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Yang L, Liu T, Tian D, Zhao H, Xia Y, Wang J, Li T, Li Q, Qi L. Non-linear association between daily mean temperature and children's hand foot and mouth disease in Chongqing, China. Sci Rep 2023; 13:20355. [PMID: 37990138 PMCID: PMC10663521 DOI: 10.1038/s41598-023-47858-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 11/19/2023] [Indexed: 11/23/2023] Open
Abstract
Chongqing was seriously affected by hand, foot, and mouth disease (HFMD), but the relationships between daily mean temperature and the incidence of HFMD remain unclear. This study used distributed lag nonlinear model to evaluate the effect of daily mean temperature on the incidence of HFMD in children aged < 5 years in Chongqing. Daily HFMD data from 2012 to 2019 in Chongqing were retrieved from the notifiable infectious disease surveillance system. A total of 413,476 HFMD cases aged < 5 years were reported in Chongqing from 2012 to 2019. The exposure-response curve of daily mean temperature and daily HFMD cases was wavy-shaped. The relative risks (RRs) increased as daily mean temperature below 5.66 °C or above 9.43 °C, with two peaks at 16.10 °C and 26.68 °C. The RRs reached the highest when the daily mean temperature at 26.68 °C on the current day (RR = 1.20, 95% CI 1.09-1.32), followed by the daily mean temperature at 16.10 °C at lag 5 days (RR = 1.07, 95% CI 1.05-1.08). The RRs for girls and daycare children were much higher than those for boys and scattered children, respectively. Taken together, daily mean temperature has strong effect on HFMD in children aged < 5 years old in Chongqing, particularly for girls and daycare children.
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Affiliation(s)
- Lin Yang
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, 400042, China
| | - Tian Liu
- Jingzhou Center for Disease Control and Prevention, Hubei, 434000, China
| | - Dechao Tian
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-Sen University, Shenzhen, 518107, Guangdong, China
| | - Han Zhao
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, 400042, China
| | - Yu Xia
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, 400042, China
| | - Ju Wang
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, 400042, China
| | - Tingting Li
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, 400042, China
| | - Qin Li
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, 400042, China.
| | - Li Qi
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, 400042, China.
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Jiang X, Ma Y, Lv Q, Liu Y, Zhang T, Yin F, Shui T. Influence of social and meteorological factors on hand, foot, and mouth disease in Sichuan Province. BMC Public Health 2023; 23:849. [PMID: 37165358 PMCID: PMC10170695 DOI: 10.1186/s12889-023-15699-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 04/18/2023] [Indexed: 05/12/2023] Open
Abstract
BACKGROUND Hand, foot and mouth disease (HFMD) caused by a variety of enteroviruses remains a major public health problem in China. Previous studies have found that social factors may contribute to the inconsistency of the relationship patterns between meteorological factors and HFMD, but the conclusions are inconsistent. The influence of social factors on the association between meteorology and HFMD is still less well understood. We aimed to analyze whether social factors affected the effect of meteorological factors on HFMD in Sichuan Province. METHOD We collected daily data on HFMD, meteorological factors and social factors in Sichuan Province from 2011 to 2017. First, we used a Bayesian spatiotemporal model combined with a distributed lag nonlinear model to evaluate the exposure-lag-response association between meteorological factors and HFMD. Second, by constructing the interaction of meteorological factors and social factors in the above model, the changes in the relative risk (RR) under different levels of social factors were evaluated. RESULTS The cumulative exposure curves for average temperature, relative humidity, and HFMD were shaped like an inverted "V" and a "U" shape. As the average temperature increased, the RR increased and peaked at 19 °C (RR 1.020 [95% confidence interval CI 1.004-1.050]). The urbanization rate, per capita gross domestic product (GDP), population density, birth rate, number of beds in health care centers and number of kindergartens interacted with relative humidity. With the increase in social factors, the correlation curve between relative humidity and HFMD changed from an "S" shape to a "U" shape. CONCLUSIONS Relative humidity and average temperature increased the risk of HFMD within a certain range, and social factors enhanced the impact of high relative humidity. These results could provide insights into the combined role of environmental factors in HFMD and useful information for regional interventions.
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Affiliation(s)
- Xiaohong Jiang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yue Ma
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Qiang Lv
- Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan, China
| | - Yaqiong Liu
- Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan, China
| | - Tao Zhang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Fei Yin
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China.
| | - Tiejun Shui
- Yunnan Center for Disease Control and Prevention, Kunming, Yunnan, China.
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Motlogeloa O, Fitchett JM. Climate and human health: a review of publication trends in the International Journal of Biometeorology. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2023:10.1007/s00484-023-02466-8. [PMID: 37129619 PMCID: PMC10153057 DOI: 10.1007/s00484-023-02466-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 03/06/2023] [Accepted: 03/27/2023] [Indexed: 05/03/2023]
Abstract
The climate-health nexus is well documented in the field of biometeorology. Since its inception, Biometeorology has in many ways become the umbrella under which much of this collaborative research has been conducted. Whilst a range of review papers have considered the development of biometeorological research and its coverage in this journal, and a few have reviewed the literature on specific diseases, none have focused on the sub-field of climate and health as a whole. Since its first issue in 1957, the International Journal of Biometeorology has published a total of 2183 papers that broadly consider human health and its relationship with climate. In this review, we identify a total of 180 (8.3%, n = 2183) of these papers that specifically focus on the intersection between meteorological variables and specific, named diagnosable diseases, and explore the publication trends thereof. The number of publications on climate and health in the journal increases considerably since 2011. The largest number of publications on the topic was in 2017 (18) followed by 2021 (17). Of the 180 studies conducted, respiratory diseases accounted for 37.2% of the publications, cardiovascular disease 17%, and cerebrovascular disease 11.1%. The literature on climate and health in the journal is dominated by studies from the global North, with a particular focus on Asia and Europe. Only 2.2% and 8.3% of these studies explore empirical evidence from the African continent and South America respectively. These findings highlight the importance of continued research on climate and human health, especially in low- and lower-middle-income countries, the populations of which are more vulnerable to climate-sensitive illnesses.
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Affiliation(s)
- Ogone Motlogeloa
- School of Geography, Archaeology and Environmental Studies, University of the Witwatersrand, Johannesburg, South Africa
| | - Jennifer M Fitchett
- School of Geography, Archaeology and Environmental Studies, University of the Witwatersrand, Johannesburg, South Africa.
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Zhao D, Zhang H, Zhang R, He S. Research on hand, foot and mouth disease incidence forecasting using hybrid model in mainland China. BMC Public Health 2023; 23:619. [PMID: 37003988 PMCID: PMC10064964 DOI: 10.1186/s12889-023-15543-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 03/28/2023] [Indexed: 04/03/2023] Open
Abstract
BACKGROUND This study aimed to construct a more accurate model to forecast the incidence of hand, foot, and mouth disease (HFMD) in mainland China from January 2008 to December 2019 and to provide a reference for the surveillance and early warning of HFMD. METHODS We collected data on the incidence of HFMD in mainland China between January 2008 and December 2019. The SARIMA, SARIMA-BPNN, and SARIMA-PSO-BPNN hybrid models were used to predict the incidence of HFMD. The prediction performance was compared using the mean absolute error(MAE), mean squared error(MSE), root mean square error (RMSE), mean absolute percentage error (MAPE), and correlation analysis. RESULTS The incidence of HFMD in mainland China from January 2008 to December 2019 showed fluctuating downward trends with clear seasonality and periodicity. The optimal SARIMA model was SARIMA(1,0,1)(2,1,2)[12], with Akaike information criterion (AIC) and Bayesian Schwarz information criterion (BIC) values of this model were 638.72, 661.02, respectively. The optimal SARIMA-BPNN hybrid model was a 3-layer BPNN neural network with nodes of 1, 10, and 1 in the input, hidden, and output layers, and the R-squared, MAE, and RMSE values were 0.78, 3.30, and 4.15, respectively. For the optimal SARIMA-PSO-BPNN hybrid model, the number of particles is 10, the acceleration coefficients c1 and c2 are both 1, the inertia weight is 1, the probability of change is 0.95, and the values of R-squared, MAE, and RMSE are 0.86, 2.89, and 3.57, respectively. CONCLUSIONS Compared with the SARIMA and SARIMA-BPNN hybrid models, the SARIMA-PSO-BPNN model can effectively forecast the change in observed HFMD incidence, which can serve as a reference for the prevention and control of HFMD.
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Affiliation(s)
- Daren Zhao
- Department of Medical Administration, Sichuan Provincial Orthopedics Hospital, Chengdu, Sichuan, People's Republic of China
| | - Huiwu Zhang
- Department of Medical Administration, Sichuan Provincial Orthopedics Hospital, Chengdu, Sichuan, People's Republic of China.
| | - Ruihua Zhang
- School of Management, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, People's Republic of China.
- General Practitioners Training Center of Sichuan Province, Chengdu, Sichuan, People's Republic of China.
| | - Sizhang He
- Department of Information and Statistics, The Affiliated Hospital of Southwest Medical University, Luzhou, 64600, Sichuan, China
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Baek K, Choi J, Park JT, Kwak K. Influence of temperature and precipitation on the incidence of hepatitis A in Seoul, Republic of Korea: a time series analysis using distributed lag linear and non-linear model. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2022; 66:1725-1736. [PMID: 35829753 DOI: 10.1007/s00484-022-02313-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 03/21/2022] [Accepted: 06/06/2022] [Indexed: 06/15/2023]
Abstract
This study aimed to analyze the association between temperature and precipitation and the incidence of hepatitis A in Seoul, Korea, as meteorological factors may have different effects on specific diseases depending on the lifestyle in each region. Weekly cases of hepatitis A, weekly mean daily precipitation, and temperature data from 2016 to 2020 were analyzed. Quasi-Poisson-generalized linear models with time variable adjusted by spline function were used considering 0-6-week lags. The association of each variable and hepatitis A incidence was assessed by the single lag and the constrained distributed lag model. Multivariable distributed lag linear and non-linear models were used to develop models with significant independent variables. Weekly mean of daily mean temperature (Tmean) and maximum temperature (Tmax) were negatively associated with hepatitis A in the 6-week lag. Precipitation was negatively associated with hepatitis A in the 5- and 6-week lags. The multivariable model showed the negative association of Tmax, precipitation and hepatitis A in the 5- and 6-week lags. In the non-linear models, the incidence rate ratio (IRR) was the highest at a Tmax of 11 °C and decreased thereafter. IRR was the highest at 12 mm of precipitation and showed decrease pattern to 25 mm and then gradually increased in the 5- and 6-week lags. Identifying the impact of climate factors on hepatitis A incidence would help in the development of strategies to prevent diseases and indirectly estimate the impact of climate change on hepatitis A epidemiology.
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Affiliation(s)
- Kiook Baek
- Department of Occupational and Environmental Medicine, Yeungnam University Hospital, Daegu, Republic of Korea
| | - Jonghyuk Choi
- Department of Preventive Medicine, College of Medicine, Dankook University, Cheonan, Republic of Korea
| | - Jong-Tae Park
- Department of Occupational and Environmental Medicine, Korea University Ansan Hospital, Ansan, Republic of Korea
| | - Kyeongmin Kwak
- Department of Occupational and Environmental Medicine, Korea University Ansan Hospital, Ansan, Republic of Korea.
