control and Prevention (CCDC) and National Meteorological Information Center of China from 2016 to 2020. The NPI data were collected from local CDCs. The incidence rate ratios (IRRs) were calculated for the entire year of 2020, and for January-July 2020 and August-December 2020. The expected case numbers were estimated using seasonal autoregressive integrated moving average models. The relationships between kindergarten closures and incidence of HFMD were quantified using a generalized additive model. The estimated associations from all cities were pooled using a multivariate meta-regression model. Findings Stringent NPIs were widely implemented for COVID-19 control from January to July 2020, and the IRRs for HFMD were less than 1 in all 31 cities, and less than 0·1 for 23 cities. Overall, the proportion of HFMD cases reduced by 52·9% (95% CI: 49·3-55·5%) after the implementation of kindergarten closures in 2020, and this effect was generally consistent across subgroups. Interpretation The decrease in HFMD incidence was strongly associated with the NPIs for COVID-19. HFMD epidemic peaks were either absent or delayed, and the final epidemic size was reduced. Kindergarten closure is an intervention to prevent HFMD outbreaks. Funding This research was supported by the National Natural Science Foundation of China (81973102 & 81773487), Public Health Talents Training Program of Shanghai Municipality (GWV-10.2-XD21), the Shanghai New Three-year Action Plan for Public Health (GWV-10.1-XK16), the Major Project of Scientific and Technical Winter Olympics from National Key Research and Development Program of China (2021YFF0306000), 13th Five-Year National Science and Technology Major Project for Infectious Diseases (2018ZX10725-509) and Key projects of the PLA logistics Scientific research Program (BHJ17J013).
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Affiliation(s)
- Zheng Zhao
- Department of Epidemiology and Health Statistics, Fudan University, Shanghai, China
| | - Canjun Zheng
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Hongchao Qi
- Department of Biostatistics, Erasmus University Medical Center, The Netherlands
| | - Yue Chen
- Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, 451 Smyth Rd, Ottawa, ON, Canada
| | - Michael P Ward
- Sydney School of Veterinary Science, The University of Sydney, Camden NSW, Australia
| | - Fengfeng Liu
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jie Hong
- Department of Epidemiology and Health Statistics, Fudan University, Shanghai, China
| | - Qing Su
- Department of Epidemiology and Health Statistics, Fudan University, Shanghai, China
| | - Jiaqi Huang
- Department of Epidemiology and Health Statistics, Fudan University, Shanghai, China
| | - Xi Chen
- Department of Epidemiology and Health Statistics, Fudan University, Shanghai, China
| | - Jiaxu Le
- Department of Epidemiology and Health Statistics, Fudan University, Shanghai, China
| | - Xiuliang Liu
- Department of Epidemiology and Health Statistics, Fudan University, Shanghai, China
| | - Minrui Ren
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jianbo Ba
- Naval Medical Center of PLA, 880 Xiangyin Road, Yangpu District, Shanghai, China
| | - Zhijie Zhang
- Department of Epidemiology and Health Statistics, Fudan University, Shanghai, China
| | - Zhaorui Chang
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhongjie Li
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China.,National Health Commission of China
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13
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Zhang L, Jiang H, Wang K, Yuan Y, Fu Q, Jin X, Zhao N, Huang X, Wang S, Zhang T, Yao K, Chan TC, Xu W, Liu S. Long-term effects of weather condition and air pollution on acute hemorrhagic conjunctivitis in China: A nationalwide surveillance study in China. ENVIRONMENTAL RESEARCH 2021; 201:111616. [PMID: 34233156 DOI: 10.1016/j.envres.2021.111616] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 06/14/2021] [Accepted: 06/26/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Global climate change could have potential impact on enterovirus (EV)-induced infectious diseases. However, the environmental factors promoting acute hemorrhagic conjunctivitis (AHC) circulation remain inconclusive. This study aimed to quantify the relationship between the environment and AHC. METHODS We retrieved the monthly counts and incidence of AHC, meteorological variables and air quality in mainland China between 2013 and 2018. Exposure risks were evaluated by multivariate distributed lag nonlinear models. RESULTS A total of 219,599 AHC cases were reported in 31 provinces of China, predominantly in southern and central China, seasonally increased in summer. AHC incidence increased by 7% between 2013 and 2018, from 2.6873 to 2.7570 per 100,000 people. A moderate positive correlation was seen between AHC and monthly mean temperature, relative humidity (RH) and precipitation. Each unit increment was associated with a relative risk for AHC of 1.058 at 17°-32 °C at lag 0 months, 1.017 at 65-71% RH at lag 1.4 months, and 1.039 at 400-569 mm at lag 2.4 months. By contrast, a negative correlation was seen between monthly ambient NO2 and AHC. CONCLUSION Long-term exposure to higher mean temperature, RH and precipitation were associated with an increased risk of AHC. The general public, especially susceptible populations, should pay close attention to weather changes and take protective measures in advance to any AHC outbreak as the above situations occur.
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Affiliation(s)
- Li Zhang
- Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, 310009, China
| | - Hui Jiang
- Beijing Chest Hospital, Capital Medical University, Beijing, 101149, China; Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, 101149, China
| | - Kehan Wang
- Center for Applied Statistics, School of Statistics, Renmin University of China, Beijing, 100872, China
| | - Yuan Yuan
- Department of Geriatrics, Beijing Jishuitan Hospital, Beijing, 100035, China
| | - Qiuli Fu
- Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, 310009, China
| | - Xiuming Jin
- Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, 310009, China
| | - Na Zhao
- Collaborative Innovation Center of Recovery and Reconstruction of Degraded Ecosystem in Wanjiang Basin Co-founded by Anhui Province and Ministry of Education, School of Ecology and Environment, Anhui Normal University, Wuhu, Anhui Province, 241002, China
| | - Xiaodan Huang
- Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, 310009, China
| | - Supen Wang
- Anhui Provincial Key Laboratory of the Conservation and Exploitation of Biological Resources, College of Life Sciences, Anhui Normal University, Wuhu, Anhui Province, 241000, China
| | - Tao Zhang
- Nanjing Jiliang Information Technology Co., Ltd, Nanjing, Jiangsu Provice, 210002, China
| | - Ke Yao
- Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, 310009, China.
| | - Ta-Chien Chan
- Research Center for Humanities and Social Sciences, Academia Sinica, Taipei, 115, Taiwan.
| | - Wangli Xu
- Center for Applied Statistics, School of Statistics, Renmin University of China, Beijing, 100872, China.
| | - Shelan Liu
- Department of Infectious Diseases, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, 310051, China.
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14
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Cheng J, Bambrick H, Frentiu FD, Devine G, Yakob L, Xu Z, Li Z, Yang W, Hu W. Extreme weather events and dengue outbreaks in Guangzhou, China: a time-series quasi-binomial distributed lag non-linear model. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2021; 65:1033-1042. [PMID: 33598765 DOI: 10.1007/s00484-021-02085-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 01/14/2021] [Accepted: 01/19/2021] [Indexed: 06/12/2023]
Abstract
Dengue transmission is climate-sensitive and permissive conditions regularly cause large outbreaks in Asia-Pacific area. As climate change progresses, extreme weather events such as heatwaves and unusually high rainfall are predicted more intense and frequent, but their impacts on dengue outbreaks remain unclear so far. This paper aimed to investigate the relationship between extreme weather events (i.e., heatwaves, extremely high rainfall and extremely high humidity) and dengue outbreaks in China. We obtained daily number of locally acquired dengue cases and weather factors for Guangzhou, China, for the period 2006-2015. The definition of dengue outbreaks was based on daily number of locally acquired cases above the threshold (i.e., mean + 2SD of daily distribution of dengue cases during peaking period). Heatwave was defined as ≥2 days with temperature ≥ 95th percentile, and extreme rainfall and humidity defined as daily values ≥95th percentile during 2006-2015. A generalized additive model was used to examine the associations between extreme weather events and dengue outbreaks. Results showed that all three extreme weather events were associated with increased risk of dengue outbreaks, with a risk increase of 115-251% around 6 weeks after heatwaves, 173-258% around 6-13 weeks after extremely high rainfall, and 572-587% around 6-13 weeks after extremely high humidity. Each extreme weather event also had good capacity in predicting dengue outbreaks, with the model's sensitivity, specificity, accuracy, and area under the receiver operating characteristics curve all exceeding 86%. This study found that heatwaves, extremely high rainfall, and extremely high humidity could act as potential drivers of dengue outbreaks.
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Affiliation(s)
- Jian Cheng
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, 4059, Australia
- Department of Epidemiology and Biostatistics & Anhui Province Key Laboratory of Major Autoimmune Disease, School of Public Health, Anhui Medical University, Anhui, China
| | - Hilary Bambrick
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, 4059, Australia
| | - Francesca D Frentiu
- Centre for Immunology and Infection Control, School of Biomedical Sciences, Queensland University of Technology, Brisbane, Australia
| | - Gregor Devine
- Mosquito Control Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Laith Yakob
- Department of Disease Control, London School of Hygiene and Tropical Medicine, London, UK
| | - Zhiwei Xu
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, 4059, Australia
- School of Public Health, Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - Zhongjie Li
- Division of Infectious Disease, Key Laboratory of Surveillance and Early Warning of Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Weizhong Yang
- Division of Infectious Disease, Key Laboratory of Surveillance and Early Warning of Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
- School of Population Medicine & Public Health, Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing, China
| | - Wenbiao Hu
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, 4059, Australia.
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15
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Spatial and Temporal Characteristics of Hand-Foot-and-Mouth Disease and Their Influencing Factors in Urumqi, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094919. [PMID: 34063073 PMCID: PMC8124546 DOI: 10.3390/ijerph18094919] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 04/30/2021] [Accepted: 05/02/2021] [Indexed: 12/23/2022]
Abstract
Hand, foot, and mouth disease (HFMD) remains a serious health threat to young children. Urumqi is one of the most severely affected cities in northwestern China. This study aims to identify the spatiotemporal distribution characteristics of HFMD, and explore the relationships between driving factors and HFMD in Urumqi, Xinjiang. METHODS HFMD surveillance data from 2014 to 2018 were obtained from the China Center for Disease Control and Prevention. The center of gravity and geographical detector model were used to analyze the spatiotemporal distribution characteristics of HFMD and identify the association between these characteristics and socioeconomic and meteorological factors. RESULTS A total of 10,725 HFMD cases were reported in Urumqi during the study period. Spatially, the morbidity number of HFMD differed regionally and the density was higher in urban districts than in rural districts. Overall, the development of HFMD in Urumqi expanded toward the southeast. Temporally, we observed that the risk of HFMD peaked from June to July. Furthermore, socioeconomic and meteorological factors, including population density, road density, GDP, temperature and precipitation were significantly associated with the occurrence of HFMD. CONCLUSIONS HFMD cases occurred in spatiotemporal clusters. Our findings showed strong associations between HFMD and socioeconomic and meteorological factors. We comprehensively considered the spatiotemporal distribution characteristics and influencing factors of HFMD, and proposed some intervention strategies that may assist in predicting the morbidity number of HFMD.
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Ma Y, Wen T, Xing D, Zhang Y. Associations between floods and bacillary dysentery cases in main urban areas of Chongqing, China, 2005-2016: a retrospective study. Environ Health Prev Med 2021; 26:49. [PMID: 33874880 PMCID: PMC8056597 DOI: 10.1186/s12199-021-00971-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 04/05/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Understanding the association between floods and bacillary dysentery (BD) incidence is necessary for us to assess the health risk of extreme weather events. This study aims at exploring the association between floods and daily bacillary dysentery cases in main urban areas of Chongqing between 2005 and 2016 as well as evaluating the attributable risk from floods. METHODS The association between floods and daily bacillary dysentery cases was evaluated by using distributed lag non-linear model, controlling for meteorological factors, long-term trend, seasonality, and day of week. The fraction and number of bacillary dysentery cases attributable to floods was calculated. Subgroup analyses were conducted to explore the association across age, gender, and occupation. RESULTS After controlling the impact of temperature, precipitation, relative humidity, long-term trend, and seasonality, a significant lag effect of floods on bacillary dysentery cases was found at 0-day, 3-day, and 4-day lag, and the cumulative relative risk (CRR) over a 7-lag day period was 1.393 (95%CI 1.216-1.596). Male had higher risk than female. People under 5 years old and people aged 15-64 years old had significantly higher risk. Students, workers, and children had significantly higher risk. During the study period, based on 7-lag days, the attributable fraction of bacillary dysentery cases due to floods was 1.10% and the attributable number was 497 persons. CONCLUSIONS This study confirms that floods can increase the risk of bacillary dysentery incidence in main urban areas of Chongqing within an accurate time scale, the risk of bacillary dysentery caused by floods is still serious. The key population includes male, people under 5 years old, students, workers, and children. Considering the lag effect of floods on bacillary dysentery, the government and public health emergency departments should advance to the emergency health response in order to minimize the potential risk of floods on public.
