Using a Bayesian spatiotemporal model to identify the influencing factors and high-risk areas of hand, foot and mouth disease (HFMD) in Shenzhen

Background The epidemic of hand, foot, and mouth disease (HFMD) has become a severe public health problem in the world and has also brought a high economic and health burden. Furthermore, the prevalence of HFMD varies significantly among different locations. However, there have been few investigations of the effects of socioeconomic factors and air pollution factors on the incidence of HFMD. Methods This study collected data on HFMD in Shenzhen, China, from 2012 to 2015. We selected eleven factors as potential risk factors for HFMD. A Bayesian spatiotemporal model was used to quantify the influence of the factors on HFMD and to identify the relative risks in different districts. Results The risk factors of HFMD were the population, population density, concentration of SO2, and concentration of NO2. The relative risks (RRs) were 1.00473 (95% CI: 1.00059–1.00761), 1.00010 (95% CI: 1.00002–1.00016), 1.00215 (95% CI: 1.00170–1.00232) and 1.00058 (95% CI: 1.00028–1.00078), respectively. The protective factors against HFMD were the per capita GDP, the number of public kindergartens, the concentration of PM10, and the concentration of O3. The RRs were 0.98840 (95% CI: 0.98660–0.99026), 0.97686 (95% CI: 0.96946–0.98403), 0.99108 (95% CI: 0.98551–0.99840) and 0.99587 (95% CI: 0.99534–0.99610), respectively. The risk of incidence in Longgang district and Pingshan district decreased, while the risk of incidence in Baoan district increased. Conclusions Studies have confirmed that socioeconomic factors and air pollution factors have an impact on the incidence of HFMD in Shenzhen, China. The results will be of great practical significance to local authorities, which is conducive to accurate prevention and can be used to formulate HFMD early warning systems.

[1]  Jinquan Cheng,et al.  Short-Term Effects of Meteorological Factors and Air Pollutants on Hand, Foot and Mouth Disease among Children in Shenzhen, China, 2009–2017 , 2019, International journal of environmental research and public health.

[2]  Y. Hao,et al.  Spatiotemporal Distribution of Hand, Foot, and Mouth Disease in Guangdong Province, China and Potential Predictors, 2009–2012 , 2019, International journal of environmental research and public health.

[3]  Q. Wei,et al.  Short-term exposure to sulfur dioxide and the risk of childhood hand, foot, and mouth disease during different seasons in Hefei, China. , 2019, The Science of the total environment.

[4]  Y. Hao,et al.  Interactions between climate factors and air pollution on daily HFMD cases: A time series study in Guangdong, China. , 2019, The Science of the total environment.

[5]  L. Duan,et al.  Epidemiologic features of enterovirus associated with hand, foot and mouth disease in 2013 and 2014 in Shenzhen, China , 2019, Scientific Reports.

[6]  Xiaosong Li,et al.  Analysis of the effect of PM10 on hand, foot and mouth disease in a basin terrain city , 2019, Scientific Reports.

[7]  J. Li,et al.  Risk Reduction Behaviors Regarding PM2.5 Exposure among Outdoor Exercisers in the Nanjing Metropolitan Area, China , 2018, International journal of environmental research and public health.

[8]  Ruixue Huang,et al.  Impact of PM10 and meteorological factors on the incidence of hand, foot, and mouth disease in female children in Ningbo, China: a spatiotemporal and time-series study , 2018, Environmental Science and Pollution Research.

[9]  Heng Zhang,et al.  Ambient temperature, humidity and hand, foot, and mouth disease: A systematic review and meta-analysis. , 2018, The Science of the total environment.

[10]  M. Akiyama,et al.  Hand, Foot, and Mouth Disease in an Adult. , 2018, The New England journal of medicine.

[11]  A. Sureda,et al.  Therapeutic relevance of ozone therapy in degenerative diseases: Focus on diabetes and spinal pain , 2018, Journal of cellular physiology.

[12]  E. Pintor,et al.  Hand, foot and mouth disease in an adult , 2018, Infection.

