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Sahoo M, Singh R, Kumar P, Kumar Mariappan A, Munnuswamy P, Singh K, Mani S, Dhama K, Kondabattula G, Das T, Thakor JC, Kashyap G, Sahoo NR. Novel pathologic findings and viral antigen distribution in cattle and buffalo calves naturally infected with Foot-and-Mouth disease virus. Vet Q 2023; 43:1-13. [PMID: 37733477 PMCID: PMC10548843 DOI: 10.1080/01652176.2023.2260435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 09/11/2023] [Indexed: 09/23/2023] Open
Abstract
The Foot-and-Mouth disease is highly contagious acute viral disease of livestock inflicting huge economic loss to the farmers. The limited knowledge regarding the pathological lesions vis-a-vis distribution of the FMDV in lesser explored endocrine glands and important vital organs other than the target organs of infected calves prompted us to take the present investigation to have detailed insight into the pathogenesis. The systematic necropsy of 37 dead calves (cattle-28 and buffalo-9) was conducted, and thin representative tissue pieces from the affected organs were collected in 10% neutral buffered formalin (NBF) for pathological and immunohistochemical investigations. The genomic detection and its serotyping were done by RT-PCR and multiplex-PCR, respectively. Necropsy examination in all cases showed myocardial lesions resembling 'tigroid heart appearance'. Other organ specific lesions include vesiculo-ulcerative stomatitis, edema of the lungs, petechial hemorrhages, edema of the endocrines, and gastroenteritis. Histopathological examination showed varying sizes of vesicles and ulcerations in stratified squamous epithelium of the tongue, acute necrotizing myocarditis, lymphoid depletion in lymphoid tissues, hepatitis, pancreatitis, thymic hyperplasia, thyroiditis, adrenitis, and enteritis. Positive immunolabeling for viral antigens was observed in endocrine glands, lymphoid organs, lungs, liver, kidneys, and intestine, in addition to other typical locations. The thyroid, adrenal glands, and pancreas, in addition to the tongue and heart, are the tissue of choice for sampling in the field during epidemics. Further, the viral genome and serotype A was confirmed in the affected tissues. This study provides insights into novel tissue tropism and pathogenesis in young calves naturally infected with FMDV.
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Affiliation(s)
- Monalisa Sahoo
- ICAR-National Institute on Foot-and-Mouth Disease (NIFMD), Bhubaneswar, India
- Division of Pathology, ICAR- Indian veterinary Research Institute (IVRI), Izatnagar, India
| | - Rajendra Singh
- Veterinary Pathology, Institute of Veterinary Science and Animal Husbandry, Siksha "O" Anusandhan, Bhubaneswar, India
| | - Pawan Kumar
- Division of Pathology, ICAR- Indian veterinary Research Institute (IVRI), Izatnagar, India
| | - Asok Kumar Mariappan
- Division of Pathology, ICAR- Indian veterinary Research Institute (IVRI), Izatnagar, India
| | - Palanivelu Munnuswamy
- Division of Pathology, ICAR- Indian veterinary Research Institute (IVRI), Izatnagar, India
| | - Karampal Singh
- CADRAD, ICAR- Indian Veterinary Research Institute (IVRI), Izatnagar, India
| | - Saminathan Mani
- CADRAD, ICAR- Indian Veterinary Research Institute (IVRI), Izatnagar, India
| | - Kuldeep Dhama
- Veterinary Pathology, Institute of Veterinary Science and Animal Husbandry, Siksha "O" Anusandhan, Bhubaneswar, India
| | - Ganesh Kondabattula
- Quality control & Quality Assurance unit, ICAR-Indian Veterinary Research Institute (IVRI), Hebbal, India
| | - Tareni Das
- ICAR-National Institute on Foot-and-Mouth Disease (NIFMD), Bhubaneswar, India
| | | | - Gayatri Kashyap
- Division of Pathology, ICAR- Indian veterinary Research Institute (IVRI), Izatnagar, India
| | - Nihar Ranjan Sahoo
- ICAR-National Institute on Foot-and-Mouth Disease (NIFMD), Bhubaneswar, India
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Yang M, Gong S, Huang S, Huo X, Wang W. Geographical characteristics and influencing factors of the influenza epidemic in Hubei, China, from 2009 to 2019. PLoS One 2023; 18:e0280617. [PMID: 38011126 PMCID: PMC10681244 DOI: 10.1371/journal.pone.0280617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 09/13/2023] [Indexed: 11/29/2023] Open
Abstract
Influenza is an acute respiratory infectious disease that commonly affects people and has an important impact on public health. Based on influenza incidence data from 103 counties in Hubei Province from 2009 to 2019, this study used time series analysis and geospatial analysis to analyze the spatial and temporal distribution characteristics of the influenza epidemic and its influencing factors. The results reveal significant spatial-temporal clustering of the influenza epidemic in Hubei Province. Influenza mainly occurs in winter and spring of each year (from December to March of the next year), with the highest incidence rate observed in 2019 and an overall upward trend in recent years. There were significant spatial and urban-rural differences in influenza prevalence in Hubei Province, with the eastern region being more seriously affected than the central and western regions, and the urban regions more seriously affected than the rural region. Hubei's influenza epidemic showed an obvious spatial agglomeration distribution from 2009 to 2019, with the strongest clustering in winter. The hot spot areas of interannual variation in influenza were mainly distributed in eastern and western Hubei, and the cold spot areas were distributed in north-central Hubei. In addition, the cold hot spot areas of influenza epidemics varied from season to season. The seasonal changes in influenza prevalence in Hubei Province are mainly governed by meteorological factors, such as temperature, sunshine, precipitation, humidity, and wind speed. Low temperature, less rain, less sunshine, low wind speed and humid weather will increase the risk of contracting influenza; the interannual changes and spatial differentiation of influenza are mainly influenced by socioeconomic factors, such as road density, number of health technicians per 1,000 population, urbanization rate and population density. The strength of influenza's influencing factors in Hubei Province exhibits significant spatial variation, but in general, the formation of spatial variation of influenza in Hubei Province is still the result of the joint action of socioeconomic factors and natural meteorological factors. Understanding the temporal and spatial distribution characteristics of influenza in Hubei Province and its influencing factors can provide a reasonable decision-making basis for influenza prevention and control and public health development in Hubei Province and can also effectively improve the scientific understanding of the public with respect to influenza and other respiratory infectious diseases to reduce the influenza incidence, which also has reference significance for the prevention and control of influenza and other respiratory infectious diseases in other countries or regions.
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Affiliation(s)
- Mengmeng Yang
- College of Urban and Environmental Sciences, Central China Normal University, Wuhan, China
| | - Shengsheng Gong
- College of Urban and Environmental Sciences, Central China Normal University, Wuhan, China
| | - Shuqiong Huang
- Hubei Provincial Center for Disease Control and Prevention, Wuhan, China
| | - Xixiang Huo
- Hubei Provincial Center for Disease Control and Prevention, Wuhan, China
| | - Wuwei Wang
- College of Urban and Environmental Sciences, Central China Normal University, Wuhan, China
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Zhang N, Fang XY, Zhou WZ, Tan ZM, Liang SY, Wang XC, Hu JL, Bao CJ, Liu WD. Epidemiological characteristics and temporal-spatial clustering analysis on human brucellosis in Jiangsu Province, 2006-2021. Sci Rep 2023; 13:20024. [PMID: 37973934 PMCID: PMC10654521 DOI: 10.1038/s41598-023-46690-z] [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: 05/09/2023] [Accepted: 11/03/2023] [Indexed: 11/19/2023] Open
Abstract
The marked increase in the incidence rate of brucellosis is a serious public health concern in Jiangsu Province. However, its temporal and spatial distribution has not been studied in depth. The main purpose of this study is to depict the demographic, temporal and spatial distribution patterns and clustering characteristics of brucellosis cases in Jiangsu Province, China, from 2006 to 2021 to develop and implement effective scientific prevention and control strategies. Data for human brucellosis cases in Jiangsu Province from 2006 to 2021 were obtained from the Nationwide Notifiable Infectious Diseases Reporting Information System (NIDRIS). Spatial autocorrelation analysis and temporal-spatial scan statistics were used to identify potential changes in the spatial and temporal distributions of human brucellosis in Jiangsu Province. During the years 2006-2021, 1347 brucellosis cases were reported in Jiangsu Province, with an average annual incidence rate of 0.1036 per 100,000 individuals. Middle-aged and elderly individuals (aged 40-69 years) were the main infected populations, accounting for 69.72% (939/1347) of all reported cases. The incidence of brucellosis in Jiangsu showed a long-term increasing trend and displayed pronounced seasonal variations, with the peak occurring between April and June annually. The incidence gradually expanded from the northern and southern areas to the central areas between 2006 and 2021. Global spatial autocorrelation analysis demonstrated a positive correlation in the incidence of brucellosis between 2008 and 2012-2021. Temporal-spatial clustering analysis showed that the primary cluster was detected in the northern, highly endemic regions of Jiangsu, and the three secondary clusters were in areas where there had been outbreaks of brucellosis. Human brucellosis remains a serious public health issue in Jiangsu Province. Northern and southern Jiangsu regions, with high rates of brucellosis, may require special plans and measures to monitor and control the disease. Additionally, the capacity to respond to outbreaks in high-incidence areas should be improved to prevent further brucellosis outbreaks.
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Affiliation(s)
- Nan Zhang
- Department of Acute Infectious Diseases Control and Prevention, Jiangsu Provincial Centre for Disease Control and Prevention, 172, Jiangsu Rd, Nanjing, 210009, Jiangsu Province, China
| | - Xin-Yu Fang
- Department of Food Safety and Evaluation, Jiangsu Provincial Centre for Disease Control and Prevention, 172, Jiangsu Rd, Nanjing, 210009, Jiangsu Province, China
| | - Wei-Zhong Zhou
- Department of Acute Infectious Diseases Control and Prevention, Jiangsu Provincial Centre for Disease Control and Prevention, 172, Jiangsu Rd, Nanjing, 210009, Jiangsu Province, China
| | - Zhong-Ming Tan
- Department of Acute Infectious Diseases Control and Prevention, Jiangsu Provincial Centre for Disease Control and Prevention, 172, Jiangsu Rd, Nanjing, 210009, Jiangsu Province, China
| | - Shu-Yi Liang
- Department of Acute Infectious Diseases Control and Prevention, Jiangsu Provincial Centre for Disease Control and Prevention, 172, Jiangsu Rd, Nanjing, 210009, Jiangsu Province, China
| | - Xiao-Chen Wang
- Department of Acute Infectious Diseases Control and Prevention, Jiangsu Provincial Centre for Disease Control and Prevention, 172, Jiangsu Rd, Nanjing, 210009, Jiangsu Province, China
| | - Jian-Li Hu
- Department of Acute Infectious Diseases Control and Prevention, Jiangsu Provincial Centre for Disease Control and Prevention, 172, Jiangsu Rd, Nanjing, 210009, Jiangsu Province, China
| | - Chang-Jun Bao
- Department of Acute Infectious Diseases Control and Prevention, Jiangsu Provincial Centre for Disease Control and Prevention, 172, Jiangsu Rd, Nanjing, 210009, Jiangsu Province, China
| | - Wen-Dong Liu
- Department of Acute Infectious Diseases Control and Prevention, Jiangsu Provincial Centre for Disease Control and Prevention, 172, Jiangsu Rd, Nanjing, 210009, Jiangsu Province, China.
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Xin X, Hu X, Zhai L, Jia J, Pan B, Han Y, Jiang F. The effect of ambient temperature on hand, foot and mouth disease in Qingdao, China, 2014-2018. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2023; 33:1081-1090. [PMID: 35510292 DOI: 10.1080/09603123.2022.2072818] [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: 02/18/2022] [Accepted: 04/27/2022] [Indexed: 06/14/2023]
Abstract
Hand, foot, and mouth disease (HFMD) is a kind of infection gastrointestinal disease. The present study aims to explore the association between ambient temperature and HFMD in Qingdao. A distributed lag nonlinear model with Poisson distribution was adopted to explore the effects of daily mean temperature on HFMD incidence. Our results found that the high temperature had acute and short-term effects and then declined rapidly along the lag days, with the maximum risk occurring 0 day of exposure. Compared with low temperature, higher effects were observed for high-temperature exposure. Overall, we found that the association between temperature and HFMD incidence was non-linear, exhibiting an approximate "J" shape, with peak value occurring at 30.5℃ (RR = 2.208, 95% CI: 1.995-2.444). Our findings suggest that ambient temperature is significantly associated with the incidence of HFMD in Qingdao. Monitoring ambient temperature changes is an appropriate recommendation to prevent HFMD.
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Affiliation(s)
- Xueling Xin
- Department of Acute Infectious Diseases, Qingdao Municipal Centre of Disease Control and Prevention, Qingdao Institute of Prevention Medicine, Qingdao City, Shandong Province, People's Republic of China
| | - Xiaowen Hu
- Department of Acute Infectious Diseases, Qingdao Municipal Centre of Disease Control and Prevention, Qingdao Institute of Prevention Medicine, Qingdao City, Shandong Province, People's Republic of China
| | - Long Zhai
- Department of Occupational Health, Qingdao Municipal Center for Disease Control and Prevention, Qingdao Institute of Prevention Medicine, Qingdao City, Shandong Province, People's Republic of China
| | - Jing Jia
- Department of Acute Infectious Diseases, Qingdao Municipal Centre of Disease Control and Prevention, Qingdao Institute of Prevention Medicine, Qingdao City, Shandong Province, People's Republic of China
| | - Bei Pan
- Department of Acute Infectious Diseases, Qingdao Municipal Centre of Disease Control and Prevention, Qingdao Institute of Prevention Medicine, Qingdao City, Shandong Province, People's Republic of China
| | - Yalin Han
- Department of Acute Infectious Diseases, Qingdao Municipal Centre of Disease Control and Prevention, Qingdao Institute of Prevention Medicine, Qingdao City, Shandong Province, People's Republic of China
| | - Fachun Jiang
- Department of Acute Infectious Diseases, Qingdao Municipal Centre of Disease Control and Prevention, Qingdao Institute of Prevention Medicine, Qingdao City, Shandong Province, People's Republic of China
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Wang W, Rosenberg MW, Chen H, Gong S, Yang M, Deng D. Epidemiological characteristics and spatiotemporal patterns of hand, foot, and mouth disease in Hubei, China from 2009 to 2019. PLoS One 2023; 18:e0287539. [PMID: 37352281 PMCID: PMC10289314 DOI: 10.1371/journal.pone.0287539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 06/07/2023] [Indexed: 06/25/2023] Open
Abstract
BACKGROUND Hand, foot, and mouth disease (HFMD) is a public health issue in Hubei and studies of- spatiotemporal clustering at a fine scale are limited. The purpose of this research was to analyze the epidemiological characteristics, temporal variation characteristics, and spatiotemporal clustering of HFMD cases at the town level from 2009 to 2019 to improve public health outcomes. METHODS Mathematical statistics, a seasonal index, wavelet analysis, and spatiotemporal scans were used to analyze epidemiological characteristics, time series trends, and spatiotemporal clusters of HFMD in Hubei. RESULTS EV-A71 (Enterovirus A71) and CVA16 (Coxsackievirus A16) constitute the two primary pathogens of the HFMD epidemic in Hubei, among which EV-A71 is the dominant pathogen, especially in 2016. In terms of age distribution, a major peak occurred at 0-5 years and a very small increase appeared at 25-35 years, with the former having a higher incidence among males than females and the latter having the opposite difference between males and females. The number/rate of HFMD cases exhibited a considerable increase followed by a moderate decline from 2009 to 2019, with the first large peak in April-July and a smaller peak in November-December. HFMD in Hubei exhibited the characteristics of a 270-day cycle with multiscale nesting, which was similar to the periodicity of HFMD cases caused by EV-A71 (9 months). Cities with a higher incidence of HFMD formed a part of an "A-shaped urban skeleton". Subdistricts had the highest incidence of HFMD, followed by towns and villages. The spatiotemporal scan results showed one most likely cluster and 22 secondary clusters, which was consistent with the geographic location of railways and rivers in Hubei. CONCLUSIONS These findings may be helpful in the prevention and control of HFMD transmission and in implementing effective measures in Hubei Province.
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Affiliation(s)
- Wuwei Wang
- Institute of China Rural Studies, Central China Normal University, Wuhan, Hubei, China
- Institute of Sustainable Development & Department of Geography, Central China Normal University, Wuhan, Hubei, China
- Department of Geography and Planning, Queen’s University, Kingston, Ontario, Canada
| | - Mark W. Rosenberg
- Department of Geography and Planning, Queen’s University, Kingston, Ontario, Canada
| | - Hongying Chen
- Center for Disease Control and Prevention of Hubei Province, Wuhan, Hubei, China
| | - Shengsheng Gong
- Institute of Sustainable Development & Department of Geography, Central China Normal University, Wuhan, Hubei, China
| | - Mengmeng Yang
- Institute of Sustainable Development & Department of Geography, Central China Normal University, Wuhan, Hubei, China
| | - Dacai Deng
- Institute of China Rural Studies, Central China Normal University, Wuhan, Hubei, China
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Zhao Y, Aung PL, Ruan S, Win KM, Wu Z, Soe TN, Soe MT, Cao Y, Sattabongkot J, Kyaw MP, Cui L, Menezes L, Parker DM. Spatio-temporal trends of malaria incidence from 2011 to 2017 and environmental predictors of malaria transmission in Myanmar. Infect Dis Poverty 2023; 12:2. [PMID: 36709318 PMCID: PMC9883610 DOI: 10.1186/s40249-023-01055-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 01/13/2023] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Myanmar bears the heaviest malaria burden in the Greater Mekong Subregion (GMS). This study assessed the spatio-temporal dynamics and environmental predictors of Plasmodium falciparum and Plasmodium vivax malaria in Myanmar. METHODS Monthly reports of malaria cases at primary health centers during 2011-2017 were analyzed to describe malaria distribution across Myanmar at the township and state/region levels by spatial autocorrelation (Moran index) and spatio-temporal clustering. Negative binomial generalized additive models identified environmental predictors for falciparum and vivax malaria, respectively. RESULTS From 2011 to 2017, there was an apparent reduction in malaria incidence in Myanmar. Malaria incidence peaked in June each year. There were significant spatial autocorrelation and clustering with extreme spatial heterogeneity in malaria cases and test positivity across the nation (P < 0.05). Areas with higher malaria incidence were concentrated along international borders. Primary clusters of P. falciparum persisted in western townships, while clusters of P. vivax shifted geographically over the study period. The primary cluster was detected from January 2011 to December 2013 and covered two states (Sagaing and Kachin). Annual malaria incidence was highest in townships with a mean elevation of 500‒600 m and a high variance in elevation (states with both high and low elevation). There was an apparent linear relationship between the mean normalized difference vegetative index and annual P. falciparum incidence (P < 0.05). CONCLUSION The decreasing trends reflect the significant achievement of malaria control efforts in Myanmar. Prioritizing the allocation of resources to high-risk areas identified in this study can achieve effective disease control.