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Zhang L, Yang Y, Lin Y, Chen H. Human Health, Environmental Quality and Governance Quality: Novel Findings and Implications From Human Health Perspective. Front Public Health 2022; 10:890741. [PMID: 35812483 PMCID: PMC9263448 DOI: 10.3389/fpubh.2022.890741] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 04/20/2022] [Indexed: 12/21/2022] Open
Abstract
Human health and wellbeing are intimately linked to the state of the environment. The current study emphasizes the role of environmental quality, government policies, and human health. This paper provides a detailed literature review of existing findings regarding our key variables of interest. The results argue that the implications of poor government policies and environmental pollution for rising economic development have led to poor environmental quality and health issues for humans. Based on earlier investigations, the present study reviewed the state-of-the-art review and determined innovative insights for outdoor and indoor environment difficulties. This study provides a detailed review of human health, environmental quality, and governance quality. In addition, the study conducts an empirical analysis using the annual data of low-income countries from 1996 to 2020. Government actions and health systems must be modified immediately to address these rising concerns successfully. The report offers policy recommendations for addressing health, governance, and environmental change mitigation issues, all of which are directly or indirectly related to the study. This article presents an overview of environmental change's health impacts and explores how health hazards may be reduced or eliminated through effective adaptation strategies.
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Affiliation(s)
- Liqin Zhang
- School of Economics, Fujian Normal University, Fuzhou, China
| | - Yuping Yang
- School of Economics, Fujian Normal University, Fuzhou, China
| | - Yesong Lin
- Fuzhou Lianjiang Ecological Environment Bureau, Fuzhou, China
| | - Huangxin Chen
- School of Economics, Fujian Normal University, Fuzhou, China
- *Correspondence: Huangxin Chen
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Ren FR, Abodurezhake Y, Cui Z, Zhang M, Wang YY, Zhang XR, Lu YQ. Effects of Meteorological Factors and Atmospheric Pollution on Hand, Foot, and Mouth Disease in Urumqi Region. Front Public Health 2022; 10:913169. [PMID: 35812470 PMCID: PMC9257078 DOI: 10.3389/fpubh.2022.913169] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 05/16/2022] [Indexed: 11/13/2022] Open
Abstract
Background Hand, foot, and mouth disease (HFMD) is a febrile rash infection caused by enteroviruses, spreading mainly via the respiratory tract and close contact. In the past two decades, HFMD has been prevalent mainly in Asia, including China and South Korea, causing a huge disease burden and putting the lives and health of children at risk. Therefore, a further study of the factors influencing HFMD incidences has far-reaching implications. In existing studies, the environmental factors affecting such incidences are mainly divided into two categories: meteorological and air. Among these studies, the former are the majority of studies on HFMD. Some scholars have studied both factors at the same, but the number is not large and the findings are quite different. Methods We collect monthly cases of HFMD in children, meteorological factors and atmospheric pollution in Urumqi from 2014 to 2020. Trend plots are used to understand the approximate trends between meteorological factors, atmospheric pollution and the number of HFMD cases. The association between meteorological factors, atmospheric pollution and the incidence of HFMD in the Urumqi region of northwest China is then investigated using multiple regression models. Results A total of 16,168 cases in children are included in this study. According to trend plots, the incidence of HFMD shows a clear seasonal pattern, with O3 (ug/m3) and temperature (°C) showing approximately the same trend as the number of HFMD cases, while AQI, PM2.5 (ug/m3), PM10 (ug/m3) and NO2 (ug/m3) all show approximately opposite trends to the number of HFMD cases. Based on multiple regression results, O3 (P = 0.001) and average station pressure (P = 0.037) are significantly and negatively associated with HFMD incidences, while SO2 (P = 0.102), average dew point temperature (P = 0.072), hail (P = 0.077), and thunder (P = 0.14) have weak significant relationships with them.
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Affiliation(s)
- Fang-rong Ren
- College of Economics and Management, Nanjing Forestry University, Nanjing, China
| | | | - Zhe Cui
- Economics and Management School, Nantong University, Nantong, China
| | - Miao Zhang
- Economics and Management School, Nantong University, Nantong, China
| | - Yu-yu Wang
- Economics and Management School, Nantong University, Nantong, China
| | - Xue-rong Zhang
- Economics and Management School, Nantong University, Nantong, China
| | - Yao-qin Lu
- Department of Infectious Disease Control, Urumqi Center for Disease Control and Prevention, Ürümqi, China
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Peng H, Chen Z, Cai L, Liao J, Zheng K, Li S, Ren X, Duan X, Tang X, Wang X, Long L, Yang C. Relationship between meteorological factors, air pollutants and hand, foot and mouth disease from 2014 to 2020. BMC Public Health 2022; 22:998. [PMID: 35581574 PMCID: PMC9112249 DOI: 10.1186/s12889-022-13365-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 05/04/2022] [Indexed: 11/10/2022] Open
Abstract
Background Meteorological factors and air pollutants have been reported to be associated with hand, foot, and mouth disease (HFMD) epidemics before the introduction of vaccine. However, there is limited evidence for studies with long-term dimensions. Methods We collected the daily HFMD counts, weather and air pollution data from 2014 to 2020 in Chengdu. Distributed lag non-linear models (DLNM) were used to assess the associations of meteorological factors and air pollutants on HFMD cases. Results From 2014–2020, high relative humidity and precipitation and extremely high and low levels of PM10, O3, SO2 and CO increased the risk of HFMD. In pre-vaccination period, extreme high and low temperatures, PM10 and NO2, low precipitation and high concentrations of PM2.5 and O3 significantly increase the risk of HFMD; In post-vaccination period, high relative humidity and low level of CO can significantly increase the incidence of HFMD; During the period of COVID-19, only low temperature will significantly increase the risk of HFMD; Low concentration of air pollutants has the greatest impact on the 6–14 age group, while the high concentration of air pollutants has the greatest impact on the 0–1 age group. Conclusions Our study suggest that high relative humidity and precipitation and extremely high and low levels of PM10, O3, SO2 and CO increased the risk of HFMD from 2014 to 2020. The results of this study provide a reference for local authorities to formulate intervention measures and establish an environment-based disease early warning system. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13365-9.
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Affiliation(s)
- Hongxia Peng
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, No.16, Section 3, Renmin south road, Wuhou District, Chengdu, Sichuan, China
| | - Zhenhua Chen
- Department of Microbiology Laboratory, Chengdu Municipal Center for Disease Control and Prevention, Chengdu, Sichuan, China
| | - Lin Cai
- Department of Gastroenterology, West China School of Public Health and West China Forth Hospital, Sichuan University, Chengdu, Sichuan, China.,Non-Communicable Diseases Research Center, West China-PUMC C.C. Chen Institute of Health, Sichuan University, Chengdu, Sichuan, China
| | - Juan Liao
- Department of Gastroenterology, West China School of Public Health and West China Forth Hospital, Sichuan University, Chengdu, Sichuan, China.,Non-Communicable Diseases Research Center, West China-PUMC C.C. Chen Institute of Health, Sichuan University, Chengdu, Sichuan, China
| | - Ke Zheng
- Department of Immunization Planning, Chengdu Municipal Center for Disease Control and Prevention, Chengdu, Sichuan, China
| | - Shuo Li
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, No.16, Section 3, Renmin south road, Wuhou District, Chengdu, Sichuan, China
| | - Xueling Ren
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, No.16, Section 3, Renmin south road, Wuhou District, Chengdu, Sichuan, China
| | - Xiaoxia Duan
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, No.16, Section 3, Renmin south road, Wuhou District, Chengdu, Sichuan, China
| | - Xueqin Tang
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, No.16, Section 3, Renmin south road, Wuhou District, Chengdu, Sichuan, China
| | - Xiao Wang
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, No.16, Section 3, Renmin south road, Wuhou District, Chengdu, Sichuan, China
| | - Lu Long
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, No.16, Section 3, Renmin south road, Wuhou District, Chengdu, Sichuan, China.
| | - Chunxia Yang
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, No.16, Section 3, Renmin south road, Wuhou District, Chengdu, Sichuan, China.
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Meng D, Xu J, Zhao J. Analysis and prediction of hand, foot and mouth disease incidence in China using Random Forest and XGBoost. PLoS One 2021; 16:e0261629. [PMID: 34936688 PMCID: PMC8694472 DOI: 10.1371/journal.pone.0261629] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 12/06/2021] [Indexed: 12/13/2022] Open
Abstract
Hand, foot and mouth disease (HFMD) is an increasingly serious public health problem, and it has caused an outbreak in China every year since 2008. Predicting the incidence of HFMD and analyzing its influential factors are of great significance to its prevention. Now, machine learning has shown advantages in infectious disease models, but there are few studies on HFMD incidence based on machine learning that cover all the provinces in mainland China. In this study, we proposed two different machine learning algorithms, Random Forest and eXtreme Gradient Boosting (XGBoost), to perform our analysis and prediction. We first used Random Forest to examine the association between HFMD incidence and potential influential factors for 31 provinces in mainland China. Next, we established Random Forest and XGBoost prediction models using meteorological and social factors as the predictors. Finally, we applied our prediction models in four different regions of mainland China and evaluated the performance of them. Our results show that: 1) Meteorological factors and social factors jointly affect the incidence of HFMD in mainland China. Average temperature and population density are the two most significant influential factors; 2) Population flux has different delayed effect in affecting HFMD incidence in different regions. From a national perspective, the model using population flux data delayed for one month has better prediction performance; 3) The prediction capability of XGBoost model was better than that of Random Forest model from the overall perspective. XGBoost model is more suitable for predicting the incidence of HFMD in mainland China.
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Affiliation(s)
- Delin Meng
- Complexity Science Institute, Qingdao University, Qingdao, Shandong, China
| | - Jun Xu
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, China
| | - Jijun Zhao
- Complexity Science Institute, Qingdao University, Qingdao, Shandong, China
- * E-mail:
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Gao Q, Liu Z, Xiang J, Tong M, Zhang Y, Wang S, Zhang Y, Lu L, Jiang B, Bi P. Forecast and early warning of hand, foot, and mouth disease based on meteorological factors: Evidence from a multicity study of 11 meteorological geographical divisions in mainland China. ENVIRONMENTAL RESEARCH 2021; 192:110301. [PMID: 33069698 DOI: 10.1016/j.envres.2020.110301] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 09/24/2020] [Accepted: 10/05/2020] [Indexed: 05/14/2023]
Abstract
BACKGROUND Hand, foot, and mouth disease (HFMD) is a significant public health issue in China. Early warning and forecasting are one of the most cost-effective ways for HFMD control and prevention. However, relevant research is limited, especially in China with a large population and diverse climatic characteristics. This study aims to identify local specific HFMD epidemic thresholds and construct a weather-based early warning model for HFMD control and prevention across China. METHODS Monthly notified HFMD cases and meteorological data for 22 cities selected from different climate zones from 2014 to 2018 were extracted from the National Notifiable Disease Surveillance System and the Meteorological Data Sharing Service System, respectively. A generalized additive model (GAM) based on meteorological factors was conducted to forecast HFMD epidemics. The receiver operator characteristic curve (ROC) was generated to determine the value of optimal warning threshold. RESULTS The developed model was solid in forecasting the epidemic of HFMD with all R square (R2) in the 22 cities above 85%, and mean absolute percentage error (MAPE) less than 1%. The warning thresholds varied by cities with the highest threshold observed in Shenzhen (n = 7195) and the lowest threshold in Liaoyang (n = 12). The areas under the curve (AUC) was greater than 0.9 for all regions, indicating a satisfied discriminating ability in epidemics detection. CONCLUSIONS The weather-based HFMD forecasting and early warning model we developed for different climate zones provides needed information on occurrence time and size of HFMD epidemics. An effective early warning system for HFMD could provide sufficient time for local authorities to implement timely interventions to minimize the HFMD morbidity and mortality.
