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Zhang L, Yang F, Zhu Z, Zeng W, Rong Z, Hu J, Li X, Zhao J, Zeng B, Li Y, Quan Y, Zhang Q, Huang Z, Li Y, Huang X, Zheng W, Xu J, Li Y, Chen Q, Xiao J, Zhang M. Assessing the impact of COVID-19 interventions on the hand, foot and mouth disease in Guangdong Province, China: a Bayesian modeling study. Front Public Health 2024; 11:1307321. [PMID: 38348379 PMCID: PMC10860754 DOI: 10.3389/fpubh.2023.1307321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 12/26/2023] [Indexed: 02/15/2024] Open
Abstract
Background The non-pharmaceutical interventions (NPIs) against COVID-19 may have affected the transmission of hand, foot and mouth disease (HFMD). We aimed to assess the impact of the NPIs on HFMD in the high epidemic area of HFMD, Guangdong Province. Methods The data of HFMD cases, etiological information, and meteorological factors in Guangdong from January 1, 2012, to December 31, 2021, were collected. Using a Bayesian structural time series (BSTS) model integrated counterfactual framework, we assessed the effect of NPIs on HFMD by different intervention periods, populations (gender, age, occupation), and cities. We further explored the correlation between the reduction of HFMD and socioeconomic factors in 21 cities. Results A total of 351,217 HFMD cases were reported and 455,327 cases were averted in Guangdong Province during 2020-2021 with a reduction of 84.94% (95%CI: 81.63-87.22%) in 2020 and 29.49% (95%CI: 15.26-39.54%) in 2021. The impact of NPIs on HFMD differed by age and gender. The effects of NPIs were more remarkable for children aged 0-2 years and scattered children. We found that the relative reductions in 21 cities were related to the composition ratio of children and COVID-19 incidence. Conclusion The reduction of HFMD incidence was significantly associated with COVID-19 NPIs, and school closure was an effective intervention to prevent HFMD outbreaks. Our findings will contribute to the development of HFMD prevention and control measures.
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Affiliation(s)
- Li Zhang
- School of Public Health, Southern Medical University, Guangzhou, China
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Fen Yang
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
- Guangdong Workstation for Emerging Infectious Disease Control and Prevention, Guangzhou, China
| | - Zhihua Zhu
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Weilin Zeng
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Zuhua Rong
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Jianxiong Hu
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Xing Li
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Jianguo Zhao
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Biao Zeng
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
- Guangdong Workstation for Emerging Infectious Disease Control and Prevention, Guangzhou, China
| | - Yihan Li
- School of Public Health, Southern Medical University, Guangzhou, China
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Yi Quan
- School of Public Health, Southern Medical University, Guangzhou, China
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Qian Zhang
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Zitong Huang
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
- School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Yuye Li
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Xing Huang
- School of Public Health, Southern Medical University, Guangzhou, China
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Wenyuan Zheng
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
- School of Medicine, Jinan University, Guangzhou, China
| | - Jiaqing Xu
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Yan Li
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
- Guangdong Workstation for Emerging Infectious Disease Control and Prevention, Guangzhou, China
| | - Qing Chen
- School of Public Health, Southern Medical University, Guangzhou, China
| | - Jianpeng Xiao
- School of Public Health, Southern Medical University, Guangzhou, China
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Meng Zhang
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
- Guangdong Workstation for Emerging Infectious Disease Control and Prevention, Guangzhou, China
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Zhan ZY, Fang HY, Xu XY, Hu ZJ. Interactions of particulate matter with temperature, heat index and relative humidity on pediatric hand, foot, and mouth disease in a subtropical city. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2023; 336:122385. [PMID: 37648054 DOI: 10.1016/j.envpol.2023.122385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 08/07/2023] [Accepted: 08/13/2023] [Indexed: 09/01/2023]