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Affiliation(s)
- Yang Ma
- School of Public Health and Management, Research Center for Medicine and Social Development, Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Yixueyuan Road, Yuzhong District, Chongqing, 400016 China
| | - Tong Wen
- School of Public Health and Management, Research Center for Medicine and Social Development, Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Yixueyuan Road, Yuzhong District, Chongqing, 400016 China
| | - Dianguo Xing
- Office of Health Emergency, Chongqing Municipal Health Commission, No.6, Qilong Road, Yubei District, Chongqing, 401147 China
| | - Yan Zhang
- School of Public Health and Management, Research Center for Medicine and Social Development, Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Yixueyuan Road, Yuzhong District, Chongqing, 400016 China
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17
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Yi S, Wang H, Yang S, Xie L, Gao Y, Ma C. Spatial and Temporal Characteristics of Hand-Foot-and-Mouth Disease and Its Response to Climate Factors in the Ili River Valley Region of China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041954. [PMID: 33671423 PMCID: PMC7923010 DOI: 10.3390/ijerph18041954] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 02/07/2021] [Accepted: 02/13/2021] [Indexed: 12/13/2022]
Abstract
Background: As the global climate changes, the number of cases of hand-foot-and-mouth disease (HFMD) is increasing year by year. This study comprehensively considers the association of time and space by analyzing the temporal and spatial distribution changes of HFMD in the Ili River Valley in terms of what climate factors could affect HFMD and in what way. Methods: HFMD cases were obtained from the National Public Health Science Data Center from 2013 to 2018. Monthly climate data, including average temperature (MAT), average relative humidity (MARH), average wind speed (MAWS), cumulative precipitation (MCP), and average air pressure (MAAP), were obtained from the National Meteorological Information Center. The temporal and spatial distribution characteristics of HFMD from 2013 to 2018 were obtained using kernel density estimation (KDE) and spatiotemporal scan statistics. A regression model of the incidence of HFMD and climate factors was established based on a geographically and temporally weighted regression (GTWR) model and a generalized additive model (GAM). Results: The KDE results show that the highest density was from north to south of the central region, gradually spreading to the whole region throughout the study period. Spatiotemporal cluster analysis revealed that clusters were distributed along the Ili and Gongnaisi river basins. The fitted curves of MAT and MARH were an inverted V-shape from February to August, and the fitted curves of MAAP and MAWS showed a U-shaped change and negative correlation from February to May. Among the individual climate factors, MCP coefficient values varied the most while MAWS values varied less from place to place. There was a partial similarity in the spatial distribution of coefficients for MARH and MAT, as evidenced by a significant degree of fit performance in the whole region. MCP showed a significant positive correlation in the range of 15–35 mm, and MAAP showed a positive correlation in the range of 925–945 hPa. HFMD incidence increased with MAT in the range of 15–23 °C, and the effective value of MAWS was in the range of 1.3–1.7 m/s, which was positively correlated with incidences of HFMD. Conclusions: HFMD incidence and climate factors were found to be spatiotemporally associated, and climate factors are mostly non-linearly associated with HFMD incidence.
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Affiliation(s)
- Suyan Yi
- College of Resources and Environmental Sciences, Xinjiang University, Urumqi 830046, China; (S.Y.); (L.X.); (Y.G.); (C.M.)
| | - Hongwei Wang
- College of Resources and Environmental Sciences, Xinjiang University, Urumqi 830046, China; (S.Y.); (L.X.); (Y.G.); (C.M.)
- Correspondence: ; Tel.: +86-135-7920-8666
| | - Shengtian Yang
- Beijing Key Laboratory of Urban Hydrological Cycle and Sponge City Technology, College of Water Sciences, Beijing Normal University, Beijing 100875, China;
| | - Ling Xie
- College of Resources and Environmental Sciences, Xinjiang University, Urumqi 830046, China; (S.Y.); (L.X.); (Y.G.); (C.M.)
| | - Yibo Gao
- College of Resources and Environmental Sciences, Xinjiang University, Urumqi 830046, China; (S.Y.); (L.X.); (Y.G.); (C.M.)
| | - Chen Ma
- College of Resources and Environmental Sciences, Xinjiang University, Urumqi 830046, China; (S.Y.); (L.X.); (Y.G.); (C.M.)
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Xie J, Zhu Y, Fan Y, Xie L, Xie R, Huang F, Cao L. Association between extreme heat and hospital admissions for cataract patients in Hefei, China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:45381-45389. [PMID: 32789637 PMCID: PMC7686207 DOI: 10.1007/s11356-020-10402-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 08/04/2020] [Indexed: 06/11/2023]
Abstract
Cataract is the first cause of blindness and the major cause of visual impairment worldwide. Under conditions of global warming, researchers have begun to give attention to the influence of increasing temperature on cataract patients. Our paper aimed to investigate the association between extreme heat and hospital admissions for cataract in Hefei, China. Based on data from the New Rural Cooperative Medical System and National Meteorological Information Center, we used a generalized additive model and a distributed lag nonlinear model to examine the relationship between extreme heat and hospitalizations for cataract, with consideration of cumulative and lagged effects. When current mean temperature was above 28 °C, each 1 °C rise was associated with a 4% decrease in the number of cataract admissions (RR = 0.96, 95% CI = 0.94-0.98). The cumulative relative risk over 11 days of lag was the lowest, which indicated that every 1 °C increase in mean temperature above 28 °C was associated with a 19% decrease in the number of hospital admissions for cataract (RR = 0.81, 95% CI = 0.75-0.88). In subgroup analyses, the negative association between extreme heat and hospital admissions for cataract was stronger among patients who were not admitted to provincial-level hospitals. In conclusion, this paper found that extreme heat was negatively associated with cataract hospitalizations in Hefei, providing useful information for hospitals and policymakers.
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Affiliation(s)
- Jingui Xie
- School of Management, Technical University of Munich, Bildungscampus 9, 74076 Heilbronn, Germany
| | - Yongjian Zhu
- School of Management, University of Science and Technology of China, 96 Jin Zhai Road, Bao He District, Hefei, 230026 Anhui People’s Republic of China
| | - Yiming Fan
- School of Management, University of Science and Technology of China, 96 Jin Zhai Road, Bao He District, Hefei, 230026 Anhui People’s Republic of China
| | - Linbo Xie
- Anhui Health College, 9 Xue Yuan Road, Jiao Yu Yuan District, Chizhou, 247099 Anhui People’s Republic of China
| | - Ruijin Xie
- Anhui Health College, 9 Xue Yuan Road, Jiao Yu Yuan District, Chizhou, 247099 Anhui People’s Republic of China
| | - Fengming Huang
- The First Affiliated Hospital of University of Science and Technology of China, 17 Lu Jiang Road, Lu Yang District, Hefei, 230001 Anhui People’s Republic of China
| | - Liqing Cao
- The First Affiliated Hospital of University of Science and Technology of China, 17 Lu Jiang Road, Lu Yang District, Hefei, 230001 Anhui People’s Republic of China
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Yang F, Ma Y, Liu F, Zhao X, Fan C, Hu Y, Hu K, Chang Z, Xiao X. Short-term effects of rainfall on childhood hand, foot and mouth disease and related spatial heterogeneity: evidence from 143 cities in mainland China. BMC Public Health 2020; 20:1528. [PMID: 33036602 PMCID: PMC7545871 DOI: 10.1186/s12889-020-09633-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 09/29/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Numerous studies have demonstrated the potential association between rainfall and hand, foot and mouth disease (HFMD), but the results are inconsistent. This study aimed to quantify the relationship between rainfall and HFMD based on a multicity study and explore the potential sources of spatial heterogeneity. METHODS We retrieved the daily counts of childhood HFMD and the meteorological variables of the 143 cities in mainland China between 2009 and 2014. A common time series regression model was applied to quantify the association between rainfall and HFMD for each of the 143 cities. Then, we adopted the meta-regression model to pool the city-specific estimates and explore the sources of heterogeneity by incorporating city-specific characteristics. RESULTS The overall pooled estimation suggested a nonlinear exposure-response relationship between rainfall and HFMD. Once rainfall exceeded 15 mm, the HFMD risk stopped increasing linearly and began to plateau with the excessive risk ratio (ERR) peaking at 21 mm of rainfall (ERR = 3.46, 95% CI: 2.05, 4.88). We also found significant heterogeneity in the rainfall-HFMD relationships (I2 = 52.75%, P < 0.001). By incorporating the city-specific characteristics into the meta-regression model, temperature and student density can explain a substantial proportion of spatial heterogeneity with I2 statistics that decreased by 5.29 and 6.80% at most, respectively. CONCLUSIONS Our findings verified the nonlinear association between rainfall and HFMD. The rainfall-HFMD relationship also varies depending on locations. Therefore, the estimation of the rain-HFMD relationship of one location should not be generalized to another location.
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Affiliation(s)
- Fan Yang
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 16, Section 3, South Renmin Road, Chengdu, Sichuan, 610041, PR China
| | - Yue Ma
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 16, Section 3, South Renmin Road, Chengdu, Sichuan, 610041, PR China
| | - Fengfeng Liu
- Division of Infectious Disease & Key Laboratory of Surveillance and Early Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing, 102206, PR China
| | - Xing Zhao
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 16, Section 3, South Renmin Road, Chengdu, Sichuan, 610041, PR China
| | - Chaonan Fan
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 16, Section 3, South Renmin Road, Chengdu, Sichuan, 610041, PR China
| | - Yifan Hu
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 16, Section 3, South Renmin Road, Chengdu, Sichuan, 610041, PR China
| | - Kuiru Hu
- Institute of Basic Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Zhaorui Chang
- Division of Infectious Disease & Key Laboratory of Surveillance and Early Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing, 102206, PR China.
| | - Xiong Xiao
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 16, Section 3, South Renmin Road, Chengdu, Sichuan, 610041, PR China.
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Tang C, Liu X, He Y, Gao J, Xu Z, Duan J, Yi W, Wei Q, Pan R, Song S, Su H. Association between extreme precipitation and ischemic stroke in Hefei, China: Hospitalization risk and disease burden. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 732:139272. [PMID: 32428771 DOI: 10.1016/j.scitotenv.2020.139272] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 03/27/2020] [Accepted: 05/05/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Ischemic stroke is an acute cardiovascular disease with high disability and mortality. Extreme precipitation has been reported to increase the risk of some cardiovascular diseases and further increase the burden of disease. At present, no studies have evaluated the relationship between extreme precipitation and ischemic stroke. OBJECTIVE The aim of this study was to quantitatively analyze the association between extreme precipitation and ischemic stroke hospitalizations and further explore disease burden and its associated susceptible population. METHODS In this study, we used Poisson generalized linear model combined with distributed lag nonlinear model to investigate the relationship between extreme precipitation (≥95th percentile) and ischemic stroke and further explored the lag effect of extreme precipitation for population with different individual characteristics. RESULTS Ischemic stroke hospitalizations were significantly associated with extreme precipitation. The single-day effect occurred on lag 3 (RR = 1.040, 95% CI: 1.058-1.073) lasted until lag 8 (RR = 1.036, 95% CI: 1.004-1.068). The cumulative lag effects of extreme precipitation on ischemic stroke lasted six days (lag 6-lag 11). Male and people aged ≥65 years were more sensitive to extreme precipitation. The attributable fraction (AF) and numbers (AN) of extreme precipitation on hospitalizations for ischemic stroke were 1.38% and 236.4, respectively. CONCLUSION Our study suggested that extreme precipitation may increase the risk of hospital admissions for ischemic stroke, emphasizing the need for society and families to pay more attention to male and people aged ≥65 years.
