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. 2021 Sep 8;21(1):1640.
doi: 10.1186/s12889-021-11665-0.

Epidemiological characteristics and spatiotemporal analysis of hand-foot-mouth diseases from 2010 to 2019 in Zibo city, Shandong, China

Lili Liu #  1 , Ling Wang #  2 , Chang Qi  1 , Yuchen Zhu  1 , Chunyu Li  1 , Yan Jia  1 , Kaili She  1 , Tingxuan Liu  1 , Yan Zhang  2 , Feng Cui  3 , Xiujun Li  4
Affiliations

Epidemiological characteristics and spatiotemporal analysis of hand-foot-mouth diseases from 2010 to 2019 in Zibo city, Shandong, China

Lili Liu et al. BMC Public Health. .

Abstract

Background: Hand-foot-mouth disease (HFMD) is a global public health issues, especially in China. It has threat the health of children under 5 years old. The early recognition of high-risk districts and understanding of epidemic characteristics can facilitate health sectors to prevent the occurrence of HFMD effectively.

Methods: Descriptive analysis was used to summarize epidemic characteristics, and the spatial autocorrelation analysis and space-time scan analysis were utilized to explore distribution pattern of HFMD and identify hot spots with statistical significance. The result was presented in ArcMap.

Results: A total of 52,095 HFMD cases were collected in Zibo city from 1 Jan 2010 to 31 Dec 2019. The annual average incidence was 129.72/100,000. The distribution of HFMD was a unimodal trend, with peak from April to September. The most susceptible age group was children under 5 years old (92.46%), and the male-to-female ratio is 1.60: 1. The main clusters were identified in Zhangdian District from 12 April 2010 to 18 September 2012. Spatial autocorrelation analysis showed that the global spatial correlation in Zibo were no statistical significance, except in 2012, 2014, 2015, 2016 and 2018. Cold spots were gathered in Boshan county and Linzi district, while hot spots only in Zhangdian District in 2018, but other years were no significance.

Conclusion: Hot spots mainly concentrated in the central and surrounding city of Zibo city. We suggest that imminent public health planning and resource allocation should be focused within those areas.

Keywords: Autocorrelation analysis; Hand-foot-mouth disease; Shandong province; Space-time clustering; Spatial epidemiology.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Geographical location of Zibo city, Shandong Province, China. (The author drew this map by ArcGIS10.5 software)
Fig. 2
Fig. 2
Yearly and monthly HFMD incidence in Zibo city, Shandong Province, China, 2010–2019
Fig. 3
Fig. 3
Sequence diagram of monthly HFMD cases from January 2010 to December 2019 in Zibo city. (The author drew this map by ArcGIS10.5 software)
Fig. 4
Fig. 4
Annual incidence (/100,000) of HFMD at county level in Zibo city, Shandong Province, 2010–2019. (The author drew this map by ArcGIS10.5 software)
Fig. 5
Fig. 5
The results of local spatial autocorrelation of HFMD in Zibo city, Shandong Province, 2010–2019 (The author drew this map by ArcGIS10.5 and OpenGeoDa1.2.0 software). There are only two kinds of results, and the same color describes the same kind of cluster areas, red represents hot spots, means the surrounding area and study areas are high incidence areas, blue represents cold spots, and the blank parts were the scanning areas with no statistical significance
Fig. 6
Fig. 6
The results of spatiotemporal scan of HFMD from 2010 to 2019 in Zibo city, Shandong Province, in 2010–2019 (The author drew this map by ArcGIS10.5 and SaTscan 9.4 software). The same color describes the same kind of cluster areas, but the blank parts were the scanning areas with no statistical significance
See this image and copyright information in PMC

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