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Affiliation(s)
- Yan Zhao
- grid.412449.e0000 0000 9678 1884Department of Immunology, College of Basic Medical Sciences, China Medical University, Shenyang, 110122 Liaoning China
| | - Pyae Linn Aung
- Myanmar Health Network Organization, Yangon, Myanmar ,grid.10223.320000 0004 1937 0490Mahidol Vivax Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Shishao Ruan
- grid.412449.e0000 0000 9678 1884Department of Immunology, College of Basic Medical Sciences, China Medical University, Shenyang, 110122 Liaoning China
| | - Kyawt Mon Win
- grid.415741.2Department of Public Health, Ministry of Health, NayPyiTaw, Myanmar
| | - Zifang Wu
- grid.412449.e0000 0000 9678 1884Department of Immunology, College of Basic Medical Sciences, China Medical University, Shenyang, 110122 Liaoning China
| | - Than Naing Soe
- grid.415741.2Department of Public Health, Ministry of Health, NayPyiTaw, Myanmar
| | - Myat Thu Soe
- Myanmar Health Network Organization, Yangon, Myanmar
| | - Yaming Cao
- grid.412449.e0000 0000 9678 1884Department of Immunology, College of Basic Medical Sciences, China Medical University, Shenyang, 110122 Liaoning China
| | - Jetsumon Sattabongkot
- grid.10223.320000 0004 1937 0490Mahidol Vivax Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | | | - Liwang Cui
- grid.170693.a0000 0001 2353 285XDivision of Infectious Diseases and International Medicine, Department of Internal Medicine, Morsani College of Medicine, University of South Florida, 3720 Spectrum Boulevard, Suite 304, Tampa, FL 33612 USA
| | - Lynette Menezes
- grid.170693.a0000 0001 2353 285XDivision of Infectious Diseases and International Medicine, Department of Internal Medicine, Morsani College of Medicine, University of South Florida, 3720 Spectrum Boulevard, Suite 304, Tampa, FL 33612 USA
| | - Daniel M. Parker
- grid.266093.80000 0001 0668 7243Department of Population Health and Disease Prevention, Department of Epidemiology, University of California, Irvine, USA
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Zare M, Jamalidoust M, Pouladfar GR, Amanati A, Shafaati M, Namayandeh M, Ziyaeyan M. A case report of severe systemic infection with neurological HFMD symptoms followed by an accidental puncture of thumb during HFMD sample collection. IDCases 2022; 27:e01434. [PMID: 35145864 PMCID: PMC8819104 DOI: 10.1016/j.idcr.2022.e01434] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 01/30/2022] [Accepted: 01/30/2022] [Indexed: 11/29/2022] Open
Abstract
A 34-year-old female clinical virology assistant was punctured with a contaminated lancet used for sampling from a suspected Hand, Foot, and Mouth disease (HFMD) patient. Five days after a puncture, the disease symptoms manifested, including high fever, ague, and stiff neck. Skin rashes suddenly appeared after day 6. Stiff neck and fever were relieved two days after the rash appeared, and rashes disappeared gradually by the next five days. Samples for molecular detection and virus cultivation were taken from the patient. Real-time PCR found the enteroviral RNA in the throat swab and skin rashes. The specific CPE of Enteroviruses appeared on the Vero cell line after three days of incubation. In this case transmission occurs through needle injury and results in the systemic disease, so unusual and unexpected viral transmission should be considered when dealing with samples.
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Affiliation(s)
- Maryam Zare
- Alborzi Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Marzieh Jamalidoust
- Alborzi Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Gholam R Pouladfar
- Alborzi Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Amanati
- Alborzi Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Shafaati
- Department of Microbiology, Faculty of Sciences, Jahrom Branch, Islamic Azad University, Jahrom, Iran
| | - Mandana Namayandeh
- Alborzi Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mazyar Ziyaeyan
- Alborzi Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Spatio-Temporal Analysis of Influenza-Like Illness and Prediction of Incidence in High-Risk Regions in the United States from 2011 to 2020. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18137120. [PMID: 34281057 PMCID: PMC8297262 DOI: 10.3390/ijerph18137120] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 06/27/2021] [Accepted: 06/29/2021] [Indexed: 01/04/2023]
Abstract
About 8% of the Americans contract influenza during an average season according to the Centers for Disease Control and Prevention in the United States. It is necessary to strengthen the early warning for influenza and the prediction of public health. In this study, Spatial autocorrelation analysis and spatial scanning analysis were used to identify the spatiotemporal patterns of influenza-like illness (ILI) prevalence in the United States, during the 2011-2020 transmission seasons. A seasonal autoregressive integrated moving average (SARIMA) model was constructed to predict the influenza incidence of high-risk states. We found the highest incidence of ILI was mainly concentrated in the states of Louisiana, District of Columbia and Virginia. Mississippi was a high-risk state with a higher influenza incidence, and exhibited a high-high cluster with neighboring states. A SARIMA (1, 0, 0) (1, 1, 0)52 model was suitable for forecasting the ILI incidence of Mississippi. The relative errors between actual values and predicted values indicated that the predicted values matched the actual values well. Influenza is still an important health problem in the United States. The spread of ILI varies by season and geographical region. The peak season of influenza was the winter and spring, and the states with higher influenza rates are concentrated in the southeast. Increased surveillance in high-risk states could help control the spread of the influenza.
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Oyana TJ, Minso J, Jones TL, McCullers JA, Arnold SR, Cormier SA. Particulate matter exposure predicts residence in high-risk areas for community acquired pneumonia among hospitalized children. Exp Biol Med (Maywood) 2021; 246:1907-1916. [PMID: 34053235 DOI: 10.1177/15353702211014456] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Particulate matter exposure is a risk factor for lower respiratory tract infection in children. Here, we investigated the geospatial patterns of community-acquired pneumonia and the impact of PM2.5 (particulate matter with an aerodynamic diameter ≤2.5 µm) on geospatial variability of pneumonia in children. We performed a retrospective analysis of prospectively collected population-based surveillance study data of community-acquired pneumonia hospitalizations among children <18 years residing in the Memphis metropolitan area, who were enrolled in the Centers for Disease Control and Prevention sponsored Etiology of Pneumonia in the Community (EPIC) study from January 2010 to June 2012. The outcome measure, residence in high- and low-risk areas for community-acquired pneumonia, was determined by calculating pneumonia incidence rates and performing cluster analysis to identify areas with higher/lower than expected rates of community-acquired pneumonia for the population at risk. High PM2.5 was defined as exposure to PM2.5 concentrations greater than the mean value (>10.75 μg/m3), and low PM2.5 is defined as exposure to PM2.5 concentrations less than or equal to the mean value (≤10.75 μg/m3). We also assessed the effects of age, sex, race/ethnicity, history of wheezing, insurance type, tobacco smoke exposure, bacterial etiology, and viral etiology of infection. Of 810 (96.1%) subjects with radiographic community-acquired pneumonia, who resided in the Memphis metropolitan area and had addresses which were successfully geocoded (Supplementary Figure F2), 220 (27.2%) patients were identified to be from high- (n = 126) or low-risk (n = 94) community-acquired pneumonia areas. Community-acquired pneumonia in Memphis metropolitan area had a non-homogenous geospatial pattern. PM2.5 was associated with residence in high-risk areas for community-acquired pneumonia. In addition, children with private insurance and bacterial, as opposed to viral, etiology of infection had a decreased risk of residence in a high-risk area for community-acquired pneumonia. The results from this paper suggest that environmental exposures as well as social risk factors are associated with childhood pneumonia.
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Affiliation(s)
- Tonny J Oyana
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN 38163, USA
| | - Jagila Minso
- Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN 38103, USA
| | - Tamekia L Jones
- Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN 38103, USA.,Children's Foundation Research Institute, Memphis, TN 38105, USA
| | - Jonathan A McCullers
- Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN 38103, USA.,Children's Foundation Research Institute, Memphis, TN 38105, USA.,Le Bonheur Children's Hospital, Memphis, TN 38103, USA
| | - Sandra R Arnold
- Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN 38103, USA.,Children's Foundation Research Institute, Memphis, TN 38105, USA.,Le Bonheur Children's Hospital, Memphis, TN 38103, USA
| | - Stephania A Cormier
- Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN 38103, USA.,Children's Foundation Research Institute, Memphis, TN 38105, USA.,Le Bonheur Children's Hospital, Memphis, TN 38103, USA.,Department of Biological Sciences, Louisiana State University and Pennington Biomedical Research Center, Baton Rouge, LA 70803, USA
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Gwitira I, Karumazondo N, Shekede MD, Sandy C, Siziba N, Chirenda J. Spatial patterns of pulmonary tuberculosis (TB) cases in Zimbabwe from 2015 to 2018. PLoS One 2021; 16:e0249523. [PMID: 33831058 PMCID: PMC8031317 DOI: 10.1371/journal.pone.0249523] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 03/21/2021] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION Accurate mapping of spatial heterogeneity in tuberculosis (TB) cases is critical for achieving high impact control as well as guide resource allocation in most developing countries. The main aim of this study was to explore the spatial patterns of TB occurrence at district level in Zimbabwe from 2015 to 2018 using GIS and spatial statistics as a preamble to identifying areas with elevated risk for prioritisation of control and intervention measures. METHODS In this study Getis-Ord Gi* statistics together with SaTscan were used to characterise TB hotspots and clusters in Zimbabwe at district level from 2015 to 2018. GIS software was used to map and visualise the results of cluster analysis. RESULTS Results show that TB occurrence exhibits spatial heterogeneity across the country. The TB hotspots were detected in the central, western and southern part of the country. These areas are characterised by artisanal mining activities as well as high poverty levels. CONCLUSIONS AND RECOMMENDATIONS Results of this study are useful to guide TB control programs and design effective strategies which are important in achieving the United Nations Sustainable Development goals (UNSDGs).
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Affiliation(s)
- Isaiah Gwitira
- Department of Geography Geospatial Sciences and Earth Observation, Faculty of Science, University of Zimbabwe, Harare, Zimbabwe
| | - Norbert Karumazondo
- Department of Geography Geospatial Sciences and Earth Observation, Faculty of Science, University of Zimbabwe, Harare, Zimbabwe
| | - Munyaradzi Davis Shekede
- Department of Geography Geospatial Sciences and Earth Observation, Faculty of Science, University of Zimbabwe, Harare, Zimbabwe
| | - Charles Sandy
- National TB Control Program, Ministry of Health and Child Care, Harare, Zimbabwe
| | - Nicolas Siziba
- National TB Control Program, Ministry of Health and Child Care, Harare, Zimbabwe
| | - Joconiah Chirenda
- Department of Community Medicine, Faculty of Medicine and Health Sciences, Parirenyatwa Hospital, University of Zimbabwe, Harare, Zimbabwe
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11
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Chen C, Jiang Q, Song Z, Li Y, Wang H, Lu Y, Wang D, Li M, Li T. Influence of temperature and humidity on hand, foot, and mouth disease in Guangzhou, 2013-2017. J Int Med Res 2021; 48:300060520929895. [PMID: 32527174 PMCID: PMC7446274 DOI: 10.1177/0300060520929895] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Objective To explore associations between temperature, humidity and hand, foot and mouth disease (HFMD) incidence in Guangzhou, China from 2013 to 2017. Methods A distributed lag non-linear model was applied to estimate the effects of daily temperature and humidity on HFMD incidence after adjusting for long-term trends, seasonal trends, and day of the week. Results In total, 353,431 confirmed HFMD cases were reported in Guangzhou over the study period. A bimodal seasonal pattern was observed. High temperatures had acute short-term effects on HFMD incidence that declined quickly over time. The effects of low humidity declined over lag periods, but increased when the humidity surpassed 60.5%. Temperature and humidity were both inversely associated with HFMD incidence during lag days 0 to 3 and with lag periods Conclusions Temperature and humidity play important roles in HFMD incidence. These data are important for developing public health strategies.
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Affiliation(s)
- Chun Chen
- Guangzhou Center for Disease Control and Prevention, Guangzhou, Guangdong, China
| | - Qinqin Jiang
- Guangzhou Center for Disease Control and Prevention, Guangzhou, Guangdong, China
| | - Zhuangzhi Song
- Center for Disease Control and Prevention of Inner Mongolia Autonomous Region, Hohhot, Inner Mongolia Autonomous Region, China
| | - Yilan Li
- Guangzhou Center for Disease Control and Prevention, Guangzhou, Guangdong, China
| | - Hui Wang
- Guangzhou Center for Disease Control and Prevention, Guangzhou, Guangdong, China
| | - Ying Lu
- Guangzhou Center for Disease Control and Prevention, Guangzhou, Guangdong, China
| | - Dahu Wang
- Guangzhou Center for Disease Control and Prevention, Guangzhou, Guangdong, China
| | - Meixia Li
- Guangzhou Center for Disease Control and Prevention, Guangzhou, Guangdong, China
| | - Tiegang Li
- Guangzhou Chest Hospital, Guangzhou, Guangdong, China
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12
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He R, Zhu B, Liu J, Zhang N, Zhang WH, Mao Y. Women's cancers in China: a spatio-temporal epidemiology analysis. BMC Womens Health 2021; 21:116. [PMID: 33743648 PMCID: PMC7981806 DOI: 10.1186/s12905-021-01260-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Accepted: 03/10/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Women's cancers, represented by breast and gynecologic cancers, are emerging as a significant threat to women's health, while previous studies paid little attention to the spatial distribution of women's cancers. This study aims to conduct a spatio-temporal epidemiology analysis on breast, cervical and ovarian cancers in China, thus visualizing and comparing their epidemiologic trends and spatio-temporal changing patterns. METHODS Data on the incidence and mortality of women's cancers between January 2010 and December 2015 were obtained from the National Cancer Registry Annual Report. Linear tests and bar charts were used to visualize and compare the epidemiologic trends. Two complementary spatial statistics (Moran's I statistics and Kulldorff's space-time scan statistics) were adopted to identify the spatial-temporal clusters. RESULTS The results showed that the incidence and mortality of breast cancer displayed slow upward trends, while that of cervical cancer increase dramatically, and the mortality of ovarian cancer also showed a fast increasing trend. Significant differences were detected in incidence and mortality of breast, cervical and ovarian cancer across east, central and west China. The average incidence of breast cancer displayed a high-high cluster feature in part of north and east China, and the opposite traits occurred in southwest China. In the meantime, the average incidence and mortality of cervical cancer in central China revealed a high-high cluster feature, and that of ovarian cancer in northern China displayed a high-high cluster feature. Besides, the anomalous clusters were also detected based on the space-time scan statistics. CONCLUSION Regional differences were detected in the distribution of women's cancers in China. An effective response requires a package of coordinated actions that vary across localities regarding the spatio-temporal epidemics and local conditions.
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Affiliation(s)
- Rongxin He
- School of Public Policy and Administration, Xi’an Jiaotong University, 28 Xianning West Road, Beilin District, Xi’an, 710049 China
- International Centre for Reproductive Health (ICRH), Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, C. Heymanslaan 10 UZ, 9000 Ghent, Belgium
- Research Center for the Belt and Road Health Policy and Health Technology Assessment, Xi’an Jiaotong University, 28 Xianning West Road, Xi’an, 710049 China
| | - Bin Zhu
- School of Public Health and Emergency Management, Southern University of Science and Technology, 1088 Xueyuan Avenue, Shenzhen, 518055 China
| | - Jinlin Liu
- School of Public Policy and Administration, Northwestern Polytechnical University, 127 Youyin West Road, Beilin District, Xi’an, 710072 China
| | - Ning Zhang
- School of Public Policy and Administration, Xi’an Jiaotong University, 28 Xianning West Road, Beilin District, Xi’an, 710049 China
- Research Center for the Belt and Road Health Policy and Health Technology Assessment, Xi’an Jiaotong University, 28 Xianning West Road, Xi’an, 710049 China
| | - Wei-Hong Zhang
- International Centre for Reproductive Health (ICRH), Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, C. Heymanslaan 10 UZ, 9000 Ghent, Belgium
| | - Ying Mao
- School of Public Policy and Administration, Xi’an Jiaotong University, 28 Xianning West Road, Beilin District, Xi’an, 710049 China
- Research Center for the Belt and Road Health Policy and Health Technology Assessment, Xi’an Jiaotong University, 28 Xianning West Road, Xi’an, 710049 China
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Ding L, Zhang N, Zhu B, Liu J, Wang X, Liu F, Mao Y. Spatiotemporal characteristics and meteorological determinants of hand, foot and mouth disease in Shaanxi Province, China: a county-level analysis. BMC Public Health 2021; 21:374. [PMID: 33596869 PMCID: PMC7890844 DOI: 10.1186/s12889-021-10385-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 02/03/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Hand, foot and mouth disease (HFMD) is one of the common intestinal infectious diseases worldwide and has caused huge economic and disease burdens in many countries. The average annual incidence rate of HFMD was 11.66% in Shaanxi during the time span from 2009 to 2018. There are distinct differences within Shaanxi, as it is a special region that crosses three temperature zones. Hence, in this study, a spatiotemporal analysis of Shaanxi was performed to reveal the characteristics of the distribution of HFMD and to explore the meteorological determinants of HFMD. METHODS The county-level and municipal data from Shaanxi Province from 2009 to 2018 were applied to research the spatiotemporal characteristics of HFMD and its meteorological determinants. Time series and spatial autocorrelation analyses were applied to assess the spatiotemporal characteristics of HFMD. This study used spatial econometric panel models to explore the relationship between HFMD and meteorological factors based on the data of 107 counties and 10 municipalities. RESULTS The incidence rate of HFMD displayed no variable trend throughout the whole research period. A high incidence rate of HFMD was observed from June to September, corresponding to a time when the climate is characterized by heavy rain, high temperature, and high humidity. The high-incidence areas were mainly located in the central region in Shaanxi, whereas the low-incidence spots were mainly found in Northern Shaanxi. Regarding the meteorological factors analysed in this study, in general, the incidence rate of HFMD in specific regions was positively associated with the rainfall, temperature and humidity. CONCLUSION These results could be applied by the government and the general public to take effective measures to prevent disease. Region-targeted policies could be enacted and implemented in the future according to specific situations in different areas and the relevant meteorological determinants. Additionally, meteorological conditions normally extend to a wide-ranging region; thus, cooperation among surrounding regions is necessary.