Abstract
The associations of hand, foot, and mouth disease (HFMD) with meteorological variables and particulate matter (PM) remain controversial, and limited evidence is available on heat index (HI) and coarse particulate (PM10-2.5). Moreover, temperature and humidity are considered major risk factors but their interaction with PM remains unclear. We combined the distributed lag non-linear and quasi-Poisson models to estimate the non-linear and lagged associations of meteorological variables and PM with HFMD based on reported HFMD during 2015-2019 in Fuzhou, China. The multiplicative term of interaction was used to explore the relationship between HFMD and meteorological variables or PM at different levels of another variable. Stratified analyses were used to identify vulnerable subpopulations. We observed inverted-V-shaped relationships between HFMD and temperature and HI, and the W- and N-shaped for relative humidity (RH) and PM, respectively. Extreme high (i.e., the 95th percentile) temperature, HI and RH increased the HFMD with relative risks (RR) of 4.00 (95% confidence interval, 2.79-5.75), 2.20 (1.71-2.83) and 1.54 (1.35-1.75) referent to the minimum effect value of 10.3 °C, 69.4 and 54.8%, respectively. Higher concentrations of PM rapidly increased the HFMD. Infants under 2 years suffered more from temperature, HI and PM. There were synergistic effects between meteorological variables and PM on HFMD. For instance, the RRs of temperature (30 °C) and RH (40%) on HFMD increased from 3.68 (2.24-6.06) to 6.44 (4.29-9.66) and from 0.45 (0.14-1.47) to 2.15 (0.90-5.12) at low (<25%) and high (>75%) categories of PM2.5, respectively. While the RRs of 70 μg/m3 of PM10 and PM10-2.5 increased from 0.65 (0.32-1.31) to 2.93 (1.63-5.26) and from 0.86 (0.23-3.21) to 3.26 (1.23-8.62) at low and high categories of HI. These findings are essential for the development a prediction and warning systems and prevention and control strategies for HFMD.
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Affiliation(s)
- Zhi-Ying Zhan
- Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou 350122, Fujian Province, China
| | - Hai-Yin Fang
- Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou 350122, Fujian Province, China; Fuzhou Center for Disease Control and Prevention, Fuzhou 350004, Fujian Province, China
| | - Xin-Ying Xu
- Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou 350122, Fujian Province, China
| | - Zhi-Jian Hu
- Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou 350122, Fujian Province, China.
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Associations between ambient air pollutants and childhood hand, foot, and mouth disease in Sichuan, China: a spatiotemporal study. Sci Rep 2023; 13:3993. [PMID: 36899026 PMCID: PMC10006415 DOI: 10.1038/s41598-023-31035-7] [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: 06/30/2022] [Accepted: 03/06/2023] [Indexed: 03/12/2023] Open
Abstract
Hand, foot, and mouth disease (HFMD) is a major public health concern in the Asia-Pacific region. Previous studies have implied that ambient air pollution may affect the incidence of HFMD, but the results among different regions are inconsistent. We aimed to deepen the understanding of the associations between air pollutants and HFMD by conducting a multicity study. Daily data on childhood HFMD counts and meteorological and ambient air pollution (PM2.5, PM10, NO2, CO, O3, and SO2) concentrations in 21 cities in Sichuan Province from 2015 to 2017 were collected. A spatiotemporal Bayesian hierarchical model framework was established, and then a distributed lag nonlinear models (DLNMs) was constructed to reveal exposure-lag-response relationships between air pollutants and HFMD while controlling for spatiotemporal effects. Furthermore, given the differences in the levels and seasonal trends of air pollutants between the basin region and plateau region, we explored whether these associations varied between different areas (basin and plateau). The associations between air pollutants and HFMD were nonlinear, with different lag responses. Low NO2 concentrations and both low and high PM2.5 and PM10 concentrations were associated with a decreased risk of HFMD. No significant associations between CO, O3, and SO2 and HFMD were found. The associations between air pollutant concentrations and HFMD were different between the basin and plateau regions. Our study revealed associations between PM2.5, PM10, and NO2 concentrations and HFMD, deepening the understanding of the relationships between air pollutants and HFMD. These findings provide evidence to support the formulation of relevant prevention measures and the establishment of an early warning system.
