Abstract
Prior studies of hand, foot, and mouth disease (HFMD) have often observed inconsistent results regarding meteorological factors. We propose the hypothesis that these meteorological associations vary in regions because of the heterogeneity of their geographical characteristics. We have tested this hypothesis by applying a geographical detector and Bayesian space–time hierarchy model to measure stratified spatiotemporal heterogeneity and local associations between meteorological factors and HFMD risk in five climate zones in China from January 2016 to December 2017. We found a significant spatial stratified heterogeneity in HFMD risk and climate zone explained 15% of the spatial stratified heterogeneity. Meanwhile, there was a significant temporal stratified heterogeneity of 14% as determined by meteorological factors. Average temperatures and relative humidity had a significant positive effect on HFMD in all climate zones, they were the most obvious in the southern temperate zone. In northern temperate, southern temperate, northern subtropics, middle subtropics and southern subtropics climate zone, a 1 °C rise in temperature was related to an increase of 3.99%, 13.76%, 4.38%, 3.99%, and 7.74% in HFMD, and a 1% increment in relative humidity was associated with a 1.51%, 5.40%, 2.21%, 3.44%, and 4.78% increase, respectively. These findings provide strong support for our hypotheses that HFMD incidence has a significant spatiotemporal stratified heterogeneity and different climate zones have distinct influences on the disease. These findings provide strong support for our hypotheses: HFMD incidence had significant spatiotemporal stratified heterogeneity and different climate zones had distinct influences on it. The study suggested that HFMD prevention and policy should be made according to meteorological variation in each climate zone.
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Data availability
The datasets are available from the corresponding author upon reasonable request.
Abbreviations
- HFMD :
-
Hand food mouth disease
- EV71 :
-
Enterovirus 71
- CV-A16 :
-
Coxsackie virus A16
- GDP :
-
Gross Domestic Product
- CDC :
-
Center for Disease Control and Prevention
- BSTHM :
-
Bayesian spatiotemporal hierarchy model
- RR :
-
Relative risk
- CI :
-
Confidence interval
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Funding
The study was supported by National Science Foundation of China (41901331, 41671172, and 42071220), Henan Postdoctoral Science Foundation (CJ3050A0670196) and a grant from State Key Laboratory of Resources and Environmental Information System. The funder had no role in study design, data collection, data analysis, data interpretation, or writing of the report.
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LW, CDX, JJQ and Li Li drafted the manuscript. LW, CDX and NLW conducted the statistical analysis and modeling. JFW guided this research. All authors contributed to the writing and modification of the manuscript. All authors read and approved the final manuscript.
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Wang, L., Xu, C., Wang, J. et al. Spatiotemporal associations between hand, foot and mouth disease and meteorological factors over multiple climate zones. Int J Biometeorol 67, 1493–1504 (2023). https://doi.org/10.1007/s00484-023-02519-y
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DOI: https://doi.org/10.1007/s00484-023-02519-y