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Affiliation(s)
- Chao Tang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, Anhui 230032, China
| | - Xiangguo Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, Anhui 230032, China
| | - Yangyang He
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, Anhui 230032, China
| | - Jiaojiao Gao
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, Anhui 230032, China
| | - Zihan Xu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, Anhui 230032, China
| | - Jun Duan
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, Anhui 230032, China
| | - Weizhuo Yi
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, Anhui 230032, China
| | - Qiannan Wei
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, Anhui 230032, China
| | - Rubing Pan
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, Anhui 230032, China
| | - Shasha Song
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, Anhui 230032, China
| | - Hong Su
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, Anhui 230032, China.
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Qi H, Li Y, Zhang J, Chen Y, Guo Y, Xiao S, Hu J, Wang W, Zhang W, Hu Y, Li Z, Zhang Z. Quantifying the risk of hand, foot, and mouth disease (HFMD) attributable to meteorological factors in East China: A time series modelling study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 728:138548. [PMID: 32361359 DOI: 10.1016/j.scitotenv.2020.138548] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 03/21/2020] [Accepted: 04/06/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Hand, foot, and mouth disease (HFMD) is a widespread infectious disease in China. Associated meteorological factors have been widely studied, but their attributable risks have not been well quantified. OBJECTIVES The study aimed to quantify the HFMD burden attributable to temperature and other meteorological factors. METHODS The daily counts of HFMD and meteorological factors in all 574 counties of East China were obtained for the period from 2009 to 2015. The exposure-lag-response relationships between meteorological factors and HFMD were quantified by using a distributed lag non-linear model for each county and the estimates from all the counties were then pooled using a multivariate mete-regression model. Attributable risks were estimated for meteorological variables according to the exposure-lag-response relationships obtained before. RESULTS The study included 4,058,702 HFMD cases. Non-optimal values of meteorological factors were attributable to approximately one third of all HFMD cases, and the attributable numbers of non-optimal ambient temperature, relative humidity, wind speed and sunshine hours were 815,942 (95% CI: 796,361-835,888), 291,759 (95% CI: 226,183-358,494), 92,060 (95% CI: 59,655-124,738) and 62,948 (95% CI: 20,621-105,773), respectively. The exposure-response relationship between temperature and HFMD was non-linear with an approximate "M" shape. High temperature had a greater influence on HFMD than low temperature did. There was a geographical heterogeneity related to water body, and more cases occurred in days with moderate high and low temperatures than in days with extreme temperature. The effects of meteorological factors on HFMD were generally consistent across subgroups. CONCLUSIONS Non-optimal temperature is the leading risk factor of HFMD in East China, and moderate hot and moderate cold days had the highest risk. Developing subgroup-targeted and region-specific programs may minimize the adverse consequences of non-optimum weather on HFMD risk.
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Affiliation(s)
- Hongchao Qi
- Department of Epidemiology and Biostatistics, School of Public Health, Fudan University, 138 Yixueyuan Rd, Xuhui District, Shanghai, China; Key Laboratory of Public Health Safety, Ministry of Education, 138 Yixueyuan Rd, Xuhui District, Shanghai, China; Department of Biostatistics, Erasmus University Medical Center, Doctor Molewaterplein 40, 3015 GD Rotterdam, Netherlands
| | - Yu Li
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, 155 Changbai Rd, Changping District, Beijing, China
| | - Jun Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Fudan University, 138 Yixueyuan Rd, Xuhui District, Shanghai, China; Key Laboratory of Public Health Safety, Ministry of Education, 138 Yixueyuan Rd, Xuhui District, Shanghai, China
| | - Yue Chen
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, 75 Laurier Ave E, Ottawa, ON K1N 6N5, Canada
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 27 Rainforest Walk, Clayton, VIC 3800, Australia
| | - Shuang Xiao
- Department of Epidemiology and Biostatistics, School of Public Health, Fudan University, 138 Yixueyuan Rd, Xuhui District, Shanghai, China; Key Laboratory of Public Health Safety, Ministry of Education, 138 Yixueyuan Rd, Xuhui District, Shanghai, China
| | - Jian Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Fudan University, 138 Yixueyuan Rd, Xuhui District, Shanghai, China; Key Laboratory of Public Health Safety, Ministry of Education, 138 Yixueyuan Rd, Xuhui District, Shanghai, China
| | - Wenge Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Fudan University, 138 Yixueyuan Rd, Xuhui District, Shanghai, China; Key Laboratory of Public Health Safety, Ministry of Education, 138 Yixueyuan Rd, Xuhui District, Shanghai, China
| | - Wenyi Zhang
- Chinese PLA Center for Disease Control and Prevention, Academy of Military Medical Sciences, 27 Taiping Rd, Haidian District, Beijing, China
| | - Yi Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Fudan University, 138 Yixueyuan Rd, Xuhui District, Shanghai, China; Key Laboratory of Public Health Safety, Ministry of Education, 138 Yixueyuan Rd, Xuhui District, Shanghai, China
| | - Zhongjie Li
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, 155 Changbai Rd, Changping District, Beijing, China.
| | - Zhijie Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Fudan University, 138 Yixueyuan Rd, Xuhui District, Shanghai, China; Key Laboratory of Public Health Safety, Ministry of Education, 138 Yixueyuan Rd, Xuhui District, Shanghai, China.
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Guo T, Liu J, Chen J, Bai Y, Long Y, Chen B, Song S, Shao Z, Liu K. Seasonal Distribution and Meteorological Factors Associated with Hand, Foot, and Mouth Disease among Children in Xi'an, Northwestern China. Am J Trop Med Hyg 2020; 102:1253-1262. [PMID: 32157992 PMCID: PMC7253124 DOI: 10.4269/ajtmh.19-0916] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 02/01/2020] [Indexed: 01/22/2023] Open
Abstract
Hand, foot, and mouth disease (HFMD) is a common infectious disease in the Asia-Pacific region that primarily affects children younger than 5 years. Previous studies have confirmed that the seasonal transmission of this disease is strongly related to meteorological factors, but the results are not consistent. In addition, the associations between weather conditions and HFMD in northwestern China have not been investigated. Therefore, we aimed to examine this issue in Xi'an, the largest city of northwestern China that has been suffering from serious HFMD epidemics. In the current study, data for HFMD and six meteorological factors were collected from 2009 to 2018. Using cross-correlation analysis, the Granger causality test, and the distributed lag nonlinear model, we estimated the quantitative relationships and exposure-lag-response effects between weekly meteorological factors and HFMD incidence among children. We found that the seasonal distribution of HFMD in Xi'an has two peaks each year and is significantly impacted by the weekly temperature, precipitation, and evaporation over an 8-week period. Higher values of temperature and evaporation had positive associations with disease transmission, whereas the association between precipitation and HFMD showed an inverted-U shape. The maximum relative risks (RRs) of HFMD for the weekly mean temperature (approximately 31.1°C), weekly cumulative evaporation (57.9 mm), and weekly cumulative precipitation (30.0 mm) were 1.56 (95% CI: 1.35-1.81), 1.40 (95% CI: 1.05-1.88), and 1.16 (95% CI: 1.11-1.70), respectively. The identified risk determinants and lag effects could provide important information for early interventions to reduce the local disease burden.
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Affiliation(s)
- Tianci Guo
- Department of Epidemiology, Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, School of Public Health, Air Force Medical University, Xi’an, P. R. China
| | - Jifeng Liu
- Department of Infectious Disease Control and Prevention, Xi’an Center for Disease Prevention and Control, Xi’an, P. R. China
| | - Junjiang Chen
- Department of Epidemiology, Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, School of Public Health, Air Force Medical University, Xi’an, P. R. China
| | - Yao Bai
- Department of Epidemiology, Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, School of Public Health, Air Force Medical University, Xi’an, P. R. China
- Department of Infectious Disease Control and Prevention, Xi’an Center for Disease Prevention and Control, Xi’an, P. R. China
| | - Yong Long
- Department of Epidemiology, Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, School of Public Health, Air Force Medical University, Xi’an, P. R. China
| | - Baozhong Chen
- Department of Infectious Disease Control and Prevention, Xi’an Center for Disease Prevention and Control, Xi’an, P. R. China
| | - Shuxuan Song
- Department of Epidemiology, Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, School of Public Health, Air Force Medical University, Xi’an, P. R. China
| | - Zhongjun Shao
- Department of Epidemiology, Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, School of Public Health, Air Force Medical University, Xi’an, P. R. China
| | - Kun Liu
- Department of Epidemiology, Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, School of Public Health, Air Force Medical University, Xi’an, P. R. China
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Hu B, Qiu W, Xu C, Wang J. Integration of a Kalman filter in the geographically weighted regression for modeling the transmission of hand, foot and mouth disease. BMC Public Health 2020; 20:479. [PMID: 32276607 PMCID: PMC7146977 DOI: 10.1186/s12889-020-08607-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 03/27/2020] [Indexed: 01/16/2023] Open
Abstract
Background Hand, foot and mouth disease (HFMD) is a common infectious disease whose mechanism of transmission continues to remain a puzzle for researchers. The measurement and prediction of the HFMD incidence can be combined to improve the estimation accuracy, and provide a novel perspective to explore the spatiotemporal patterns and determinant factors of an HFMD epidemic. Methods In this study, we collected weekly HFMD incidence reports for a total of 138 districts in Shandong province, China, from May 2008 to March 2009. A Kalman filter was integrated with geographically weighted regression (GWR) to estimate the HFMD incidence. Spatiotemporal variation characteristics were explored and potential risk regions were identified, along with quantitatively evaluating the influence of meteorological and socioeconomic factors on the HFMD incidence. Results The results showed that the average error covariance of the estimated HFMD incidence by district was reduced from 0.3841 to 0.1846 compared to the measured incidence, indicating an overall improvement of over 50% in error reduction. Furthermore, three specific categories of potential risk regions of HFMD epidemics in Shandong were identified by the filter processing, with manifest filtering oscillations in the initial, local and long-term periods, respectively. Amongst meteorological and socioeconomic factors, the temperature and number of hospital beds per capita, respectively, were recognized as the dominant determinants that influence HFMD incidence variation. Conclusions The estimation accuracy of the HFMD incidence can be significantly improved by integrating a Kalman filter with GWR and the integration is effective for exploring spatiotemporal patterns and determinants of an HFMD epidemic. Our findings could help establish more accurate HFMD prevention and control strategies in Shandong. The present study demonstrates a novel approach to exploring spatiotemporal patterns and determinant factors of HFMD epidemics, and it can be easily extended to other regions and other infectious diseases similar to HFMD.
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Affiliation(s)
- Bisong Hu
- School of Geography and Environment, Jiangxi Normal University, Nanchang, 330022, China.,State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, 100101, China
| | - Wenqing Qiu
- School of Geography and Environment, Jiangxi Normal University, Nanchang, 330022, China
| | - Chengdong Xu
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, 100101, China
| | - Jinfeng Wang
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, 100101, China.
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Effects of temperature fluctuations on spatial-temporal transmission of hand, foot, and mouth disease. Sci Rep 2020; 10:2541. [PMID: 32054890 PMCID: PMC7018740 DOI: 10.1038/s41598-020-59265-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 01/27/2020] [Indexed: 11/08/2022] Open
Abstract
Hand, foot, and mouth disease (HFMD), predominantly occurs among infants and children. Previous studies have shown that suitable, stable temperatures favor HFMD virus reproduction; however, temperature fluctuations also affect virus transmission, and there are, so far, no studies concerning the association between such fluctuations and the incidence of HFMD. The objective of this study was to map the spatial-temporal distribution of HFMD incidence and quantify the long-term effects of temperature fluctuations on HFMD incidence in children. HFMD cases in children under five, from January 2009 to December 2013, in Beijing, Tianjin, and Hebei provinces of China, were used in this study. The GeoDetector and Bayesian space-time hierarchy models were employed to explore the spatial-temporal association between temperature fluctuations and HFMD incidence. The results indicate that HFMD incidence had significant spatial stratified heterogeneity (GeoDetector q-statistic = 0.83, p < 0.05), and that areas with higher risk mainly appeared in metropolises and their adjacent regions. HFMD transmission was negatively associated with temperature fluctuations. A 1 °C increase in the standard deviation of maximum and minimum temperatures was associated with decreases of 8.22% and 11.87% in the risk of HFMD incidence, respectively. The study suggests that large temperature fluctuations affect virus growth or multiplication, thereby inhibiting the activity of the virus and potentially even leading to its extinction, and consequently affecting the spatial-temporal distribution of HFMD. The findings can serve as a reference for the practical control of this disease and offer help in the rational allocation of medical resources.