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Zheng H, Liu D, Zhao X, Zhao X, Liu Y, Li D, Shi T, Ren X. Influence and prediction of meteorological factors on brucellosis in a northwest region of China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:9962-9973. [PMID: 36064850 DOI: 10.1007/s11356-022-22831-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 08/29/2022] [Indexed: 06/15/2023]
Abstract
This paper aims to study the cumulative lag effect of meteorological factors on brucellosis incidence and the prediction performance based on Random Forest model. The monthly number of brucellosis cases and meteorological data from 2015 to 2019 in Yongchang of Gansu Province, northwest China, were used to build distributed lag nonlinear model (DLNM). The number of brucellosis cases of lag 1 month and meteorological data from 2015 to 2018 were used to build RF model to predict the brucellosis incidence in 2019. Meanwhile, SARIMA model was established to compare the prediction performance with RF model according to R2 and RMSE. The results indicated that the population had a high incidence risk at temperature between 5 and 13 °C and lag between 0 and 18 days, sunshine duration between 225 and 260 h and lag between 0 and 1 month, and atmosphere pressure between 789 and 793.5 hPa and lag between 0 and 18 days. The R2 and RMSE of train set and test set in RF model were 0.903, 1.609, 0.824, and 2.657, respectively, and the R2 and RMSE in SARIMA model were 0.530 and 7.008. This study found significant nonlinear and lag associations between meteorological factors and brucellosis incidence. The prediction performance of RF model was more accurate and practical compared with SARIMA model.
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Affiliation(s)
- Hongmiao Zheng
- School of Public Health, Lanzhou University, Gansu, China
| | - Dongpeng Liu
- Gansu Provincial Center for Disease Control and Prevention, Gansu, China
| | - Xin Zhao
- School of Public Health, Lanzhou University, Gansu, China
| | - Xiangkai Zhao
- School of Public Health, Lanzhou University, Gansu, China
| | - Yanchen Liu
- School of Public Health, Lanzhou University, Gansu, China
| | - Donghua Li
- School of Public Health, Lanzhou University, Gansu, China
| | - Tianshan Shi
- School of Public Health, Lanzhou University, Gansu, China
| | - Xiaowei Ren
- School of Public Health, Lanzhou University, Gansu, China.
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Huang J, Ma Y, Lv Q, Liu Y, Zhang T, Yin F, Shui T. Interactive effects of meteorological factors and air pollutants on hand, foot, and mouth disease in Chengdu, China: a time-series study. BMJ Open 2022; 12:e067127. [PMID: 36450433 PMCID: PMC9716848 DOI: 10.1136/bmjopen-2022-067127] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES Hand, foot, and mouth disease (HFMD) is a viral infectious disease that poses a substantial threat in the Asia-Pacific region. It is widely reported that meteorological factors are associated with HFMD. However, the relationships between air pollutants and HFMD are still controversial. In addition, the interactive effects between meteorological factors and air pollutants on HFMD remain unknown. To fill this research gap, we conducted a time-series study. DESIGN A time-series study. SETTING AND PARTICIPANTS Daily cases of HFMD as well as meteorological and air pollution data were collected in Chengdu from 2011 to 2017. A total of 184 610 HFMD cases under the age of 15 were included in our study. OUTCOME MEASURES Distributed lag nonlinear models were used to investigate the relationships between HFMD and environmental factors, including mean temperature, relative humidity, SO2, NO2, and PM10. Then, the relative excess risk due to interaction (RERI) and the proportion attributable to interaction were calculated to quantitatively evaluate the interactions between meteorological factors and air pollutants on HFMD. Bivariate response surface models were used to visually display the interactive effects. RESULTS The cumulative exposure-response curves of SO2 and NO2 were inverted 'V'-shaped and 'M'-shaped, respectively, and the risk of HFMD gradually decreased with increasing PM10 concentrations. We found that there were synergistic interactions between mean temperature and SO2, relative humidity and SO2, as well as relative humidity and PM10 on HFMD, with individual RERIs of 0.334 (95% CI 0.119 to 0.548), 0.428 (95% CI 0.214 to 0.642) and 0.501 (95% CI 0.262 to 0.741), respectively, indicating that the effects of SO2 and PM10 on HFMD were stronger under high temperature (>17.3°C) or high humidity (>80.0%) conditions. CONCLUSIONS There were interactive effects between meteorological factors and air pollutants on HFMD. Our findings could provide guidance for targeted and timely preventive and control measures for HFMD.