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Affiliation(s)
- Qi Gao
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, People's Republic of China; Shandong University Climate Change and Health Center, Jinan, Shandong Province, People's Republic of China
| | - Zhidong Liu
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, People's Republic of China; Shandong University Climate Change and Health Center, Jinan, Shandong Province, People's Republic of China
| | - Jianjun Xiang
- School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia; School of Public Health, Fujian Medical University, Fuzhou, 350108, People's Republic of China
| | - Michael Tong
- School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia
| | - Ying Zhang
- School of Public Health, China Studies Centre, The University of Sydney, New South Wales, Australia
| | - Shuzi Wang
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, People's Republic of China; Shandong University Climate Change and Health Center, Jinan, Shandong Province, People's Republic of China
| | - Yiwen Zhang
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, People's Republic of China; Shandong University Climate Change and Health Center, Jinan, Shandong Province, People's Republic of China
| | - Liang Lu
- Shandong University Climate Change and Health Center, Jinan, Shandong Province, People's Republic of China; State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, People's Republic of China
| | - Baofa Jiang
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, People's Republic of China; Shandong University Climate Change and Health Center, Jinan, Shandong Province, People's Republic of China.
| | - Peng Bi
- School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia
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11
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Zheng Y, Wang K, Zhang L, Wang L. Study on the relationship between the incidence of influenza and climate indicators and the prediction of influenza incidence. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:473-481. [PMID: 32815008 DOI: 10.1007/s11356-020-10523-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 08/13/2020] [Indexed: 06/11/2023]
Abstract
In recent 2 years, the incidence of influenza showed a slight upward trend in Guangxi; therefore, some joint actions should be done to help preventing and controlling this disease. The factors analysis of affecting influenza and early prediction of influenza incidence may help policy-making so as to take effective measures to prevent and control influenza. In this study, we used the cross correlation function (CCF) to analyze the effect of climate indicators on influenza incidence, ARIMA and ARIMAX (autoregressive integrated moving average model with exogenous input variables) model methods to do predictive analysis of influenza incidence. The results of CCF analysis showed that climate indicators (PM2.5, PM10, SO2, CO, NO2, O3, average temperature, maximum temperature, minimum temperature, average relative humidity, and sunshine duration) had significant effects on the incidence of influenza. People need to take good precautions in the days of severe air pollution and keep warm in cold weather to prevent influenza. We found that the ARIMAX (1,0,1)(0,0,1)12 with NO2 model has good predictive performance, which can be used to predict the influenza incidence in Guangxi, and the predicted incidence may be useful in developing early warning systems and providing important evidence for influenza control policy-making and public health intervention.
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Affiliation(s)
- Yanling Zheng
- College of Medical Engineering and Technology, Xinjiang Medical University, Urumqi, 830011, People's Republic of China.
| | - Kai Wang
- College of Medical Engineering and Technology, Xinjiang Medical University, Urumqi, 830011, People's Republic of China
| | - Liping Zhang
- College of Medical Engineering and Technology, Xinjiang Medical University, Urumqi, 830011, People's Republic of China
| | - Lei Wang
- College of Medical Engineering and Technology, Xinjiang Medical University, Urumqi, 830011, People's Republic of China
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12
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Ma Y, Zhang Y, Cheng B, Feng F, Jiao H, Zhao X, Ma B, Yu Z. A review of the impact of outdoor and indoor environmental factors on human health in China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:42335-42345. [PMID: 32833174 DOI: 10.1007/s11356-020-10452-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 08/09/2020] [Indexed: 06/11/2023]
Abstract
The Intergovernmental Panel on Climate Change (IPCC) reported that global climate change has led to the increased occurrence of extreme weather events. In the context of global climate change, more evidence indicates that abnormal meteorological conditions could increase the risk of epidemiological mortality and morbidity. In this study, using a systematic review, we evaluated a total of 175 studies (including 158 studies on outdoor environment and 17 studies on indoor environment) to summarize the impact of outdoor and indoor environment on human health in China using the database of PubMed, Web of Science, the Cochrane Library, and Embase. In particular, we focused on studies about cardiovascular and respiratory mortality and morbidity, the prevalence of digestive system diseases, infectious diseases, and preterm birth. Most of the studies we reviewed were conducted in three of the metropolises of China, including Beijing, Guangzhou, and Shanghai. For the outdoor environment, we summarized the effects of climate change-related phenomena on health, including ambient air temperature, diurnal temperature range (DTR), temperature extremes, and so on. Studies on the associations between temperature and human health accounted for 79.7% of the total studies reviewed. We also screened out 19 articles to explore the effect of air temperature on cardiovascular diseases in different cities in the final meta-analysis. Besides, modern lifestyle involves a large amount of time spent indoors; therefore, indoor environment also plays an important role in human health. Nevertheless, studies on the impact of indoor environment on human health are rarely reported in China. According to the limited reports, adverse indoor environment could impose a high health risk on children.
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Affiliation(s)
- Yuxia Ma
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China.
| | - Yifan Zhang
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Bowen Cheng
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Fengliu Feng
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Haoran Jiao
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Xiaoyan Zhao
- Neurology Department, General Hospital of the Chinese People's Liberation Army, Beijing, 100000, China
| | - Bingji Ma
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Zhiang Yu
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
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Abstract
To examine the effects of temperature on the daily cases of hand, foot, and mouth disease (HFMD).Data on the daily cases of HFMD in Lanzhou from 2008 to 2015 were obtained, and meteorological data from the same period were collected. A distributed lag nonlinear model was fitted to reveal the relationship between the daily mean temperature and the daily cases of HFMD.From 2008 to 2015, 25,644 cases were reported, of which children under 5 years of age accounted for 78.68% of cases. The highest peak of HFMD cases was usually reported between April to July each year. An inverse V-shaped relationship was observed between daily mean temperature and HFMD cases; a temperature of 18°C was associated with a maximum risk of HFMD. The relative risk (RR) was 1.57 (95% confidence interval: 1.23-1.23), and boys and children aged 3 to 5 years were populations with the highest risk. The cumulative risks of high temperature (20.2°C and 25.2°C) in the total, age-specific, and gender-specific groups peaked on lag 14 days; RR was higher in girls than in boys and in children aged 1 to 2 years than in other age groups. However, the effects of low temperature (-5.3°C, 2.0°C, and 12.8°C) were not significant for both gender-specific and age-specific patients.High temperature may increase the risk of HFMD, and boys and children aged 3 to 5 years were at higher risks on lag 0 day; however, the cumulative risks in girls and children aged 1 to 2 years increased with the increasing number of lag days.
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Affiliation(s)
- Jinyu Wang
- School of Basic Medical Science, Lanzhou University
| | - Sheng Li
- The First People's Hospital of Lanzhou City, Lanzhou, PR China
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Ji XY, Huang LY, Song J, Fei CN, Liu J, Liu H. Short-term effects of meteorological factors, air pollution, and sunspot on childhood hand, foot, and mouth disease in Tianjin, China: a new time series regression, 2014-2018. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:37022-37035. [PMID: 32577970 PMCID: PMC7311115 DOI: 10.1007/s11356-020-09794-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 06/17/2020] [Indexed: 06/11/2023]
Abstract
This study is aimed at defining the relationship between a set of environmental factors and childhood HFMD and then at estimating the related effect. The 16 environmental factors included meteorological, air pollution, and sunspot. A traditional TSR modified by using susceptible-infectious-recovery models and distribution lag nonlinear model was applied to estimate the short-term effects of daily environmental factors on children HFMD occurrence in 2014-2018 with adjustment of potential confounding factors. A total of 70,027 children aged 0-15 years with HFMD were enrolled. No significant effect was observed for daily sunspot numbers and average visibility. We found positive effects of the ambient average temperature, with an approximately m-shaped curve of the overall cumulative relationship, peaking at 25.6 °C with a relative risk (RR) of 1.45 (95% confidence intervals 1.21-1.73). The largest RR value of hot effect was achieved on the current day and then decreased by 2 days (total group, male group, and scatter group) or 1 day (female group and nursery group), and the effect lasted about 6 to 8 days from the lag 4 or lag 6 day. A greater association of temperature with HFMD for the female group and the scattered group was observed. This study suggests that ambient average temperature might be a risk factor for children HFMD in Tianjin. Further studies are warranted to confirm these findings.
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Affiliation(s)
- Xue-Yue Ji
- Department of Infectious Disease, Tianjin Centers for Disease Control and Prevention, No. 6 Huayue Road, Hedong District, Tianjin, China.
| | - Li-Yuan Huang
- Editorial Department of China Journal Environment and Health, Tianjin Centers for Disease Control and Prevention, Tianjin, China
| | - Jia Song
- Department of Infectious Disease, Tianjin Centers for Disease Control and Prevention, No. 6 Huayue Road, Hedong District, Tianjin, China
| | - Chun-Nan Fei
- Department of Infectious Disease, Tianjin Centers for Disease Control and Prevention, No. 6 Huayue Road, Hedong District, Tianjin, China
| | - Jun Liu
- Department of Infectious Disease, Tianjin Centers for Disease Control and Prevention, No. 6 Huayue Road, Hedong District, Tianjin, China
| | - He Liu
- Department of Infectious Disease, Tianjin Centers for Disease Control and Prevention, No. 6 Huayue Road, Hedong District, Tianjin, China
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Wang Y, Cao Z, Zeng D, Wang X, Wang Q. Using deep learning to predict the hand-foot-and-mouth disease of enterovirus A71 subtype in Beijing from 2011 to 2018. Sci Rep 2020; 10:12201. [PMID: 32699245 PMCID: PMC7376109 DOI: 10.1038/s41598-020-68840-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Accepted: 06/19/2020] [Indexed: 02/07/2023] Open
Abstract
Hand-foot-and-month disease (HFMD), especially the enterovirus A71 (EV-A71) subtype, is a major health problem in Beijing, China. Previous studies mainly used regressive models to forecast the prevalence of HFMD, ignoring its intrinsic age groups. This study aims to predict HFMD of EV-A71 subtype in three age groups (0–3, 3–6 and > 6 years old) from 2011 to 2018 using residual-convolutional-recurrent neural network (CNNRNN-Res), convolutional-recurrent neural network (CNNRNN) and recurrent neural network (RNN). They were compared with auto-regressio, global auto-regression and vector auto-regression on both short-term and long-term prediction. Results showed that CNNRNN-Res and RNN had higher accuracies on point forecast tasks, as well as robust performances in long-term prediction. Three deep learning models also had better skills in peak intensity forecast, and CNNRNN-Res achieved the best results in the peak month forecast. We also found that three age groups had consistent outbreak trends and similar patterns of prediction errors. These results highlight the superior performance of deep learning models in HFMD prediction and can assist the decision-makers to refine the HFMD control measures according to age groups.