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Hao J, Yang Z, Yang W, Huang S, Tian L, Zhu Z, Lu Y, Xiang H, Liu S. Impact of Ambient Temperature and Relative Humidity on the Incidence of Hand-Foot-Mouth Disease in Wuhan, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:117358. [PMID: 31936369 DOI: 10.1016/j.atmosenv.2020.117358] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 01/02/2020] [Accepted: 01/07/2020] [Indexed: 05/19/2023]
Abstract
Background: Few studies have previously explored the relationship between hand, foot, and mouth disease (HFMD) and meteorological factors with the effect modification of air pollution, and these studies had inconsistent findings. We therefore applied a time-series analysis assessing the effects of temperature and humidity on the incidence of HFMD in Wuhan, China to deepen our understanding of the relationship between meteorological factors and the risk of HFMD. Methods: Daily HFMD cases were retrieved from Hubei Provincial Center for Disease Control and Prevention from 1 February 2013 to 31 January 2017. Daily meteorological data including 24 h average temperature, relative humidity, wind velocity, and atmospheric pressure were obtained from Hubei Meteorological Bureau. Data on Air pollution was collected from 10 national air-monitoring stations in Wuhan city. We adopted a distributed lag non-linear model (DLNM) combined with Poisson regression and time-series analysis to estimate the effects of temperature and relative humidity on the incidence HFMD. Results: We found that the association between temperature and HFMD incidence was non-linear, exhibiting an approximate "M" shape with two peaks occurring at 2.3 °C (RR = 1.760, 95% CI: 1.218-2.542) and 27.9 °C (RR = 1.945, 95% CI: 1.570-2.408), respectively. We observed an inverted "V" shape between relative humidity and HFMD. The risk of HFMD reached a maximum value at a relative humidity of 89.2% (RR = 1.553, 95% CI: 1.322-1.824). The largest delayed cumulative effects occurred at lag 6 for temperature and lag 13 for relative humidity. Conclusions: The non-linear relationship between meteorological factors and the incidence of HFMD on different lag days could be used in the early targeted warning system of infectious diseases, reducing the possible outbreaks and burdens of HFMD among sensitive populations.
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Affiliation(s)
- Jiayuan Hao
- Department of Global Health, School of Health Sciences, Wuhan University, 115# Donghu Road, Wuhan 430071, China
- Global Health Institute, Wuhan University, 115# Donghu Road, Wuhan 430071, China
| | - Zhiyi Yang
- Department of Global Health, School of Health Sciences, Wuhan University, 115# Donghu Road, Wuhan 430071, China
- Global Health Institute, Wuhan University, 115# Donghu Road, Wuhan 430071, China
| | - Wenwen Yang
- Hubei Provincial Center for Disease control and Prevention, Wuhan 430079, China
| | - Shuqiong Huang
- Hubei Provincial Center for Disease control and Prevention, Wuhan 430079, China
| | - Liqiao Tian
- State Key Laboratory of Information Engineering in Surveying, Mapping and Remote Sensing, Wuhan University, Wuhan 430079, China
| | - Zhongmin Zhu
- State Key Laboratory of Information Engineering in Surveying, Mapping and Remote Sensing, Wuhan University, Wuhan 430079, China
- College of Information Science and Engineering, Wuchang Shouyi University, Wuhan 430064, China
| | - Yuanan Lu
- Environmental Health Laboratory, Department of Public Health Sciences, University of Hawaii at Manoa, 1960 East-West Rd, Biomed Bldg, D105, Honolulu, HI 96822, USA
| | - Hao Xiang
- Department of Global Health, School of Health Sciences, Wuhan University, 115# Donghu Road, Wuhan 430071, China
- Global Health Institute, Wuhan University, 115# Donghu Road, Wuhan 430071, China
| | - Suyang Liu
- Department of Global Health, School of Health Sciences, Wuhan University, 115# Donghu Road, Wuhan 430071, China
- Global Health Institute, Wuhan University, 115# Donghu Road, Wuhan 430071, China
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A method for hand-foot-mouth disease prediction using GeoDetector and LSTM model in Guangxi, China. Sci Rep 2019; 9:17928. [PMID: 31784625 PMCID: PMC6884467 DOI: 10.1038/s41598-019-54495-2] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 11/14/2019] [Indexed: 12/14/2022] Open
Abstract
Hand-foot-mouth disease (HFMD) is a common infectious disease in children and is particularly severe in Guangxi, China. Meteorological conditions are known to play a pivotal role in the HFMD. Previous studies have reported numerous models to predict the incidence of HFMD. In this study, we proposed a new method for the HFMD prediction using GeoDetector and a Long Short-Term Memory neural network (LSTM). The daily meteorological factors and HFMD records in Guangxi during 2014–2015 were adopted. First, potential risk factors for the occurrence of HFMD were identified based on the GeoDetector. Then, region-specific prediction models were developed in 14 administrative regions of Guangxi, China using an optimized three-layer LSTM model. Prediction results (the R-square ranges from 0.39 to 0.71) showed that the model proposed in this study had a good performance in HFMD predictions. This model could provide support for the prevention and control of HFMD. Moreover, this model could also be extended to the time series prediction of other infectious diseases.
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Xu Z, Hu W, Jiao K, Ren C, Jiang B, Ma W. The effect of temperature on childhood hand, foot and mouth disease in Guangdong Province, China, 2010-2013: a multicity study. BMC Infect Dis 2019; 19:969. [PMID: 31718560 PMCID: PMC6852944 DOI: 10.1186/s12879-019-4594-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 10/24/2019] [Indexed: 12/30/2022] Open
Abstract
Background Hand, foot and mouth disease (HFMD) is a serious infectious disease, which has become a public health problem. Previous studies have shown that temperature may influence the incidence of HFMD, but most only focus on single city and the results are highly heterogeneous. Therefore, a multicity study was conducted to explore the association between temperature and HFMD in different cities and search for modifiers that influence the heterogeneity. Methods We collected daily cases of childhood HFMD (aged 0–5 years) and meteorological factors of 21 cities in Guangdong Province in the period of 2010–2013. Distributed lag non-linear model (DLNM) with quasi-Poisson was adopted to quantify the effects of temperature on HFMD in 21 cities. Then the effects of each city were pooled by multivariate meta-analysis to obtain the heterogeneity among 21 cities. Potential city-level factors were included in meta-regression to explore effect modifiers. Results A total of 1,048,574 childhood cases were included in this study. There was a great correlation between daily childhood HFMD cases and temperature in each city, which was non-linear and lagged. High heterogeneity was showed in the associations between temperature and HFMD in 21 cities. The pooled temperature-HFMD association was peaking at the 79th percentile of temperature with relative risk (RR) of 2.474(95% CI: 2.065–2.965) as compared to the median temperature. Latitude was the main modifier for reducing the heterogeneity to 69.28% revealed by meta-analysis. Conclusions There was a strong non-linear and lagged correlation between temperature and HFMD. Latitude was strongly associated with the relationship between temperature and HFMD. Meanwhile, it had an effect on modifying the relationship. These findings can conducive to local governments developing corresponding preventive measures.
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Affiliation(s)
- Zece Xu
- Department of Epidemiology, School of Public Health, Shandong University, 44 West Wenhua Road, Jinan, Shandong, 250012, People's Republic of China
| | - Wenqi Hu
- Qianfoshan Hospital of Shandong Province, 16766 Jingshi Road, Jinan, Shandong, 250012, People's Republic of China
| | - Kedi Jiao
- Department of Epidemiology, School of Public Health, Shandong University, 44 West Wenhua Road, Jinan, Shandong, 250012, People's Republic of China
| | - Ci Ren
- Department of Epidemiology, School of Public Health, Shandong University, 44 West Wenhua Road, Jinan, Shandong, 250012, People's Republic of China
| | - Baofa Jiang
- Department of Epidemiology, School of Public Health, Shandong University, 44 West Wenhua Road, Jinan, Shandong, 250012, People's Republic of China.,Shandong University Climate Change and Health Center, 44 West Wenhua Road, Jinan, Shandong, 250012, People's Republic of China
| | - Wei Ma
- Department of Epidemiology, School of Public Health, Shandong University, 44 West Wenhua Road, Jinan, Shandong, 250012, People's Republic of China. .,Shandong University Climate Change and Health Center, 44 West Wenhua Road, Jinan, Shandong, 250012, People's Republic of China.
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Fu T, Chen T, Dong ZB, Luo SY, Miao Z, Song XP, Huang RT, Sun JM. Development and comparison of forecast models of hand-foot-mouth disease with meteorological factors. Sci Rep 2019; 9:15691. [PMID: 31666565 PMCID: PMC6821763 DOI: 10.1038/s41598-019-52044-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 10/12/2019] [Indexed: 12/03/2022] Open
Abstract
Hand-foot-mouth disease (HFMD) is an acute intestinal virus infectious disease which is one of major public health problems in mainland China. Previous studies indicated that HFMD was significantly influenced by climatic factors, but the associated factors were different in different areas and few study on HFMD forecast models was conducted. Here, we analyzed epidemiological characteristics of HFMD in Yiwu City, Zhejiang Province and constructed three forecast models. Overall, a total of 32554 HFMD cases were reported and 12 cases deceased in Yiwu City, Zhejiang Province. The incidence of HFMD peaked every other year and the curve of HFMD incidence had an approximately W-shape. The majority of HFMD cases were children and 95.76% cases aged ≤5 years old from 2008 to 2016. Furthermore, we constructed and compared three forecast models using autoregressive integrated moving average (ARIMA) model, negative binomial regression model (NBM), and quasi-Poisson generalized additive model (GAM). All the three models had high agreements between predicted values and observed values, while GAM fitted best. The exposure-response curve of monthly mean temperature and HFMD was approximately V-shaped. Our study explored epidemiological characteristics of HFMD in Yiwu City and provided accurate methods for early warning which would be great importance for the control and prevention of HFMD.
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Affiliation(s)
- Tao Fu
- Yiwu Municipal Center for Disease Control and Prevention, Yiwu, China
| | - Ting Chen
- West China School of Public Health, Sichuan University, Chengdu, China
| | - Zhen-Bin Dong
- Juxian Center for Disease Control and Prevention, Juxian, China
| | - Shu-Ying Luo
- Yiwu Municipal Center for Disease Control and Prevention, Yiwu, China
| | - Ziping Miao
- Key Laboratory of Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Xiu-Ping Song
- State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Ru-Ting Huang
- Fengtai Center for Disease Control and Prevention, Beijing, China
| | - Ji-Min Sun
- Key Laboratory of Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China.
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Yan S, Wei L, Duan Y, Li H, Liao Y, Lv Q, Zhu F, Wang Z, Lu W, Yin P, Cheng J, Jiang H. Short-Term Effects of Meteorological Factors and Air Pollutants on Hand, Foot and Mouth Disease among Children in Shenzhen, China, 2009-2017. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16193639. [PMID: 31569796 PMCID: PMC6801881 DOI: 10.3390/ijerph16193639] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 09/12/2019] [Accepted: 09/23/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND A few studies have explored the association between meteorological factors and hand, foot, and mouth disease (HFMD) with inconsistent results. Besides, studies about the effects of air pollutants on HFMD are very limited. METHODS Daily HFMD cases among children aged 0-14 years in Shenzhen were collected from 2009 to 2017. A distributed lag nonlinear model (DLNM) model was fitted to simultaneously assess the nonlinear and lagged effects of meteorological factors and air pollutants on HFMD incidence, and to further examine the differences of the effect across different subgroups stratified by gender, age and childcare patterns. RESULTS The cumulative relative risk (cRR) (median as reference) of HFMD rose with the increase of daily temperature and leveled off at about 30 °C (cRR: 1.40, 95%CI: 1.29, 1.51). There was a facilitating effect on HFMD when relative humidity was 46.0% to 88.8% (cRR at 95th percentile: 1.18, 95%CI: 1.11, 1.27). Short daily sunshine duration (5th vs. 50th) promoted HFMD (cRR: 1.07, 95%CI: 1.02, 1.11). The positive correlation between rainfall and HFMD reversed when it exceeded 78.3 mm (cRR: 1.41, 95% CI: 1.22, 1.63). Ozone suppressed HFMD when it exceeded 104 µg /m3 (cRR at 99th percentile: 0.85, 95%CI: 0.76, 0.94). NO2 promoted HFMD among infants and the cRR peaked at lag 9 day (cRR: 1.47, 95%CI: 1.02, 2.13) (99th vs. 50th). Besides, children aged below one year, males and scattered children were more vulnerable to high temperature, high relative humidity, and short sunshine duration. CONCLUSIONS Temperature, relative humidity, sunshine duration, rainfall, ozone and NO2 were significantly associated with HFMD, and such effects varied with gender age and childcare patterns. These findings highlight the need for more prevention effort to the vulnerable populations and may be helpful for developing an early environment-based warning system for HFMD.