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Affiliation(s)
- Li Ding
- School of Humanities and Social Science, Xi’an Jiaotong University, Xi’an, China
- Health Commission of Xi’an, Xi’an, China
| | - Ning Zhang
- School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an, China
- Research Center for the Belt and Road Health Policy and Health Technology Assessment, Xi’an Jiaotong University, Xi’an, China
| | - Bin Zhu
- Research Center for the Belt and Road Health Policy and Health Technology Assessment, Xi’an Jiaotong University, Xi’an, China
- Department of Public Policy, City University of Hong Kong, Hong Kong, China
| | - Jinlin Liu
- Research Center for the Belt and Road Health Policy and Health Technology Assessment, Xi’an Jiaotong University, Xi’an, China
- Water H. Shorenstein Asia-Pacific Research Center, Stanford University, Stanford, CA USA
| | - Xue Wang
- Research Center for the Belt and Road Health Policy and Health Technology Assessment, Xi’an Jiaotong University, Xi’an, China
- The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Feng Liu
- Shaanxi Provincial Centre of Disease Control and Prevention, Xi’an, China
| | - Ying Mao
- School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an, China
- Research Center for the Belt and Road Health Policy and Health Technology Assessment, Xi’an Jiaotong University, Xi’an, China
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Gwitira I, Mukonoweshuro M, Mapako G, Shekede MD, Chirenda J, Mberikunashe J. Spatial and spatio-temporal analysis of malaria cases in Zimbabwe. Infect Dis Poverty 2020; 9:146. [PMID: 33092651 PMCID: PMC7584089 DOI: 10.1186/s40249-020-00764-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 10/14/2020] [Indexed: 01/26/2023] Open
Abstract
Background Although effective treatment for malaria is now available, approximately half of the global population remain at risk of the disease particularly in developing countries. To design effective malaria control strategies there is need to understand the pattern of malaria heterogeneity in an area. Therefore, the main objective of this study was to explore the spatial and spatio-temporal pattern of malaria cases in Zimbabwe based on malaria data aggregated at district level from 2011 to 2016. Methods Geographical information system (GIS) and spatial scan statistic were applied on passive malaria data collected from health facilities and aggregated at district level to detect existence of spatial clusters. The global Moran’s I test was used to infer the presence of spatial autocorrelation while the purely spatial retrospective analyses were performed to detect the spatial clusters of malaria cases with high rates based on the discrete Poisson model. Furthermore, space-time clusters with high rates were detected through the retrospective space-time analysis based on the discrete Poisson model. Results Results showed that there is significant positive spatial autocorrelation in malaria cases in the study area. In addition, malaria exhibits spatial heterogeneity as evidenced by the existence of statistically significant (P < 0.05) spatial and space-time clusters of malaria in specific geographic regions. The detected primary clusters persisted in the eastern region of the study area over the six year study period while the temporal pattern of malaria reflected the seasonality of the disease where clusters were detected within particular months of the year. Conclusions Geographic regions characterised by clusters of high rates were identified as malaria high risk areas. The results of this study could be useful in prioritizing resource allocation in high-risk areas for malaria control and elimination particularly in resource limited settings such as Zimbabwe. The results of this study are also useful to guide further investigation into the possible determinants of persistence of high clusters of malaria cases in particular geographic regions which is useful in reducing malaria burden in such areas.
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Affiliation(s)
- Isaiah Gwitira
- Department of Geography Geospatial Sciences and Earth Observation, University of Zimbabwe, P. O. Box MP 167, Mount Pleasant, Harare, Zimbabwe.
| | - Munashe Mukonoweshuro
- Department of Geography Geospatial Sciences and Earth Observation, University of Zimbabwe, P. O. Box MP 167, Mount Pleasant, Harare, Zimbabwe
| | - Grace Mapako
- Department of Geography Geospatial Sciences and Earth Observation, University of Zimbabwe, P. O. Box MP 167, Mount Pleasant, Harare, Zimbabwe
| | - Munyaradzi D Shekede
- Department of Geography Geospatial Sciences and Earth Observation, University of Zimbabwe, P. O. Box MP 167, Mount Pleasant, Harare, Zimbabwe
| | - Joconiah Chirenda
- Department of Community Medicine, University of Zimbabwe, 3rd Floor New Health Sciences Building, College of Health Sciences, P O Box A178, Avondale, Harare, Zimbabwe
| | - Joseph Mberikunashe
- National Malaria Control Program, Ministry of Health and Child Care, 4th Floor, Kaguvi Building, Central Avenue (Between 4th and 5th Street), Harare, Zimbabwe
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15
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Kou Z, Jia J, Liu X, Luo T, Xin X, Gong J, Zhang J, Sun D, Jiang F, Gao R. Epidemiological characteristics and spatial-temporal clusters of hand, foot, and mouth disease in Qingdao City, China, 2013-2018. PLoS One 2020; 15:e0233914. [PMID: 32502174 PMCID: PMC7274432 DOI: 10.1371/journal.pone.0233914] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 05/14/2020] [Indexed: 12/05/2022] Open
Abstract
Background Hand, foot, and mouth disease (HFMD) has become one of the most important infectious diseases recent years. Qingdao City has suffered from serious HFMD epidemic. This study aimed to describe epidemiological characteristics and investigate spatial-temporal distribution at town level in Qingdao City. Method The surveillance data of HFMD during 2013–2018 were collected from the National Notifiable Disease Surveillance System. The global Moran’s I statistic was used to detect the spatial autocorrelation of HFMD cases by ArcGis 10.0 software. Purely spatial and spatial-temporal analysis was used to detect epidemic clusters by SatScanTM v9.6 software. Results The annual average incidence of HFMD cases in Qingdao City from 2013 to 2018 was 123.16 per 100000, while the incidence rate of children≤5years old was 2879.80 per 100000. The majority (88.97%) of HFMD cases were aged within 0–5 years old and the males were 60.20%. Other enterovirus (EV), enteriovirus 71(EV71), and Coxsackievirus A16 (CA16) accounted for 48.75%, 30.91% and 20.34%. The seasonal peak was between May and October. HFMD had positive spatial autocorrelation at town level with global Moran’s I from 0.19 to 0.31(P<0.001). Spatial-temporal cluster analysis detected six most likely clusters and three secondary clusters from 2013 to 2018. The most likely cluster was located in urban and urban-rural fringe areas. Conclusions Urban and urban-rural fringe areas were the major locations of the clusters with other EV as the dominant pathogen between May and October. The findings suggested that the prevention and control of HFMD in Qingdao City should be focus on these high-risk periods and locations which had important public health significance for the allocation of public health resources.
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Affiliation(s)
- Zengqiang Kou
- Shandong Center for Disease Control and Prevention, Jinan, China
| | - Jing Jia
- Department of Acute Infectious Disease, Qingdao Centre for Disease Control and Prevention, Qingdao Institute of Prevention Medicine, Qingdao, Shandong, China
| | - Xiaohui Liu
- Department of Acute Infectious Disease, Qingdao Centre for Disease Control and Prevention, Qingdao Institute of Prevention Medicine, Qingdao, Shandong, China
| | - Tingting Luo
- Department of Public Health, Qingdao University Medical College, Qingdao, Shandong, China
| | - Xueling Xin
- Department of Acute Infectious Disease, Qingdao Centre for Disease Control and Prevention, Qingdao Institute of Prevention Medicine, Qingdao, Shandong, China
| | - Jinling Gong
- Department of Acute Infectious Disease, Qingdao Centre for Disease Control and Prevention, Qingdao Institute of Prevention Medicine, Qingdao, Shandong, China
| | - Jingfei Zhang
- Department of Acute Infectious Disease, Qingdao Centre for Disease Control and Prevention, Qingdao Institute of Prevention Medicine, Qingdao, Shandong, China
| | - Dapeng Sun
- Shandong Center for Disease Control and Prevention, Jinan, China
- * E-mail: (DS); (FJ); (RG)
| | - Fachun Jiang
- Department of Acute Infectious Disease, Qingdao Centre for Disease Control and Prevention, Qingdao Institute of Prevention Medicine, Qingdao, Shandong, China
- * E-mail: (DS); (FJ); (RG)
| | - Ruqin Gao
- Department of Acute Infectious Disease, Qingdao Centre for Disease Control and Prevention, Qingdao Institute of Prevention Medicine, Qingdao, Shandong, China
- * E-mail: (DS); (FJ); (RG)
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Mao Y, He R, Zhu B, Liu J, Zhang N. Notifiable Respiratory Infectious Diseases in China: A Spatial-Temporal Epidemiology Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E2301. [PMID: 32235375 PMCID: PMC7177391 DOI: 10.3390/ijerph17072301] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Revised: 03/25/2020] [Accepted: 03/26/2020] [Indexed: 12/21/2022]
Abstract
Nowadays, tuberculosis, scarlet fever, measles, influenza, and mumps are five major notifiable respiratory infectious diseases (RIDs) in China. The objective of this study was to describe, visualize, and compare the spatial-temporal distributions of these five RIDs from 2006 to 2016. In addition to descriptive epidemiology analysis, seasonality and spatial autocorrelation analysis were also applied to explore the epidemiologic trends and spatial changing patterns of the five RIDs, respectively. The results indicated that the incidence of tuberculosis, measles, and mumps presented a downtrend trend, while those of scarlet fever and influenza was in a strong uptrend across the research period. The incidences of the five diseases all peaked in spring. There were significant spatial disparities in the distribution of tuberculosis, scarlet fever, and measles cases, with the hotspots mainly located in the western plateau region, northern plain region, and southern mountainous region. To conclude, notable epidemiological differences were observed across regions, indicating that some provincial units should pay more attention to prevent and control respiratory infectious diseases.
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Affiliation(s)
- Ying Mao
- School of Public Policy and Administration, Xi’an Jiaotong University, 28 Xianning West Road, Xi’an 710049, China; (R.H.); (B.Z.); (J.L.); (N.Z.)
- Research Center for the Belt and Road Health Policy and Health Technology Assessment, Xi’an Jiaotong University, 28 Xianning West Road, Xi’an 710049, China
| | - Rongxin He
- School of Public Policy and Administration, Xi’an Jiaotong University, 28 Xianning West Road, Xi’an 710049, China; (R.H.); (B.Z.); (J.L.); (N.Z.)
- Research Center for the Belt and Road Health Policy and Health Technology Assessment, Xi’an Jiaotong University, 28 Xianning West Road, Xi’an 710049, China
| | - Bin Zhu
- School of Public Policy and Administration, Xi’an Jiaotong University, 28 Xianning West Road, Xi’an 710049, China; (R.H.); (B.Z.); (J.L.); (N.Z.)
- Research Center for the Belt and Road Health Policy and Health Technology Assessment, Xi’an Jiaotong University, 28 Xianning West Road, Xi’an 710049, China
- Department of Public Policy, City University of Hong Kong, Hong Kong 999077, China
| | - Jinlin Liu
- School of Public Policy and Administration, Xi’an Jiaotong University, 28 Xianning West Road, Xi’an 710049, China; (R.H.); (B.Z.); (J.L.); (N.Z.)
- Research Center for the Belt and Road Health Policy and Health Technology Assessment, Xi’an Jiaotong University, 28 Xianning West Road, Xi’an 710049, China
- Walter H. Shorenstein Asia-Pacific Research Center, Stanford University, Stanford, CA 94305, USA
| | - Ning Zhang
- School of Public Policy and Administration, Xi’an Jiaotong University, 28 Xianning West Road, Xi’an 710049, China; (R.H.); (B.Z.); (J.L.); (N.Z.)
- Research Center for the Belt and Road Health Policy and Health Technology Assessment, Xi’an Jiaotong University, 28 Xianning West Road, Xi’an 710049, China
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Chen J, Wang J, Wang M, Liang R, Lu Y, Zhang Q, Chen Q, Niu B. Retrospect and Risk Analysis of Foot-and-Mouth Disease in China Based on Integrated Surveillance and Spatial Analysis Tools. Front Vet Sci 2020; 6:511. [PMID: 32039251 PMCID: PMC6986238 DOI: 10.3389/fvets.2019.00511] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 12/23/2019] [Indexed: 12/24/2022] Open
Abstract
Foot-and-mouth disease (FMD) is a highly contagious disease of livestock and seriously affects the development of animal husbandry. It is necessary to defend the spread of FMD. To explore the distribution characteristics and transmission of FMD between 2010 and 2017 in China, Global Moran's I test and Getis-Ord Gi index were used to analyze the spatial cluster. A space-time permutation scan statistic was applied to analyze the spatio-temporal pattern. GIS-based method was employed to create a map representing the distribution pattern, directional trend, and hotspots for each outbreak. The number of cases was defined as the number of animals with FMD for the above analysis. We also constructed a phylogenetic tree to compare the homology and variation of FMD virus (FMDV) to provide a clue for the potential development of an effective vaccine. The results indicated that the FMD outbreaks in China had obvious time patterns and clusters in space and space-time, with the outbreaks concentrated in the first half of each year. The outbreaks of FMD decreased each year from 2010 with an obvious downward trend of hotspots. Spatial analysis revealed that the distribution of FMD outbreaks in 2010, 2015, and 2017 exhibited a clustered pattern. Space-time scanning revealed that the spatio-temporal clusters were centered in Guangdong, Tibet and the junction of Wuhan, Jiangxi, Anhui. Comparison of the spatial analysis and space-time analysis of FMD outbreaks revealed that Guangdong was the same cluster of the two in 2010. In addition, the directional trend analysis indicated that the FMD transmission was oriented northwest-southeast. The findings demonstrated that FMDV in China can be divided into three pedigrees and the homology of these strains is very high while comparing the first FMDV strain with the others. The data provide a basis for the effective monitoring and prevention of FMD, and for the development of an FMD vaccine in China.
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Affiliation(s)
- Jiahui Chen
- Shanghai Key Laboratory of Bio-Energy Crops, School of Life Sciences, Shanghai University, Shanghai, China
| | - Jianying Wang
- Shanghai Key Laboratory of Bio-Energy Crops, School of Life Sciences, Shanghai University, Shanghai, China
| | - Minjia Wang
- Shanghai Key Laboratory of Bio-Energy Crops, School of Life Sciences, Shanghai University, Shanghai, China
| | - Ruirui Liang
- Shanghai Key Laboratory of Bio-Energy Crops, School of Life Sciences, Shanghai University, Shanghai, China
| | - Yi Lu
- Shanghai Key Laboratory of Bio-Energy Crops, School of Life Sciences, Shanghai University, Shanghai, China
| | - Qiang Zhang
- Tech Ctr Anim Plant & Food Inspect & Quarantine, Shanghai Customs, Shanghai, China
| | - Qin Chen
- Shanghai Key Laboratory of Bio-Energy Crops, School of Life Sciences, Shanghai University, Shanghai, China
| | - Bing Niu
- Shanghai Key Laboratory of Bio-Energy Crops, School of Life Sciences, Shanghai University, Shanghai, China
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Ng TC, Wen TH. Spatially Adjusted Time-varying Reproductive Numbers: Understanding the Geographical Expansion of Urban Dengue Outbreaks. Sci Rep 2019; 9:19172. [PMID: 31844099 PMCID: PMC6914775 DOI: 10.1038/s41598-019-55574-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 11/26/2019] [Indexed: 12/25/2022] Open
Abstract
The basic reproductive number (R0) is a fundamental measure used to quantify the transmission potential of an epidemic in public health practice. However, R0 cannot reflect the time-varying nature of an epidemic. A time-varying effective reproductive number Rt can provide more information because it tracks the subsequent evolution of transmission. However, since it neglects individual-level geographical variations in exposure risk, Rt may smooth out interpersonal heterogeneous transmission potential, obscure high-risk spreaders, and hence hamper the effectiveness of control measures in spatial dimension. Therefore, this study proposes a new method for quantifying spatially adjusted (time-varying) reproductive numbers that reflects spatial heterogeneity in transmission potential among individuals. This new method estimates individual-level effective reproductive numbers (Rj) and a summarized indicator for population-level time-varying reproductive number (Rt). Data from the five most severe dengue outbreaks in southern Taiwan from 1998-2015 were used to demonstrate the ability of the method to highlight early spreaders contributing to the geographic expansion of dengue transmission. Our results show spatial heterogeneity in the transmission potential of dengue among individuals and identify the spreaders with the highest Rj during the epidemic period. The results also reveal that super-spreaders are usually early spreaders that locate at the edges of the epidemic foci, which means that these cases could be the drivers of the expansion of the outbreak. Therefore, our proposed method depicts a more detailed spatial-temporal dengue transmission process and identifies the significant role of the edges of the epidemic foci, which could be weak spots in disease control and prevention.