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Affiliation(s)
- Jiaqi Huang
- Department of Epidemiology and Health Statistics, West China School of Public Health, Sichuan University, Chengdu, China
| | - Yue Ma
- Department of Epidemiology and Health Statistics, West China School of Public Health, Sichuan University, Chengdu, China
| | - Qiang Lv
- Department of Acute Infectious Disease Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan, China
| | - Yaqiong Liu
- Department of Acute Infectious Disease Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan, China
| | - Tao Zhang
- Department of Epidemiology and Health Statistics, West China School of Public Health, Sichuan University, Chengdu, China
| | - Fei Yin
- Department of Epidemiology and Health Statistics, West China School of Public Health, Sichuan University, Chengdu, China
| | - Tiejun Shui
- Department of Leprosy Control and Prevention, Yunnan Center for Disease Control and Prevention, Kunming, Yunnan, China
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Li M, Ma Y, Luo C, Lv Q, Liu Y, Zhang T, Yin F, Shui T. Modification effects of socioeconomic factors on associations between air pollutants and hand, foot, and mouth disease: A multicity time-series study based on heavily polluted areas in the basin area of Sichuan Province, China. PLoS Negl Trop Dis 2022; 16:e0010896. [PMID: 36413517 PMCID: PMC9681081 DOI: 10.1371/journal.pntd.0010896] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 10/14/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Hand, foot, and mouth disease (HFMD) is a serious threat among children in China. Some studies have found that air pollution is associated with HFMD incidence, but the results showed heterogeneity. In this study, we aimed to explore the heterogeneity of associations between air pollutants and the number of HFMD cases and to identify significant socioeconomic effect modifiers. METHODS We collected daily surveillance data on HFMD cases in those aged less than 15 years, air pollution variables and meteorological variables from 2015 to 2017 in the basin area of Sichuan Province. We also collected socioeconomic indicator data. We conducted a two-stage multicity time-series analysis. In the first stage, we constructed a distributed lag nonlinear model (DLNM) to obtain cumulative exposure-response curves between each air pollutant and the numbers of HFMD cases for every city. In the second stage, we carried out a multivariable meta-regression to merge the estimations in the first stage and to identify significant socioeconomic effect modifiers. RESULTS We found that PM10, NO2 and O3 concentrations were associated with the number of HFMD cases. An inverted V-shaped association between PM10 and the number of HFMD cases was observed. The overall NO2-HFMD association was a hockey-stick shape. For the relationships of PM10, SO2, NO2, O3 and CO with HFMD counts, approximately 58.5%, 48.4%, 51.0%, 55.6% and 52.5% of the heterogeneity could be explained, respectively. The proportion of primary school students, population density, urbanization rate, number of licensed physicians and number of hospital beds explained part of the heterogeneity and modified the relationships. CONCLUSION Our study explored the heterogeneity of associations between air pollutants and HFMD counts. The proportion of primary school students, population density, urbanization rate, number of licensed physicians and number of hospital beds could modify the relationships. The results can serve as a reference for relevant public health decision making.