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Affiliation(s)
- Siyu Yan
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan 430030, China.
| | - Lan Wei
- Shenzhen Center for Disease Control and Prevention, 8 Longyuan Rd, Shenzhen 518055, China.
| | - Yanran Duan
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan 430030, China.
| | - Hongyan Li
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan 430030, China.
| | - Yi Liao
- Shenzhen Center for Disease Control and Prevention, 8 Longyuan Rd, Shenzhen 518055, China.
| | - Qiuying Lv
- Shenzhen Center for Disease Control and Prevention, 8 Longyuan Rd, Shenzhen 518055, China.
| | - Fang Zhu
- Shenzhen Center for Disease Control and Prevention, 8 Longyuan Rd, Shenzhen 518055, China.
| | - Zhihui Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan 430030, China.
| | - Wanrong Lu
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan 430030, China.
| | - Ping Yin
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan 430030, China.
| | - Jinquan Cheng
- Shenzhen Center for Disease Control and Prevention, 8 Longyuan Rd, Shenzhen 518055, China.
| | - Hongwei Jiang
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan 430030, China.
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Chan EYY, Ho JY, Hung HHY, Liu S, Lam HCY. Health impact of climate change in cities of middle-income countries: the case of China. Br Med Bull 2019; 130:5-24. [PMID: 31070715 PMCID: PMC6587073 DOI: 10.1093/bmb/ldz011] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 01/31/2019] [Accepted: 04/23/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND This review examines the human health impact of climate change in China. Through reviewing available research findings under four major climate change phenomena, namely extreme temperature, altered rainfall pattern, rise of sea level and extreme weather events, relevant implications for other middle-income population with similar contexts will be synthesized. SOURCES OF DATA Sources of data included bilingual peer-reviewed articles published between 2000 and 2018 in PubMed, Google Scholar and China Academic Journals Full-text Database. AREAS OF AGREEMENT The impact of temperature on mortality outcomes was the most extensively studied, with the strongest cause-specific mortality risks between temperature and cardiovascular and respiratory mortality. The geographical focuses of the studies indicated variations in health risks and impacts of different climate change phenomena across the country. AREAS OF CONTROVERSY While rainfall-related studies predominantly focus on its impact on infectious and vector-borne diseases, consistent associations were not often found. GROWING POINTS Mental health outcomes of climate change had been gaining increasing attention, particularly in the context of extreme weather events. The number of projection studies on the long-term impact had been growing. AREAS TIMELY FOR DEVELOPING RESEARCH The lack of studies on the health implications of rising sea levels and on comorbidity and injury outcomes warrants immediate attention. Evidence is needed to understand health impacts on vulnerable populations living in growing urbanized cities and urban enclaves, in particular migrant workers. Location-specific climate-health outcome thresholds (such as temperature-mortality threshold) will be needed to support evidence-based clinical management plans and health impact mitigation strategies to protect vulnerable communities.
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Affiliation(s)
- Emily Y Y Chan
- Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response (CCOUC), Division of Global Health and Humanitarian Medicine, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
- Division of Global Health and Humanitarian Medicine, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
- François-Xavier Bagnoud Center for Health & Human Rights, Harvard University, Boston, MA, USA
| | - Janice Y Ho
- Division of Global Health and Humanitarian Medicine, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Heidi H Y Hung
- Division of Global Health and Humanitarian Medicine, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Sida Liu
- Division of Global Health and Humanitarian Medicine, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Holly C Y Lam
- Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response (CCOUC), Division of Global Health and Humanitarian Medicine, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
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31
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Jiao K, Hu W, Ren C, Xu Z, Ma W. Impacts of tropical cyclones and accompanying precipitation and wind velocity on childhood hand, foot and mouth disease in Guangdong Province, China. ENVIRONMENTAL RESEARCH 2019; 173:262-269. [PMID: 30928857 DOI: 10.1016/j.envres.2019.03.041] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 01/20/2019] [Accepted: 03/17/2019] [Indexed: 05/04/2023]
Abstract
OBJECTIVE Guangdong province is one of the provinces most frequently hit by tropical cyclones in China. Hand, foot and mouth disease (HFMD) continues to severely affect public health across the world. Our study aimed to evaluate the impacts of different grades of tropical cyclones and accompanying precipitation and wind velocity on HFMD among children younger than 6 years old in Guangdong province from 2009 to 2013. METHODS A time-stratified case-crossover design was used to examine the association between tropical cyclones and childhood HFMD. Principal component analysis (PCA) was first used to eliminate multicollinearity among meteorological variables. Conditional Poisson regression was then applied to calculate odds ratios (ORs) and the 95% confidence intervals (CIs). RESULTS Tropical storms increased the risk of HFMD among children below 6 years of age on lag 4 days (OR = 1.55, 95%CI: 1.28-1.88). Tropical storms were also a risk factor for boys below 3 years of age, boys between 3 and 6 and girls below 3 years of age with the largest OR = 1.52 (95%CI:1.15-2.00), OR = 1.81 (95%CI = 1.21-2.71) and OR = 1.51 (95%CI = 1.04-2.19), respectively. Precipitation during tropical cyclones had an adverse effect on childhood HFMD when reaching 25-49.9 mm or above 100 mm with OR = 1.20 (95%CI = 1.00-1.43) on lag 0 day and OR = 1.25 (95%CI = 1.04-1.49) on lag 7 days, respectively. For extreme wind velocity during tropical cyclones, the impact on childhood HFMD was largest on the day tropical cyclones landed (OR = 1.25, 95%CI: 1.06-1.48) with winds up to 13.9-24.4 m/s. CONCLUSIONS Tropical storms can increase the risk of HFMD among children younger than 3 years old, especially boys between 3 and 6 years old. Precipitation during tropical cyclones is a risk factor for childhood HFMD when it is between 25 and 49.9 mm or above 100 mm. As extreme wind velocity reaches 13.9-24.4 m/s, it has an adverse effect on children's health. Children below 3 years old and boys between 3 and 6 should be given more consideration during tropical storms.
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Affiliation(s)
- Kedi Jiao
- Department of Epidemiology, School of Public Health, Shandong University, 44 West Wenhua Road, Jinan, Shandong, 250012, PR China.
| | - Wenqi Hu
- Department of Epidemiology, School of Public Health, Shandong University, 44 West Wenhua Road, Jinan, Shandong, 250012, PR China.
| | - Ci Ren
- Department of Epidemiology, School of Public Health, Shandong University, 44 West Wenhua Road, Jinan, Shandong, 250012, PR China.
| | - Zece Xu
- Department of Epidemiology, School of Public Health, Shandong University, 44 West Wenhua Road, Jinan, Shandong, 250012, PR China.
| | - Wei Ma
- Department of Epidemiology, School of Public Health, Shandong University, 44 West Wenhua Road, Jinan, Shandong, 250012, PR China; Shandong University Climate Change and Health Center, 44 West Wenhua Road, Jinan, Shandong, 250012, PR China.
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Incidence, aetiology, and serotype spectrum analysis of adult hand, foot, and mouth disease patients: A retrospective observational cohort study in northern Zhejiang, China. Int J Infect Dis 2019; 85:28-36. [PMID: 31100417 DOI: 10.1016/j.ijid.2019.05.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 05/07/2019] [Accepted: 05/08/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Hand, foot, and mouth disease (HFMD) in adults has rarely been reported in the literature, although its clinical significance is underestimated. This study was performed to systematically elucidate the epidemiological characteristics of adult HFMD. METHODS A total of 266 adult patients with HFMD were recruited. The control group comprised 40 healthy adults. Swabs and serum samples were collected. Enterovirus strains were tested by RT-PCR, and cytokine expression was examined using commercial kits. Socio-demographic data were collected through follow-up telephone calls. Daily meteorological data were obtained from the China Meteorological Data Sharing Service System. Socio-economic data were collected from the statistical bureau. RESULTS This study identified several unique spatiotemporal patterns in adult HFMD. Having a child recently diagnosed with HFMD was a risk factor for HFMD, whereas keeping pets was a protective factor against HFMD. The results of this study indicate the existence of subclinical carriers or misdiagnosed patients who might be the latent infectious source of HFMD. Further, this study also indicated that adults may act as the main infectious source of trans-regional spread of HFMD. CONCLUSIONS This study revealed the potential hazards of adult HFMD and is a reminder of the vital clinical significance of further research into adult HFMD.
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Xu C, Zhang X, Xiao G. Spatiotemporal decomposition and risk determinants of hand, foot and mouth disease in Henan, China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 657:509-516. [PMID: 30550914 DOI: 10.1016/j.scitotenv.2018.12.039] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2018] [Revised: 12/04/2018] [Accepted: 12/04/2018] [Indexed: 06/09/2023]
Abstract
Hand, foot and mouth disease (HFMD) remains an increasing public health concern. The spatiotemporal variation of HFMD can be represented from multiple-perspectives, and it may be driven by different dominant factors. In this study, the HFMD cases in children under the age of five years in each county in Henan province, China, from 2009 to 2013 were assessed to explore the integrative spatiotemporal patterns of HFMD and investigate their driving factors. The empirical orthogonal function was applied to identify representative spatiotemporal patterns. Then, GeoDetector was used to quantify the determinant powers of driving factors to the disease. The results indicated that the most prominent spatiotemporal pattern explained 56.21% of the total variance, presented in big cities, e.g. capital city and municipal districts. The dominant factors of this pattern were per capita gross domestic product and relative humidity, with determinant powers of 62% and 42%, respectively. The secondary spatiotemporal pattern explained 10.52% of the total variance, presented in the counties around big cities. The dominant factors for this pattern were the ratio of urban to rural population and precipitation, with determinant powers of 26% and 41%, respectively. These findings unveiled the key spatiotemporal features and their determinants related to the disease; this will be helpful in establishing accurate spatiotemporal preventing of HFMD.
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Affiliation(s)
- Chengdong Xu
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, China
| | - Xiangxue Zhang
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, China; The School of Earth Science and Resources, Chang'an University, Xi'an 710054, China
| | - Gexin Xiao
- China National Center for Food Safety Risk Assessment, Beijing 100022, China.
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Zhang Q, Zhou M, Yang Y, You E, Wu J, Zhang W, Jin J, Huang F. Short-term effects of extreme meteorological factors on childhood hand, foot, and mouth disease reinfection in Hefei, China: A distributed lag non-linear analysis. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 653:839-848. [PMID: 30759610 DOI: 10.1016/j.scitotenv.2018.10.349] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Revised: 10/04/2018] [Accepted: 10/26/2018] [Indexed: 05/04/2023]
Abstract
BACKGROUND Hand, foot, and mouth disease (HFMD) is a major public health issue in China with a high burden of reinfection. Previous studies presented evidence of the relationship between meteorological factors and HFMD incidence, but no study examined the effects of extreme meteorological factors on HFMD reinfection. METHODS Daily HFMD reinfection counts and meteorological data of Hefei city were collected from 2011 to 2016. A distributed lag non-linear model was used to quantify the effects of extreme weather (wind speed, sunshine duration, and precipitation) on HFMD reinfection. All effects were presented as relative risk (RR), with 90th or 10th percentiles of meteorological variables compare with their median values. Confounding factors, such as mean temperature, relative humidity, day of week, and long-term trend were controlled. RESULTS A total of 4873 HFMD reinfection cases aged 0-11 years were reported. Extremely high precipitation, low wind speed, and low sunshine duration increased HFMD reinfection risk. The effect of extremely high precipitation was greatest at 8 days lag (RR = 1.01, 95%CI: 1.00-1.02). Extremely low wind speed and low sunshine increased 19% (RR = 1.19, 95%CI: 1.09-1.32) and 12% (RR = 1.12, 95%CI: 1.00-1.26) risk at lag 0-12 days, respectively. By contrast, extremely high wind speed and high sunshine duration exerted certain protective effects on HFMD reinfection at lag 0-12 days (RR = 0.76, 95%CI: 0.66-0.88; RR = 0.88, 95%CI: 0.79-0.99, respectively). Subgroup analyses showed that nursery children were the most sensitive people to the extreme wind speed and sunshine duration. Children aged 4-11 years appeared to be more susceptible to extreme sunshine duration than children aged <3 years. CONCLUSION The present study provides evidence that extreme meteorological factors exert delayed effects on HFMD reinfection. Developing an early warning system is necessary for the protection of children from harm due to extreme meteorological factors.