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Affiliation(s)
- Ta-Chou Ng
- Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, 100, Taiwan
| | - Tzai-Hung Wen
- Department of Geography, National Taiwan University, Taipei City, 106, Taiwan.
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Liu H, Song G, He N, Zhai S, Song H, Kong Y, Liang L, Liu X. Spatial-temporal variation and risk factor analysis of hand, foot, and mouth disease in children under 5 years old in Guangxi, China. BMC Public Health 2019; 19:1491. [PMID: 31703735 PMCID: PMC6842152 DOI: 10.1186/s12889-019-7619-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Accepted: 09/13/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Hand, foot and mouth disease (HFMD) incidence is a critical challenge to disease control and prevention in parts of China, particularly Guangxi. However, the association between socioeconomic factors and meteorological factors on HFMD is still unclear. METHODS This study applied global and local Moran's I to examine the spatial pattern of HFMD and series analysis to explore the temporal pattern. The effects of meteorological factors and socioeconomic factors on HFMD incidence in Guangxi, China were analyzed using GeoDetector Model. RESULTS This study collected 45,522 cases from 87 counties in Guangxi during 2015, among which 43,711 cases were children aged 0-4 years. Temporally, there were two HFMD risk peaks in 2015. One peak was in September with 7890 cases. The other appeared in May with 4687 cases of HFMD. A high-risk cluster was located in the valley areas. The tertiary industry, precipitation and second industry had more influence than other risk factors on HFMD incidence with explanatory powers of 0.24, 0.23 and 0.21, respectively. The interactive effect of any two risk factors would enhance the risk of HFMD. CONCLUSIONS This study suggests that precipitation and tertiary industry factors might have stronger effects on the HFMD incidence in Guangxi, China, compared with other factors. High-risk of HFMD was identified in the valley areas characterized by high temperature and humidity. Local government should pay more attention and strengthen public health services level in this area.
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Affiliation(s)
- Huan Liu
- Laboratory of Geospatial Technology for the Middle and Lower Yellow River Regions, Ministry of Education, Henan University, Kaifeng, 475004 Henan China
| | - Genxin Song
- Laboratory of Geospatial Technology for the Middle and Lower Yellow River Regions, Ministry of Education, Henan University, Kaifeng, 475004 Henan China
| | - Nan He
- Laboratory of Geospatial Technology for the Middle and Lower Yellow River Regions, Ministry of Education, Henan University, Kaifeng, 475004 Henan China
| | - Shiyan Zhai
- Laboratory of Geospatial Technology for the Middle and Lower Yellow River Regions, Ministry of Education, Henan University, Kaifeng, 475004 Henan China
- Institute of Urban Big Data, College of Environment and Planning, Henan University, Kaifeng, 475004 Henan China
| | - Hongquan Song
- Laboratory of Geospatial Technology for the Middle and Lower Yellow River Regions, Ministry of Education, Henan University, Kaifeng, 475004 Henan China
- Institute of Urban Big Data, College of Environment and Planning, Henan University, Kaifeng, 475004 Henan China
| | - Yunfeng Kong
- Laboratory of Geospatial Technology for the Middle and Lower Yellow River Regions, Ministry of Education, Henan University, Kaifeng, 475004 Henan China
- Institute of Urban Big Data, College of Environment and Planning, Henan University, Kaifeng, 475004 Henan China
| | - Lizhong Liang
- The Affiliated Hospital of Guangdong Medical University, Zhanjiang, 524001 China
| | - Xiaoxiao Liu
- Department of Community Health Science, Cumming School of Medicine, University of Calgary, Calgary, Canada
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Liu J, Xiang X, Pu Z, Long Y, Xiao D, Zhang W, Li Q, Li X, Li S, Shao Z, Yang X, Xiong Y. Epidemic pattern of hand-foot-and-mouth disease in Xi'an, China from 2008 through 2015. BMC Infect Dis 2019; 19:19. [PMID: 30616531 PMCID: PMC6322279 DOI: 10.1186/s12879-018-3624-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Accepted: 12/17/2018] [Indexed: 11/21/2022] Open
Abstract
Background Hand, foot and mouth disease (HFMD) is an infectious disease caused by enteroviruses that has a severely impair for those high incidence countries such as China.The current study aimed to investigate the epidemic pattern of HFMD by time and region in Northwestern China. Methods All reported HFMD cases from 2008 to 2015 were collected from local Disease Control and Prevention.The HFMD was diagnosed in accordance with the guidebook provided by the National Health and Family Planning Commission of the People’s Republic of China. Results A total of 154,869 cases of probable HFMD were reported. The overall incidence of HFMD has been increased from 91.68 per 100/000 in 2008 to 335.64 per 100/000 in 2015.The case mortality is decreased from 0.014 per100/000 to 0.011 per 100/000 during the time period. Most HFMD (93.82%) occurred in children younger than 5 years. The seasonal peak of HFMD infections occurred in April–July and September–November and Central regions of Xi’an city were the major locations of the clusters (incidence rate 245.75/100,000; relative risk 1.19, P < 0.01). EVA71 was the predominant enterovirus serotype, accounting for 50.0% of all reported HFMD cases since 2011.The most susceptible group infected by HFMD was children younger than 5 years, especially boys. Conclusions Incidence of HFMD has been increasing in the past few years, however, the case fatality is decreasing. Season and region shall be considered as influence factors in the prevention of HFMD.
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Affiliation(s)
- JiFeng Liu
- Institute of Endemic Diseases of School of Public Health, Health Science Center, Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, Xi'an Jiaotong University, No.76, YanTa West RD, Xi'an, 710061, Shaanxi, China
| | - XiaoMei Xiang
- Xi'an Center for Maternal and Child Care Service, Fourth Military Medical University, No.73, Xi'an West Street, Xi'an, 710002, Shaanxi, China
| | - ZhongShu Pu
- Department of Epidemiology, School of Public Health, Fourth Military Medical University, No. 17, Changle West RD, Xi'an, 710032, Shaanxi, China
| | - Yong Long
- Xi'an Center for Maternal and Child Care Service, Fourth Military Medical University, No.73, Xi'an West Street, Xi'an, 710002, Shaanxi, China
| | - Dan Xiao
- Xi'an Center for Maternal and Child Care Service, Fourth Military Medical University, No.73, Xi'an West Street, Xi'an, 710002, Shaanxi, China
| | - WeiLu Zhang
- Xi'an Center for Maternal and Child Care Service, Fourth Military Medical University, No.73, Xi'an West Street, Xi'an, 710002, Shaanxi, China
| | - Qian Li
- Center of Disease Control and Prevention of Xi'an, Shaanxi Province, China; No,599 Xiying Rd, Xi'an 710054, Xi'an, 710061, Shaanxi, China
| | - XiTong Li
- Center of Disease Control and Prevention of Xi'an, Shaanxi Province, China; No,599 Xiying Rd, Xi'an 710054, Xi'an, 710061, Shaanxi, China
| | - SiYao Li
- Center of Disease Control and Prevention of Xi'an, Shaanxi Province, China; No,599 Xiying Rd, Xi'an 710054, Xi'an, 710061, Shaanxi, China
| | - ZhongJun Shao
- Xi'an Center for Maternal and Child Care Service, Fourth Military Medical University, No.73, Xi'an West Street, Xi'an, 710002, Shaanxi, China
| | - XiaoLi Yang
- Institute of Endemic Diseases of School of Public Health, Health Science Center, Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, Xi'an Jiaotong University, No.76, YanTa West RD, Xi'an, 710061, Shaanxi, China
| | - YongMin Xiong
- Institute of Endemic Diseases of School of Public Health, Health Science Center, Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, Xi'an Jiaotong University, No.76, YanTa West RD, Xi'an, 710061, Shaanxi, China.
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Xu L, Shi Y, Rainey JJ, Zhang Z, Zhang H, Zhao J, Li Y, Rao H, Li Y, Liao Q, Ma Y. Epidemiological features and spatial clusters of hand, foot, and mouth disease in Qinghai Province, China, 2009-2015. BMC Infect Dis 2018; 18:624. [PMID: 30518329 PMCID: PMC6280489 DOI: 10.1186/s12879-018-3509-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Accepted: 11/08/2018] [Indexed: 01/26/2023] Open
Abstract
Background Hand, Foot, and Mouth Disease (HFMD) is most frequently caused by Enterovirus71 (EV-A71) or Coxsackie virus A16 (CV-A16), infants and young children are at greatest risk. Describing the epidemiology of HFMD can help develop and better target interventions, including the use of pediatric EV-A71 vaccination. Methods We obtained data from the national surveillance system for HFMD cases with onset dates from 2009 to 2015. We defined probable cases as patient with skin papular or vesicular rashes on the hands, feet, mouth, or buttocks and confirmed cases as patients with the above symptoms along with laboratory-based enterovirus detection. We generated overall and age-specific annual incidence rates and described the temporal variability and seasonality of HFMD in Qinghai Province. We identified spatial clustering of HFMD incidence at the county level using the Local Indicator of Spatial Associationand an alpha level of 0.05. Results During the study period, 14,480 HFMD probable or confirmed cases were reported in Qinghai Province. Of the 2158 (14.9%) with laboratory confirmation, 924 (42.6%) were caused by CV-A16 and 830 (38.2%) were caused by EV-A71. The majority (89%) of all case-patients were ≤ 5 years of age and male (61.5%). The overall mean annual HFMD incidence rate was 36.4 cases per 100,000 populations, while the incidence rate for children ≤5 years of age was 379.5 cases per 100,000. Case reports peaked during the months of May through July. HFMD was predominantly caused by EV-A71, except in 2010 and 2014 when CV-A16 was the predominant causative agent. High incidence rates of HFMD were clustered (Moran’s I = 0.59, P < 0.05) in the eastern region of the province. Conclusion HFMD remains an important cause of childhood disease in Qinghai Province, occurring in an acyclical pattern of increased incidence, primarily due to CV-A16 circulation every three years. Incidence is also seasonal and tends to spatially cluster in the eastern region of the province. Since approximately 40% of confirmed HFMD cases were due to EV-A71, EV-A71 vaccination is likely to have a positive impact on the HFMD disease burden. Routine analysis of local surveillance data is crucial for describing disease occurrence and changes in etiology. Electronic supplementary material The online version of this article (10.1186/s12879-018-3509-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Lili Xu
- Institute for Infectious Disease Control and Prevention, Qinghai Provincial Center for Disease Control and Prevention, Xining, Qinghai, China
| | - Yan Shi
- Institute for Infectious Disease Control and Prevention, Qinghai Provincial Center for Disease Control and Prevention, Xining, Qinghai, China
| | - Jeanette J Rainey
- International Emerging Infections Program, Division of Global Health Protection, United States Centers for Disease Control and Prevention, Beijing, China.,Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, USA
| | - Zhijie Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Fudan University, Shanghai, China
| | - Huayi Zhang
- Institute for Infectious Disease Control and Prevention, Qinghai Provincial Center for Disease Control and Prevention, Xining, Qinghai, China
| | - Jinhua Zhao
- Institute for Infectious Disease Control and Prevention, Qinghai Provincial Center for Disease Control and Prevention, Xining, Qinghai, China
| | - Yonghong Li
- Institute for Infectious Disease Control and Prevention, Qinghai Provincial Center for Disease Control and Prevention, Xining, Qinghai, China
| | - Huaxiang Rao
- Institute for Infectious Disease Control and Prevention, Qinghai Provincial Center for Disease Control and Prevention, Xining, Qinghai, China
| | - Yanming Li
- Institute for Infectious Disease Control and Prevention, Qinghai Provincial Center for Disease Control and Prevention, Xining, Qinghai, China
| | - Qiaohong Liao
- Department of Epidemiology and Biostatistics, School of Public Health, Fudan University, Shanghai, China. .,Division of Infectious Disease, Key Laboratory of Surveillance and Early Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China.
| | - Yongcheng Ma
- Institute for Infectious Disease Control and Prevention, Qinghai Provincial Center for Disease Control and Prevention, Xining, Qinghai, China.
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Gwitira I, Murwira A, Mberikunashe J, Masocha M. Spatial overlaps in the distribution of HIV/AIDS and malaria in Zimbabwe. BMC Infect Dis 2018; 18:598. [PMID: 30482166 PMCID: PMC6260695 DOI: 10.1186/s12879-018-3513-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 11/09/2018] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND In most developing economies particularly in Africa, more people are likely to die of HIV/AIDS and malaria compared to other diseases. HIV/AIDS tends to be superimposed on the long standing malaria burden particularly in sub-Saharan Africa. The detection and understanding of spatial overlaps in disease occurrence is important for integrated and targeted disease control. Integrated disease control can enhance efficiency and cost-effectiveness through the development of drugs targeting multiple infections in the same geographic space. METHODS Using Zimbabwe as a case study, this study tests the hypothesis that malaria clusters coincide with HIV/AIDS clusters in space. Case data for the two diseases were obtained from the Ministry of Health and Child Care in Zimbabwe at district level via the District Health Information System (DHIS). Kulldorff's spatial scan statistic was used to test for spatial overlaps in clusters of high cases of HIV/AIDS and malaria at district level. The spatial scan test was used to identify areas with higher cases of HIV/AIDS and malaria than would be expected under spatial randomness. RESULTS Results of this study indicate that primary clusters of HIV/AIDS and malaria were not spatially coincident in Zimbabwe. While no spatial overlaps were detected between primary clusters of the two diseases, spatial overlaps were detected among statistically significant secondary clusters of HIV/AIDS and malaria. Spatial overlaps between HIV/AIDS and malaria occurred in five districts in the northern and eastern regions of Zimbabwe. In addition, findings of this study indicate that HIV/AIDS is more widespread in Zimbabwe compared to malaria. CONCLUSIONS The results of this study may therefore be used as a basis for spatially-targeted control of HIV/AIDS and malaria particularly in high disease burden areas. This is important as previous interventions have targeted the two diseases separately. Thus, targeted control could assist in resource allocation through prioritising areas in greatest need hence maximising the impact of disease control.
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Affiliation(s)
- Isaiah Gwitira
- Department of Geography and Environmental Science, University of Zimbabwe, P. O. Box MP 167, Mount Pleasant, Harare, Zimbabwe
| | - Amon Murwira
- Department of Geography and Environmental Science, University of Zimbabwe, P. O. Box MP 167, Mount Pleasant, Harare, Zimbabwe
| | - Joseph Mberikunashe
- Ministry of Health and Child Care, 4th Floor, Kaguvi Building, Central Avenue (between 4th and 5th Street), Harare, Zimbabwe
| | - Mhosisi Masocha
- Department of Geography and Environmental Science, University of Zimbabwe, P. O. Box MP 167, Mount Pleasant, Harare, Zimbabwe
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Genetic characteristics of the P1 coding region of Coxsackievirus A16 associated with hand, foot, and mouth disease in China. Mol Biol Rep 2018; 45:1947-1955. [PMID: 30182173 DOI: 10.1007/s11033-018-4345-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 08/29/2018] [Indexed: 01/04/2023]
Abstract
Coxsackievirus A16 (CVA16) is one of the major etiological agents of hand, foot, and mouth disease (HFMD) in young children. To investigate the genetic characteristics of the P1 coding region gene of CVA16 associated with HFMD in China, we included the sequences of CVA16 specimens obtained from outbreak investigations and sporadic HFMD cases between 1998 and 2014 in China from GenBank, we genotyped the CVA16 sequences and analyzed P1 coding region sequences that encode structural proteins with bioinformatics software. CVA16 was classified into genotypes A and B1 based on the VP1 gene; the B1b and B1a subgenotypes were the major CVA16 strains and predominated in the coastal areas of China. Four strains were found to show inter- and intra-typic recombination in the P1 region. The amino acid identities of VP1, VP2, VP3, and VP4 proteins in all Chinese CVA16 strains were 88.2-100%, 83.0-100%, 87.6-100%, and 72.4-100%, respectively. A total of 251 amino acid substitution sites were detected in the structural proteins encoded by the P1 coding region gene. The amino acid sequences of the P1 coding region in Chinese CVA16 strains were highly conserved, although some amino acid mutations occurred with high frequency: VP1-T11A (10%), N14S (14%), L23M/V (11%), T98M (16%), V107A (14%), N102D (6.1%), E145V (8.8%), N218D (10%), E241K (22%), T248A/I (6.8%); VP2-I217V (22%), T226A (38%); VP3-N141S/G (5.4%), and N240D (15%). The genetic characteristics of CVA16 in the P1 coding region gene may provide a basis for developing a CVA16 vaccine and preventing and controlling HFMD in China.
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Hossain Khan MA, Anwar KS, Muraduzzaman AKM, Hossain Mollah MA, Akhter-ul-Alam SM, Munisul Islam K, Hoque SA, Nazrul Islam M, Ali MA. Emerging Hand Foot Mouth Disease in Bangladeshi Children- First Report of Rapid Appraisal on Pocket Outbreak: Clinico-epidemiological Perspective Implicating Public Health Emergency. F1000Res 2018; 7:1156. [PMID: 31372207 PMCID: PMC6662677 DOI: 10.12688/f1000research.15170.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/12/2018] [Indexed: 10/14/2023] Open
Abstract
Background: Hand, foot and mouth disease (HFMD) is a common contagious disease among children under 5 years, particularly in the Asia-Pacific-region. We report a localized outbreak of childhood HFMD for the first time from Bangladesh, diagnosed only based on clinical features due to gross lack of in laboratory-diagnostic facilities. Methods: Following the World Health Organization's case-definition, we conducted a rapid-appraisal of HFMD among 143 children attending Pabna Medical College and General Hospital with fever, mouth ulcers and rash. Data were collected between September and November 2017 using a preset syndromic approach and stringent differential diagnostic-protocols. Results: The mean age of children was 2.9±2.3 years. Age did not differ with sex (P=0.98), first sibling being more likely to (62%) belong to middle-income families. Younger children (<5 years) were more likely to suffer with moderate-to-high (38.5°C) fever (P<0.04), painful oral ulcers (P<0.03) and painful/itchy rash (P<0.01). Sex did not differ with other symptoms, but boys had less painful oral ulcers than girls (P<0.04). Fever (63%) and chicken-pox-like-rash (62%) was observed more in mid-October to mid-November than September to mid-October (P<0.01 and P<0.03, respectively). No differences in symptoms (fever, oral ulcers and extremity rash) were observed with precipitation, nor with ambient temperature. Children <5 years (85%) had quicker recovery (within 5 days) than those ≥5 years (69%), (P<0.04), with marginal differences in sex (P<0.05). Conclusions: Our findings highlight the potential usefulness in diagnosing HFMD based on clinical parameters, although stringent differential diagnosis remains indispensable. It is particularly applicable for resource-constrained countries who lack appropriate virology laboratory equipment. Since no specific treatment or effective vaccination is available for this disease, supportive therapy and preventive measures remain the primary methods to circumvent transmission augmented by climate-related factors. Standardized virology laboratory warrants appropriate diagnosis and globally representative multivalent vaccine is deemed essential towards preventing HFMD.
