To determine the linear and non-linear interacting relationships between weather factors and hand, foot and mouth disease (HFMD) in children in Gansu, China, and gain further traction as an early warning signal based on weather variability for HFMD transmission.
Weekly HFMD cases aged less than 15 and meteorological information from 2010 to 2014 in Jiuquan, Lanzhou and Tianshu, Gansu, China were collected. Generalized linear regression models (GLM) with Poisson link and classification and regression trees (CART) were employed to determine the combined and interactive relationship of weather factors and HFMD in both linear and non-linear ways.
GLM suggested an increase in weekly HFMD of 5.9% [95% confidence interval (CI): 5.4%, 6.5%] in Tianshui, 2.8% [2.5%, 3.1%] in Lanzhou and 1.8% [1.4%, 2.2%] in Jiuquan in association with a 1 °C increase in average temperature, respectively. And 1% increase of relative humidity could increase weekly HFMD of 2.47% [2.23%, 2.71%] in Lanzhou and 1.11% [0.72%, 1.51%] in Tianshui. CART revealed that average temperature and relative humidity were the first two important determinants, and their threshold values for average temperature deceased from 20 °C of Jiuquan to 16 °C in Tianshui; and for relative humidity, threshold values increased from 38% of Jiuquan to 65% of Tianshui.
Average temperature was the primary weather factor in three areas, more sensitive in southeast Tianshui, compared with northwest Jiuquan; Relative humidity’s effect on HFMD showed a non-linear interacting relationship with average temperature.
Seiff A. Cambodia unravels cause of mystery illness. Lancet (London, England). 2012;380(9838):206. CrossRef
Ma E, Chan KC, Cheng P, Wong C, Chuang SK. The enterovirus 71 epidemic in 2008—public health implications for Hong Kong. Int J Infect Dis. 2010;14(9):775–80. CrossRef
Sun S, Jiang L, Liang Z, Mao Q, Su W, Zhang H, Li X, Jin J, Xu L, Zhao D. Evaluation of monovalent and bivalent vaccines against lethal enterovirus 71 and Coxsackievirus A16 infection in newborn mice. Human Vaccin Immunother. 2014;10(10):2885–95. CrossRef
Zhao D, Wang L, Cheng J, Xu J, Xu Z, Xie M, Yang H, Li K, Wen L, Wang X, et al. Impact of weather factors on hand, foot and mouth disease, and its role in short-term incidence trend forecast in Huainan City, Anhui Province. Int J Biometeorol. 2016;61(3):1-9.
Gardner ES. Forecasting: methods and applications (Second Edition), Makridakis, S., Wheelwright, S. C. and McGee, V. E., New York: Wiley, 1983. Price: $47.85/$20.15 (cloth), $34.15/E14.35 (paper). Pages: 923. J Forecasting. 1984;3(4):457–60. CrossRef
Bartholomew D, Box GEP, Jenkins GM. Time series analysis: forecasting and control. In: Holden-day series in time series analysis, revised Ed, San Francisco: Holden-day, vol. 1976; 1976. p. 199–201.
Nelder JA, Wedderburn RWM. Generalized linear models. J R Stat Soc Ser A (General). 1972;135(3):370–84. CrossRef
Team RC: R: a language and environment for statistical computing: R Foundation for stastical computing. 2017.
Ma E, Lam T, Chan KC, Wong C, Chuang SK. Changing epidemiology of hand, foot, and mouth disease in Hong Kong, 2001-2009. Jpn J Infect Dis. 2010;63(6):422–6. PubMed
Wang Y, Feng Z, Yang Y, Self S, Gao Y, Longini IM, Wakefield J, Zhang J, Wang L, Chen X, et al. Hand, foot, and mouth disease in China: patterns of spread and transmissibility. Epidemiology (Cambridge, Mass). 2011;22(6):781–92. CrossRef
- Different responses of weather factors on hand, foot and mouth disease in three different climate areas of Gansu, China
- BioMed Central
Neu im Fachgebiet Innere Medizin
Meistgelesene Bücher aus der Inneren Medizin
Mail Icon II