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Affiliation(s)
- Yuejiao Wang
- The State Key Laboratory for Management and Control of Complex Systems, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190, China.,University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Zhidong Cao
- The State Key Laboratory for Management and Control of Complex Systems, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190, China.
| | - Daniel Zeng
- The State Key Laboratory for Management and Control of Complex Systems, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190, China
| | - Xiaoli Wang
- Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, Beijing, 100013, China
| | - Quanyi Wang
- Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, Beijing, 100013, China
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Global Research Output and Theme Trends on Climate Change and Infectious Diseases: A Restrospective Bibliometric and Co-Word Biclustering Investigation of Papers Indexed in PubMed (1999-2018). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17145228. [PMID: 32698499 PMCID: PMC7400491 DOI: 10.3390/ijerph17145228] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 07/14/2020] [Accepted: 07/14/2020] [Indexed: 12/15/2022]
Abstract
Climate change is a challenge for the sustainable development of an international economy and society. The impact of climate change on infectious diseases has been regarded as one of the most urgent research topics. In this paper, an analysis of the bibliometrics, co-word biclustering, and strategic diagram was performed to evaluate global scientific production, hotspots, and developing trends regarding climate change and infectious diseases, based on the data of two decades (1999–2008 and 2009–2018) from PubMed. According to the search strategy and inclusion criteria, a total of 1443 publications were found on the topic of climate change and infectious diseases. There has been increasing research productivity in this field, which has been supported by a wide range of subject categories. The top highly-frequent major MeSH (medical subject headings)/subheading combination terms could be divided into four clusters for the first decade and five for the second decade using a biclustering analysis. At present, some significant public health challenges (global health, and travel and tropical climate, etc.) are at the center of the whole target research network. In the last ten years, “Statistical model”, “Diarrhea”, “Dengue”, “Ecosystem and biodiversity”, and “Zoonoses” have been considered as emerging hotspots, but they still need more attention for further development.
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Hu Y, Xu L, Pan H, Shi X, Chen Y, Lynn H, Mao S, Zhang H, Cao H, Zhang J, Zhang J, Xiao S, Hu J, Li X, Yao S, Zhang Z, Zhao G. Transmission center and driving factors of hand, foot, and mouth disease in China: A combined analysis. PLoS Negl Trop Dis 2020; 14:e0008070. [PMID: 32150558 PMCID: PMC7062235 DOI: 10.1371/journal.pntd.0008070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 01/17/2020] [Indexed: 11/18/2022] Open
Abstract
Hand, foot, and mouth disease (HFMD) has become a major public health issue in China. The disease incidence varies substantially over time and across space. To understand the heterogeneity of HFMD transmission, we compare the spatiotemporal dynamics of HFMD in Qinghai and Shanghai by conducting combined analysis of epidemiological, wavelet time series, and mathematical methods to county-level data from 2009 to 2016. We observe hierarchical epidemic waves in Qinghai, emanating from Huangzhong and in Shanghai from Fengxian. Besides population, we also find that the traveling waves are significantly associated with socio-economic and geographical factors. The population mobility also varies between the two regions: long-distance movement in Qinghai and between-neighbor commuting in Shanghai. Our findings provide important evidence for characterizing the heterogeneity of HFMD transmission and for the design and implementation of interventions, such as deploying optimal vaccine and changing local driving factors in the transmission center, to prevent or limit disease spread in these areas.
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Affiliation(s)
- Yi Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
- Laboratory for Spatial Analysis and Modeling, School of Public Health, Fudan University, Shanghai, China
| | - Lili Xu
- Institute for Infectious Disease Control and Prevention, Qinghai Provincial Center for Disease Control and Prevention, Qinghai, China
| | - Hao Pan
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Xun Shi
- Department of Geography, Dartmouth College, Hanover, New Hampshire, United States of America
| | - Yue Chen
- Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ontario, Canada
| | - Henry Lynn
- Department of Epidemiology and Biostatistics, School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
- Laboratory for Spatial Analysis and Modeling, School of Public Health, Fudan University, Shanghai, China
| | - Shenghua Mao
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Huayi Zhang
- Institute for Infectious Disease Control and Prevention, Qinghai Provincial Center for Disease Control and Prevention, Qinghai, China
| | - Hailan Cao
- Institute for Infectious Disease Control and Prevention, Qinghai Provincial Center for Disease Control and Prevention, Qinghai, China
| | - Jun Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
- Laboratory for Spatial Analysis and Modeling, School of Public Health, Fudan University, Shanghai, China
| | - Jing Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
- Laboratory for Spatial Analysis and Modeling, School of Public Health, Fudan University, Shanghai, China
| | - Shuang Xiao
- Department of Epidemiology and Biostatistics, School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
- Laboratory for Spatial Analysis and Modeling, School of Public Health, Fudan University, Shanghai, China
| | - Jian Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
- Laboratory for Spatial Analysis and Modeling, School of Public Health, Fudan University, Shanghai, China
| | - Xiande Li
- Department of Geography, Shanghai Normal University, Shanghai, China
| | - Shenjun Yao
- Key Laboratory of Geographic Information Science, Ministry of Education, East China Normal University, Shanghai, China
- School of Geographic Sciences, East China Normal University, Shanghai, China
| | - Zhijie Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
- Laboratory for Spatial Analysis and Modeling, School of Public Health, Fudan University, Shanghai, China
- * E-mail:
| | - Genming Zhao
- Department of Epidemiology and Biostatistics, School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
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Impact of Ambient Temperature and Relative Humidity on the Incidence of Hand-Foot-Mouth Disease in Wuhan, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17020428. [PMID: 31936369 PMCID: PMC7013846 DOI: 10.3390/ijerph17020428] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 01/02/2020] [Accepted: 01/07/2020] [Indexed: 12/14/2022]
Abstract
Background: Few studies have previously explored the relationship between hand, foot, and mouth disease (HFMD) and meteorological factors with the effect modification of air pollution, and these studies had inconsistent findings. We therefore applied a time-series analysis assessing the effects of temperature and humidity on the incidence of HFMD in Wuhan, China to deepen our understanding of the relationship between meteorological factors and the risk of HFMD. Methods: Daily HFMD cases were retrieved from Hubei Provincial Center for Disease Control and Prevention from 1 February 2013 to 31 January 2017. Daily meteorological data including 24 h average temperature, relative humidity, wind velocity, and atmospheric pressure were obtained from Hubei Meteorological Bureau. Data on Air pollution was collected from 10 national air-monitoring stations in Wuhan city. We adopted a distributed lag non-linear model (DLNM) combined with Poisson regression and time-series analysis to estimate the effects of temperature and relative humidity on the incidence HFMD. Results: We found that the association between temperature and HFMD incidence was non-linear, exhibiting an approximate "M" shape with two peaks occurring at 2.3 °C (RR = 1.760, 95% CI: 1.218-2.542) and 27.9 °C (RR = 1.945, 95% CI: 1.570-2.408), respectively. We observed an inverted "V" shape between relative humidity and HFMD. The risk of HFMD reached a maximum value at a relative humidity of 89.2% (RR = 1.553, 95% CI: 1.322-1.824). The largest delayed cumulative effects occurred at lag 6 for temperature and lag 13 for relative humidity. Conclusions: The non-linear relationship between meteorological factors and the incidence of HFMD on different lag days could be used in the early targeted warning system of infectious diseases, reducing the possible outbreaks and burdens of HFMD among sensitive populations.
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Hao J, Yang Z, Yang W, Huang S, Tian L, Zhu Z, Lu Y, Xiang H, Liu S. Impact of Ambient Temperature and Relative Humidity on the Incidence of Hand-Foot-Mouth Disease in Wuhan, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:117358. [PMID: 31936369 DOI: 10.1016/j.atmosenv.2020.117358] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 01/02/2020] [Accepted: 01/07/2020] [Indexed: 05/19/2023]
Abstract
Background: Few studies have previously explored the relationship between hand, foot, and mouth disease (HFMD) and meteorological factors with the effect modification of air pollution, and these studies had inconsistent findings. We therefore applied a time-series analysis assessing the effects of temperature and humidity on the incidence of HFMD in Wuhan, China to deepen our understanding of the relationship between meteorological factors and the risk of HFMD. Methods: Daily HFMD cases were retrieved from Hubei Provincial Center for Disease Control and Prevention from 1 February 2013 to 31 January 2017. Daily meteorological data including 24 h average temperature, relative humidity, wind velocity, and atmospheric pressure were obtained from Hubei Meteorological Bureau. Data on Air pollution was collected from 10 national air-monitoring stations in Wuhan city. We adopted a distributed lag non-linear model (DLNM) combined with Poisson regression and time-series analysis to estimate the effects of temperature and relative humidity on the incidence HFMD. Results: We found that the association between temperature and HFMD incidence was non-linear, exhibiting an approximate "M" shape with two peaks occurring at 2.3 °C (RR = 1.760, 95% CI: 1.218-2.542) and 27.9 °C (RR = 1.945, 95% CI: 1.570-2.408), respectively. We observed an inverted "V" shape between relative humidity and HFMD. The risk of HFMD reached a maximum value at a relative humidity of 89.2% (RR = 1.553, 95% CI: 1.322-1.824). The largest delayed cumulative effects occurred at lag 6 for temperature and lag 13 for relative humidity. Conclusions: The non-linear relationship between meteorological factors and the incidence of HFMD on different lag days could be used in the early targeted warning system of infectious diseases, reducing the possible outbreaks and burdens of HFMD among sensitive populations.