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Affiliation(s)
- Md. Azraf Hossain Khan
- Department of Dermatology and Venereology, Pabna Medical College and General Hospital, Pabna, 6600, Bangladesh
| | - Kazi Selim Anwar
- US-CDC’s GHSA Project, Institute of Epidemiology, Disease Control and Research (IEDCR), Dhaka, 1212, Bangladesh
| | - A. K. M. Muraduzzaman
- Department of Virology, Institute of Epidemiology, Disease Control and Research (IEDCR), Dhaka, 1212, Bangladesh
| | - Md. Abid Hossain Mollah
- Department of Pediatrics, Ibrahim Medical College & Hospital, Institute of Research & Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM), Dhaka, 1200, Bangladesh
| | - S. M. Akhter-ul-Alam
- Department of Dermatology and Venereology, Pabna Medical College and General Hospital, Pabna, 6600, Bangladesh
| | - Kazi Munisul Islam
- Infectious Disease Division, International Center for Diarrheal Diseases Research, Bangladesh (icddr,b), Dhaka, 1212, Bangladesh
| | - Sheikh Ariful Hoque
- Tissue Culture Laboratory, Centre for Advanced Research in Sciences (CARS), University of Dhaka, Dhaka, 1000, Bangladesh
| | - Md. Nazrul Islam
- Department of Dermatology and Venereology, Pabna Medical College and General Hospital, Pabna, 6600, Bangladesh
| | - Md. Ahasan Ali
- Microbiology Section, Institute of Public Health (IPH), Mohakhali, Dhaka, 1212, Bangladesh
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Hossain Khan MA, Anwar KS, Muraduzzaman AKM, Hossain Mollah MA, Akhter-ul-Alam SM, Munisul Islam K, Hoque SA, Nazrul Islam M, Ali MA. Emerging Hand Foot Mouth Disease in Bangladeshi Children- First Report of Rapid Appraisal on Pocket Outbreak: Clinico-epidemiological Perspective Implicating Public Health Emergency. F1000Res 2018; 7:1156. [PMID: 31372207 PMCID: PMC6662677 DOI: 10.12688/f1000research.15170.3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/14/2019] [Indexed: 11/20/2022] Open
Abstract
Background: Hand, foot and mouth disease (HFMD) is a common contagious disease among children under 5 years, particularly in the Asia-Pacific-region. We report a localized outbreak of childhood HFMD for the first time from Bangladesh, diagnosed only based on clinical features due to lack in laboratory-diagnostic facilities. Methods: Following the World Health Organization's case-definition, we conducted a rapid-appraisal of HFMD among all of the 143 children attending Pabna Medical College and General Hospital with fever, mouth ulcers and extremity rash. Data were collected between September and November 2017 using a preset syndromic approach and stringent differential diagnostic-protocols. Results: The mean age of children was 2.9±2.3 years. There was a significant difference among the age and sex of children (P=0.98), first sibling being more belonging to middle-income families (62%). Younger children (<5 years) were more likely to suffer with moderate-to-high (38.5°C) fever (P<0.04), painful oral ulcers (P<0.03) and painful/itchy rash (P<0.01). Sex did not differ with other symptoms, but boys had less painful oral ulcers than girls (P<0.04). Fever (63%) and chicken-pox-like-rash (62%) was observed more in mid-October to mid-November than September to mid-October (P<0.01 and P<0.03, respectively). No differences in symptoms (fever, oral ulcers and extremity rash) were observed with precipitation, nor with ambient temperature. Children <5 years (85%) had quicker recovery (within 5 days) than those ≥5 years (69%), (P<0.04), with marginal differences in sex (P<0.05). Conclusions: Our findings highlight potential usefulness in diagnosing HFMD based on clinical parameters, although stringent differential diagnosis remains indispensable, which is particularly applicable for resource-constrained countries lacking appropriate virology/essential laboratories. Since no specific treatment or effective vaccination is available for HFMD, supportive therapy and preventive measures remain the primary methods to circumvent disease-transmission augmented by climate-related factors. Standardized virology laboratory warrants appropriate diagnosis and globally representative multivalent-vaccine deem essential towards preventing HFMD.
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Affiliation(s)
- Md. Azraf Hossain Khan
- Department of Dermatology and Venereology, Pabna Medical College and General Hospital, Pabna, 6600, Bangladesh
| | - Kazi Selim Anwar
- US-CDC’s GHSA Project, Institute of Epidemiology, Disease Control and Research (IEDCR), Dhaka, 1212, Bangladesh
| | - A. K. M. Muraduzzaman
- Department of Virology, Institute of Epidemiology, Disease Control and Research (IEDCR), Dhaka, 1212, Bangladesh
| | - Md. Abid Hossain Mollah
- Department of Pediatrics, Ibrahim Medical College & Hospital, Institute of Research & Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM), Dhaka, 1200, Bangladesh
| | - S. M. Akhter-ul-Alam
- Department of Dermatology and Venereology, Pabna Medical College and General Hospital, Pabna, 6600, Bangladesh
| | - Kazi Munisul Islam
- Infectious Disease Division, International Center for Diarrheal Diseases Research, Bangladesh (icddr,b), Dhaka, 1212, Bangladesh
| | - Sheikh Ariful Hoque
- Tissue Culture Laboratory, Centre for Advanced Research in Sciences (CARS), University of Dhaka, Dhaka, 1000, Bangladesh
| | - Md. Nazrul Islam
- Department of Dermatology and Venereology, Pabna Medical College and General Hospital, Pabna, 6600, Bangladesh
| | - Md. Ahasan Ali
- Microbiology Section, Institute of Public Health (IPH), Mohakhali, Dhaka, 1212, Bangladesh
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Hossain Khan MA, Anwar KS, Muraduzzaman AKM, Hossain Mollah MA, Akhter-ul-Alam SM, Munisul Islam K, Hoque SA, Nazrul Islam M, Ali MA. Emerging Hand Foot Mouth Disease in Bangladeshi Children- First Report of Rapid Appraisal on Pocket Outbreak: Clinico-epidemiological Perspective Implicating Public Health Emergency. F1000Res 2018; 7:1156. [PMID: 31372207 PMCID: PMC6662677 DOI: 10.12688/f1000research.15170.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/19/2018] [Indexed: 10/14/2023] Open
Abstract
Background: Hand, foot and mouth disease (HFMD) is a common contagious disease among children under 5 years, particularly in the Asia-Pacific-region. We report a localized outbreak of childhood HFMD for the first time from Bangladesh, diagnosed only based on clinical features due to gross lack in laboratory-diagnostic facilities. Methods: Following the World Health Organization's case-definition, we conducted a rapid-appraisal of HFMD among all of the 143 children attending Pabna Medical College and General Hospital with fever, mouth ulcers and extremity rash. Data were collected between September and November 2017 using a preset syndromic approach and stringent differential diagnostic-protocols. Results: The mean age of children was 2.9±2.3 years. Age did not differ with sex (P=0.98), first sibling being more belonging to middle-income families (62%). Younger children (<5 years) were more likely to suffer with moderate-to-high (38.5°C) fever (P<0.04), painful oral ulcers (P<0.03) and painful/itchy rash (P<0.01). Sex did not differ with other symptoms, but boys had less painful oral ulcers than girls (P<0.04). Fever (63%) and chicken-pox-like-rash (62%) was observed more in mid-October to mid-November than September to mid-October (P<0.01 and P<0.03, respectively). No differences in symptoms (fever, oral ulcers and extremity rash) were observed with precipitation, nor with ambient temperature. Children <5 years (85%) had quicker recovery (within 5 days) than those ≥5 years (69%), (P<0.04), with marginal differences in sex (P<0.05). Conclusions: Our findings highlight the potential usefulness in diagnosing HFMD based on clinical parameters, although stringent differential diagnosis remains indispensable. It is particularly applicable for resource-constrained countries who lack appropriate virology/essential laboratory equipment. Since no specific treatment or effective vaccination is available for this disease, supportive therapy and preventive measures remain the primary methods to circumvent transmission augmented by climate-related factors. Standardized virology laboratory warrants appropriate diagnosis and globally representative multivalent vaccine is deemed essential towards preventing HFMD.
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Affiliation(s)
- Md. Azraf Hossain Khan
- Department of Dermatology and Venereology, Pabna Medical College and General Hospital, Pabna, 6600, Bangladesh
| | - Kazi Selim Anwar
- US-CDC’s GHSA Project, Institute of Epidemiology, Disease Control and Research (IEDCR), Dhaka, 1212, Bangladesh
| | - A. K. M. Muraduzzaman
- Department of Virology, Institute of Epidemiology, Disease Control and Research (IEDCR), Dhaka, 1212, Bangladesh
| | - Md. Abid Hossain Mollah
- Department of Pediatrics, Ibrahim Medical College & Hospital, Institute of Research & Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM), Dhaka, 1200, Bangladesh
| | - S. M. Akhter-ul-Alam
- Department of Dermatology and Venereology, Pabna Medical College and General Hospital, Pabna, 6600, Bangladesh
| | - Kazi Munisul Islam
- Infectious Disease Division, International Center for Diarrheal Diseases Research, Bangladesh (icddr,b), Dhaka, 1212, Bangladesh
| | - Sheikh Ariful Hoque
- Tissue Culture Laboratory, Centre for Advanced Research in Sciences (CARS), University of Dhaka, Dhaka, 1000, Bangladesh
| | - Md. Nazrul Islam
- Department of Dermatology and Venereology, Pabna Medical College and General Hospital, Pabna, 6600, Bangladesh
| | - Md. Ahasan Ali
- Microbiology Section, Institute of Public Health (IPH), Mohakhali, Dhaka, 1212, Bangladesh
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Yin DQ, Wang CB, Wang CB, Xiao-Zhou, Ji SX. Epidemiology Characteristics of Human Coxsackievirus A16 and Enterovirus 71 Circulating in Linyi, China, from 2009 to 2017. Jpn J Infect Dis 2018; 71:470-473. [PMID: 29962487 DOI: 10.7883/yoken.jjid.2018.035] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
In China, a rapid expansion of hand, foot, and mouth disease (HFMD) outbreaks has occurred since 2004, and HFMD has become an important issue in China. There are more than 20 types of enterovirus causing HFMD, of which coxsackievirus A16 (CA16) and enterovirus 71 (EV71) are the most common. This study aimed to analyze the epidemiological characteristics of HFMD caused by EV71 and CA16 in Linyi, Shandong province, China, from 2009 to 2017. The stool specimens and throat samples of 5,324 patients with HFMD were obtained for nucleic acid detection of enterovirus. A total of 4,040 HFMD cases were caused by viral pathogens. Of these, 1,706 cases were positive for EV71 and 1,266 were positive for CA16. These 2 virus strains appeared alternately in Linyi city. The incidence of EV71-positive and CA16-positive cases was highest in children aged 0-5 years, with male patients being predominant. This outbreak of HMFD caused by EV71 and CA16 mainly occurred between April and July and appeared alternately between the years 2011 and 2017. These results demonstrated that the epidemiological analysis of EV71 and CA16 can provide a scientific basis for the prevention and treatment of the disease.
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Affiliation(s)
- De-Qing Yin
- Department of Microbiology Laboratory, Linyi Center for Disease Control and Prevention
| | - Chuan-Bao Wang
- Department of Microbiology Laboratory, Linyi Center for Disease Control and Prevention
| | - Chuan-Bao Wang
- Department of Microbiology Laboratory, Linyi Center for Disease Control and Prevention
| | - Xiao-Zhou
- Department of Pathology, Shandong Medical College
| | - Sheng-Xiang Ji
- Department of Microbiology Laboratory, Linyi Center for Disease Control and Prevention
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Zhao Q, Li S, Cao W, Liu DL, Qian Q, Ren H, Ding F, Williams G, Huxley R, Zhang W, Guo Y. Modeling the Present and Future Incidence of Pediatric Hand, Foot, and Mouth Disease Associated with Ambient Temperature in Mainland China. ENVIRONMENTAL HEALTH PERSPECTIVES 2018; 126:047010. [PMID: 29681142 PMCID: PMC6071822 DOI: 10.1289/ehp3062] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2017] [Revised: 03/17/2018] [Accepted: 03/22/2018] [Indexed: 05/09/2023]
Abstract
BACKGROUND There is limited evidence about the association between ambient temperature and the incidence of pediatric hand, foot, and mouth disease (HFMD) nationwide in China. OBJECTIVES We examined the childhood temperature-HFMD associations across mainland China, and we projected the change in HFMD cases due to projected temperature change by the 2090s. METHODS Data on daily HFMD (children 0-14 y old) counts and weather were collected from 362 sites during 2009-2014. Daily temperature by the 2090s was downscaled under the Representative Concentration Pathway (RCP) 4.5 and 8.5 scenarios. Temperature-HFMD associations were quantified using a two-stage Poisson regression with a distributed lag nonlinear model. The impact of changes in temperature on the incidence of HFMD was estimated by combining the fitted temperature-HFMD associations with projected temperatures under each scenario, assuming a constant population structure. Sensitivity analyses were performed to assess the influence of primary model assumptions. RESULTS During 2009-2014, >11 million HFMD cases were reported. In most regions, the temperature-HFMD association had an inverted U shape with a peak at approximately 20°C, but the association leveled off or continued to increase in the Inner Mongolia and Northeast regions. When estimates were pooled across all regions and the population size was held constant, the projected incidence of HFMD increased by 3.2% [95% empirical confidence interval (eCI): −13.5%, 20.0%] and 5.3% (95% eCI: −33.3%, 44.0%) by the 2090s under the RCP 4.5 and 8.5 scenarios, respectively. However, regional projections suggest that HFMD may decrease with climate change in temperate areas of central and eastern China. CONCLUSION Our estimates suggest that the association between temperature and HFMD varies across China and that the future impact of climate change on HFMD incidence will vary as well. Other factors, including changes in the size of the population at risk (children 0-14 y old) will also influence future HFMD trends. https://doi.org/10.1289/EHP3062.
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Affiliation(s)
- Qi Zhao
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Shanshan Li
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Wei Cao
- Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, China
| | - De-Li Liu
- New South Wales Department of Primary Industries, Wagga Wagga, New South Wales, Australia
| | - Quan Qian
- Center for Disease Surveillance and Research, Institute for Disease Control and Prevention of Chinese People’s Liberation Army, Beijing, China
| | - Hongyan Ren
- Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, China
| | - Fan Ding
- Public Health Emergency Center, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Gail Williams
- Division of Epidemiology and Biostatistics, School of Public Health, University of Queensland, Brisbane, Queensland, Australia
| | - Rachel Huxley
- College of Science, Health and Engineering, La Trobe University, Melbourne, Victoria, Australia
| | - Wenyi Zhang
- Center for Disease Surveillance and Research, Institute for Disease Control and Prevention of Chinese People’s Liberation Army, Beijing, China
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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Zhu B, Fu Y, Liu J, Mao Y. Spatial distribution of 12 class B notifiable infectious diseases in China: A retrospective study. PLoS One 2018; 13:e0195568. [PMID: 29621351 PMCID: PMC5886686 DOI: 10.1371/journal.pone.0195568] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Accepted: 03/26/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND China is the largest developing country with a relatively developed public health system. To further prevent and eliminate the spread of infectious diseases, China has listed 39 notifiable infectious diseases characterized by wide prevalence or great harm, and classified them into classes A, B, and C, with severity decreasing across classes. Class A diseases have been almost eradicated in China, thus making class B diseases a priority in infectious disease prevention and control. In this retrospective study, we analyze the spatial distribution patterns of 12 class B notifiable infectious diseases that remain active all over China. METHODS Global and local Moran's I and corresponding graphic tools are adopted to explore and visualize the global and local spatial distribution of the incidence of the selected epidemics, respectively. Inter-correlations of clustering patterns of each pair of diseases and a cumulative summary of the high/low cluster frequency of the provincial units are also provided by means of figures and maps. RESULTS Of the 12 most commonly notifiable class B infectious diseases, viral hepatitis and tuberculosis show high incidence rates and account for more than half of the reported cases. Almost all the diseases, except pertussis, exhibit positive spatial autocorrelation at the provincial level. All diseases feature varying spatial concentrations. Nevertheless, associations exist between spatial distribution patterns, with some provincial units displaying the same type of cluster features for two or more infectious diseases. Overall, high-low (unit with high incidence surrounded by units with high incidence, the same below) and high-high spatial cluster areas tend to be prevalent in the provincial units located in western and southwest China, whereas low-low and low-high spatial cluster areas abound in provincial units in north and east China. CONCLUSION Despite the various distribution patterns of 12 class B notifiable infectious diseases, certain similarities between their spatial distributions are present. Substantial evidence is available to support disease-specific, location-specific, and disease-combined interventions. Regarding provinces that show high-high/high-low patterns of multiple diseases, comprehensive interventions targeting different diseases should be established. As to the adjacent provincial units revealing similar patterns, coordinated actions need to be taken across borders.