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Affiliation(s)
- Qian Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Shushan District, Hefei, Anhui 230032, China
| | - Mengmeng Zhou
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Shushan District, Hefei, Anhui 230032, China
| | - Yuwei Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Shushan District, Hefei, Anhui 230032, China
| | - Enqing You
- Hefei Center for Disease Control and Prevention, 86 Luan Road, Luyang District, Hefei, Anhui 230061, China
| | - Jinju Wu
- Hefei Center for Disease Control and Prevention, 86 Luan Road, Luyang District, Hefei, Anhui 230061, China
| | - Wenyan Zhang
- Hefei Center for Disease Control and Prevention, 86 Luan Road, Luyang District, Hefei, Anhui 230061, China
| | - Jing Jin
- Hefei Center for Disease Control and Prevention, 86 Luan Road, Luyang District, Hefei, Anhui 230061, China
| | - Fen Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Shushan District, Hefei, Anhui 230032, China; Central Laboratory of Preventive Medicine, School of Public Health, Anhui Medical University, 81 Meishan Road, Shushan District, Hefei, Anhui 230032, China; Laboratory for environmental Toxicology, Anhui Medical University, 81 Meishan Road, Shushan District, Hefei, Anhui 230032, China.
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Yu G, Li Y, Cai J, Yu D, Tang J, Zhai W, Wei Y, Chen S, Chen Q, Qin J. Short-term effects of meteorological factors and air pollution on childhood hand-foot-mouth disease in Guilin, China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 646:460-470. [PMID: 30056233 DOI: 10.1016/j.scitotenv.2018.07.329] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 07/14/2018] [Accepted: 07/23/2018] [Indexed: 05/04/2023]
Abstract
BACKGROUND Previous studies have always focused on the impact of various meteorological factors on Hand-foot-mouth disease (HFMD). However, only few studies have investigated the simultaneous effects of climate and air pollution on HFMD incidence. METHODS Daily HFMD counts among children aged 0-14 years in Guilin city were collected from 2014 to 2016. Distributed lag nonlinear models (DLNM) were used to assess the effects of extreme meteorological factors and air pollution indicators, as well as the effects of different lag days on HFMD incidence. Furthermore, this study explored the variability across gender and age groups. RESULTS Extreme temperatures, high precipitation and low-O3 concentration increased the risk of HFMD. Hot effect was stronger and longer lasting than cold effect. Risks of rainy effect and low-O3 effect continued to increase as lag days extended, with the maximum RR values: 1.60 (1.38, 1.86) (90th vs median) and 1.48 (1.16, 1.89) (1th vs median) at 0-14 lag days, respectively. By contrast, extremely high wind speed, low precipitation, low PM2.5 and high O3 exerted a certain protective effect on HFMD incidence. The corresponding minimum RR values were: 0.85 (0.74, 0.98) (90th vs median) at 0-14 lag days, 0.98 (0.97, 0.99) (10th vs median) at 0-14 lag days, 0.73 (0.61, 0.88) (1th vs median) at 0-14 lag days and 0.81 (0.73, 0.90) (99th vs median) at 0-7 lag days, respectively. Male children and children aged 0-1 years (followed by 1-3 years) were the most susceptible subgroups to extreme climatic effects and air pollution. CONCLUSIONS Our results indicated that daily meteorological factors and air pollution exert non-linear and delayed effects on pediatric HFMD, and such effects vary depending on gender and age. These findings may serve as a reference for the development of an early warning system and for the adoption of specific interventions for vulnerable groups.
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Affiliation(s)
- Guoqi Yu
- Department of Environmental and Occupational Health, Guangxi Medical University, Shuangyong Road, 22, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Yonghong Li
- Guangxi Center for Disease Control and Prevention, Acute Infectious Disease Prevention and Control Institute, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Jiansheng Cai
- Department of Environmental and Occupational Health, Guangxi Medical University, Shuangyong Road, 22, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Dongmei Yu
- Department of Environmental and Occupational Health, Guangxi Medical University, Shuangyong Road, 22, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Jiexia Tang
- Department of Environmental and Occupational Health, Guangxi Medical University, Shuangyong Road, 22, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Wenwen Zhai
- Department of Health Related Social and Behavioral Science, West China School of Public Health, Sichuan University, Chengdu, Sichuan, China
| | - Yi Wei
- Department of Environmental and Occupational Health, Guangxi Medical University, Shuangyong Road, 22, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Shiyi Chen
- Department of Environmental and Occupational Health, Guangxi Medical University, Shuangyong Road, 22, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Quanhui Chen
- Department of Environmental and Occupational Health, Guangxi Medical University, Shuangyong Road, 22, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Jian Qin
- Department of Environmental and Occupational Health, Guangxi Medical University, Shuangyong Road, 22, Nanning, Guangxi Zhuang Autonomous Region, China; Guangxi Colleges and Universities Key Laboratory of Prevention and Control of Highly Prevalent Diseases, Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China.
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Zhang X, Xu C, Xiao G. Space-time heterogeneity of hand, foot and mouth disease in children and its potential driving factors in Henan, China. BMC Infect Dis 2018; 18:638. [PMID: 30526525 PMCID: PMC6286567 DOI: 10.1186/s12879-018-3546-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 11/23/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Hand, foot and mouth disease (HFMD) has become a substantial threat recently. However few studies have quantified spatiotemporal heterogeneity of HFMD and detected spatiotemporal interactive effect of potential driving factors on this disease. METHODS Using GeoDetector and Bayesian space-time hierarchy model, we characterized the epidemiology of HFMD in Henan, one of the largest population provinces in China, from 2012 to 2013, and quantified the impacts of potential driving factors. RESULTS Notably, 21.43 and 24.60% counties were identified as hot and cold spots, respectively. Spatially, the hotspots were mainly clustered in regions where the economic level was high. Temporally, the highest incidence period of HFMD was discovered to be in late spring and early summer. The impact of meteorological and socio-economic factors on the disease are significant, and this study found that a 1 °C rise in temperature was related to an increase of 4.09% in the HFMD incidence, a 1% increment in relative humidity was associated with a 1.77% increase of the disease, and a 1% increment in ratio of urban to rural population was associated with a 0.16% increase of the disease. CONCLUSION Meteorological and socio-economic factors presented significantly association with HFMD incidence, high-risk mainly appeared in large cities and their adjacent regions in hot and humid season. These findings will be helpful for HFMD risk control and disease-prevention policies implementation.
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Affiliation(s)
- Xiangxue Zhang
- The School of Earth Science and Resources, Chang’an University, Xi’an, 710054 China
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, 11A, Datun Road, Chaoyang District, Beijing, 100101 China
| | - Chengdong Xu
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, 11A, Datun Road, Chaoyang District, Beijing, 100101 China
| | - Gexin Xiao
- China National Center for Food Safety Risk Assessment, Beijing, 100022 China
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Meteorological factors and its association with hand, foot and mouth disease in Southeast and East Asia areas: a meta-analysis. Epidemiol Infect 2018; 147:e50. [PMID: 30451130 PMCID: PMC6518576 DOI: 10.1017/s0950268818003035] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Since the late 1990s, hand, foot and mouth disease (HFMD) has become a common health problem that mostly affects children and infants in Southeast and East Asia. Global climate change is considered to be one of the major risk factors for HFMD. This study aimed to assess the correlation between meteorological factors and HFMD in the Asia-Pacific region. PubMed, Web of Science, Embase, China National Knowledge Infrastructure, Wanfang Data and Weipu Database were searched to identify relevant articles published before May 2018. Data were collected and analysed using R software. We searched 2397 articles and identified 51 eligible papers in this study. The present study included eight meteorological factors; mean temperature, mean highest temperature, mean lowest temperature, rainfall, relative humidity and hours of sunshine were positively correlated with HFMD, with correlation coefficients (CORs) of 0.52 (95% confidence interval (CI) 0.42–0.60), 0.43 (95% CI 0.23–0.59), 0.43 (95% CI 0.23–0.60), 0.27 (95% CI 0.19–0.35), 0.19 (95% CI 0.02–0.35) and 0.19 (95% CI 0.11–0.27), respectively. There were sufficient data to support a negative correlation between mean pressure and HFMD (COR = −0.51, 95% CI −0.63 to −0.36). There was no notable correlation with wind speed (COR = 0.10, 95% CI −0.03 to 0.23). Our findings suggest that meteorological factors affect the incidence of HFMD to a certain extent.
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Li H, Chen H, Wang H, Yu E. Future precipitation changes over China under 1.5 °C and 2.0 °C global warming targets by using CORDEX regional climate models. THE SCIENCE OF THE TOTAL ENVIRONMENT 2018; 640-641:543-554. [PMID: 29864667 DOI: 10.1016/j.scitotenv.2018.05.324] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 05/25/2018] [Accepted: 05/25/2018] [Indexed: 06/08/2023]
Abstract
This study aims to characterize future changes in precipitation extremes over China based on regional climate models (RCMs) participating in the Coordinated Regional Climate Downscaling Experiment (CORDEX)-East Asia project. The results of five RCMs involved in CORDEX-East Asia project that driven by HadGEM2-AO are compared with the simulation of CMA-RegCM driven by BCC-CSM1.1. Eleven precipitation extreme indices that developed by the Expert Team on Climate Change Detection and Indices are employed to evaluate precipitation extreme changes over China. Generally, RCMs can reproduce their spatiotemporal characteristics over China in comparison with observations. For future climate projections, RCMs indicate that both the occurrence and intensity of precipitation extremes in most regions of China will increase when the global temperature increases by 1.5/2.0 °C. The yearly maximum five-day precipitation (RX5D) averaged over China is reported to increase by 4.4% via the CMA-RegCM under the 1.5 °C warming in comparison with the baseline period (1986-2005); however, a relatively large increase of 11.1% is reported by the multi-model ensemble median (MME) when using the other five models. Furthermore, the reoccurring risks of precipitation extremes over most regions of China will further increase due to the additional 0.5 °C warming. For example, RX5D will further increase by approximately 8.9% over NWC, 3.8% over NC, 2.3% over SC, and approximately 1.0% over China. Extremes, such as the historical 20-year return period event of yearly maximum one-day precipitation (RX1D) and RX5D, will become more frequent, with occurrences happening once every 8.8 years (RX1D) and 11.5 years (RX5D) under the 1.5 °C warming target, and there will be two fewer years due to the additional 0.5 °C warming. In addition, the intensity of these events will increase by approximately 9.2% (8.5%) under the 1.5 °C warming target and 12.6% (11.0%) under the 2.0 °C warming target for RX1D (RX5D).