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Affiliation(s)
- Jiayuan Hao
- Department of Global Health, School of Health Sciences, Wuhan University, 115# Donghu Road, Wuhan 430071, China
- Global Health Institute, Wuhan University, 115# Donghu Road, Wuhan 430071, China
| | - Zhiyi Yang
- Department of Global Health, School of Health Sciences, Wuhan University, 115# Donghu Road, Wuhan 430071, China
- Global Health Institute, Wuhan University, 115# Donghu Road, Wuhan 430071, China
| | - Wenwen Yang
- Hubei Provincial Center for Disease control and Prevention, Wuhan 430079, China
| | - Shuqiong Huang
- Hubei Provincial Center for Disease control and Prevention, Wuhan 430079, China
| | - Liqiao Tian
- State Key Laboratory of Information Engineering in Surveying, Mapping and Remote Sensing, Wuhan University, Wuhan 430079, China
| | - Zhongmin Zhu
- State Key Laboratory of Information Engineering in Surveying, Mapping and Remote Sensing, Wuhan University, Wuhan 430079, China
- College of Information Science and Engineering, Wuchang Shouyi University, Wuhan 430064, China
| | - Yuanan Lu
- Environmental Health Laboratory, Department of Public Health Sciences, University of Hawaii at Manoa, 1960 East-West Rd, Biomed Bldg, D105, Honolulu, HI 96822, USA
| | - Hao Xiang
- Department of Global Health, School of Health Sciences, Wuhan University, 115# Donghu Road, Wuhan 430071, China
- Global Health Institute, Wuhan University, 115# Donghu Road, Wuhan 430071, China
| | - Suyang Liu
- Department of Global Health, School of Health Sciences, Wuhan University, 115# Donghu Road, Wuhan 430071, China
- Global Health Institute, Wuhan University, 115# Donghu Road, Wuhan 430071, China
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Liu W, Bao C, Zhou Y, Ji H, Wu Y, Shi Y, Shen W, Bao J, Li J, Hu J, Huo X. Forecasting incidence of hand, foot and mouth disease using BP neural networks in Jiangsu province, China. BMC Infect Dis 2019; 19:828. [PMID: 31590636 PMCID: PMC6781406 DOI: 10.1186/s12879-019-4457-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 09/10/2019] [Indexed: 08/22/2023] Open
Abstract
Background Hand, foot and mouth disease (HFMD) is a rising public health problem and has attracted considerable attention worldwide. The purpose of this study was to develop an optimal model with meteorological factors to predict the epidemic of HFMD. Methods Two types of methods, back propagation neural networks (BP) and auto-regressive integrated moving average (ARIMA), were employed to develop forecasting models, based on the monthly HFMD incidences and meteorological factors during 2009–2016 in Jiangsu province, China. Root mean square error (RMSE) and mean absolute percentage error (MAPE) were employed to select model and evaluate the performance of the models. Results Four models were constructed. The multivariate BP model was constructed using the HFMD incidences lagged from 1 to 4 months, mean temperature, rainfall and their one order lagged terms as inputs. The other BP model was fitted just using the lagged HFMD incidences as inputs. The univariate ARIMA model was specified as ARIMA (1,0,1)(1,1,0)12 (AIC = 1132.12, BIC = 1440.43). And the multivariate ARIMAX with one order lagged temperature as external predictor was fitted based on this ARIMA model (AIC = 1132.37, BIC = 1142.76). The multivariate BP model performed the best in both model fitting stage and prospective forecasting stage, with a MAPE no more than 20%. The performance of the multivariate ARIMAX model was similar to that of the univariate ARIMA model. Both performed much worse than the two BP models, with a high MAPE near to 40%. Conclusion The multivariate BP model effectively integrated the autocorrelation of the HFMD incidence series. Meanwhile, it also comprehensively combined the climatic variables and their hysteresis effects. The introduction of the climate terms significantly improved the prediction accuracy of the BP model. This model could be an ideal method to predict the epidemic level of HFMD, which is of great importance for the public health authorities.
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Affiliation(s)
- Wendong Liu
- Jiangsu Province Center for Diseases Control and Prevention, Nanjing, China.
| | - Changjun Bao
- Jiangsu Province Center for Diseases Control and Prevention, Nanjing, China
| | - Yuping Zhou
- Jiangsu Province Center for Diseases Control and Prevention, Nanjing, China
| | - Hong Ji
- Jiangsu Province Center for Diseases Control and Prevention, Nanjing, China
| | - Ying Wu
- Jiangsu Province Center for Diseases Control and Prevention, Nanjing, China
| | - Yingying Shi
- Jiangsu Province Center for Diseases Control and Prevention, Nanjing, China
| | - Wenqi Shen
- Jiangsu Province Center for Diseases Control and Prevention, Nanjing, China
| | - Jing Bao
- Jiangsu Meteorological Service Center, Nanjing, China
| | - Juan Li
- Jiangsu Meteorological Service Center, Nanjing, China
| | - Jianli Hu
- Jiangsu Province Center for Diseases Control and Prevention, Nanjing, China
| | - Xiang Huo
- Jiangsu Province Center for Diseases Control and Prevention, Nanjing, China
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21
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Chan EYY, Ho JY, Hung HHY, Liu S, Lam HCY. Health impact of climate change in cities of middle-income countries: the case of China. Br Med Bull 2019; 130:5-24. [PMID: 31070715 PMCID: PMC6587073 DOI: 10.1093/bmb/ldz011] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 01/31/2019] [Accepted: 04/23/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND This review examines the human health impact of climate change in China. Through reviewing available research findings under four major climate change phenomena, namely extreme temperature, altered rainfall pattern, rise of sea level and extreme weather events, relevant implications for other middle-income population with similar contexts will be synthesized. SOURCES OF DATA Sources of data included bilingual peer-reviewed articles published between 2000 and 2018 in PubMed, Google Scholar and China Academic Journals Full-text Database. AREAS OF AGREEMENT The impact of temperature on mortality outcomes was the most extensively studied, with the strongest cause-specific mortality risks between temperature and cardiovascular and respiratory mortality. The geographical focuses of the studies indicated variations in health risks and impacts of different climate change phenomena across the country. AREAS OF CONTROVERSY While rainfall-related studies predominantly focus on its impact on infectious and vector-borne diseases, consistent associations were not often found. GROWING POINTS Mental health outcomes of climate change had been gaining increasing attention, particularly in the context of extreme weather events. The number of projection studies on the long-term impact had been growing. AREAS TIMELY FOR DEVELOPING RESEARCH The lack of studies on the health implications of rising sea levels and on comorbidity and injury outcomes warrants immediate attention. Evidence is needed to understand health impacts on vulnerable populations living in growing urbanized cities and urban enclaves, in particular migrant workers. Location-specific climate-health outcome thresholds (such as temperature-mortality threshold) will be needed to support evidence-based clinical management plans and health impact mitigation strategies to protect vulnerable communities.
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Affiliation(s)
- Emily Y Y Chan
- Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response (CCOUC), Division of Global Health and Humanitarian Medicine, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
- Division of Global Health and Humanitarian Medicine, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
- François-Xavier Bagnoud Center for Health & Human Rights, Harvard University, Boston, MA, USA
| | - Janice Y Ho
- Division of Global Health and Humanitarian Medicine, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Heidi H Y Hung
- Division of Global Health and Humanitarian Medicine, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Sida Liu
- Division of Global Health and Humanitarian Medicine, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Holly C Y Lam
- Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response (CCOUC), Division of Global Health and Humanitarian Medicine, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
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22
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Lu JY, Chen ZQ, Liu YH, Liu WH, Ma Y, Li TG, Zhang ZB, Yang ZC. Effect of meteorological factors on scarlet fever incidence in Guangzhou City, Southern China, 2006-2017. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 663:227-235. [PMID: 30711589 DOI: 10.1016/j.scitotenv.2019.01.318] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 12/19/2018] [Accepted: 01/24/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVE To explore the relationship between meteorological factors and scarlet fever incidence from 2006 to 2017 in Guangzhou, the largest subtropical city of Southern China, and assist public health prevention and control measures. METHODS Data for weekly scarlet fever incidence and meteorological variables from 2006 to 2017 in Guangzhou were collected from the National Notifiable Disease Report System (NNDRS) and the Guangzhou Meteorological Bureau (GZMB). Distributed lag nonlinear models (DLNMs) were conducted to estimate the effect of meteorological factors on weekly scarlet fever incidence in Guangzhou. RESULTS We observed nonlinear effects of temperature, relative humidity, and wind velocity. The risk was the highest when the weekly mean temperature was 31 °C during lag week 14, yielding a relative risk (RR) of 1.48 (95% CI: 1.01-2.17). When relative humidity was 43.5% during lag week 0, the RR was 1.49 (95% CI: 1.04-2.12); the highest RR (1.55, 95% CI: 1.20-1.99) was reached when relative humidity was 93.5% during lag week 20. When wind velocity was 4.4 m/s during lag week 13, the RR was highest at 3.41 (95% CI: 1.57-7.44). Positive correlations were observed among weekly temperature ranges and atmospheric pressure with scarlet fever incidence, while a negative correlation was detected with aggregate rainfall. The cumulative extreme effect of meteorological variables on scarlet fever incidence was statistically significant, except for the high effect of wind velocity. CONCLUSION Weekly mean temperature, relative humidity, and wind velocity had double-trough effects on scarlet fever incidence; high weekly temperature range, high atmospheric pressure, and low aggregate rainfall were risk factors for scarlet fever morbidity. Our findings provided preliminary, but fundamental, information that may be useful for a better understanding of epidemic trends of scarlet fever and for developing an early warning system. Laboratory surveillance for scarlet fever should be strengthened in the future.
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Affiliation(s)
- Jian-Yun Lu
- Department of Infectious Disease Control and Prevention, Guangzhou Center For Disease Control and Prevention, Baiyun District Qi De Road, Guangzhou, Guangdong Province 510440, China
| | - Zong-Qiu Chen
- Department of Infectious Disease Control and Prevention, Guangzhou Center For Disease Control and Prevention, Baiyun District Qi De Road, Guangzhou, Guangdong Province 510440, China
| | - Yan-Hui Liu
- Department of Infectious Disease Control and Prevention, Guangzhou Center For Disease Control and Prevention, Baiyun District Qi De Road, Guangzhou, Guangdong Province 510440, China
| | - Wen-Hui Liu
- Department of Infectious Disease Control and Prevention, Guangzhou Center For Disease Control and Prevention, Baiyun District Qi De Road, Guangzhou, Guangdong Province 510440, China
| | - Yu Ma
- Department of Infectious Disease Control and Prevention, Guangzhou Center For Disease Control and Prevention, Baiyun District Qi De Road, Guangzhou, Guangdong Province 510440, China
| | - Tie-Gang Li
- Department of Infectious Disease Control and Prevention, Guangzhou Center For Disease Control and Prevention, Baiyun District Qi De Road, Guangzhou, Guangdong Province 510440, China.
| | - Zhou-Bin Zhang
- Guangzhou Center For Disease Control and Prevention, Baiyun District Qi De Road, Guangzhou, Guangdong Province 510440, China
| | - Zhi-Cong Yang
- Guangzhou Center For Disease Control and Prevention, Baiyun District Qi De Road, Guangzhou, Guangdong Province 510440, China
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23
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Zhang Q, Zhou M, Yang Y, You E, Wu J, Zhang W, Jin J, Huang F. Short-term effects of extreme meteorological factors on childhood hand, foot, and mouth disease reinfection in Hefei, China: A distributed lag non-linear analysis. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 653:839-848. [PMID: 30759610 DOI: 10.1016/j.scitotenv.2018.10.349] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Revised: 10/04/2018] [Accepted: 10/26/2018] [Indexed: 05/04/2023]
Abstract
BACKGROUND Hand, foot, and mouth disease (HFMD) is a major public health issue in China with a high burden of reinfection. Previous studies presented evidence of the relationship between meteorological factors and HFMD incidence, but no study examined the effects of extreme meteorological factors on HFMD reinfection. METHODS Daily HFMD reinfection counts and meteorological data of Hefei city were collected from 2011 to 2016. A distributed lag non-linear model was used to quantify the effects of extreme weather (wind speed, sunshine duration, and precipitation) on HFMD reinfection. All effects were presented as relative risk (RR), with 90th or 10th percentiles of meteorological variables compare with their median values. Confounding factors, such as mean temperature, relative humidity, day of week, and long-term trend were controlled. RESULTS A total of 4873 HFMD reinfection cases aged 0-11 years were reported. Extremely high precipitation, low wind speed, and low sunshine duration increased HFMD reinfection risk. The effect of extremely high precipitation was greatest at 8 days lag (RR = 1.01, 95%CI: 1.00-1.02). Extremely low wind speed and low sunshine increased 19% (RR = 1.19, 95%CI: 1.09-1.32) and 12% (RR = 1.12, 95%CI: 1.00-1.26) risk at lag 0-12 days, respectively. By contrast, extremely high wind speed and high sunshine duration exerted certain protective effects on HFMD reinfection at lag 0-12 days (RR = 0.76, 95%CI: 0.66-0.88; RR = 0.88, 95%CI: 0.79-0.99, respectively). Subgroup analyses showed that nursery children were the most sensitive people to the extreme wind speed and sunshine duration. Children aged 4-11 years appeared to be more susceptible to extreme sunshine duration than children aged <3 years. CONCLUSION The present study provides evidence that extreme meteorological factors exert delayed effects on HFMD reinfection. Developing an early warning system is necessary for the protection of children from harm due to extreme meteorological factors.