[13]  M. Kwan,et al.  Spatiotemporal Variations and Driving Factors of Air Pollution in China , 2017, International journal of environmental research and public health.

[14]  Lianshui Li,et al.  Correlation Analysis of PM10 and the Incidence of Lung Cancer in Nanchang, China , 2017, International journal of environmental research and public health.

[15]  M. Jit,et al.  Economic costs and health-related quality of life for hand, foot and mouth disease (HFMD) patients in China , 2017, PloS one.

[16]  A. Sumi,et al.  Association between meteorological factors and reported cases of hand, foot, and mouth disease from 2000 to 2015 in Japan , 2017, Epidemiology and Infection.

[17]  Y. Poovorawan,et al.  Human enteroviruses associated with and without diarrhea in Thailand between 2010 and 2016 , 2017, PloS one.

[18]  Y. Hao,et al.  Estimating the basic reproduction rate of HFMD using the time series SIR model in Guangdong, China , 2017, PloS one.

[19]  Chao Liu,et al.  Is short‐term exposure to ambient fine particles associated with measles incidence in China? A multi‐city study , 2017, Environmental research.

[20]  R. Charrel,et al.  An Outbreak of Kingella Kingae Infections Complicating a Severe Hand, Foot, And Mouth Disease Outbreak in Nice, France, 2016. , 2017, The Pediatric infectious disease journal.

[21]  Chengdong Xu 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 , 2017, International journal of environmental research and public health.

[22]  Yang Liu,et al.  A comparison of individual exposure, perception, and acceptable levels of PM2.5 with air pollution policy objectives in China , 2017, Environmental research.

[23]  Timothy W. Collins,et al.  Racial Differences in Perceptions of Air Pollution Health Risk: Does Environmental Exposure Matter? , 2017, International journal of environmental research and public health.

[24]  Robert Cohen,et al.  Ambulatory Pediatric Surveillance of Hand, Foot and Mouth Disease as Signal of an Outbreak of Coxsackievirus A6 Infections, France, 2014–2015 , 2016, Emerging infectious diseases.

[25]  Jijun Zhao,et al.  Determinants of the Transmission Variation of Hand, Foot and Mouth Disease in China , 2016, PloS one.

[26]  Qing Ye,et al.  Haze is an important medium for the spread of rotavirus. , 2016, Environmental pollution.

[27]  William B. Goggins,et al.  Hand, Foot and Mouth Disease in Hong Kong: A Time-Series Analysis on Its Relationship with Weather , 2016, PloS one.

[28]  S. Jonasson,et al.  Inhaled sulfur dioxide causes pulmonary and systemic inflammation leading to fibrotic respiratory disease in a rat model of chemical-induced lung injury. , 2016, Toxicology.

[29]  D. Hober,et al.  Hand, foot and mouth disease (HFMD): emerging epidemiology and the need for a vaccine strategy , 2016, Medical Microbiology and Immunology.

[30]  Hong Yang,et al.  Genetic evolution of Human Enterovirus A71 subgenotype C4 in Shenzhen, China, 1998-2013. , 2016, The Journal of infection.

[31]  Ruixue Huang,et al.  Effects of Meteorological Parameters and PM10 on the Incidence of Hand, Foot, and Mouth Disease in Children in China , 2016, International journal of environmental research and public health.

[32]  Sanjay Rampal,et al.  Cyclical Patterns of Hand, Foot and Mouth Disease Caused by Enterovirus A71 in Malaysia , 2016, PLoS neglected tropical diseases.

[33]  Alimin Maidin,et al.  Challenges in evaluating PM concentration levels, commuting exposure, and mask efficacy in reducing PM exposure in growing, urban communities in a developing country. , 2016, The Science of the total environment.

[34]  G. Valacchi,et al.  Ozone: A Multifaceted Molecule with Unexpected Therapeutic Activity. , 2016, Current medicinal chemistry.

[35]  A. Campos‐Arceiz,et al.  The Link between Knowledge, Attitudes and Practices in Relation to Atmospheric Haze Pollution in Peninsular Malaysia , 2015, PloS one.

[36]  Xiang Cong,et al.  Epidemiological Research on Hand, Foot, and Mouth Disease in Mainland China , 2015, Viruses.