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Affiliation(s)
- Bin Zhu
- School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an, Shaanxi, China
- Department of Public Policy, City University of Hong Kong, Hong Kong, China
| | - Yang Fu
- Department of Public Policy, City University of Hong Kong, Hong Kong, China
| | - Jinlin Liu
- School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Ying Mao
- School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an, Shaanxi, China
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Zhu B, Liu J, Fu Y, Zhang B, Mao Y. Spatio-Temporal Epidemiology of Viral Hepatitis in China (2003-2015): Implications for Prevention and Control Policies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E661. [PMID: 29614809 PMCID: PMC5923703 DOI: 10.3390/ijerph15040661] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 03/19/2018] [Accepted: 03/30/2018] [Indexed: 12/18/2022]
Abstract
Viral hepatitis, as one of the most serious notifiable infectious diseases in China, takes heavy tolls from the infected and causes a severe economic burden to society, yet few studies have systematically explored the spatio-temporal epidemiology of viral hepatitis in China. This study aims to explore, visualize and compare the epidemiologic trends and spatial changing patterns of different types of viral hepatitis (A, B, C, E and unspecified, based on the classification of CDC) at the provincial level in China. The growth rates of incidence are used and converted to box plots to visualize the epidemiologic trends, with the linear trend being tested by chi-square linear by linear association test. Two complementary spatial cluster methods are used to explore the overall agglomeration level and identify spatial clusters: spatial autocorrelation analysis (measured by global and local Moran's I) and space-time scan analysis. Based on the spatial autocorrelation analysis, the hotspots of hepatitis A remain relatively stable and gradually shrunk, with Yunnan and Sichuan successively moving out the high-high (HH) cluster area. The HH clustering feature of hepatitis B in China gradually disappeared with time. However, the HH cluster area of hepatitis C has gradually moved towards the west, while for hepatitis E, the provincial units around the Yangtze River Delta region have been revealing HH cluster features since 2005. The space-time scan analysis also indicates the distinct spatial changing patterns of different types of viral hepatitis in China. It is easy to conclude that there is no one-size-fits-all plan for the prevention and control of viral hepatitis in all the provincial units. An effective response requires a package of coordinated actions, which should vary across localities regarding the spatial-temporal epidemic dynamics of each type of virus and the specific conditions of each provincial unit.
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Affiliation(s)
- Bin Zhu
- School of Public Policy and Administration, Xi'an Jiaotong University, 28 Xianning West Road, Xi'an 710049, China.
- Department of Public Policy, City University of Hong Kong, Tat Chee Avenue, Kowloon, Hong Kong, China.
| | - Jinlin Liu
- School of Public Policy and Administration, Xi'an Jiaotong University, 28 Xianning West Road, Xi'an 710049, China.
| | - Yang Fu
- College of Management, Shenzhen University, Nanhai Ave 3688, Shenzhen 518060, China.
| | - Bo Zhang
- School of Human Settlements and Civil Engineering, Xi'an Jiaotong University, 28 Xianning West Road, Xi'an 710049, China.
| | - Ying Mao
- School of Public Policy and Administration, Xi'an Jiaotong University, 28 Xianning West Road, Xi'an 710049, China.
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Li L, Qiu W, Xu C, Wang J. A spatiotemporal mixed model to assess the influence of environmental and socioeconomic factors on the incidence of hand, foot and mouth disease. BMC Public Health 2018; 18:274. [PMID: 29463224 PMCID: PMC5819665 DOI: 10.1186/s12889-018-5169-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Accepted: 02/09/2018] [Indexed: 11/12/2022] Open
Abstract
Background As a common infectious disease, hand, foot and mouth disease (HFMD) is affected by multiple environmental and socioeconomic factors, and its pathogenesis is complex. Furthermore, the transmission of HFMD is characterized by strong spatial clustering and autocorrelation, and the classical statistical approach may be biased without consideration of spatial autocorrelation. In this paper, we propose to embed spatial characteristics into a spatiotemporal additive model to improve HFMD incidence assessment. Methods Using incidence data (6439 samples from 137 monitoring district) for Shandong Province, China, along with meteorological, environmental and socioeconomic spatial and spatiotemporal covariate data, we proposed a spatiotemporal mixed model to estimate HFMD incidence. Geo-additive regression was used to model the non-linear effects of the covariates on the incidence risk of HFMD in univariate and multivariate models. Furthermore, the spatial effect was constructed to capture spatial autocorrelation at the sub-regional scale, and clusters (hotspots of high risk) were generated using spatiotemporal scanning statistics as a predictor. Linear and non-linear effects were compared to illustrate the usefulness of non-linear associations. Patterns of spatial effects and clusters were explored to illustrate the variation of the HFMD incidence across geographical sub-regions. To validate our approach, 10-fold cross-validation was conducted. Results The results showed that there were significant non-linear associations of the temporal index, spatiotemporal meteorological factors and spatial environmental and socioeconomic factors with HFMD incidence. Furthermore, there were strong spatial autocorrelation and clusters for the HFMD incidence. Spatiotemporal meteorological parameters, the normalized difference vegetation index (NDVI), the temporal index, spatiotemporal clustering and spatial effects played important roles as predictors in the multivariate models. Efron’s cross-validation R2 of 0.83 was acquired using our approach. The spatial effect accounted for 23% of the R2, and notable patterns of the posterior spatial effect were captured. Conclusions We developed a geo-additive mixed spatiotemporal model to assess the influence of meteorological, environmental and socioeconomic factors on HFMD incidence and explored spatiotemporal patterns of such incidence. Our approach achieved a competitive performance in cross-validation and revealed strong spatial patterns for the HFMD incidence rate, illustrating important implications for the epidemiology of HFMD. Electronic supplementary material The online version of this article (10.1186/s12889-018-5169-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Lianfa Li
- LREIS, Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, China. .,University of Chinese Academy of Sciences, Beijing, 10049, China.
| | - Wenyang Qiu
- LREIS, Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, China.,University of Chinese Academy of Sciences, Beijing, 10049, China
| | - Chengdong Xu
- LREIS, Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, China.,University of Chinese Academy of Sciences, Beijing, 10049, China
| | - Jinfeng Wang
- LREIS, Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, China.,University of Chinese Academy of Sciences, Beijing, 10049, China
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32
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Dong W, Yang K, Xu Q, Liu L, Chen J. Spatio-temporal pattern analysis for evaluation of the spread of human infections with avian influenza A(H7N9) virus in China, 2013-2014. BMC Infect Dis 2017; 17:704. [PMID: 29065855 PMCID: PMC5655814 DOI: 10.1186/s12879-017-2781-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Accepted: 10/03/2017] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND A large number (n = 460) of A(H7N9) human infections have been reported in China from March 2013 through December 2014, and H7N9 outbreaks in humans became an emerging issue for China health, which have caused numerous disease outbreaks in domestic poultry and wild bird populations, and threatened human health severely. The aims of this study were to investigate the directional trend of the epidemic and to identify the significant presence of spatial-temporal clustering of influenza A(H7N9) human cases between March 2013 and December 2014. METHODS Three distinct epidemic phases of A(H7N9) human infections were identified in this study. In each phase, standard deviational ellipse analysis was conducted to examine the directional trend of disease spreading, and retrospective space-time permutation scan statistic was then used to identify the spatio-temporal cluster patterns of H7N9 outbreaks in humans. RESULTS The ever-changing location and the increasing size of the three identified standard deviational ellipses showed that the epidemic moved from east to southeast coast, and hence to some central regions, with a future epidemiological trend of continue dispersing to more central regions of China, and a few new human cases might also appear in parts of the western China. Furthermore, A(H7N9) human infections were clustering in space and time in the first two phases with five significant spatio-temporal clusters (p < 0.05), but there was no significant cluster identified in phase III. CONCLUSIONS There was a new epidemiologic pattern that the decrease in significant spatio-temporal cluster of A(H7N9) human infections was accompanied with an obvious spatial expansion of the outbreaks during the study period, and identification of the spatio-temporal patterns of the epidemic can provide valuable insights for better understanding the spreading dynamics of the disease in China.
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Affiliation(s)
- Wen Dong
- School of Information Science and Technology, Yunnan Normal University, Kunming, Yunnan China
- GIS Technology Engineering Research Centre for West-China Resources and Environment of Educational Ministry, Yunnan Normal University, Kunming, Yunnan China
| | - Kun Yang
- School of Information Science and Technology, Yunnan Normal University, Kunming, Yunnan China
- GIS Technology Engineering Research Centre for West-China Resources and Environment of Educational Ministry, Yunnan Normal University, Kunming, Yunnan China
| | - Quanli Xu
- School of Tourism and Geographic Science, Yunnan Normal University, Kunming, Yunnan China
- GIS Technology Engineering Research Centre for West-China Resources and Environment of Educational Ministry, Yunnan Normal University, Kunming, Yunnan China
| | - Lin Liu
- School of Information Science and Technology, Yunnan Normal University, Kunming, Yunnan China
| | - Juan Chen
- School of Information Science and Technology, Yunnan Normal University, Kunming, Yunnan China
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33
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Notifiable Sexually Transmitted Infections in China: Epidemiologic Trends and Spatial Changing Patterns. SUSTAINABILITY 2017. [DOI: 10.3390/su9101784] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Wu X, Hu S, Kwaku AB, Li Q, Luo K, Zhou Y, Tan H. Spatio-temporal clustering analysis and its determinants of hand, foot and mouth disease in Hunan, China, 2009-2015. BMC Infect Dis 2017; 17:645. [PMID: 28946852 PMCID: PMC5613322 DOI: 10.1186/s12879-017-2742-9] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Accepted: 09/15/2017] [Indexed: 11/10/2022] Open
Abstract
Background Hand, foot and mouth disease (HFMD) is one of the highest reported infectious diseases with several outbreaks across the world. This study aimed at describing epidemiological characteristics, investigating spatio-temporal clustering changes, and identifying determinant factors in different clustering areas of HFMD. Methods Descriptive statistics was used to evaluate the epidemic characteristics of HFMD from 2009 to 2015. Spatial autocorrelation and spatio-temporal cluster analysis were used to explore the spatial temporal patterns. An autologistic regression model was employed to explore determinants of HFMD clustering. Results The incidence rates of HFMD ranged from 54.31/10 million to 318.06/10 million between 2009 and 2015 in Hunan. Cases were mainly prevalent in children aged 5 years and even younger, with an average male-to-female sex ratio of 1.66, and two epidemic periods in each year. Clustering areas gathered in the northern regions in 2009 and in the central regions from 2010 to 2012. They moved to central-southern regions in 2013 and 2014 and central-western regions in 2015. The significant risk factors of HFMD clusters were rainfall (OR = 2.187), temperature (OR = 4.329) and humidity (OR = 2.070). The protect factor was wind speed (OR = 0.258). Conclusions The HFMD incidence from 2009 to 2015 in Hunan showed a new spatiotemporal clustering tendency, with the shifting trend of clustering areas toward south and west. Meteorological factors showed a strong association with HFMD clustering, which may assist in predicting future spatial-temporal clusters. Electronic supplementary material The online version of this article (10.1186/s12879-017-2742-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Xinrui Wu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, 410008, People's Republic of China
| | - Shixiong Hu
- Hunan Center for Disease Control and Prevention, Changsha, Hunan, 410078, People's Republic of China
| | - Abuaku Benjamin Kwaku
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, 410008, People's Republic of China.,Department of Epidemiology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, PO Box LG581, Legon, Accra, Ghana
| | - Qi Li
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, 410008, People's Republic of China
| | - Kaiwei Luo
- Hunan Center for Disease Control and Prevention, Changsha, Hunan, 410078, People's Republic of China
| | - Ying Zhou
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, 410008, People's Republic of China
| | - Hongzhuan Tan
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, 410008, People's Republic of China.
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35
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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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Chen SM, Qiu L, Du ZH, Jin YM, Du JW, Chen Y, Watanabe C, Umezaki M. Spatial Clustering of Severe Hand-Foot-Mouth Disease Cases on Hainan Island, China. Jpn J Infect Dis 2017; 70:604-608. [PMID: 28890503 DOI: 10.7883/yoken.jjid.2016.407] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The incidence of severe hand-foot-mouth disease (HFMD) in Southeast and East Asia has increased in recent years. This study explored spatial clusters of the incidence and proportion of severe HFMD cases on Hainan Island, where the prevalence and mortality of HFMD were the highest in China during 2011. A spatial autocorrelation statistic (Anselin's Local Moran I) was calculated for the Empirical Bayesian (EB)-smoothed dataset of severe HFMD cases. Significant spatial clusters were detected for both the incidence and proportion of severe HFMD cases. Population density was higher in spatial clusters with a high proportion of severe HFMD cases among total HFMD cases. We speculate that a higher proportion of severe HFMD cases were diagnosed in densely populated townships. This should be considered when analyzing the HFMD database of Hainan Island.
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Affiliation(s)
- Shao-Ming Chen
- Hainan Provincial Center for Disease Control and Prevention.,Department of Human Ecology, School of International Health, Graduate School of Medicine, The University of Tokyo
| | - Li Qiu
- Hainan Provincial Center for Disease Control and Prevention
| | - Zhong-Hua Du
- Hainan Provincial Center for Disease Control and Prevention
| | - Yu-Ming Jin
- Hainan Provincial Center for Disease Control and Prevention
| | - Jian-Wei Du
- Hainan Provincial Center for Disease Control and Prevention
| | - Yan Chen
- Hainan Provincial Center for Disease Control and Prevention
| | - Chiho Watanabe
- Department of Human Ecology, School of International Health, Graduate School of Medicine, The University of Tokyo
| | - Masahiro Umezaki
- Department of Human Ecology, School of International Health, Graduate School of Medicine, The University of Tokyo
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Epidemiological characteristics of hand, foot, and mouth disease in Shandong, China, 2009-2016. Sci Rep 2017; 7:8900. [PMID: 28827733 PMCID: PMC5567189 DOI: 10.1038/s41598-017-09196-z] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Accepted: 07/21/2017] [Indexed: 11/09/2022] Open
Abstract
In the past decade, hand, foot, and mouth disease (HFMD) has posed a serious threat to childhood health in China; however, no epidemiological data from large HFMD epidemics have been described since 2013. In the present study, we described the epidemiological patterns of HFMD in Shandong province during 2009–2016 from a large number of symptomatic cases (n = 839,483), including >370,000 HFMD cases since 2013. Our results revealed that HFMD activity has remained at a high level and continued to cause annual epidemics in Shandong province from 2013 onwards. Although the incidence rate was significantly higher in urban areas than in rural areas, no significantly higher case-severity and case-fatality rates were found in urban areas. Furthermore, the seventeen cities of Shandong province could be classified into three distinct epidemiological groups according to the different peak times from southwest (inland) to northeast (coastal) regions. Notably, a replacement of the predominant HFMD circulating agent was seen and non-EVA71/Coxsackievirus A16 enteroviruses became dominant in 2013 and 2015, causing approximately 30% of the severe cases. Our study sheds light on the latest epidemiological characteristics of HFMD in Shandong province and should prove helpful for the prevention and control of the disease in Shandong and elsewhere.
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Zhou ZM, Xu Y, Hu CS, Pan QJ, Wei JJ. Epidemiological Features of Hand, Foot and Mouth Disease during the Period of 2008-14 in Wenzhou, China. J Trop Pediatr 2017; 63:182-188. [PMID: 27765889 DOI: 10.1093/tropej/fmw070] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
This study aimed to analyze the epidemiological characteristics of hand, foot and mouth disease (HFMD) during 2008-14 in Wenzhou, China. The epidemiological data of HFMD retrieved from the Wenzhou Center for Disease Control and Prevention were retrospectively analyzed. HFMD infections with enterovirus 71 (EV71), Cox A16 or other pathogens were further verified by polymerase chain reaction (PCR) and real-time PCR. A total of 213 617 cases of HFMD were reported between 2008 and 2014 in Wenzhou. The average incidence was 384.31 of 100 000, and the fatality rate was 0.14‰. The incidence of HFMD peaked between April and July, and it occurred more frequently in males than in females. Approximately 92.68% of the HFMD patients were children aged <5 years. Nearly 80% of the cases were diagnosed within 2 days after onset. The major HFMD pathogen was EV71. This study suggested that appropriate comprehensive prevention and control measures should be taken to avoid the spread of HFMD.
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Affiliation(s)
- Zu-Mu Zhou
- Department of Emergency Response, Wenzhou Center for Disease Control and Prevention, Wenzhou, Zhejiang, 325000, China
| | - Yi Xu
- Department of Emergency Response, Wenzhou Center for Disease Control and Prevention, Wenzhou, Zhejiang, 325000, China
| | - Cai-Song Hu
- Department of Emergency Response, Wenzhou Center for Disease Control and Prevention, Wenzhou, Zhejiang, 325000, China
| | - Qiong-Jiao Pan
- Department of infectious disease control and prevention, Wenzhou Center for Disease Control and Prevention, Wenzhou, Zhejiang, 325000, China
| | - Jing-Jiao Wei
- Department of infectious disease control and prevention, Wenzhou Center for Disease Control and Prevention, Wenzhou, Zhejiang, 325000, China
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Tian H, Zhang Y, Shi Y, Li X, Sun Q, Liu L, Zhao D, Xu B. Epidemiological and aetiological characteristics of hand, foot, and mouth disease in Shijiazhuang City, Hebei province, China, 2009-2012. PLoS One 2017; 12:e0176604. [PMID: 28486500 PMCID: PMC5423607 DOI: 10.1371/journal.pone.0176604] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 04/13/2017] [Indexed: 12/18/2022] Open
Abstract
Large outbreaks of hand, foot, and mouth disease (HFMD) have repeatedly occurred in mainland of China since 2007. In this study, we investigated the epidemiological and aetiological characteristics of HFMD in Shijiazhuang City, one of the biggest northern cities of China. A total of 57,173 clinical HFMD cases, including 911 severe and 32 fatal cases, were reported in Shijiazhuang City during 2009–2012. The disease incidence peaked during March–July, with a small increase in the number of cases observed in November of each year. Seventeen potential HFMD-causing enterovirus serotypes were detected, with the most frequent serotypes being EV-A71 and CV-A16. CV-A10 was also a frequently detected causative serotype, and was associated with the second largest number of severe HFMD cases, following EV-A71. Phylogenetic analysis revealed that all EV-A71, CV-A16 and CV-A10 strains from Shijiazhuang City had co-evolved and co-circulated with those from other Chinese provinces. Our findings underscore the need for enhanced surveillance and molecular detection for HFMD, and suggest that EV-A71 vaccination may be an effective intervention strategy for HFMD prevention and vaccines against CV-A10 and CV-A16 are also urgently needed.
