Spatial-Temporal Clusters and Risk Factors of Hand, Foot, and Mouth Disease at the District Level in Guangdong Province, China

Abstract

ObjectiveHand, foot, and mouth disease (HFMD) has posed a great threat to the health of children and become a public health priority in China. This study aims to investigate the epidemiological characteristics, spatial-temporal patterns, and risk factors of HFMD in Guangdong Province, China, and to provide scientific information for public health responses and interventions.MethodsHFMD surveillance data from May 2008 to December 2011were provided by the Chinese Center for Disease Control and Prevention. We firstly conducted a descriptive analysis to evaluate the epidemic characteristics of HFMD. Then, Kulldorff scan statistic based on a discrete Poisson model was used to detect spatial-temporal clusters. Finally, a spatial paneled model was applied to identify the risk factors.ResultsA total of 641,318 HFMD cases were reported in Guangdong Province during the study period (total population incidence: 17.51 per 10,000). Male incidence was higher than female incidence for all age groups, and approximately 90% of the cases were children years old. Spatial-temporal cluster analysis detected four most likely clusters and several secondary clusters (P<0.001) with the maximum cluster size 50% and 20% respectively during 2008–2011. Monthly average temperature, relative humidity, the proportion of population years, male-to-female ratio, and total sunshine were demonstrated to be the risk factors for HFMD.ConclusionChildren years old, especially boys, were more susceptible to HFMD and we should take care of their vulnerability. Provincial capital city Guangzhou and the Pearl River Delta regions had always been the spatial-temporal clusters and future public health planning and resource allocation should be focused on these areas. Furthermore, our findings showed a strong association between HFMD and meteorological factors, which may assist in predicting HFMD incidence.

Spatial Clustering of Severe Hand-Foot-Mouth Disease Cases on Hainan Island, China

“…However, no spatial clustering studies of the incidence of severe HFMD or the proportion of severe HFMD cases among total HFMD cases have been conducted. Several studies have reported spatial clustering of the incidence of general HFMD (7)(8)(9)(10)(11), although all previous studies of HFMD clusters used district-level incidence data, which might have masked the potential effect of local environment. Thus, we analyzed the incidence of severe HFMD and the proportion of severe HFMD among total HFMD cases at the township level, which facilitated evaluation of the link between severe HFMD and environment factors at a higher geographical resolution.…”

Demographic characteristics of patients with hand-foot-and-mouth disease. Atypical cases series

“…Younger age (<5 years) predominance was related to the differences in serum antibodies according to age groups. 4 Additionally, a seroprevalence study from Germany reported that 66% of children aged 1-4 years did not posses neutralizing antibodies to CV-A16. 11 Since 2004, there has been an increase in the number of reports of a more severe form of HFMD associated with CV-A6.…”

“…4 In another study 89.75% of HFMD patients were aged <4 years. 8 Other studies confirmed the younger age (<5 years) and HFMD cases due to CV-A6 during an outbreak between 2011 and 2012 in North America.…”

“…3 HFMD is typically mild and self-limited but sometimes serious complications occur. [4][5] HFMD primarily affects children aged <5 years. 4 …”

Doktor Muda Competencies: Self-efficacy and Hand Washing Demonstration Skill among School Children in Malaysia

“…In order to nurture a healthy, intelligent and active pupil; efforts are needed to empower them so that they can be responsible for their own health. Therefore, hygiene promotion is the main focus of the policymakers to reduce the occurrence of infectious disease (Curtis, S. Cairncross, & R. Yondi, 2000;Te et al, 2013).…”