Short-Term Effects of Climatic Variables on Hand, Foot, and Mouth Disease in Mainland China, 2008–2013: A Multilevel Spatial Poisson Regression Model Accounting for Overdispersion

Abstract Background Numerous studies have demonstrated the potential association between rainfall and hand, foot and mouth disease (HFMD), but the results are inconsistent. This study aimed to quantify the relationship between rainfall and HFMD based on a multicity study and explore the potential sources of spatial heterogeneity. Methods We retrieved the daily counts of childhood HFMD and the meteorological variables of the 143 cities in mainland China between 2009 and 2014. A common time series regression model was applied to quantify the association between rainfall and HFMD for each of the 143 cities. Then, we adopted the meta-regression model to pool the city-specific estimates and explore the sources of heterogeneity by incorporating city-specific characteristics. Results The overall pooled estimation suggested a nonlinear exposure-response relationship between rainfall and HFMD. Once rainfall exceeded 15 mm, the HFMD risk stopped increasing linearly and began to plateau with the excessive risk ratio (ERR) peaking at 21 mm of rainfall (ERR = 3.46, 95% CI: 2.05, 4.88). We also found significant heterogeneity in the rainfall-HFMD relationships (I2 = 52.75%, P < 0.001). By incorporating the city-specific characteristics into the meta-regression model, temperature and student density can explain a substantial proportion of spatial heterogeneity with I2 statistics that decreased by 5.29 and 6.80% at most, respectively. Conclusions Our findings verified the nonlinear association between rainfall and HFMD. The rainfall-HFMD relationship also varies depending on locations. Therefore, the estimation of the rain-HFMD relationship of one location should not be generalized to another location.

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Assessment of foot-and-mouth disease risk areas in mainland China based spatial multi-criteria decision analysis

10.21203/rs.3.rs-424752/v1 ◽

2021 ◽

Author(s):

Wang Haoran ◽

Xiao Jianhua ◽

Ouyang Maolin ◽

Gao Hongyan ◽

Bie Jia ◽

...

Keyword(s):

Risk Factors ◽

Decision Analysis ◽

Disease Risk ◽

Mainland China ◽

Foot And Mouth Disease ◽

Mouth Disease ◽

Multi Criteria Decision Analysis ◽

Foot And Mouth ◽

Risk Areas ◽

And Control

Abstract Background Foot-and-mouth disease (FMD) is a highly contagious viral disease of cloven-hoofed animals. As a transboundary animal disease, the prevention and control of FMD are important. This study was based on spatial multi-criteria decision analysis (MCDA) to assess FMD risk areas in mainland China. Ten risk factors were identified for constructing risk maps by scoring, and the analytic hierarchy process (AHP) was used to calculate the criteria weights of all factors. Different risk factors had different units and attributes, and fuzzy membership was used to standardize the risk factors. The weighted linear combination (WLC) and one-at-a-time (OAT) were used to obtain risk and uncertainty maps as well as to perform sensitivity analysis. Results Four major risk areas were identified in mainland China, including western (Xinjiang and Tibet), southern (Yunnan, Guizhou, Guangxi and Guangdong), northern (Gansu, Ningxia and Inner Mongolia), and eastern (Hebei, Henan, Anhui, Jiangsu and Shandong). We found spring as the main season for FMD outbreaks. Risk areas were associated with the distance to previous outbreak points, grazing areas and cattle density. Receiver operating characteristic (ROC) analysis indicated that the risk map had good predictive power (AUC = 0.8532). Conclusions These results can be used to delineate FMD risk areas in mainland China, and provinces can adopt the targeted preventive measures and control strategies.

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Association of PM2.5 and its Components with Lengths of Hospital Stay for Hand Foot and Mouth Disease in Children

10.21203/rs.3.rs-986232/v2 ◽

2021 ◽

Author(s):

Wei Li ◽

Jieguo Wang ◽

Kai Zhou ◽

Ye Tian ◽

Feiran Wei ◽

...

Keyword(s):

Hospital Stay ◽

Foot And Mouth Disease ◽

Mouth Disease ◽

Health Concern ◽

Public Health Concern ◽

Short Term ◽

Illness Onset ◽

Short Term Exposure ◽

Foot And Mouth ◽

Demographic Features

Abstract Background Hand foot and mouth disease (HFMD) is a public health concern. Studies on air pollution and the lengths of hospital stay (LOS) of HFMD are scarce. Methods We characterized the clinic demographic features of 5135 hospitalized HFMD in Nanjing, China from 2012 to 2017, and analyzed the association between short-term exposure to PM2.5 as well as its components (OM, BC, SO42−, NH4+, NIT, SOIL and SS) and the LOS of HFMD. Results Among them 98.62% were aged 0–6 years old, and 3772 (73.46%) were hospitalized for seven days or less. The LOS of HFMD children was different in different ages, illness onset years and illness onset seasons (P<0.01). For per IQR increase in PM2.5 concentrations, LOS of HFMD increased by 0.52(0.33, 0.71), 0.50 (95% CI, 0.31–0.69) and 0.46 (95% CI, 0.28–0.65) day in adjusted models at lag 3 days, lag 7days and lag 14 days, respectively. In addition, per IQR increase of BC, SO42−, NH4+, NIT and SOIL were also significantly associated with the LOS of HFMD. Conclusions Our findings corroborated the hypothesis that short-term PM2.5 exposure was associated with increased the LOS of HFMD, and its components (BC, SO42−, NH4+, NIT and SOIL) of PM2.5 might play a key role in the prolonged LOS of HFMD.

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