Spatio-temporal clustering analysis and its determinants of hand, foot and mouth disease in Hunan, China, 2009–2015

SUMMARYChina has recently experienced a marked increase in the incidence of hand, foot and mouth disease (HFMD). Effective spatio-temporal monitoring of HFMD incidence is important for successful implementation of control and prevention measures. This study monitored county-level HFMD reported incidence rates for Sichuan province, China by examining spatio-temporal patterns. County-level data on HFMD daily cases between January 2008 and December 2013 were obtained from the China Information System for Disease Control and Prevention. We first conducted purely temporal and purely spatial descriptive analyses to characterize the distribution patterns of HFMD. Then, the global Moran's I statistic and space–time scan statistic were used to detect the spatial autocorrelation and identify the high-risk clusters in each year, respectively. A total of 212267 HFMD cases were reported in Sichuan province during the study period (annual average incidence 43·65/100000), and the incidence seasonal peak was between April and July. Relatively high incidence rates appeared in the northeastern–southwestern belt. HFMD had positive spatial autocorrelation at the county level with global Moran's I increasing from 0·27 to 0·52 (P < 0·001). Spatio-temporal cluster analysis detected six most-likely clusters and several secondary clusters from 2008 to 2013. The centres of the six most-likely clusters were all located in the provincial capital city Chengdu. Chengdu and its neighbouring cities had always been spatio-temporal clusters, which indicated the need for further intensive space–time surveillance. Allocating more resources to these areas at suitable times might help to reduce HFMD incidence more effectively.

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Spatio-temporal point processes, partial likelihood, foot and mouth disease

Statistical Methods in Medical Research ◽

10.1191/0962280206sm454oa ◽

2006 ◽

Vol 15 (4) ◽

pp. 325-336 ◽

Cited By ~ 66

Author(s):

Peter J Diggle

Keyword(s):

Point Processes ◽

Foot And Mouth Disease ◽

Mouth Disease ◽

Partial Likelihood ◽

Foot And Mouth ◽

Spatio Temporal

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Epidemiological features of hand-foot-and-mouth disease in Shenzhen, China from 2008 to 2010

Epidemiology and Infection ◽

10.1017/s0950268813002586 ◽

2013 ◽

Vol 142 (8) ◽

pp. 1751-1762 ◽

Cited By ~ 12

Author(s):

S. ZHENG ◽

C. X. CAO ◽

J. Q. CHENG ◽

Y. S. WU ◽

X. XIE ◽

...

Keyword(s):

Rank Correlation ◽

Temporal Distribution ◽

Foot And Mouth Disease ◽

Epidemiological Data ◽

Mouth Disease ◽

Propagation Mechanism ◽

Spearman’S Rank Correlation ◽

Temperature And Precipitation ◽

Foot And Mouth ◽

Spatio Temporal

SUMMARYThis study analysed the spatio-temporal distribution and propagation of hand-foot-and-mouth disease (HFMD) in Shenzhen from 2008 to 2010. Specifically, we examined the epidemiological data, temporal distribution and spatial distribution, and then the relationship between meteorological, social factors and the number of reported HFMD cases was analysed using Spearman's rank correlation. Finally, a geographically weighted regression model was constructed for the number of reported HFMD cases in 2009. It was found that three independent variables, i.e. the number of reported HFMD cases in 2008 and, annual average temperature and precipitation, had different spatial impacts on the number of reported HFMD cases in 2009. In addition, these variables accounted for the propagation mechanism of HFMD in the centre and east of Shenzhen, where the high incidence rate areas are located. These results will be of great help in understanding the spatio-temporal distribution of HFMD and developing approaches to prevent this disease.

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