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Affiliation(s)
- Qian Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Shushan District, Hefei, Anhui 230032, China
| | - Mengmeng Zhou
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Shushan District, Hefei, Anhui 230032, China
| | - Yuwei Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Shushan District, Hefei, Anhui 230032, China
| | - Enqing You
- Hefei Center for Disease Control and Prevention, 86 Luan Road, Luyang District, Hefei, Anhui 230061, China
| | - Jinju Wu
- Hefei Center for Disease Control and Prevention, 86 Luan Road, Luyang District, Hefei, Anhui 230061, China
| | - Wenyan Zhang
- Hefei Center for Disease Control and Prevention, 86 Luan Road, Luyang District, Hefei, Anhui 230061, China
| | - Jing Jin
- Hefei Center for Disease Control and Prevention, 86 Luan Road, Luyang District, Hefei, Anhui 230061, China
| | - Fen Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Shushan District, Hefei, Anhui 230032, China; Central Laboratory of Preventive Medicine, School of Public Health, Anhui Medical University, 81 Meishan Road, Shushan District, Hefei, Anhui 230032, China; Laboratory for environmental Toxicology, Anhui Medical University, 81 Meishan Road, Shushan District, Hefei, Anhui 230032, China.
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24
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Yu G, Li Y, Cai J, Yu D, Tang J, Zhai W, Wei Y, Chen S, Chen Q, Qin J. Short-term effects of meteorological factors and air pollution on childhood hand-foot-mouth disease in Guilin, China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 646:460-470. [PMID: 30056233 DOI: 10.1016/j.scitotenv.2018.07.329] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 07/14/2018] [Accepted: 07/23/2018] [Indexed: 05/04/2023]
Abstract
BACKGROUND Previous studies have always focused on the impact of various meteorological factors on Hand-foot-mouth disease (HFMD). However, only few studies have investigated the simultaneous effects of climate and air pollution on HFMD incidence. METHODS Daily HFMD counts among children aged 0-14 years in Guilin city were collected from 2014 to 2016. Distributed lag nonlinear models (DLNM) were used to assess the effects of extreme meteorological factors and air pollution indicators, as well as the effects of different lag days on HFMD incidence. Furthermore, this study explored the variability across gender and age groups. RESULTS Extreme temperatures, high precipitation and low-O3 concentration increased the risk of HFMD. Hot effect was stronger and longer lasting than cold effect. Risks of rainy effect and low-O3 effect continued to increase as lag days extended, with the maximum RR values: 1.60 (1.38, 1.86) (90th vs median) and 1.48 (1.16, 1.89) (1th vs median) at 0-14 lag days, respectively. By contrast, extremely high wind speed, low precipitation, low PM2.5 and high O3 exerted a certain protective effect on HFMD incidence. The corresponding minimum RR values were: 0.85 (0.74, 0.98) (90th vs median) at 0-14 lag days, 0.98 (0.97, 0.99) (10th vs median) at 0-14 lag days, 0.73 (0.61, 0.88) (1th vs median) at 0-14 lag days and 0.81 (0.73, 0.90) (99th vs median) at 0-7 lag days, respectively. Male children and children aged 0-1 years (followed by 1-3 years) were the most susceptible subgroups to extreme climatic effects and air pollution. CONCLUSIONS Our results indicated that daily meteorological factors and air pollution exert non-linear and delayed effects on pediatric HFMD, and such effects vary depending on gender and age. These findings may serve as a reference for the development of an early warning system and for the adoption of specific interventions for vulnerable groups.
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Affiliation(s)
- Guoqi Yu
- Department of Environmental and Occupational Health, Guangxi Medical University, Shuangyong Road, 22, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Yonghong Li
- Guangxi Center for Disease Control and Prevention, Acute Infectious Disease Prevention and Control Institute, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Jiansheng Cai
- Department of Environmental and Occupational Health, Guangxi Medical University, Shuangyong Road, 22, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Dongmei Yu
- Department of Environmental and Occupational Health, Guangxi Medical University, Shuangyong Road, 22, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Jiexia Tang
- Department of Environmental and Occupational Health, Guangxi Medical University, Shuangyong Road, 22, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Wenwen Zhai
- Department of Health Related Social and Behavioral Science, West China School of Public Health, Sichuan University, Chengdu, Sichuan, China
| | - Yi Wei
- Department of Environmental and Occupational Health, Guangxi Medical University, Shuangyong Road, 22, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Shiyi Chen
- Department of Environmental and Occupational Health, Guangxi Medical University, Shuangyong Road, 22, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Quanhui Chen
- Department of Environmental and Occupational Health, Guangxi Medical University, Shuangyong Road, 22, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Jian Qin
- Department of Environmental and Occupational Health, Guangxi Medical University, Shuangyong Road, 22, Nanning, Guangxi Zhuang Autonomous Region, China; Guangxi Colleges and Universities Key Laboratory of Prevention and Control of Highly Prevalent Diseases, Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China.
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25
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Du Z, Lawrence WR, Zhang W, Zhang D, Yu S, Hao Y. Bayesian spatiotemporal analysis for association of environmental factors with hand, foot, and mouth disease in Guangdong, China. Sci Rep 2018; 8:15147. [PMID: 30310172 PMCID: PMC6181968 DOI: 10.1038/s41598-018-33109-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Accepted: 09/21/2018] [Indexed: 11/09/2022] Open
Abstract
Hand, foot, and mouth disease (HFMD) remains a significant public health and economic burden in parts of China, particularly Guangdong Province. Although the association between meteorological factors and HFMD has been well documented, significant gaps remain in our understanding of the potential impact of environmental factors. Using county-level monthly HFMD data from China CDC and environmental data from multiple sources, we used spatiotemporal Bayesian models to evaluate the association between HFMD and environmental factors including vegetation index, proportion of artificial surface, road capacity, temperature and humidity, and assessed the spatial and temporal dynamic of the association. Statistically significant correlation coefficients from -0.056 to 0.36 (all P < 0.05) were found between HFMD incidence and all environmental factors. The contributions of these factors for HFMD incidence were estimated to be 16.32%, 12.31%, 14.61%, 13.53%, and 2.63%. All environmental factors including vegetation index (Relative Risk: 0.889; Credible Interval: 0.883-0.895), artificial surface (1.028; 1.022-1.034), road capacity (1.033; 1.028-1.038), temperature (1.039; 1.028-1.05), and relative humidity (1.015; 1.01-1.021) were statistically retained in the final spatiotemporal model. More comprehensive environmental factors were identified as associating with HFMD incidence. Taking these environmental factors into consideration for prevention and control strategy might be of great practical significance.
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Affiliation(s)
- Zhicheng Du
- Department of Medical Statistics and Epidemiology & Health Information Research Center & Guangdong Key Laboratory of Medicine, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China.,Key Laboratory of Tropical Diseases and Control of the Ministry of Education, Guangzhou, 510080, China
| | - Wayne R Lawrence
- Department of Medical Statistics and Epidemiology & Health Information Research Center & Guangdong Key Laboratory of Medicine, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China.,Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, Rensselaer, 12144, USA
| | - Wangjian Zhang
- Department of Medical Statistics and Epidemiology & Health Information Research Center & Guangdong Key Laboratory of Medicine, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China.,Key Laboratory of Tropical Diseases and Control of the Ministry of Education, Guangzhou, 510080, China.,Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, Rensselaer, 12144, USA
| | - Dingmei Zhang
- Department of Medical Statistics and Epidemiology & Health Information Research Center & Guangdong Key Laboratory of Medicine, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China.,Key Laboratory of Tropical Diseases and Control of the Ministry of Education, Guangzhou, 510080, China
| | - Shicheng Yu
- Chinese Center for Disease Control and Prevention, Beijing, 102206, China
| | - Yuantao Hao
- Department of Medical Statistics and Epidemiology & Health Information Research Center & Guangdong Key Laboratory of Medicine, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China. .,Key Laboratory of Tropical Diseases and Control of the Ministry of Education, Guangzhou, 510080, China.
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26
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Coates SJ, Davis MDP, Andersen LK. Temperature and humidity affect the incidence of hand, foot, and mouth disease: a systematic review of the literature - a report from the International Society of Dermatology Climate Change Committee. Int J Dermatol 2018; 58:388-399. [PMID: 30187452 DOI: 10.1111/ijd.14188] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2018] [Revised: 07/13/2018] [Accepted: 07/17/2018] [Indexed: 12/12/2022]
Abstract
Hand, foot, and mouth disease (HFMD) is an enterovirus-mediated condition that predominantly affects children under 5 years of age. The tendency for outbreaks to peak in warmer summer months suggests a relationship between HFMD and weather patterns. We reviewed the English-language literature for articles describing a relationship between meteorological variables and HFMD. Seventy-two studies meeting criteria were identified. A positive, statistically significant relationship was identified between HFMD cases and both temperature (61 of 67 studies, or 91.0%, reported a positive relationship) [CI 81.8-95.8%, P = 0.0001] and relative humidity (41 of 54 studies, or 75.9%) [CI 63.1-85.4%, P = 0.0001]. No significant relationship was identified between HFMD and precipitation, wind speed, and/or sunshine. Most countries reported a single peak of disease each year (most commonly early Summer), but subtropical and tropical climate zones were significantly more likely to experience a bimodal distribution of cases throughout the year (two peaks a year; most commonly late spring/early summer, with a smaller peak in autumn). The rising global incidence of HFMD, particularly in Pacific Asia, may be related to climate change. Weather forecasting might be used effectively in the future to indicate the risk of HFMD outbreaks and the need for targeted public health interventions.