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Affiliation(s)
- Huixin Li
- Nansen-Zhu International Research Centre, Institute of Atmospheric Physics, Chinese Academy of Sciences, Beijing, China; University of Chinese Academy of Sciences, Beijing, China
| | - Huopo Chen
- Nansen-Zhu International Research Centre, Institute of Atmospheric Physics, Chinese Academy of Sciences, Beijing, China; Collaborative Innovation Center on Forecast and Evaluation of Meteorological Disasters, Nanjing University of Information Science and Technology, Nanjing, China.
| | - Huijun Wang
- Nansen-Zhu International Research Centre, Institute of Atmospheric Physics, Chinese Academy of Sciences, Beijing, China; Collaborative Innovation Center on Forecast and Evaluation of Meteorological Disasters, Nanjing University of Information Science and Technology, Nanjing, China
| | - Entao Yu
- Nansen-Zhu International Research Centre, Institute of Atmospheric Physics, Chinese Academy of Sciences, Beijing, China; Collaborative Innovation Center on Forecast and Evaluation of Meteorological Disasters, Nanjing University of Information Science and Technology, Nanjing, China
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Coates SJ, Davis MDP, Andersen LK. Temperature and humidity affect the incidence of hand, foot, and mouth disease: a systematic review of the literature - a report from the International Society of Dermatology Climate Change Committee. Int J Dermatol 2018; 58:388-399. [PMID: 30187452 DOI: 10.1111/ijd.14188] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2018] [Revised: 07/13/2018] [Accepted: 07/17/2018] [Indexed: 12/12/2022]
Abstract
Hand, foot, and mouth disease (HFMD) is an enterovirus-mediated condition that predominantly affects children under 5 years of age. The tendency for outbreaks to peak in warmer summer months suggests a relationship between HFMD and weather patterns. We reviewed the English-language literature for articles describing a relationship between meteorological variables and HFMD. Seventy-two studies meeting criteria were identified. A positive, statistically significant relationship was identified between HFMD cases and both temperature (61 of 67 studies, or 91.0%, reported a positive relationship) [CI 81.8-95.8%, P = 0.0001] and relative humidity (41 of 54 studies, or 75.9%) [CI 63.1-85.4%, P = 0.0001]. No significant relationship was identified between HFMD and precipitation, wind speed, and/or sunshine. Most countries reported a single peak of disease each year (most commonly early Summer), but subtropical and tropical climate zones were significantly more likely to experience a bimodal distribution of cases throughout the year (two peaks a year; most commonly late spring/early summer, with a smaller peak in autumn). The rising global incidence of HFMD, particularly in Pacific Asia, may be related to climate change. Weather forecasting might be used effectively in the future to indicate the risk of HFMD outbreaks and the need for targeted public health interventions.
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Affiliation(s)
- Sarah J Coates
- Department of Dermatology, The University of California San Francisco, San Francisco, CA, USA
| | - Mark D P Davis
- Division of Clinical Dermatology, Mayo Clinic, Rochester, MN, USA
| | - Louise K Andersen
- Department of Dermato-Venereology, Aarhus University Hospital, Aarhus, Denmark
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Yang Y, You E, Wu J, Zhang W, Jin J, Zhou M, Jiang C, Huang F. Effects of relative humidity on childhood hand, foot, and mouth disease reinfection in Hefei, China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2018; 630:820-826. [PMID: 29499537 DOI: 10.1016/j.scitotenv.2018.02.262] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Revised: 02/10/2018] [Accepted: 02/21/2018] [Indexed: 05/04/2023]
Abstract
BACKGROUND In recent years, hand, foot, and mouth disease (HFMD) has become a major public health issue in China, and its reinfection rate has been high. Numerous studies have examined the effects of meteorological factors involved in HFMD infection. However, no study has investigated the effects on HFMD reinfection. The present study analyzed the relationship between relative humidity and HFMD reinfection. METHODS We employed a distributed lag nonlinear model to evaluate the relationship between relative humidity and childhood HFMD reinfection in Hefei, China during 2011-2016. This model controlled confounding factors, including seasonality, long-term trend, day of the week, precipitation, and mean temperature. RESULTS Childhood HFMD reinfection cases occurred mainly from April to July, and the second peak occurred from October to December. A statistically significant association was observed between relative humidity and HFMD reinfection with delayed effects. The adverse effect of high relative humidity (>75%) appeared later than those of low relative humidity (<75%). Moreover, the highest relative risk (RR 1.08, 95% CI 1.04-1.13) occurred when the relative humidity was 100% and had an 8-day lag. Given the differences between gender and age groups, the effects of extremely high relative humidity on females and those aged ≥4years were higher than those of other groups and caused the highest cumulative relative risks at lag 0-9 or 0-10days (Female: RR 2.00, 95% CI 1.23-3.26; Male: RR 1.55, 95% CI 1.04-2.30; Aged ≥4years: RR 2.31, 95% CI 1.27-4.18; Aged <4years: RR 1.51, 95% CI 1.04-2.20). CONCLUSION High and low relative humidity were found to cause the elevated risks of HFMD reinfection, and the highest risk was observed at extremely high relative humidity. Early warning systems should be built for the protection of susceptible populations, particularly females and children aged ≥4years.
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Affiliation(s)
- Yuwei Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Shushan District, Hefei, Anhui 230032, PR China
| | - Enqing You
- Hefei Center for Disease Control and Prevention, 86 Luan Road, Luyang District, Hefei, Anhui 230061, PR China
| | - Jinju Wu
- Hefei Center for Disease Control and Prevention, 86 Luan Road, Luyang District, Hefei, Anhui 230061, PR China
| | - Wenyan Zhang
- Hefei Center for Disease Control and Prevention, 86 Luan Road, Luyang District, Hefei, Anhui 230061, PR China
| | - Jin Jin
- Hefei Center for Disease Control and Prevention, 86 Luan Road, Luyang District, Hefei, Anhui 230061, PR China
| | - Mengmeng Zhou
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Shushan District, Hefei, Anhui 230032, PR China
| | - Chunxiao Jiang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Shushan District, Hefei, Anhui 230032, PR China
| | - Fen Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Shushan District, Hefei, Anhui 230032, PR China.
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Floods Increase the Risks of Hand-Foot-Mouth Disease in Qingdao, China, 2009-2013: A Quantitative Analysis. Disaster Med Public Health Prep 2018; 12:723-729. [PMID: 29734967 DOI: 10.1017/dmp.2017.154] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND We aimed to quantify the impact of few times floods on hand-foot-mouth disease (HFMD) in Qingdao during 2009-2013. METHODS The Spearman correlation test was applied to examine the lagged effects of floods on monthly morbidity of HFMD during study period in Qingdao. We further quantified the effects of 5 flood events on the morbidity of HFMD using the time-series Poisson regression controlling for climatic factors, seasonality, and lagged effects among different populations. RESULTS A total of 55,920 cases of HFMD were reported in the study region over the study period. The relative risks of floods on the morbidity of HFMD among the total population, males, females, under 1-2 years old, and 3-5 years old were 1.178, 1.165, 1.198, 1.338, and 1.245, respectively. CONCLUSIONS This study has, for the first time, provided the positive evidence of the impact of floods on HFMD. It demonstrates that floods can significantly increase the risk of HFMD during study period. Additionally, among the different populations, the risks were higher among children under 1-5 years old. (Disaster Med Public Health Preparedness. 2018;12:723-729).
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Spatio-temporal analysis of the relationship between meteorological factors and hand-foot-mouth disease in Beijing, China. BMC Infect Dis 2018; 18:158. [PMID: 29614964 PMCID: PMC5883540 DOI: 10.1186/s12879-018-3071-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Accepted: 03/26/2018] [Indexed: 11/29/2022] Open
Abstract
Background Hand-foot-mouth disease (HFMD) is a common infectious disease in China and occurs mostly in infants and children. Beijing is a densely populated megacity, in which HFMD has been increasing in the last decade. The aim of this study was to quantify spatio-temporal characteristics of HFMD and the relationship between meteorological factors and HFMD incidence in Beijing, China. Methods Daily counts of HFMD cases from January 2010 to December 2012 were obtained from the Beijing Center for Disease Prevention and Control (CDC). Seasonal trend decomposition with Loess smoothing was used to explore seasonal patterns and temporal trends of HFMD. Bayesian spatiotemporal Poisson regression models were used to quantify spatiotemporal patterns of HFMD incidence and associations with meteorological factors. Results There were 114,777 HFMD cases reported to Beijing CDC from 1 January 2010 to 31 December 2012 and the raw incidence was 568.6 per 100,000 people. May to July was the peak period of HFMD incidence each year. Low-incidence townships were clustered in central, northeast and southwest regions of Beijing. Mean temperature, relative humidity, wind velocity and sunshine hours were all positively associated with HFMD. The effect of wind velocity was significant with a RR of 3.30 (95%CI: 2.37, 4.60) per meter per second increase, as was sunshine hours with a RR of 1.20 (95%CI: 1.02, 1.40) per 1 hour increase. Conclusions The distribution of HFMD in Beijing was spatiotemporally heterogeneous, and was associated with meteorological factors. Meteorological monitoring could be incorporated into prediction and surveillance of HFMD in Beijing. Electronic supplementary material The online version of this article (10.1186/s12879-018-3071-3) contains supplementary material, which is available to authorized users.
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Zhou ZM, Xu Y, Hu CS, Pan QJ, Wei JJ. Epidemiological Features of Hand, Foot and Mouth Disease during the Period of 2008-14 in Wenzhou, China. J Trop Pediatr 2017; 63:182-188. [PMID: 27765889 DOI: 10.1093/tropej/fmw070] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
This study aimed to analyze the epidemiological characteristics of hand, foot and mouth disease (HFMD) during 2008-14 in Wenzhou, China. The epidemiological data of HFMD retrieved from the Wenzhou Center for Disease Control and Prevention were retrospectively analyzed. HFMD infections with enterovirus 71 (EV71), Cox A16 or other pathogens were further verified by polymerase chain reaction (PCR) and real-time PCR. A total of 213 617 cases of HFMD were reported between 2008 and 2014 in Wenzhou. The average incidence was 384.31 of 100 000, and the fatality rate was 0.14‰. The incidence of HFMD peaked between April and July, and it occurred more frequently in males than in females. Approximately 92.68% of the HFMD patients were children aged <5 years. Nearly 80% of the cases were diagnosed within 2 days after onset. The major HFMD pathogen was EV71. This study suggested that appropriate comprehensive prevention and control measures should be taken to avoid the spread of HFMD.
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Affiliation(s)
- Zu-Mu Zhou
- Department of Emergency Response, Wenzhou Center for Disease Control and Prevention, Wenzhou, Zhejiang, 325000, China
| | - Yi Xu
- Department of Emergency Response, Wenzhou Center for Disease Control and Prevention, Wenzhou, Zhejiang, 325000, China
| | - Cai-Song Hu
- Department of Emergency Response, Wenzhou Center for Disease Control and Prevention, Wenzhou, Zhejiang, 325000, China
| | - Qiong-Jiao Pan
- Department of infectious disease control and prevention, Wenzhou Center for Disease Control and Prevention, Wenzhou, Zhejiang, 325000, China
| | - Jing-Jiao Wei
- Department of infectious disease control and prevention, Wenzhou Center for Disease Control and Prevention, Wenzhou, Zhejiang, 325000, China
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Xu C. Spatio-Temporal Pattern and Risk Factor Analysis of Hand, Foot and Mouth Disease Associated with Under-Five Morbidity in the Beijing-Tianjin-Hebei Region of China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14040416. [PMID: 28406470 PMCID: PMC5409617 DOI: 10.3390/ijerph14040416] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2017] [Revised: 03/31/2017] [Accepted: 03/31/2017] [Indexed: 11/19/2022]
Abstract
Hand, foot and mouth disease (HFMD) in children under the age of five is a major public health issue in China. Beijing–Tianjin–Hebei is the largest urban agglomeration in northern China. The present study aimed to analyze the epidemiological features of HFMD, reveal spatial clusters, and detect risk factors in this region. Reports of HFMD cases in Beijing–Tianjin–Hebei from 1 January 2013 to 31 December 2013 were collected from 211 counties or municipal districts. First, the epidemiological features were explored, and then SaTScan analysis was carried out to detect spatial clusters of HFMD. Finally, GeoDetector and spatial paneled model were used to identify potential risk factors among the socioeconomic and meteorological variables. There were a total of 90,527 HFMD cases in the year 2013. The highest rate was in individuals aged one year, with an incidence of 24.76/103. Boys (55,168) outnumbered girls (35,359). Temporally, the incidence rose rapidly from April, peaking in June (4.08/103). Temperature, relative humidity and wind speed were positively associated with the incidence rate, while precipitation and sunshine hours had a negative association. The explanatory powers of these factors were 57%, 13%, 2%, 21% and 12%, respectively. Spatially, the highest-risk regions were located in Beijing and neighboring areas, with a relative risk (RR) value of 3.04. The proportion of primary industry was negatively associated with HFMD transmission, with an explanatory power of 32%. Gross domestic product (GDP) per capita, proportion of tertiary industry, and population density were positively associated with disease incidence, with explanatory powers of 22%, 17% and 15%, respectively. These findings may be helpful in the risk assessment of HFMD transmission and for implementing effective interventions to reduce the burden of this disease.
