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. 2020 Nov 6;99(45):e23007.
doi: 10.1097/MD.0000000000023007.

Nonlinear effect of temperature on hand, foot, and mouth disease in Lanzhou, China

Jinyu Wang  1 , Sheng Li  2
Affiliations

Nonlinear effect of temperature on hand, foot, and mouth disease in Lanzhou, China

Jinyu Wang et al. Medicine (Baltimore). .

Abstract

To examine the effects of temperature on the daily cases of hand, foot, and mouth disease (HFMD).Data on the daily cases of HFMD in Lanzhou from 2008 to 2015 were obtained, and meteorological data from the same period were collected. A distributed lag nonlinear model was fitted to reveal the relationship between the daily mean temperature and the daily cases of HFMD.From 2008 to 2015, 25,644 cases were reported, of which children under 5 years of age accounted for 78.68% of cases. The highest peak of HFMD cases was usually reported between April to July each year. An inverse V-shaped relationship was observed between daily mean temperature and HFMD cases; a temperature of 18°C was associated with a maximum risk of HFMD. The relative risk (RR) was 1.57 (95% confidence interval: 1.23-1.23), and boys and children aged 3 to 5 years were populations with the highest risk. The cumulative risks of high temperature (20.2°C and 25.2°C) in the total, age-specific, and gender-specific groups peaked on lag 14 days; RR was higher in girls than in boys and in children aged 1 to 2 years than in other age groups. However, the effects of low temperature (-5.3°C, 2.0°C, and 12.8°C) were not significant for both gender-specific and age-specific patients.High temperature may increase the risk of HFMD, and boys and children aged 3 to 5 years were at higher risks on lag 0 day; however, the cumulative risks in girls and children aged 1 to 2 years increased with the increasing number of lag days.

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Conflict of interest statement

The authors have no conflicts of interests to disclose.

Figures

Figure 1
Figure 1
Daily distribution of meteorological variables and hand, foot, and mouth disease cases from 2008 to 2015.
Figure 2
Figure 2
Three-dimensional plot of the relationship between the mean temperature and hand, foot, and mouth disease over 30 lag days.
Figure 3
Figure 3
Plot of RR by temperature at specific lags, and RR by lag at specific temperatures. RR = relative risk .
Figure 4
Figure 4
Overall relative risks of mean temperature for the total hand, foot, and mouth disease cases over 30 days.
Figure 5
Figure 5
Overall relative risks of mean temperature for age- and gender-specific hand, foot, and mouth disease cases over 30 days.
See this image and copyright information in PMC

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