135 / 2019-11-05 16:35:51

Analysis on the Spatio-temporal characteristics of Hand-foot-mouth disease in Shaanxi Province, 2013-2017

Hand-foot-mouth disease,Spatial-temporal epidemiological characteristics,Power-law method

【Abstract】 Objective To study the spatial-temporal dynamical features of hand-foot-mouth disease (HFMD) in Shaanxi Province, so as to provide evidence for the development of relative prevention and control programs on HFMD. Methods Surveillance data of HFMD was collected from the China Information System for Diseases Control and Prevention from 2013 to 2017. Related data on population and gross domestic product (GDP) was obtained from Shaanxi Statistical Yearbook. Statistical tools as R3.4.1, ArcGIS10.2 and Satscan9.2 software were used to describe the spatial-temporal distribution of the disease. Power-law method on spatial-temporal-multicomponent model was used to analyze the spatial-temporal evolution of the HFMD epidemics in Shaanxi Province. Results A total of 268 587 cases of HFMD were reported in Shaanxi Province from 2013 to 2017, of which 3 264 were severe cases and 45 were death cases,with an average annual incidence as 142.21 per 100 000. Obvious seasonal characteristics were noticed, with 70.65% of the total cases identified between April and July. Counties with high incidence were mainly distributed in the mid- and east parts of Guanzhong area. Through temporal and spatial scan statistics, we identified that Class I clustering area was fixed to the central and southeast regions of Shaanxi province which were around Xi’an City from 2013 to 2017, with the relative risk (RR) as 2.24, ranging from 2.18 to 3.08. Results from Power-law analysis showed that the continuous follow-up impact from the previous HFMD epidemics appeared strong in Tongguan, Pucheng districts of Weinan City and Weiyang district of Xi’an, with autoregressive components as 1.14, 0.97 and 0.89, respectively. The risk of HFMD seemed high in Huayin city, Changan and Yanta districts and with the endemic components as 5.08, 4.12 and 4.08, respectively. Impact of the epidemics on nearby districts was largely seen in Lianhu district of Xi’an, Wugong district of Xianyang and Gaoling district of Xi’an with epidemic components as 2.12, 2.08 and 1.77, respectively. The etiological constituents of HFMD were mainly caused by other entero-viruses (EV) as well as coxsackie virus(Cox) A16 during 2013 to 2017. Conclusion Significant spatial-temporal heterogeneity of HFMD was seen in Shaanxi Province, which called for specific strategies to be developed in the highly endemic areas.
【Key words】Hand-foot-mouth disease(HFMD); Spatial-temporal epidemiological characteristics; Power-law method