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. 2020 Mar 20;14(3):e0008085.
doi: 10.1371/journal.pntd.0008085. eCollection 2020 Mar.

Using a Bayesian spatiotemporal model to identify the influencing factors and high-risk areas of hand, foot and mouth disease (HFMD) in Shenzhen

Xiaoyi He  1 , Shengjie Dong  2 , Liping Li  1 , Xiaojian Liu  3 , Yongsheng Wu  3 , Zhen Zhang  3 , Shujiang Mei  3
Affiliations

Using a Bayesian spatiotemporal model to identify the influencing factors and high-risk areas of hand, foot and mouth disease (HFMD) in Shenzhen

Xiaoyi He et al. PLoS Negl Trop Dis. .

Abstract

Background: The epidemic of hand, foot, and mouth disease (HFMD) has become a severe public health problem in the world and has also brought a high economic and health burden. Furthermore, the prevalence of HFMD varies significantly among different locations. However, there have been few investigations of the effects of socioeconomic factors and air pollution factors on the incidence of HFMD.

Methods: This study collected data on HFMD in Shenzhen, China, from 2012 to 2015. We selected eleven factors as potential risk factors for HFMD. A Bayesian spatiotemporal model was used to quantify the influence of the factors on HFMD and to identify the relative risks in different districts.

Results: The risk factors of HFMD were the population, population density, concentration of SO2, and concentration of NO2. The relative risks (RRs) were 1.00473 (95% CI: 1.00059-1.00761), 1.00010 (95% CI: 1.00002-1.00016), 1.00215 (95% CI: 1.00170-1.00232) and 1.00058 (95% CI: 1.00028-1.00078), respectively. The protective factors against HFMD were the per capita GDP, the number of public kindergartens, the concentration of PM10, and the concentration of O3. The RRs were 0.98840 (95% CI: 0.98660-0.99026), 0.97686 (95% CI: 0.96946-0.98403), 0.99108 (95% CI: 0.98551-0.99840) and 0.99587 (95% CI: 0.99534-0.99610), respectively. The risk of incidence in Longgang district and Pingshan district decreased, while the risk of incidence in Baoan district increased.

Conclusions: Studies have confirmed that socioeconomic factors and air pollution factors have an impact on the incidence of HFMD in Shenzhen, China. The results will be of great practical significance to local authorities, which is conducive to accurate prevention and can be used to formulate HFMD early warning systems.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig 1
Fig 1. Shenzhen city and its location in Guangdong province.
This figure was generated using ArcGIS Geographic Information Systems software version 10.2 (ESRI, USA).
Fig 2
Fig 2. The statistical graph of the reported HFMD cases in Shenzhen, from 2012 to 2015.
The characteristics distribution of age groups and sex, from 2012 to 2015(Fig.2.A). The distribution of the number of cases of each district from 2012 to 2015(Fig.2.B). The trends in the number of cases of each district from 2012 to 2015(Fig.2.C).
Fig 3
Fig 3. The variation of the pollutant over the 4 years, from 2012 to 2015.
Fig 4
Fig 4. The Spatial distribution of standardized incidence rates of HFMD in each region in Shenzhen, from 2012 to 2015.
This figure was generated using ArcGIS Geographic Information Systems software version 10.2 (ESRI, USA).
Fig 5
Fig 5. The spatial distribution of relative risk (only spatio-temporal effect) of HFMD in each region in Shenzhen.
This figure was generated using ArcGIS Geographic Information Systems software version 10.2 (ESRI, USA).
Fig 6
Fig 6. The Spatial distribution of relative risk (added explanatory variables) of HFMD in each region in Shenzhen.
This figure was generated using ArcGIS Geographic Information Systems software version 10.2 (ESRI, USA).
See this image and copyright information in PMC

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