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Affiliation(s)
- Chengdong Xu
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciencesand Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, China.
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Impacts of ambient temperature on the burden of bacillary dysentery in urban and rural Hefei, China. Epidemiol Infect 2017; 145:1567-1576. [PMID: 28294081 DOI: 10.1017/s0950268817000280] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Bacillary dysentery continues to be a major health issue in developing countries and ambient temperature is a possible environmental determinant. However, evidence about the risk of bacillary dysentery attributable to ambient temperature under climate change scenarios is scarce. We examined the attributable fraction (AF) of temperature-related bacillary dysentery in urban and rural Hefei, China during 2006-2012 and projected its shifting pattern under climate change scenarios using a distributed lag non-linear model. The risk of bacillary dysentery increased with the temperature rise above a threshold (18·4 °C), and the temperature effects appeared to be acute. The proportion of bacillary dysentery attributable to hot temperatures was 18·74% (95 empirical confidence interval (eCI): 8·36-27·44%). Apparent difference of AF was observed between urban and rural areas, with AF varying from 26·87% (95% eCI 16·21-36·68%) in urban area to -1·90% (95 eCI -25·03 to 16·05%) in rural area. Under the climate change scenarios alone (1-4 °C rise), the AF from extreme hot temperatures (>31·2 °C) would rise greatly accompanied by the relatively stable AF from moderate hot temperatures (18·4-31·2 °C). If climate change proceeds, urban area may be more likely to suffer from rapidly increasing burden of disease from extreme hot temperatures in the absence of effective mitigation and adaptation strategies.
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Zhao D, Wang L, Cheng J, Xu J, Xu Z, Xie M, Yang H, Li K, Wen L, Wang X, Zhang H, Wang S, Su H. Impact of weather factors on hand, foot and mouth disease, and its role in short-term incidence trend forecast in Huainan City, Anhui Province. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2017; 61:453-461. [PMID: 27557791 DOI: 10.1007/s00484-016-1225-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Revised: 07/28/2016] [Accepted: 07/30/2016] [Indexed: 05/04/2023]
Abstract
Hand, foot, and mouth disease (HFMD) is one of the most common communicable diseases in China, and current climate change had been recognized as a significant contributor. Nevertheless, no reliable models have been put forward to predict the dynamics of HFMD cases based on short-term weather variations. The present study aimed to examine the association between weather factors and HFMD, and to explore the accuracy of seasonal auto-regressive integrated moving average (SARIMA) model with local weather conditions in forecasting HFMD. Weather and HFMD data from 2009 to 2014 in Huainan, China, were used. Poisson regression model combined with a distributed lag non-linear model (DLNM) was applied to examine the relationship between weather factors and HFMD. The forecasting model for HFMD was performed by using the SARIMA model. The results showed that temperature rise was significantly associated with an elevated risk of HFMD. Yet, no correlations between relative humidity, barometric pressure and rainfall, and HFMD were observed. SARIMA models with temperature variable fitted HFMD data better than the model without it (sR 2 increased, while the BIC decreased), and the SARIMA (0, 1, 1)(0, 1, 0)52 offered the best fit for HFMD data. In addition, compared with females and nursery children, males and scattered children may be more suitable for using SARIMA model to predict the number of HFMD cases and it has high precision. In conclusion, high temperature could increase the risk of contracting HFMD. SARIMA model with temperature variable can effectively improve its forecast accuracy, which can provide valuable information for the policy makers and public health to construct a best-fitting model and optimize HFMD prevention.
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Affiliation(s)
- Desheng Zhao
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui Province, 230032, China
| | - Lulu Wang
- School of Nursing, Anhui Medical University, Hefei, Anhui, China
| | - Jian Cheng
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui Province, 230032, China
| | - Jun Xu
- Department of Clinical Laboratory, the Affiliated Provincial Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Zhiwei Xu
- School of Public Health and Social Work & Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Brisbane, QLD, 4509, Australia
| | - Mingyu Xie
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui Province, 230032, China
| | - Huihui Yang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui Province, 230032, China
| | - Kesheng Li
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui Province, 230032, China
| | - Lingying Wen
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui Province, 230032, China
| | - Xu Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui Province, 230032, China
| | - Heng Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui Province, 230032, China
| | - Shusi Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui Province, 230032, China
| | - Hong Su
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui Province, 230032, China.
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ZHANG F, LIU Z, GAO L, ZHANG C, JIANG B. Short-term impacts of floods on enteric infectious disease in Qingdao, China, 2005-2011. Epidemiol Infect 2016; 144:3278-3287. [PMID: 27312685 PMCID: PMC9150198 DOI: 10.1017/s0950268816001084] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Revised: 04/16/2016] [Accepted: 05/06/2016] [Indexed: 11/07/2022] Open
Abstract
The current study aimed to examine the relationship between floods and the three enteric infectious diseases, namely bacillary dysentery (BD), hand-foot-mouth disease (HFMD) and other infectious diarrhoea (OID) in Qingdao, China. Relative risks (RRs) and 95% confidence intervals (CIs) of floods on BD, HFMD and OID were calculated using a quasi-Poisson generalized linear model, adjusting for daily average temperature, daily average relative humidity, and seasonal and long-term temporal trends. Two separate models within two different periods were designed. Model 1 for the summer period showed that floods were positively associated with BD for 4- to 12-day lags, with the greatest effects for 7-day (RR 1·41, 95% CI 1·22-1·62) and 11-day (RR 1·42, 95% CI 1·22-1·64) lags. Similar findings were found in model 2 for the whole study period for 5- to 12-day lags. However, HFMD and OID were not significantly associated with floods in both models. Results from this study will provide insight into the health risks associated with floods and may help inform public health precautionary measures for such disasters.
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Affiliation(s)
- F. ZHANG
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, Shandong Province, China
- Shandong University Climate Change and Health Centre, Jinan, Shandong Province, China
| | - Z. LIU
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, Shandong Province, China
- Shandong University Climate Change and Health Centre, Jinan, Shandong Province, China
| | - L. GAO
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, Shandong Province, China
- Shandong University Climate Change and Health Centre, Jinan, Shandong Province, China
| | - C. ZHANG
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, Shandong Province, China
- Shandong University Climate Change and Health Centre, Jinan, Shandong Province, China
| | - B. JIANG
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, Shandong Province, China
- Shandong University Climate Change and Health Centre, Jinan, Shandong Province, China
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Wang P, Goggins WB, Chan EYY. Hand, Foot and Mouth Disease in Hong Kong: A Time-Series Analysis on Its Relationship with Weather. PLoS One 2016; 11:e0161006. [PMID: 27532865 PMCID: PMC4988669 DOI: 10.1371/journal.pone.0161006] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2016] [Accepted: 07/28/2016] [Indexed: 11/18/2022] Open
Abstract
Background Hand, foot and mouth disease (HFMD) is an emerging enterovirus-induced infectious disease for which the environmental risk factors promoting disease circulation remain inconclusive. This study aims to quantify the association of daily weather variation with hospitalizations for HFMD in Hong Kong, a subtropical city in China. Methods A time series of daily counts of HFMD public hospital admissions from 2008 through 2011 in Hong Kong was regressed on daily mean temperature, relative humidity, wind speed, solar radiation and total rainfall, using a combination of negative binomial generalized additive models and distributed lag non-linear models, adjusting for trend, season, and day of week. Results There was a positive association between temperature and HFMD, with increasing trends from 8 to 20°C and above 25°C with a plateau in between. A hockey-stick relationship of relative humidity with HFMD was found, with markedly increasing risks over 80%. Moderate rainfall and stronger wind and solar radiation were also found to be associated with more admissions. Conclusions The present study provides quantitative evidence that short-term meteorological variations could be used as early indicators for potential HFMD outbreaks. Climate change is likely to lead to a substantial increase in severe HFMD cases in this subtropical city in the absence of further interventions.
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Affiliation(s)
- Pin Wang
- School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - William B. Goggins
- School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
- * E-mail:
| | - Emily Y. Y. Chan
- Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response, School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
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Liu ZD, Li J, Zhang Y, Ding GY, Xu X, Gao L, Liu XN, Liu QY, Jiang BF. Distributed lag effects and vulnerable groups of floods on bacillary dysentery in Huaihua, China. Sci Rep 2016; 6:29456. [PMID: 27427387 PMCID: PMC4947917 DOI: 10.1038/srep29456] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Accepted: 06/17/2016] [Indexed: 11/09/2022] Open
Abstract
Understanding the potential links between floods and bacillary dysentery in China is important to develop appropriate intervention programs after floods. This study aimed to explore the distributed lag effects of floods on bacillary dysentery and to identify the vulnerable groups in Huaihua, China. Weekly number of bacillary dysentery cases from 2005–2011 were obtained during flood season. Flood data and meteorological data over the same period were obtained from the China Meteorological Data Sharing Service System. To examine the distributed lag effects, a generalized linear mixed model combined with a distributed lag non-linear model were developed to assess the relationship between floods and bacillary dysentery. A total of 3,709 cases of bacillary dysentery were notified over the study period. The effects of floods on bacillary dysentery continued for approximately 3 weeks with a cumulative risk ratio equal to 1.52 (95% CI: 1.08–2.12). The risks of bacillary dysentery were higher in females, farmers and people aged 15–64 years old. This study suggests floods have increased the risk of bacillary dysentery with 3 weeks’ effects, especially for the vulnerable groups identified. Public health programs should be taken to prevent and control a potential risk of bacillary dysentery after floods.
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Affiliation(s)
- Zhi-Dong Liu
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, Shandong Province, People's Republic of China.,Shandong University Climate Change and Health Center, Jinan, Shandong Province, People's Republic of China
| | - Jing Li
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, Shandong Province, People's Republic of China.,Shandong University Climate Change and Health Center, Jinan, Shandong Province, People's Republic of China
| | - Ying Zhang
- School of Public Health, China Studies Centre, The University of Sydney, New South Wales, Australia
| | - Guo-Yong Ding
- Department of Epidemiology, School of Public Health, Taishan Medical College, Taian, Shandong Province, People's Republic of China
| | - Xin Xu
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, Shandong Province, People's Republic of China.,Shandong University Climate Change and Health Center, Jinan, Shandong Province, People's Republic of China
| | - Lu Gao
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, Shandong Province, People's Republic of China.,Shandong University Climate Change and Health Center, Jinan, Shandong Province, People's Republic of China
| | - Xue-Na Liu
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, Shandong Province, People's Republic of China.,Shandong University Climate Change and Health Center, Jinan, Shandong Province, People's Republic of China
| | - Qi-Yong Liu
- Shandong University Climate Change and Health Center, Jinan, Shandong Province, People's Republic of China.,State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, China CDC, Beijing 102206, P. R. China
| | - Bao-Fa Jiang
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, Shandong Province, People's Republic of China.,Shandong University Climate Change and Health Center, Jinan, Shandong Province, People's Republic of China
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50
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Effects of Meteorological Parameters and PM10 on the Incidence of Hand, Foot, and Mouth Disease in Children in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13050481. [PMID: 27171104 PMCID: PMC4881106 DOI: 10.3390/ijerph13050481] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2016] [Revised: 04/29/2016] [Accepted: 05/05/2016] [Indexed: 12/13/2022]
Abstract
Hand, foot, and mouth disease (HFMD) is a globally-prevalent infectious disease. However, few data are available on prevention measures for HFMD. The purpose of this investigation was to evaluate the impacts of temperature, humidity, and air pollution, particularly levels of particulate matter with an aerodynamic diameter 10 micrometers (PM10), on the incidence of HFMD in a city in Eastern China. Daily morbidity, meteorological, and air pollution data for Ningbo City were collected for the period from January 2012 to December 2014. A total of 86,695 HFMD cases were enrolled in this study. We used a distributed lag nonlinear model (DLNM) with Poisson distribution to analyze the nonlinear lag effects of daily mean temperature, daily humidity, and found significant relationships with the incidence of HFMD; in contrast, PM10 level showed no relationship to the incidence of HFMD. Our findings will facilitate the development of effective preventive measures and early forecasting of HFMD outbreaks.
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