Many studies have shown that the relationship between ambient temperature, relative humidity and mumps has been highlighted. However, these studies showed inconsistent results. Therefore, the goal of our study is to conduct a meta-analysis to clarify this relationship and to quantify the size of these effects as well as the potential factors. Systematic literature researches on PubMed, Embase.com, Web of Science Core Collection, Cochrane library, Chinese BioMedical Literature Database (CBM) and China National Knowledge Infrastructure (CNKI) were performed up to February 7, 2022 for articles analyzing the relationships between ambient temperature, relative humidity and incidence of mumps. Eligibility assessment and data extraction were conducted independently by two researchers, and meta-analysis was performed to synthesize these data. We also assessed sources of heterogeneity by study region, regional climate, study population. Finally, a total of 14 studies were screened out from 1154 records and identified to estimate the relationship between ambient temperature, relative humidity and incidence of mumps. It was found that per 1 °C increase and decrease in the ambient temperature were significantly associated with increased incidence of mumps with RR of 1.0191 (95% CI: 1.0129–1.0252, I2 = 92.0%, Egger’s test P = 0.001, N = 13) for per 1 °C increase and 1.0244 (95% CI: 1.0130–1.0359, I2 = 86.6%, Egger’s test P = 0.077, N = 9) for per 1 °C decrease. As to relative humidity, only high effect of relative humidity was slightly significant (for per 1 unit increase with RR of 1.0088 (95% CI: 1.0027–1.0150), I2 = 72.6%, Egger’s test P = 0.159, N = 9). Subgroup analysis showed that regional climate with temperate areas may have a higher risk of incidence of mumps than areas with subtropical climate in cold effect of ambient temperature and low effect of relative humidity. In addition, meta-regression analysis showed that regional climate may affect the association between incidence of mumps and cold effect of ambient temperature. Our results suggest ambient temperature could affect the incidence of mumps significantly, of which both hot and cold effect of ambient temperature may increase the incidence of mumps. Further studies are still needed to clarify the relationship between the incidence of mumps and ambient temperature outside of east Asia, and many other meteorological factors. These results of ambient temperature are important for establishing preventive measures on mumps, especially in temperate areas. The policy-makers should pay more attention to ambient temperature changes and take protective measures in advance.
Background Mild hand, foot and mouth disease (HFMD) cases make up a relatively high proportion of HFMD while have often been overlooked. This study aimed to investigate the epidemiological and etiological characteristics of mild HFMD in Nanjing. Methods Data on mild HFMD cases, during 2010–2019 in Nanjing, were collected from the China Information System for Disease Control and Prevention. This study mainly focused on mild cases aged < 7 years. Descriptive analysis was used to summarize epidemiological and etiological characteristics of mild cases. Flexible spatial scan statistic was used to detect spatial clusters of mild cases. Results A total of 175,339 mild cases aged < 7 years were reported, accounting for 94.4% of all mild cases. There was a higher average annual incidence of mild HFMD in children aged < 7 years (4,428 cases/100,000) compared with children aged ≥ 7 years (14 cases/100,000, P < 0.001), and especially children aged 1-year-old (7,908 cases/100,000). Mild cases showed semi-annual peaks of activity, including a major peak (April to July) and a minor peak (September to November). The average annual incidence was higher in males (5,040 cases/100,000) than females (3,755 cases/100,000). Based on the cumulative reported cases, the most likely cluster was detected, including Yuhuatai District, Jiangning District, Jiangbei new Area, and Pukou District. The annual distribution of enterovirus serotypes showed a significant difference. During 2010–2016, Enterovirus 71 (EV71), Coxsackievirus A16 (Cox A16), and other non-EV71/Cox A16 EVs, accounted for 29.1%, 34.6%, 36.3% of all the enterovirus test positive cases, respectively. Moreover, during 2017–2019, Cox A6, Cox A16, EV71, and other non-EV71/Cox A16/Cox A6 EVs, accounted for 47.3%, 32.5%, 10.7%, 9.5%, respectively. Conclusions Children under 7 years old are at higher risk of mild HFMD. Regions with high risk are mainly concentrated in the areas surrounding central urban areas. Cox A16 and Cox A6 became the dominant serotypes and they alternated or were co-epidemic. Our findings could provide valuable information for improving the regional surveillance, prevention and control strategies of HFMD.
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