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Affiliation(s)
- Mengyao Li
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Yue Ma
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Caiying Luo
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Qiang Lv
- Sichuan Center for Disease Control and Prevention, Chengdu, People’s Republic of China
| | - Yaqiong Liu
- Sichuan Center for Disease Control and Prevention, Chengdu, People’s Republic of China
| | - Tao Zhang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Fei Yin
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, People’s Republic of China
- * E-mail: (FY); (TS)
| | - Tiejun Shui
- Yunnan Center for Disease Control and Prevention, Kunming, People’s Republic of China
- * E-mail: (FY); (TS)
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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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Zhang L, Jiang H, Wang K, Yuan Y, Fu Q, Jin X, Zhao N, Huang X, Wang S, Zhang T, Yao K, Chan TC, Xu W, Liu S. Long-term effects of weather condition and air pollution on acute hemorrhagic conjunctivitis in China: A nationalwide surveillance study in China. ENVIRONMENTAL RESEARCH 2021; 201:111616. [PMID: 34233156 DOI: 10.1016/j.envres.2021.111616] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 06/14/2021] [Accepted: 06/26/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Global climate change could have potential impact on enterovirus (EV)-induced infectious diseases. However, the environmental factors promoting acute hemorrhagic conjunctivitis (AHC) circulation remain inconclusive. This study aimed to quantify the relationship between the environment and AHC. METHODS We retrieved the monthly counts and incidence of AHC, meteorological variables and air quality in mainland China between 2013 and 2018. Exposure risks were evaluated by multivariate distributed lag nonlinear models. RESULTS A total of 219,599 AHC cases were reported in 31 provinces of China, predominantly in southern and central China, seasonally increased in summer. AHC incidence increased by 7% between 2013 and 2018, from 2.6873 to 2.7570 per 100,000 people. A moderate positive correlation was seen between AHC and monthly mean temperature, relative humidity (RH) and precipitation. Each unit increment was associated with a relative risk for AHC of 1.058 at 17°-32 °C at lag 0 months, 1.017 at 65-71% RH at lag 1.4 months, and 1.039 at 400-569 mm at lag 2.4 months. By contrast, a negative correlation was seen between monthly ambient NO2 and AHC. CONCLUSION Long-term exposure to higher mean temperature, RH and precipitation were associated with an increased risk of AHC. The general public, especially susceptible populations, should pay close attention to weather changes and take protective measures in advance to any AHC outbreak as the above situations occur.
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Affiliation(s)
- Li Zhang
- Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, 310009, China
| | - Hui Jiang
- Beijing Chest Hospital, Capital Medical University, Beijing, 101149, China; Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, 101149, China
| | - Kehan Wang
- Center for Applied Statistics, School of Statistics, Renmin University of China, Beijing, 100872, China
| | - Yuan Yuan
- Department of Geriatrics, Beijing Jishuitan Hospital, Beijing, 100035, China
| | - Qiuli Fu
- Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, 310009, China
| | - Xiuming Jin
- Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, 310009, China
| | - Na Zhao
- Collaborative Innovation Center of Recovery and Reconstruction of Degraded Ecosystem in Wanjiang Basin Co-founded by Anhui Province and Ministry of Education, School of Ecology and Environment, Anhui Normal University, Wuhu, Anhui Province, 241002, China
| | - Xiaodan Huang
- Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, 310009, China
| | - Supen Wang
- Anhui Provincial Key Laboratory of the Conservation and Exploitation of Biological Resources, College of Life Sciences, Anhui Normal University, Wuhu, Anhui Province, 241000, China
| | - Tao Zhang
- Nanjing Jiliang Information Technology Co., Ltd, Nanjing, Jiangsu Provice, 210002, China
| | - Ke Yao
- Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, 310009, China.
| | - Ta-Chien Chan
- Research Center for Humanities and Social Sciences, Academia Sinica, Taipei, 115, Taiwan.
| | - Wangli Xu
- Center for Applied Statistics, School of Statistics, Renmin University of China, Beijing, 100872, China.
| | - Shelan Liu
- Department of Infectious Diseases, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, 310051, China.