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Affiliation(s)
- Sarah J Coates
- Department of Dermatology, The University of California San Francisco, San Francisco, CA, USA
| | - Mark D P Davis
- Division of Clinical Dermatology, Mayo Clinic, Rochester, MN, USA
| | - Louise K Andersen
- Department of Dermato-Venereology, Aarhus University Hospital, Aarhus, Denmark
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27
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Yang Y, You E, Wu J, Zhang W, Jin J, Zhou M, Jiang C, Huang F. Effects of relative humidity on childhood hand, foot, and mouth disease reinfection in Hefei, China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2018; 630:820-826. [PMID: 29499537 DOI: 10.1016/j.scitotenv.2018.02.262] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Revised: 02/10/2018] [Accepted: 02/21/2018] [Indexed: 05/04/2023]
Abstract
BACKGROUND In recent years, hand, foot, and mouth disease (HFMD) has become a major public health issue in China, and its reinfection rate has been high. Numerous studies have examined the effects of meteorological factors involved in HFMD infection. However, no study has investigated the effects on HFMD reinfection. The present study analyzed the relationship between relative humidity and HFMD reinfection. METHODS We employed a distributed lag nonlinear model to evaluate the relationship between relative humidity and childhood HFMD reinfection in Hefei, China during 2011-2016. This model controlled confounding factors, including seasonality, long-term trend, day of the week, precipitation, and mean temperature. RESULTS Childhood HFMD reinfection cases occurred mainly from April to July, and the second peak occurred from October to December. A statistically significant association was observed between relative humidity and HFMD reinfection with delayed effects. The adverse effect of high relative humidity (>75%) appeared later than those of low relative humidity (<75%). Moreover, the highest relative risk (RR 1.08, 95% CI 1.04-1.13) occurred when the relative humidity was 100% and had an 8-day lag. Given the differences between gender and age groups, the effects of extremely high relative humidity on females and those aged ≥4years were higher than those of other groups and caused the highest cumulative relative risks at lag 0-9 or 0-10days (Female: RR 2.00, 95% CI 1.23-3.26; Male: RR 1.55, 95% CI 1.04-2.30; Aged ≥4years: RR 2.31, 95% CI 1.27-4.18; Aged <4years: RR 1.51, 95% CI 1.04-2.20). CONCLUSION High and low relative humidity were found to cause the elevated risks of HFMD reinfection, and the highest risk was observed at extremely high relative humidity. Early warning systems should be built for the protection of susceptible populations, particularly females and children aged ≥4years.
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Affiliation(s)
- Yuwei Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Shushan District, Hefei, Anhui 230032, PR China
| | - Enqing You
- Hefei Center for Disease Control and Prevention, 86 Luan Road, Luyang District, Hefei, Anhui 230061, PR China
| | - Jinju Wu
- Hefei Center for Disease Control and Prevention, 86 Luan Road, Luyang District, Hefei, Anhui 230061, PR China
| | - Wenyan Zhang
- Hefei Center for Disease Control and Prevention, 86 Luan Road, Luyang District, Hefei, Anhui 230061, PR China
| | - Jin Jin
- Hefei Center for Disease Control and Prevention, 86 Luan Road, Luyang District, Hefei, Anhui 230061, PR China
| | - Mengmeng Zhou
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Shushan District, Hefei, Anhui 230032, PR China
| | - Chunxiao Jiang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Shushan District, Hefei, Anhui 230032, PR China
| | - Fen Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Shushan District, Hefei, Anhui 230032, PR China.
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28
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Hu W, Li Y, Han W, Xue L, Zhang W, Ma W, Bi P. Meteorological factors and the incidence of mumps in Fujian Province, China, 2005-2013: Non-linear effects. THE SCIENCE OF THE TOTAL ENVIRONMENT 2018; 619-620:1286-1298. [PMID: 29734606 PMCID: PMC7112015 DOI: 10.1016/j.scitotenv.2017.11.108] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Revised: 11/09/2017] [Accepted: 11/09/2017] [Indexed: 04/14/2023]
Abstract
BACKGROUND Mumps is still an important public health issue in the world with several recent outbreaks. The seasonable distribution of the disease suggested that meteorological factors may influence the incidence of mumps. The aim of this study was to explore the possible association between meteorological factors and the incidence of mumps, and to provide scientific evidence to relevant health authorities for the disease control and prevention. METHODS We obtained the data of mumps cases and daily meteorological factors in Fujian Province in Eastern China over the period of 2005-2013. Using distributed lag non-linear model (DLNM) approach, we assessed the relationship between the meteorological factors and mumps incidence. RESULTS The effects of meteorological factors on the mumps incidence were all non-linear. Compared with the lowest risk values, the upper level of precipitation, atmospheric pressure and relative humidity could increase the risk of mumps, whereas the low level of wind velocity, temperature, diurnal temperature range and sunshine duration may also increase the risk. Moderate atmospheric pressure and low wind velocity had larger cumulative effects within 30lagdays and the relative risks were 10.02 (95%CI: 2.47-40.71) and 12.45 (95%CI: 1.40-110.78). For temperature, the cumulative effect within 30lagdays of minimum temperature was higher than that from maximum temperature in most populations. The cumulative effects of minimum temperature for males, children aged 10-14 and students were higher than those in other populations. CONCLUSIONS Meteorological factors, especially temperature and wind velocity, should be taken into consideration in the prevention and warning of possible mumps epidemic. Special attention should be paid to the vulnerable populations, such as teenagers and young adults.
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Affiliation(s)
- Wenqi Hu
- Department of Epidemiology, School of Public Health, Shandong University, 44 West Wenhua Road, Jinan, Shandong 250012, PR China
| | - Yuying Li
- Department of Epidemiology, School of Public Health, Shandong University, 44 West Wenhua Road, Jinan, Shandong 250012, PR China
| | - Weixiao Han
- Department of Epidemiology, School of Public Health, Shandong University, 44 West Wenhua Road, Jinan, Shandong 250012, PR China
| | - Li Xue
- Department of Epidemiology, School of Public Health, Shandong University, 44 West Wenhua Road, Jinan, Shandong 250012, PR China
| | - Wenchao Zhang
- Department of Epidemiology, School of Public Health, Shandong University, 44 West Wenhua Road, Jinan, Shandong 250012, PR China
| | - Wei Ma
- Department of Epidemiology, School of Public Health, Shandong University, 44 West Wenhua Road, Jinan, Shandong 250012, PR China; Climate Change and Health Center, Shandong University, 44 West Wenhua Road, Jinan, Shandong 250012, PR China.
| | - Peng Bi
- School of Public Health, The University of Adelaide, Level 8, Hughes Building, North Terrace Campus, Adelaide, SA 5005, Australia.
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29
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Sun J, Lu L, Yang J, Liu K, Wu H, Liu Q. Association between Severe Fever with Thrombocytopenia Syndrome Incidence and Ambient Temperature. Am J Trop Med Hyg 2018; 98:1478-1483. [PMID: 29557340 DOI: 10.4269/ajtmh.17-0991] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Severe fever with thrombocytopenia syndrome (SFTS) is emerging in China. To explore the lagged effects and nonlinear association between temperature and SFTS, we collected data on ambient temperature and SFTS cases and analyzed the data using a distributed lag nonlinear model. A total of 1,933 SFTS cases were reported in the study area from 2011 to 2015. Our study revealed a nonlinear relationship between weekly temperature and SFTS. The exposure-response curve was an approximately reversed U-shaped peak at 23°C. High temperatures had acute and short-term effects, whereas low temperatures had persistent and long-term effects. The effects of lower temperatures (1.62°C and 6.97°C) could last 24 weeks, but the effect of 29.30°C was not significant at lag 8 weeks. Our results provide information to better understand the effect of temperature variation on SFTS and may have policy implications for disease prevention and control.
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Affiliation(s)
- Jimin Sun
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China.,State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Liang Lu
- State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jun Yang
- State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Keke Liu
- State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Haixia Wu
- State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Qiyong Liu
- State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
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Chen Y, Chu CW, Chen MIC, Cook AR. The utility of LASSO-based models for real time forecasts of endemic infectious diseases: A cross country comparison. J Biomed Inform 2018; 81:16-30. [PMID: 29496631 PMCID: PMC7185473 DOI: 10.1016/j.jbi.2018.02.014] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Revised: 01/19/2018] [Accepted: 02/24/2018] [Indexed: 01/09/2023]
Abstract
A LASSO based forecast model for endemic infectious diseases is proposed. Predictions at 4 weeks achieve desirable accuracy. Models predict outbreaks but may struggle to predict outbreak size.
Introduction Accurate and timely prediction for endemic infectious diseases is vital for public health agencies to plan and carry out any control methods at an early stage of disease outbreaks. Climatic variables has been identified as important predictors in models for infectious disease forecasts. Various approaches have been proposed in the literature to produce accurate and timely predictions and potentially improve public health response. Methods We assessed how the machine learning LASSO method may be useful in providing useful forecasts for different pathogens in countries with different climates. Separate LASSO models were constructed for different disease/country/forecast window with different model complexity by including different sets of predictors to assess the importance of different predictors under various conditions. Results There was a more apparent cyclicity for both climatic variables and incidence in regions further away from the equator. For most diseases, predictions made beyond 4 weeks ahead were increasingly discrepant from the actual scenario. Prediction models were more accurate in capturing the outbreak but less sensitive to predict the outbreak size. In different situations, climatic variables have different levels of importance in prediction accuracy. Conclusions For LASSO models used for prediction, including different sets of predictors has varying effect in different situations. Short term predictions generally perform better than longer term predictions, suggesting public health agencies may need the capacity to respond at short-notice to early warnings.
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Affiliation(s)
- Yirong Chen
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Tahir Foundation Building, 12 Science Drive 2, 117549, Singapore
| | - Collins Wenhan Chu
- Genome Institute of Singapore, 60 Biopolis Street, Genome, 138672, Singapore
| | - Mark I C Chen
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Tahir Foundation Building, 12 Science Drive 2, 117549, Singapore; Department of Clinical Epidemiology, Communicable Disease Centre, Tan Tock Seng Hospital, Singapore, Moulmein Road, 308433, Singapore
| | - Alex R Cook
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Tahir Foundation Building, 12 Science Drive 2, 117549, Singapore.