[37]  Y. Poovorawan,et al.  PREVALENCE OF HUMAN ENTEROVIRUS AMONG PATIENTS WITH HAND, FOOT, AND MOUTH DISEASE AND HERPANGINA IN THAILAND, 2013. , 2015, The Southeast Asian journal of tropical medicine and public health.

[38]  Hong Yang,et al.  Characterization of severe hand, foot, and mouth disease in Shenzhen, China, 2009–2013 , 2015, Journal of medical virology.

[39]  S. Rutherford,et al.  The Epidemiological Study of Coxsackievirus A6 revealing Hand, Foot and Mouth Disease Epidemic patterns in Guangdong, China , 2015, Scientific Reports.

[40]  V. Travagli,et al.  The usefulness of ozone treatment in spinal pain , 2015, Drug design, development and therapy.

[41]  Ragini Singh,et al.  An outbreak of hand-foot-mouth disease: A report from the hills of northern India. , 2015, The National medical journal of India.

[42]  Qingwei Liu,et al.  Towards broadly protective polyvalent vaccines against hand, foot and mouth disease. , 2015, Microbes and infection.

[43]  F. Okada,et al.  Inflammation-Related Carcinogenesis: Current Findings in Epidemiological Trends, Causes and Mechanisms , 2014, Yonago acta medica.

[44]  Yanchen Bo,et al.  Using an autologistic regression model to identify spatial risk factors and spatial risk patterns of hand, foot and mouth disease (HFMD) in Mainland China , 2014, BMC Public Health.

[45]  Peter R Harris,et al.  Does heightening risk appraisals change people's intentions and behavior? A meta-analysis of experimental studies. , 2014, Psychological bulletin.

[46]  Sheng Zheng,et al.  Epidemiological features of hand-foot-and-mouth disease in Shenzhen, China from 2008 to 2010 , 2013, Epidemiology and Infection.

[47]  Y. He,et al.  Severe hand, foot and mouth disease in Shenzhen, South China: what matters most? , 2013, Epidemiology and Infection.

[48]  Sandra Smole,et al.  Hand, Foot, and Mouth Disease Caused by Coxsackievirus A6 , 2012, Emerging infectious diseases.

[49]  Álvaro R. Osornio-Vargas,et al.  Air pollution: An environmental factor contributing to intestinal disease. , 2011, Journal of Crohn's & colitis.

[50]  Mary-Louise McLaws,et al.  The role of particle size in aerosolised pathogen transmission: A review , 2010, Journal of Infection.

[51]  V. Travagli,et al.  The ozone paradox: Ozone is a strong oxidant as well as a medical drug , 2009, Medicinal research reviews.

[52]  Ya-Ching Lin,et al.  Ozone exposure in the culture medium inhibits enterovirus 71 virus replication and modulates cytokine production in rhabdomyosarcoma cells. , 2007, Antiviral research.

[53]  Ya-Ching Lin,et al.  Effects of ozone exposure on inactivation of intra- and extracellular enterovirus 71. , 2006, Antiviral research.

[54]  B. Baxt,et al.  Foot-and-Mouth Disease , 2004, Clinical Microbiology Reviews.

[55]  Tatsuo Kato,et al.  [Hand, foot and mouth disease]. , 2003, Nihon rinsho. Japanese journal of clinical medicine.

[56]  Jinquan Cheng,et al.  A hand hygiene intervention to decrease hand, foot and mouth disease and absence due to sickness among kindergarteners in China: A cluster-randomized controlled trial. , 2019, The Journal of infection.

[57]  J. Qin,et al.  Short-term effects of meteorological factors and air pollution on childhood hand-foot-mouth disease in Guilin, China. , 2019, The Science of the total environment.

[58]  Lei Meng,et al.  Socio-ecological factors and hand, foot and mouth disease in dry climate regions: a Bayesian spatial approach in Gansu, China , 2016, International Journal of Biometeorology.

[59]  Li Yua Analysis on the missing reports of infectious diseases in medical institutions in Shenzhen City , 2015 .