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Zhang R, Lin Z, Guo Z, Chang Z, Niu R, Wang Y, Wang S, Li Y. Daily mean temperature and HFMD: risk assessment and attributable fraction identification in Ningbo China. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2021; 31:664-671. [PMID: 33547422 PMCID: PMC8263339 DOI: 10.1038/s41370-021-00291-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 01/06/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Hand, foot, and mouth disease (HFMD) remains a significant public health issue, especially in developing countries. Many studies have reported the association between environmental temperature and HFMD. However, the results are highly heterogeneous in different regions. In addition, there are few studies on the attributable risk of HFMD due to temperature. OBJECTIVES The study aimed to assess the association between temperature and HFMD incidence and to evaluate the attributable burden of HFMD due to temperature in Ningbo China. METHODS The research used daily incidence of HFMD from 2014 to 2017 and distributed lag non-linear model (DLNM) to investigate the effects of daily mean temperature (Tmean) on HFMD incidence from lag 0 to 30 days, after controlling potential confounders. The lag effects and cumulative relative risk (CRR) were analyzed. Attributable fraction (AF) of HFMD incidence due to temperature was calculated. Stratified analysis by gender and age were also conducted. RESULTS The significant associations between Tmean and HFMD incidence were observed in Ningbo for lag 0-30. Two peaks were observed at both low (5-11 °C) and high (16-29 °C) temperature scales. For low temperature scale, the highest CRR was 2.22 (95% CI: 1.61-3.07) at 7 °C on lag 0-30. For high temperature scale, the highest CRR was 3.54 (95% CI: 2.58-4.88) at 24 °C on lag 0-30. The AF due to low and high temperature was 5.23% (95% CI: 3.10-7.14%) and 39.55% (95% CI: 30.91-45.51%), respectively. There was no significant difference between gender- and age-specific AFs, even though the school-age and female children had slightly higher AF values. CONCLUSIONS The result indicates that both high and low temperatures were associated with daily incidence of HFMD, and more burdens were caused by heat in Ningbo.
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Affiliation(s)
- Rui Zhang
- Chinese Center for Disease Control and Prevention, Beijing, 102206, China
| | - Zhehan Lin
- China Population Communication Center, Beijing, 100013, China
| | - Zhen Guo
- Institute of Medical Information/Medical Library, CAMS & PUMC, Beijing, 100020, China
| | - Zhaorui Chang
- Chinese Center for Disease Control and Prevention, Beijing, 102206, China
| | - Ran Niu
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, 100050, China
| | - Yu Wang
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China
| | - Songwang Wang
- Chinese Center for Disease Control and Prevention, Beijing, 102206, China.
| | - Yonghong Li
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China.
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Association of Short-Term Exposure to Meteorological Factors and Risk of Hand, Foot, and Mouth Disease: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17218017. [PMID: 33143315 PMCID: PMC7663009 DOI: 10.3390/ijerph17218017] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 10/25/2020] [Accepted: 10/27/2020] [Indexed: 12/17/2022]
Abstract
(1) Background: Inconsistencies were observed in studies on the relationship between short-term exposure to meteorological factors and the risk of hand, foot, and mouth disease (HFMD). This systematic review and meta-analysis was aimed to assess the overall effects of meteorological factors on the incidence of HFMD to help clarify these inconsistencies and serve as a piece of evidence for policy makers to determine relevant risk factors. (2) Methods: Articles published as of 24 October 2020, were searched in the four databases, namely, PubMed, Web of Science, Embase, and MEDLINE. We applied a meta-analysis to assess the impact of ambient temperature, relative humidity, rainfall, wind speed, and sunshine duration on the incidence of HFMD. We conducted subgroup analyses by exposure metrics, exposure time resolution, regional climate, national income level, gender, and age as a way to seek the source of heterogeneity. (3) Results: Screening by the given inclusion and exclusion criteria, a total of 28 studies were included in the analysis. We observed that the incidence of HFMD based on the single-day lag model is significantly associated with ambient temperature, relative humidity, rainfall, and wind speed. In the cumulative lag model, ambient temperature and relative humidity significantly increased the incidence of HFMD as well. Subgroup analysis showed that extremely high temperature and relative humidity significantly increased the risk of HFMD. Temperate regions, high-income countries, and children under five years old are major risk factors for HFMD. (4) Conclusions: Our results suggest that various meteorological factors can increase the incidence of HFMD. Therefore, the general public, especially susceptible populations, should pay close attention to weather changes and take protective measures in advance.
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