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Affiliation(s)
- Huifang Tian
- Shijiazhuang Center for Disease Control and Prevention, Shijiazhuang City, Hebei Province, People’s Republic of China
- * E-mail:
| | - Yong Zhang
- WHO WPRO Regional Polio Reference Laboratory and Key Laboratory for Medical Virology, National Health and Family Planning Commission of China; National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of China
| | - Yan Shi
- Shijiazhuang Center for Disease Control and Prevention, Shijiazhuang City, Hebei Province, People’s Republic of China
| | - Xiujuan Li
- Shijiazhuang Center for Disease Control and Prevention, Shijiazhuang City, Hebei Province, People’s Republic of China
| | - Qiang Sun
- WHO WPRO Regional Polio Reference Laboratory and Key Laboratory for Medical Virology, National Health and Family Planning Commission of China; National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of China
| | - Li Liu
- Shijiazhuang Center for Disease Control and Prevention, Shijiazhuang City, Hebei Province, People’s Republic of China
| | - Dong Zhao
- Shijiazhuang Center for Disease Control and Prevention, Shijiazhuang City, Hebei Province, People’s Republic of China
| | - Baohong Xu
- Shijiazhuang Center for Disease Control and Prevention, Shijiazhuang City, Hebei Province, People’s Republic of China
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Epidemics and aetiology of hand, foot and mouth disease in Xiamen, China, from 2008 to 2015. Epidemiol Infect 2017; 145:1865-1874. [PMID: 28367766 DOI: 10.1017/s0950268817000309] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Over the past 8 years, human enteroviruses (HEVs) have caused 27 227 cases of hand, foot and mouth disease (HFMD) in Xiamen, including 99 severe cases and six deaths. We aimed to explore the molecular epidemiology of HFMD in Xiamen to inform the development of diagnostic assays, vaccines and other interventions. From January 2009 to September 2015, 5866 samples from sentinel hospitals were tested using nested reverse transcription PCR that targeted the HEV 5' untranslated region and viral protein 1 region. Of these samples, 4290 were tested positive for HEV and the amplicons were sequenced and genotyped. Twenty-two genotypes were identified. Enterovirus 71 (EV71) and coxsackieviruses A16, A6 and A10 (CA16, CA6 and CA10) were the most common genotypes, and there were no changes in the predominant lineages of these genotypes. EV71 became the most predominant genotype every 2 years. From 2013, CA6 replaced CA16 as one of the two most common genotypes. The results demonstrate the vast diversity of HFMD pathogens, and that minor genotypes are able to replace major genotypes. We recommend carrying-out long-term monitoring of the full spectrum of HFMD pathogens, which could facilitate epidemic prediction and the development of diagnostic assays and vaccines.
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Zhao J, Li X. Determinants of the Transmission Variation of Hand, Foot and Mouth Disease in China. PLoS One 2016; 11:e0163789. [PMID: 27701445 PMCID: PMC5049751 DOI: 10.1371/journal.pone.0163789] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Accepted: 09/14/2016] [Indexed: 11/19/2022] Open
Abstract
Severe outbreaks of hand, foot and mouth disease (HFMD) have occurred in China for decades. Our understanding of the HFMD transmission process and its determinants is still limited. In this paper, factors that affect the local variation of HFMD transmission process were studied. Three classes of factors, including meteorological, demographic and public health intervention factors, were carefully selected and their effects on HFMD transmission were investigated with Pearson's correlation coefficient and multiple linear regression models. The determining factors for the variation of HFMD transmission were different for the southeastern and the northwestern regions of China. In the northwest, fadeouts occurred yearly, and the average age at infection and the fadeout were negatively correlated with the population density. In the southeast, HFMD transmission was governed by the combined effects of the birth rate, the relative humidity and the interaction of the Health System Performance and the log of the population density. When the Health System Performance was low, HFMD transmission increased with the population density, but when the Health System Performance was high, the better health performance counteracted the transmission increase due to the higher population density.
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Affiliation(s)
- Jijun Zhao
- Institute of Complexity Science, Qingdao University, Qingdao, China
| | - Xinmin Li
- School of Mathematics and Statistics, Qingdao University, Qingdao, China
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Koh WM, Bogich T, Siegel K, Jin J, Chong EY, Tan CY, Chen MIC, Horby P, Cook AR. The Epidemiology of Hand, Foot and Mouth Disease in Asia: A Systematic Review and Analysis. Pediatr Infect Dis J 2016; 35:e285-300. [PMID: 27273688 PMCID: PMC5130063 DOI: 10.1097/inf.0000000000001242] [Citation(s) in RCA: 159] [Impact Index Per Article: 19.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/22/2016] [Indexed: 12/22/2022]
Abstract
CONTEXT Hand, foot and mouth disease (HFMD) is a widespread pediatric disease caused primarily by human enterovirus 71 (EV-A71) and Coxsackievirus A16 (CV-A16). OBJECTIVE This study reports a systematic review of the epidemiology of HFMD in Asia. DATA SOURCES PubMed, Web of Science and Google Scholar were searched up to December 2014. STUDY SELECTION Two reviewers independently assessed studies for epidemiologic and serologic information about prevalence and incidence of HFMD against predetermined inclusion/exclusion criteria. DATA EXTRACTION Two reviewers extracted answers for 8 specific research questions on HFMD epidemiology. The results are checked by 3 others. RESULTS HFMD is found to be seasonal in temperate Asia with a summer peak and in subtropical Asia with spring and fall peaks, but not in tropical Asia; evidence of a climatic role was identified for temperate Japan. Risk factors for HFMD include hygiene, age, gender and social contacts, but most studies were underpowered to adjust rigorously for confounding variables. Both community-level and school-level transmission have been implicated, but their relative importance for HFMD is inconclusive. Epidemiologic indices are poorly understood: No supporting quantitative evidence was found for the incubation period of EV-A71; the symptomatic rate of EV-A71/Coxsackievirus A16 infection was from 10% to 71% in 4 studies; while the basic reproduction number was between 1.1 and 5.5 in 3 studies. The uncertainty in these estimates inhibits their use for further analysis. LIMITATIONS Diversity of study designs complicates attempts to identify features of HFMD epidemiology. CONCLUSIONS Knowledge on HFMD remains insufficient to guide interventions such as the incorporation of an EV-A71 vaccine in pediatric vaccination schedules. Research is urgently needed to fill these gaps.
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Affiliation(s)
- Wee Ming Koh
- From the Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore; Standard Analytics, New York, New York; Rollins School of Public Health, Emory University, Atlanta, Georgia; Duke-NUS Graduate Medical School, Singapore; Communicable Disease Centre, Tan Tock Seng Hospital, Singapore; Nuffield Department of Medicine, University of Oxford, United Kingdom; and Yale-NUS College, National University of Singapore, Singapore
| | - Tiffany Bogich
- From the Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore; Standard Analytics, New York, New York; Rollins School of Public Health, Emory University, Atlanta, Georgia; Duke-NUS Graduate Medical School, Singapore; Communicable Disease Centre, Tan Tock Seng Hospital, Singapore; Nuffield Department of Medicine, University of Oxford, United Kingdom; and Yale-NUS College, National University of Singapore, Singapore
| | - Karen Siegel
- From the Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore; Standard Analytics, New York, New York; Rollins School of Public Health, Emory University, Atlanta, Georgia; Duke-NUS Graduate Medical School, Singapore; Communicable Disease Centre, Tan Tock Seng Hospital, Singapore; Nuffield Department of Medicine, University of Oxford, United Kingdom; and Yale-NUS College, National University of Singapore, Singapore
| | - Jing Jin
- From the Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore; Standard Analytics, New York, New York; Rollins School of Public Health, Emory University, Atlanta, Georgia; Duke-NUS Graduate Medical School, Singapore; Communicable Disease Centre, Tan Tock Seng Hospital, Singapore; Nuffield Department of Medicine, University of Oxford, United Kingdom; and Yale-NUS College, National University of Singapore, Singapore
| | - Elizabeth Y. Chong
- From the Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore; Standard Analytics, New York, New York; Rollins School of Public Health, Emory University, Atlanta, Georgia; Duke-NUS Graduate Medical School, Singapore; Communicable Disease Centre, Tan Tock Seng Hospital, Singapore; Nuffield Department of Medicine, University of Oxford, United Kingdom; and Yale-NUS College, National University of Singapore, Singapore
| | - Chong Yew Tan
- From the Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore; Standard Analytics, New York, New York; Rollins School of Public Health, Emory University, Atlanta, Georgia; Duke-NUS Graduate Medical School, Singapore; Communicable Disease Centre, Tan Tock Seng Hospital, Singapore; Nuffield Department of Medicine, University of Oxford, United Kingdom; and Yale-NUS College, National University of Singapore, Singapore
| | - Mark IC Chen
- From the Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore; Standard Analytics, New York, New York; Rollins School of Public Health, Emory University, Atlanta, Georgia; Duke-NUS Graduate Medical School, Singapore; Communicable Disease Centre, Tan Tock Seng Hospital, Singapore; Nuffield Department of Medicine, University of Oxford, United Kingdom; and Yale-NUS College, National University of Singapore, Singapore
| | - Peter Horby
- From the Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore; Standard Analytics, New York, New York; Rollins School of Public Health, Emory University, Atlanta, Georgia; Duke-NUS Graduate Medical School, Singapore; Communicable Disease Centre, Tan Tock Seng Hospital, Singapore; Nuffield Department of Medicine, University of Oxford, United Kingdom; and Yale-NUS College, National University of Singapore, Singapore
| | - Alex R. Cook
- From the Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore; Standard Analytics, New York, New York; Rollins School of Public Health, Emory University, Atlanta, Georgia; Duke-NUS Graduate Medical School, Singapore; Communicable Disease Centre, Tan Tock Seng Hospital, Singapore; Nuffield Department of Medicine, University of Oxford, United Kingdom; and Yale-NUS College, National University of Singapore, Singapore
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Wang C, Cao K, Zhang Y, Fang L, Li X, Xu Q, Huang F, Tao L, Guo J, Gao Q, Guo X. Different effects of meteorological factors on hand, foot and mouth disease in various climates: a spatial panel data model analysis. BMC Infect Dis 2016; 16:233. [PMID: 27230283 PMCID: PMC4881061 DOI: 10.1186/s12879-016-1560-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2015] [Accepted: 05/10/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Major outbreaks of hand, foot and mouth disease (HFMD) have been reported in China since 2008, posing a great threat to the health of children. Although many studies have examined the effect of meteorological variables on the incidence of HFMD, the results have been inconsistent. This study aimed to quantify the relationship between meteorological factors and HFMD occurrence in different climates of mainland China using spatial panel data models. METHODS All statistical analyses were carried out according to different climate types. We firstly conducted a descriptive analysis to summarize the epidemic characteristics of HFMD from May 2008 to November 2012 and then detected the spatial autocorrelation of HFMD using a global autocorrelation statistic (Moran's I) in each month. Finally, the association between HFMD incidence and meteorological factors was explored by spatial panel data models. RESULTS The 353 regions were divided into 4 groups according to climate (G1: subtropical monsoon climate; G2: temperate monsoon climate; G3: temperate continental climate; G4: plateau mountain climate). The Moran's I values were significant with high correlations in most months of group G1 and G2 and some months of group G3 and G4. This suggested the existence of a high spatial autocorrelation with HFMD. Spatial panel data models were more appropriate to describe the data than fixed effect models. The results showed that HFMD incidences were significantly associated with average atmospheric pressure (AAP), average temperature (AT), average vapor pressure (AVP), average relative humidity (ARH), monthly precipitation (MP), average wind speed (AWS), monthly total sunshine hours (MSH), mean temperature difference (MTD), rain day (RD) and average temperature distance (ATD), but the effect of meteorological factors might differ in various climate types. CONCLUSIONS Spatial panel data models are useful and effective when longitudinal data are available and spatial autocorrelation exists. Our findings showed that meteorological factors were related to the occurrence of HFMD, which were also affected by climate type.
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Affiliation(s)
- Chao Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, No.10 Xitoutiao, Youanmen Wai Street, Fengtai District, Beijing, 100069, PR China.,Beijing Municipal Key Laboratory of Clinical Epidemiology, No.10 Xitoutiao, Youanmen Wai Street, Fengtai District, Beijing, 100069, PR China.,Department of Statistics and Information, Beijing Centers for Disease Control and Prevention, No.16, Hepingli Middle Street, Dongcheng District, Beijing, 100013, PR China
| | - Kai Cao
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, No.10 Xitoutiao, Youanmen Wai Street, Fengtai District, Beijing, 100069, PR China.,Beijing Municipal Key Laboratory of Clinical Epidemiology, No.10 Xitoutiao, Youanmen Wai Street, Fengtai District, Beijing, 100069, PR China
| | - Yingjie Zhang
- National Center for Public Health, Surveillance and Information Services, Chinese Center for Disease Control and Prevention, No. 155 Changbai Street, Changping District, Beijing, 102206, PR China
| | - Liqun Fang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, No. 20 Dongda Street, Fengtai District, Beijing, 100071, PR China
| | - Xia Li
- The Graduate Entry Medical School, University of Limerick, Limerick, Ireland
| | - Qin Xu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, No.10 Xitoutiao, Youanmen Wai Street, Fengtai District, Beijing, 100069, PR China.,Beijing Municipal Key Laboratory of Clinical Epidemiology, No.10 Xitoutiao, Youanmen Wai Street, Fengtai District, Beijing, 100069, PR China
| | - Fangfang Huang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, No.10 Xitoutiao, Youanmen Wai Street, Fengtai District, Beijing, 100069, PR China.,Beijing Municipal Key Laboratory of Clinical Epidemiology, No.10 Xitoutiao, Youanmen Wai Street, Fengtai District, Beijing, 100069, PR China
| | - Lixin Tao
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, No.10 Xitoutiao, Youanmen Wai Street, Fengtai District, Beijing, 100069, PR China.,Beijing Municipal Key Laboratory of Clinical Epidemiology, No.10 Xitoutiao, Youanmen Wai Street, Fengtai District, Beijing, 100069, PR China
| | - Jin Guo
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, No.10 Xitoutiao, Youanmen Wai Street, Fengtai District, Beijing, 100069, PR China.,Beijing Municipal Key Laboratory of Clinical Epidemiology, No.10 Xitoutiao, Youanmen Wai Street, Fengtai District, Beijing, 100069, PR China
| | - Qi Gao
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, No.10 Xitoutiao, Youanmen Wai Street, Fengtai District, Beijing, 100069, PR China.,Beijing Municipal Key Laboratory of Clinical Epidemiology, No.10 Xitoutiao, Youanmen Wai Street, Fengtai District, Beijing, 100069, PR China
| | - Xiuhua Guo
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, No.10 Xitoutiao, Youanmen Wai Street, Fengtai District, Beijing, 100069, PR China. .,Beijing Municipal Key Laboratory of Clinical Epidemiology, No.10 Xitoutiao, Youanmen Wai Street, Fengtai District, Beijing, 100069, PR China.
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Ge E, Zhang X, Wang X, Wei X. Spatial and temporal analysis of tuberculosis in Zhejiang Province, China, 2009-2012. Infect Dis Poverty 2016; 5:11. [PMID: 26906041 PMCID: PMC4763446 DOI: 10.1186/s40249-016-0104-2] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Accepted: 01/25/2016] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Tuberculosis (TB) is an infectious disease of major public health concern. The disease has demonstrated large space-time variations. This study aims to explore the space-time dynamics of TB cases in an economically and geographically dynamic province in China with specific references of TB control for policy makers. METHODS Data on all reported TB cases from 2009 to 2012 were collected from the TB program at the Zhejiang Provincial Center for Disease Control and Prevention. We employed time series and exploratory spatial data analyses, including Moran's I, Local Getis's G i (*) , and Kulldorff's space-time scan statistics, to identify the temporal trends and spatial patterns of TB at a county level. RESULTS A total of 147,941 TB cases were reported during 2009-2012 in Zhejiang. A higher proportion of TB cases were younger, male, and registered permanent residents among all TB cases notified in the province. TB cases were reported most frequently in April with small peaks in June, July, and October. This disease was spatially clustering with Moran's I values ranged from 0.29 to 0.32 (p < 0.001). A most likely cluster and ten secondary clusters were identified, mainly concentrated in the southeast and west counties of the province. CONCLUSIONS This study identified seasonal patterns and significant space-time clusters of TB cases in Zhejiang, China. Poverty, migration, and seasonal effects may play important roles in potential clusters.
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Affiliation(s)
- Erjia Ge
- School of Biomedical Sciences, The Chinese University of Hong Kong, Hong Kong, S.A.R., China.
| | - Xin Zhang
- The Chinese University of Hong Kong, Shenzhen Research Institute, Shenzhen, China.
| | - Xiaomeng Wang
- TB Program, Zhejiang Centre for Disease Control and Prevention, No. 630 Xincheng Road, Binjiang District, Hangzhou, Zhejiang, 310051, China.
| | - Xiaolin Wei
- JC School of Public Health, The Chinese University of Hong Kong, 2/F, School of Public Health, Prince of Wales Hospital, Shatin, Hong Kong, China. .,Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON, M5T 3 M7, Canada.