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Gou F, Liu X, He J, Liu D, Cheng Y, Liu H, Yang X, Wei K, Zheng Y, Jiang X, Meng L, Hu W. Different responses of weather factors on hand, foot and mouth disease in three different climate areas of Gansu, China. BMC Infect Dis 2018; 18:15. [PMID: 29310596 PMCID: PMC5759838 DOI: 10.1186/s12879-017-2860-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 11/26/2017] [Indexed: 01/25/2023] Open
Abstract
Background To determine the linear and non-linear interacting relationships between weather factors and hand, foot and mouth disease (HFMD) in children in Gansu, China, and gain further traction as an early warning signal based on weather variability for HFMD transmission. Method Weekly HFMD cases aged less than 15 and meteorological information from 2010 to 2014 in Jiuquan, Lanzhou and Tianshu, Gansu, China were collected. Generalized linear regression models (GLM) with Poisson link and classification and regression trees (CART) were employed to determine the combined and interactive relationship of weather factors and HFMD in both linear and non-linear ways. Results GLM suggested an increase in weekly HFMD of 5.9% [95% confidence interval (CI): 5.4%, 6.5%] in Tianshui, 2.8% [2.5%, 3.1%] in Lanzhou and 1.8% [1.4%, 2.2%] in Jiuquan in association with a 1 °C increase in average temperature, respectively. And 1% increase of relative humidity could increase weekly HFMD of 2.47% [2.23%, 2.71%] in Lanzhou and 1.11% [0.72%, 1.51%] in Tianshui. CART revealed that average temperature and relative humidity were the first two important determinants, and their threshold values for average temperature deceased from 20 °C of Jiuquan to 16 °C in Tianshui; and for relative humidity, threshold values increased from 38% of Jiuquan to 65% of Tianshui. Conclusion Average temperature was the primary weather factor in three areas, more sensitive in southeast Tianshui, compared with northwest Jiuquan; Relative humidity’s effect on HFMD showed a non-linear interacting relationship with average temperature.
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Affiliation(s)
- Faxiang Gou
- Institute for Communicable Disease Control and Prevention, Gansu Center for Diseases Prevention and Control, Lanzhou, Gansu, China
| | - Xinfeng Liu
- Institute for Communicable Disease Control and Prevention, Gansu Center for Diseases Prevention and Control, Lanzhou, Gansu, China
| | - Jian He
- Institute for Communicable Disease Control and Prevention, Gansu Center for Diseases Prevention and Control, Lanzhou, Gansu, China
| | - Dongpeng Liu
- Institute for Communicable Disease Control and Prevention, Gansu Center for Diseases Prevention and Control, Lanzhou, Gansu, China
| | - Yao Cheng
- Institute for Communicable Disease Control and Prevention, Gansu Center for Diseases Prevention and Control, Lanzhou, Gansu, China
| | - Haixia Liu
- Institute for Communicable Disease Control and Prevention, Gansu Center for Diseases Prevention and Control, Lanzhou, Gansu, China
| | - Xiaoting Yang
- Institute for Communicable Disease Control and Prevention, Gansu Center for Diseases Prevention and Control, Lanzhou, Gansu, China
| | - Kongfu Wei
- Institute for Communicable Disease Control and Prevention, Gansu Center for Diseases Prevention and Control, Lanzhou, Gansu, China
| | - Yunhe Zheng
- Institute for Communicable Disease Control and Prevention, Gansu Center for Diseases Prevention and Control, Lanzhou, Gansu, China
| | - Xiaojuan Jiang
- Institute for Communicable Disease Control and Prevention, Gansu Center for Diseases Prevention and Control, Lanzhou, Gansu, China
| | - Lei Meng
- Institute for Communicable Disease Control and Prevention, Gansu Center for Diseases Prevention and Control, Lanzhou, Gansu, China.
| | - Wenbiao Hu
- School of Public Health and Social Work, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia.
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Phung D, Nguyen HX, Nguyen HLT, Do CM, Tran QD, Chu C. Spatiotemporal variation of hand-foot-mouth disease in relation to socioecological factors: A multiple-province analysis in Vietnam. THE SCIENCE OF THE TOTAL ENVIRONMENT 2018; 610-611:983-991. [PMID: 28838035 DOI: 10.1016/j.scitotenv.2017.08.158] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 08/02/2017] [Accepted: 08/15/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Hand-foot-and-mouth disease (HFMD) is a significant public health issue in Asia-pacific countries. Numerous studies have examined the relationship between socio-ecological factors and HFMD however the research findings were inconsistent. This study examined the association between socio-ecologic factors and HFMD in multiple provinces across Vietnam. METHODS We applied a spatial autoregressive model using a Bayesian framework to examine the relationship between HFMD and socio-demographic factors. We used a Generalized Linear Model (GLD) with Poisson family to examine the province-specific association between monthly HFMD and climatic factors while controlling for spatial lag, seasonality and long-term trend of HFMD. Then, we used a random-effect meta-analysis to generate pooled effect size of climate-HFMD association for regional and country scale. RESULTS One percent increase in newborn breastfed within 1h of birth, households with permanent houses, and households accessed to safe water resulted in 1.57% (95% CI: -2.25, -0.93), 0.96% (-1.66, -0.23), and 1.13% (-2.16, -0.18) reduction in HFMD incidence, respectively. At the country-level, HFMD increased 7% (RR: 1.07; 95%CI: 1.052-1.088) and 3.1% (RR: 1.031, 95%CI: 1.024-1.039) for 1°C increase in monthly temperature above 26°C and 1% increase in monthly humidity above 76%. Whereas, HFMD decreased 3.1% associated with 1mm increase in monthly cumulative rainfalls. The climate-HFMD relationship was varied by regions and provinces across the country. CONCLUSIONS The findings reflect an important implication for the climate change adaptation strategies and public-health decision, of which development of weather-based early warning systems should be considered to strengthen communicable disease prevention system.
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Affiliation(s)
- Dung Phung
- Centre for Environment and Population Health, Griffith University, Australia; School of Public Health, Sun Yat-sen University, China.
| | - Huong Xuan Nguyen
- Centre for Environment and Population Health, Griffith University, Australia
| | | | - Cuong Manh Do
- Health Environment Management Agency, Ministry of Health, Vietnam
| | - Quang Dai Tran
- General Department of Preventive Medicine, Ministry of Health, Vietnam
| | - Cordia Chu
- Centre for Environment and Population Health, Griffith University, Australia
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Du Z, Xu L, Zhang W, Zhang D, Yu S, Hao Y. Predicting the hand, foot, and mouth disease incidence using search engine query data and climate variables: an ecological study in Guangdong, China. BMJ Open 2017; 7:e016263. [PMID: 28988169 PMCID: PMC5640051 DOI: 10.1136/bmjopen-2017-016263] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES Hand, foot, and mouth disease (HFMD) has caused a substantial burden in China, especially in Guangdong Province. Based on the enhanced surveillance system, we aimed to explore whether the addition of temperate and search engine query data improves the risk prediction of HFMD. DESIGN Ecological study. SETTING AND PARTICIPANTS Information on the confirmed cases of HFMD, climate parameters and search engine query logs was collected. A total of 1.36 million HFMD cases were identified from the surveillance system during 2011-2014. Analyses were conducted at aggregate level and no confidential information was involved. OUTCOME MEASURES A seasonal autoregressive integrated moving average (ARIMA) model with external variables (ARIMAX) was used to predict the HFMD incidence from 2011 to 2014, taking into account temperature and search engine query data (Baidu Index, BDI). Statistics of goodness-of-fit and precision of prediction were used to compare models (1) based on surveillance data only, and with the addition of (2) temperature, (3) BDI, and (4) both temperature and BDI. RESULTS A high correlation between HFMD incidence and BDI (r=0.794, p<0.001) or temperature (r=0.657, p<0.001) was observed using both time series plot and correlation matrix. A linear effect of BDI (without lag) and non-linear effect of temperature (1 week lag) on HFMD incidence were found in a distributed lag non-linear model. Compared with the model based on surveillance data only, the ARIMAX model including BDI reached the best goodness-of-fit with an Akaike information criterion (AIC) value of -345.332, whereas the model including both BDI and temperature had the most accurate prediction in terms of the mean absolute percentage error (MAPE) of 101.745%. CONCLUSIONS An ARIMAX model incorporating search engine query data significantly improved the prediction of HFMD. Further studies are warranted to examine whether including search engine query data also improves the prediction of other infectious diseases in other settings.
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Affiliation(s)
- Zhicheng Du
- Department of Medical Statistics and Epidemiology & Health Information Research Center & Guangdong Key Laboratory of Medicine, School of Public Health, Sun Yat-sen University, Guangzhou, China
- Key Laboratory of Tropical Diseases and Control of the Ministry of Education, Guangzhou, China
| | - Lin Xu
- Department of Medical Statistics and Epidemiology & Health Information Research Center & Guangdong Key Laboratory of Medicine, School of Public Health, Sun Yat-sen University, Guangzhou, China
- Key Laboratory of Tropical Diseases and Control of the Ministry of Education, Guangzhou, China
- School of Public Health, University of Hong Kong, Hong Kong, China
| | - Wangjian Zhang
- Department of Medical Statistics and Epidemiology & Health Information Research Center & Guangdong Key Laboratory of Medicine, School of Public Health, Sun Yat-sen University, Guangzhou, China
- Key Laboratory of Tropical Diseases and Control of the Ministry of Education, Guangzhou, China
| | - Dingmei Zhang
- Department of Medical Statistics and Epidemiology & Health Information Research Center & Guangdong Key Laboratory of Medicine, School of Public Health, Sun Yat-sen University, Guangzhou, China
- Key Laboratory of Tropical Diseases and Control of the Ministry of Education, Guangzhou, China
| | - Shicheng Yu
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yuantao Hao
- Department of Medical Statistics and Epidemiology & Health Information Research Center & Guangdong Key Laboratory of Medicine, School of Public Health, Sun Yat-sen University, Guangzhou, China
- Key Laboratory of Tropical Diseases and Control of the Ministry of Education, Guangzhou, China
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Spatiotemporal risk mapping of hand, foot and mouth disease and its association with meteorological variables in children under 5 years. Epidemiol Infect 2017; 145:2912-2920. [DOI: 10.1017/s0950268817001984] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
SUMMARYHand, foot and mouth disease (HFMD) risk has become an increasing concern in the Beijing–Tianjin–Hebei region, which is the biggest urban agglomeration in north-eastern Asia. In the study, spatiotemporal epidemiological features of HFMD were analysed, and a Bayesian space–time hierarchy model was used to detect local spatial relative risk (RR) and to assess the effect of meteorological factors. From 2009 to 2013, there was an obvious seasonal pattern of HFMD risk. The highest risk period was in the summer, with an average monthly incidence of 4·17/103, whereas the index in wintertime was 0·16/103. Meteorological variables influenced temporal changes in HFMD. A 1 °C rise in air temperature was associated with an 11·5% increase in HFMD (corresponding RR 1·122). A 1% rise in relative humidity was related to a 9·51% increase in the number of HFMD cases (corresponding RR 1·100). A 1 hPa increment in air pressure was related to a 0·11% decrease in HFMD (corresponding RR 0·999). A 1 h increase in sunshine was associated with a 0·28% rise in HFMD cases (corresponding RR 1·003). A 1 m/s rise in wind speed was related to a 6·2% increase in HFMD (corresponding RR 1·064). High-risk areas were mainly large cities, such as Beijing, Tianjin, Shijiazhuang and their neighbouring areas. These findings can contribute to risk control and implementation of disease-prevention policies.
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Andersen LK, Davis MDP. A wake-up call to dermatologists - climate change affects the skin. Int J Dermatol 2017; 56:e198-e199. [PMID: 28436009 DOI: 10.1111/ijd.13617] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Revised: 02/25/2017] [Accepted: 03/10/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Louise K Andersen
- Department of Dermato-Venereology, Aarhus University Hospital, Aarhus C, Denmark
| | - Mark D P Davis
- Department of Dermatology, Mayo Clinic, Rochester, MN, USA
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