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Wang C, Li X, Zhang Y, Xu Q, Huang F, Cao K, Tao L, Guo J, Gao Q, Wang W, Fang L, Guo X. Spatiotemporal Cluster Patterns of Hand, Foot, and Mouth Disease at the County Level in Mainland China, 2008-2012. PLoS One 2016; 11:e0147532. [PMID: 26809151 PMCID: PMC4726594 DOI: 10.1371/journal.pone.0147532] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Accepted: 01/05/2016] [Indexed: 12/03/2022] Open
Abstract
Background Hand, foot, and mouth disease (HFMD) is known to be a highly contagious childhood illness. In recent years, the number of reported cases of HFMD has significantly increased in mainland China. This study aims at the epidemiological features, spatiotemporal patterns of HMFD at the county/district level in mainland China. Methods Data on reported HFMD cases for each county from 1 January 2008 to 31 December 2012 were obtained from the Chinese Center for Disease Control and Prevention. Cluster analysis, spatial autocorrelation, and retrospective scan methods were used to explore the spatiotemporal patterns of the disease. Results The annual incidences varied greatly among the counties, ranging from 0 to 74.31‰ with the median of 5.42‰ (interquartile range: 1.54‰–13.55‰) during 2008–2012 in mainland China. Counties close to provincial capital cities generally had higher incidences than rural counties. A seasonal distribution was observed between the northern and southern China, of which dual epidemic were shown in southern China and usually only one in northern China. Based on the global and local spatial autocorrelation analysis, we found that the spatial distribution of HFMD was presented a significant clustering pattern for each year (P<0.001), and hotspots of the disease were mostly distributed in coastal provinces of China. The retrospective scan statistic further identified the dynamics of spatiotemporal clustering areas of the disease, which were mainly distributed in the counties of eastern and southern China, as well as provincial capitals and their surrounding counties. Conclusions The spatiotemporal clustering areas of the disease identified in this way were relatively stable, and imminent public health planning and resource allocation should be focused within those areas.
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Affiliation(s)
- Chao Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Xia Li
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
- Graduate Entry Medical School, University of Limerick, Limerick, Ireland
| | - Yingjie Zhang
- National Center for Public Health, Surveillance and Information Services, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Qin Xu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Fangfang Huang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Kai Cao
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Lixin Tao
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Jin Guo
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Qi Gao
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Wei Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
- School of Medical Sciences, Edith Cowan University, Perth, Western Australia, Australia
| | - Liqun Fang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
- * E-mail: (XG); (LF)
| | - Xiuhua Guo
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
- * E-mail: (XG); (LF)
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Chen B, Sumi A, Toyoda S, Hu Q, Zhou D, Mise K, Zhao J, Kobayashi N. Time series analysis of reported cases of hand, foot, and mouth disease from 2010 to 2013 in Wuhan, China. BMC Infect Dis 2015; 15:495. [PMID: 26530702 PMCID: PMC4630926 DOI: 10.1186/s12879-015-1233-0] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Accepted: 10/19/2015] [Indexed: 12/02/2022] Open
Abstract
Background Hand, foot, and mouth disease (HFMD) is an infectious disease caused by a group of enteroviruses, including Coxsackievirus A16 (CVA16) and Enterovirus A71 (EV-A71). In recent decades, Asian countries have experienced frequent and widespread HFMD outbreaks, with deaths predominantly among children. In several Asian countries, epidemics usually peak in the late spring/early summer, with a second small peak in late autumn/early winter. We investigated the possible underlying association between the seasonality of HFMD epidemics and meteorological variables, which could improve our ability to predict HFMD epidemics. Methods We used a time series analysis composed of a spectral analysis based on the maximum entropy method (MEM) in the frequency domain and the nonlinear least squares method in the time domain. The time series analysis was applied to three kinds of monthly time series data collected in Wuhan, China, where high-quality surveillance data for HFMD have been collected: (i) reported cases of HFMD, (ii) reported cases of EV-A71 and CVA16 detected in HFMD patients, and (iii) meteorological variables. Results In the power spectral densities for HFMD and EV-A71, the dominant spectral lines were observed at frequency positions corresponding to 1-year and 6-month cycles. The optimum least squares fitting (LSF) curves calculated for the 1-year and 6-month cycles reproduced the bimodal cycles that were clearly observed in the HFMD and EV-A71 data. The peak months on the LSF curves for the HFMD data were consistent with those for the EV-A71 data. The risk of infection was relatively high at 10 °C ≤ t < 15 °C (t, temperature [°C]) and 15 °C ≤ t < 20 °C, and peaked at 20 °C ≤ t < 25 °C. Conclusion In this study, the HFMD infections occurring in Wuhan showed two seasonal peaks, in summer (June) and winter (November or December). The results obtained with a time series analysis suggest that the bimodal seasonal peaks in HFMD epidemics are attributable to EV-A71 epidemics. Our results suggest that controlling the spread of EV-A71 infections when the temperature is approximately 20–25 °C should be considered to prevent HFMD infections in Wuhan, China. Electronic supplementary material The online version of this article (doi:10.1186/s12879-015-1233-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Banghua Chen
- Department of Infectious Diseases Prevention and Control, Wuhan Centers for Disease Control and Prevention, Wuhan, Hubei, China.
| | - Ayako Sumi
- Department of Hygiene, Sapporo Medical University School of Medicine, S-1, W-17, Chuo-ku, Sapporo, 060-8556, Hokkaido, Japan.
| | - Shin'ichi Toyoda
- Department of Information Engineering, College of Industrial Technology, Hyogo, Japan.
| | - Quan Hu
- Wuhan Centers for Disease Control and Prevention, 24 Jianghanbei Road, Wuhan, 430000, Hubei, China.
| | - Dunjin Zhou
- Wuhan Centers for Disease Control and Prevention, 24 Jianghanbei Road, Wuhan, 430000, Hubei, China.
| | - Keiji Mise
- Department of Admission, Center of Medical Education, Sapporo Medical University, Hokkaido, Japan.
| | - Junchan Zhao
- School of Mathematics and Statistics, Hunan University of Commerce, Changsha, Hunan, China.
| | - Nobumichi Kobayashi
- Department of Hygiene, Sapporo Medical University School of Medicine, S-1, W-17, Chuo-ku, Sapporo, 060-8556, Hokkaido, Japan.
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Zhang C, Yang Y, Chi Y, Yin J, Yan L, Ku Z, Liu Q, Huang Z, Zhou D. Hexon-modified recombinant E1-deleted adenoviral vectors as bivalent vaccine carriers for Coxsackievirus A16 and Enterovirus 71. Vaccine 2015; 33:5087-94. [PMID: 26296491 DOI: 10.1016/j.vaccine.2015.08.016] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Revised: 07/31/2015] [Accepted: 08/06/2015] [Indexed: 02/03/2023]
Abstract
Hand, foot and mouth disease (HFMD) is a major public health concern in Asia; more efficient vaccines against HFMD are urgently required. Adenoviral (Ad) capsids have been used widely for the presentation of foreign antigens to induce specific immune responses in the host. Here, we describe a novel bivalent vaccine for HFMD based on the hexon-modified, E1-deleted chimpanzee adenovirus serotype 68 (AdC68). The novel vaccine candidate was generated by incorporating the neutralising epitope of Coxsackievirus A16 (CA16), PEP71, into hypervariable region 1 (HVR1), and a shortened neutralising epitope of Enterovirus 71 (EV71), sSP70, into HVR2 of the AdC68 hexon. In order to enhance the immunogenicity of EV71, VP1 of EV71 was cloned into the E1-region of the AdC68 vectors. The results demonstrated that these two epitopes were well presented on the virion surface and had high affinity towards specific antibodies, and VP1 of EV71 was also significantly expressed. In pre-clinical mouse models, the hexon-modified AdC68 elicited neutralising antibodies against both CA16 and EV71, which conferred protection to suckling mice against a lethal challenge of CA16 and EV71. In summary, this study demonstrates that the hexon-modified AdC68 may represent a promising bivalent vaccine carrier against EV71 and CA16 and an epitope-display platform for other pathogens.
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Affiliation(s)
- Chao Zhang
- Vaccine Research Center, Key Laboratory of Molecular Virology & Immunology, Institut Pasteur of Shanghai, Chinese Academy of Sciences, Shanghai 200031, China
| | - Yong Yang
- Vaccine Research Center, Key Laboratory of Molecular Virology & Immunology, Institut Pasteur of Shanghai, Chinese Academy of Sciences, Shanghai 200031, China
| | - Yudan Chi
- Vaccine Research Center, Key Laboratory of Molecular Virology & Immunology, Institut Pasteur of Shanghai, Chinese Academy of Sciences, Shanghai 200031, China
| | - Jieyun Yin
- Vaccine Research Center, Key Laboratory of Molecular Virology & Immunology, Institut Pasteur of Shanghai, Chinese Academy of Sciences, Shanghai 200031, China
| | - Lijun Yan
- Vaccine Research Center, Key Laboratory of Molecular Virology & Immunology, Institut Pasteur of Shanghai, Chinese Academy of Sciences, Shanghai 200031, China
| | - Zhiqiang Ku
- Vaccine Research Center, Key Laboratory of Molecular Virology & Immunology, Institut Pasteur of Shanghai, Chinese Academy of Sciences, Shanghai 200031, China
| | - Qingwei Liu
- Vaccine Research Center, Key Laboratory of Molecular Virology & Immunology, Institut Pasteur of Shanghai, Chinese Academy of Sciences, Shanghai 200031, China
| | - Zhong Huang
- Vaccine Research Center, Key Laboratory of Molecular Virology & Immunology, Institut Pasteur of Shanghai, Chinese Academy of Sciences, Shanghai 200031, China.
| | - Dongming Zhou
- Vaccine Research Center, Key Laboratory of Molecular Virology & Immunology, Institut Pasteur of Shanghai, Chinese Academy of Sciences, Shanghai 200031, China.
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Zhu L, Yuan Z, Wang X, Li J, Wang L, Liu Y, Xue F, Liu Y. The Impact of Ambient Temperature on Childhood HFMD Incidence in Inland and Coastal Area: A Two-City Study in Shandong Province, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:8691-704. [PMID: 26213955 PMCID: PMC4555242 DOI: 10.3390/ijerph120808691] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Revised: 07/13/2015] [Accepted: 07/17/2015] [Indexed: 12/04/2022]
Abstract
Hand, foot and mouth disease (HFMD) has been a substantial burden throughout the Asia-Pacific countries over the past decades. For the purposes of disease prevention and climate change health impact assessment, it is important to understand the temperature-disease association for HFMD in different geographical locations. This study aims to assess the impact of temperature on HFMD incidence in an inland city and a coastal city and investigate the heterogeneity of temperature-disease associations. Daily morbidity data and meteorological variables of the study areas were collected for the period from 2007 to 2012. A total of 108,377 HFMD cases were included in this study. A distributed lag non-linear model (DLNM) with Poisson distribution was used to examine the nonlinear lagged effects of daily mean temperature on HFMD incidence. After controlling potential confounders, temperature showed significant association with HFMD incidence and the two cities demonstrated different impact modes ( I2= 96.1%; p < 0.01). The results highlight the effect of temperature on HFMD incidence and the impact pattern may be modified by geographical localities. Our findings can be a practical reference for the early warning and intervention strategies of HFMD.
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Affiliation(s)
- Lin Zhu
- Department of Epidemiology and Biostatistics, School of Public Health, Shandong University, Jinan 250012, China.
| | - Zhongshang Yuan
- Department of Epidemiology and Biostatistics, School of Public Health, Shandong University, Jinan 250012, China.
| | - Xianjun Wang
- Shandong Center for Disease Control and Prevention, Jinan 250012, China.
| | - Jie Li
- Department of Epidemiology and Biostatistics, School of Public Health, Shandong University, Jinan 250012, China.
| | - Lu Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Shandong University, Jinan 250012, China.
| | - Yunxia Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Shandong University, Jinan 250012, China.
| | - Fuzhong Xue
- Department of Epidemiology and Biostatistics, School of Public Health, Shandong University, Jinan 250012, China.
| | - Yanxun Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Shandong University, Jinan 250012, China.
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Liu W, Ji H, Shan J, Bao J, Sun Y, Li J, Bao C, Tang F, Yang K, Bergquist R, Peng Z, Zhu Y. Spatiotemporal Dynamics of Hand-Foot-Mouth Disease and Its Relationship with Meteorological Factors in Jiangsu Province, China. PLoS One 2015; 10:e0131311. [PMID: 26121573 PMCID: PMC4488144 DOI: 10.1371/journal.pone.0131311] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Accepted: 06/01/2015] [Indexed: 11/18/2022] Open
Abstract
Hand, foot and mouth disease (HFMD) is an important public health issue in mainland China, including Jiangsu Province. The main purpose of this study was to depict the epidemiological characteristics of HFMD and evaluate the effects of meteorological variables on its dynamics via spatiotemporal analytic methods, which is essential for formulating scientific and effective prevention and control strategies and measures. In total, 497,910 cases of HFMD occurred in the 2009-2013 period, with an average annual incidence of 126.3 per 100,000 in Jiangsu. Out of these, 87.7% were under 5 years old with a male-to-female incidence ratio of 1.4. The dominant pathogens of the laboratory-confirmed cases were EV71 and CoxA16, accounting for 44.8% and 30.6% of all cases, respectively. Two incidence peaks were observed in each year, the higher occurring between April and June, the lower between November and December. The incidence ranged between 16.8 and 233.5 per 100,000 at the county level. The incidence in the South of the province was generally higher than that in the northern regions. The most likely spatiotemporal cluster detected by space–time scan analysis occurred in May-June of 2012 in the southern region. Average temperature and rainfall were positively correlated with HFMD incidence, while the number of days with rainfall ≥ 0.1mm, low temperature, high temperature and hours of sunshine were negatively related. Particularly, relative humidity had no relationship. In conclusion, the prevalence of HFMD in Jiangsu Province has an obvious feature of seasonality. The etiological composition changed dynamically and might be a latent driving force for the temporal variation of the incidence of HFMD. A moderately warm environment promotes the transmission of the HFMD viruses, while particularly cold and hot climate conditions restrain their transmission.
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Affiliation(s)
- Wendong Liu
- Key Lab of Enteric Pathogenic Microbiology, Ministry of Health, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Hong Ji
- Key Lab of Enteric Pathogenic Microbiology, Ministry of Health, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Jun Shan
- Key Lab of Enteric Pathogenic Microbiology, Ministry of Health, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Jin Bao
- Jiangsu Meteorological Service Center, Nanjing, China
| | - Yan Sun
- Jiangsu Meteorological Observatory, Nanjing, China
| | - Juan Li
- Jiangsu Meteorological Service Center, Nanjing, China
| | - Changjun Bao
- Key Lab of Enteric Pathogenic Microbiology, Ministry of Health, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Fenyang Tang
- Key Lab of Enteric Pathogenic Microbiology, Ministry of Health, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Kun Yang
- Department of Schistosomiasis Control, Jiangsu Institute of Parasitic Diseases, Wuxi, China
| | | | - Zhihang Peng
- Department of Epidemiology & Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Yefei Zhu
- Key Lab of Enteric Pathogenic Microbiology, Ministry of Health, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
- * E-mail:
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50
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Liu Y, Wang X, Pang C, Yuan Z, Li H, Xue F. Spatio-temporal analysis of the relationship between climate and hand, foot, and mouth disease in Shandong province, China, 2008-2012. BMC Infect Dis 2015; 15:146. [PMID: 25887074 PMCID: PMC4374415 DOI: 10.1186/s12879-015-0901-4] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Accepted: 03/13/2015] [Indexed: 12/03/2022] Open
Abstract
Background Hand, foot, and mouth disease (HFMD) is the most common communicable disease in China. Shandong Province is one of the most seriously affected areas. The distribution of HFMD had spatial heterogeneity and seasonal characteristic in this setting. The aim of this study was to explore the associations between climate and HFMD by a Bayesian approach from spatio-temporal interactions perspective. Methods The HFMD data of Shandong Province during 2008–2012 were derived from the China National Disease Surveillance Reporting and Management System. And six climatic indicators were obtained from the Meteorological Bureau of Shandong Province. The global spatial autocorrelation statistic (Moran’s I) was used to detect the spatial autocorrelation of HFMD cases in each year. The optimal one among four Bayesian models was further adopted to estimate the relative risk of the occurrence of HFMD via Markov chain Monte Carlo. Results The annual average incidence rate of HFMD was 104.40 per 100,000 in Shandong Province. Positive spatial autocorrelation appeared at county level (Moran’s I ≥0.30, P < 0.001). The best fitting Spatio-temporal interactive model showed that annual average temperature, annual average pressure, annual average relative humidity, annual average wind speed and annual sunshine hours were significantly positive related to the occurrence of HFMD. The estimated relative risk of 36, 87, 91, 79, 65 out of 140 counties for 2008–2012 respectively were significantly more than 1. Conclusions There were obvious spatio-temporal heterogeneity of HFMD in Shandong Province, and the climatic indicators were associated with the epidemic of HFMD. Bayesian approach should be recommended to capture the spatial-temporal pattern of HFMD.
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Affiliation(s)
- Yunxia Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Shandong University, Jinan, Shandong, China.
| | - Xianjun Wang
- Shandong Center for Disease Control and Prevention, Jinan, Shandong, China.
| | - Chunkun Pang
- Institute office, Shandong Academy of Medical Science, Jinan, Shandong, China.
| | - Zhongshang Yuan
- Department of Epidemiology and Biostatistics, School of Public Health, Shandong University, Jinan, Shandong, China.
| | - Hongkai Li
- Department of Epidemiology and Biostatistics, School of Public Health, Shandong University, Jinan, Shandong, China.
| | - Fuzhong Xue
- Department of Epidemiology and Biostatistics, School of Public Health, Shandong University, Jinan, Shandong, China.
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