Skip to main content Accessibility help
×
Home

Spatio-temporal clustering of hand, foot and mouth disease at the county level in Sichuan province, China, 2008–2013

  • L. LIU (a1) (a2), X. ZHAO (a1), F. YIN (a1) and Q. LV (a2)

Summary

China has recently experienced a marked increase in the incidence of hand, foot and mouth disease (HFMD). Effective spatio-temporal monitoring of HFMD incidence is important for successful implementation of control and prevention measures. This study monitored county-level HFMD reported incidence rates for Sichuan province, China by examining spatio-temporal patterns. County-level data on HFMD daily cases between January 2008 and December 2013 were obtained from the China Information System for Disease Control and Prevention. We first conducted purely temporal and purely spatial descriptive analyses to characterize the distribution patterns of HFMD. Then, the global Moran's I statistic and space–time scan statistic were used to detect the spatial autocorrelation and identify the high-risk clusters in each year, respectively. A total of 212267 HFMD cases were reported in Sichuan province during the study period (annual average incidence 43·65/100000), and the incidence seasonal peak was between April and July. Relatively high incidence rates appeared in the northeastern–southwestern belt. HFMD had positive spatial autocorrelation at the county level with global Moran's I increasing from 0·27 to 0·52 (P < 0·001). Spatio-temporal cluster analysis detected six most-likely clusters and several secondary clusters from 2008 to 2013. The centres of the six most-likely clusters were all located in the provincial capital city Chengdu. Chengdu and its neighbouring cities had always been spatio-temporal clusters, which indicated the need for further intensive space–time surveillance. Allocating more resources to these areas at suitable times might help to reduce HFMD incidence more effectively.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Spatio-temporal clustering of hand, foot and mouth disease at the county level in Sichuan province, China, 2008–2013
      Available formats
      ×

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Spatio-temporal clustering of hand, foot and mouth disease at the county level in Sichuan province, China, 2008–2013
      Available formats
      ×

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Spatio-temporal clustering of hand, foot and mouth disease at the county level in Sichuan province, China, 2008–2013
      Available formats
      ×

Copyright

Corresponding author

* Author for correspondence: Dr F. Yin, West China School of Public Health, Sichuan University, No. 16 Section 3, Renminnan Road, Chengdu, Sichuan 610041, People's Republic of China, 610041. (Email: westsilverhx@163.com)

References

Hide All
1. Jiang, M, et al. Autopsy findings in children with hand, foot, and mouth disease. New England Journal of Medicine 2012; 367: 9192.
2. World Health Organization. A Guide to Clinical Management and Public Health Response for Hand, Foot and Mouth Disease (HFMD). Geneva: WHO Press, 2011.
3. Liu, Y, et al. Detecting Spatial-temporal clusters of HFMD from 2007 to 2011 in Shandong province, China. PLoS One 2013; 8: e63447.
4. Deng, T, et al. Spatial-temporal clusters and risk factors of hand, foot, and mouth disease at the district level in Guangdong Province, China. PLoS One 2013; 8: e56943.
5. Samphutthanon, R, et al. Spatio-temporal distribution and hotspots of hand, foot and mouth disease (HFMD) in Northern Thailand. International Journal of Environmental Research and Public Health 2013; 11: 312336.
6. ZHU, Q, et al. Surveillance of hand, foot, and mouth disease in mainland China (2008–2009). Biomedical and Environmental Sciences 2011; 24: 349356.
7. Blomqvist, S, et al. Co-circulation of coxsackieviruses A6 and A10 in hand, foot and mouth disease outbreak in Finland. Journal of Clinical Virology 2010; 48: 4954.
8. Chua, KB, Kasri, AR. Hand foot and mouth disease due to enterovirus 71 in Malaysia. Virologica Sinica 2011; 26: 221228.
9. Fujimoto, T, et al. Hand, foot, and mouth disease caused by coxsackievirus A6, Japan, 2011. Emerging Infectious Diseases 2012; 18: 337.
10. Xie, Y, et al. Spatio-temporal clustering of hand, foot, and mouth disease at the county level in Guangxi, China. PLoS One 2014; 9: e88065.
11. The Ministry of Health of China. Hand, foot and mouth disease prevention and control guideline, China (2009 version) (http://www.gov.cn/gzdt/2009-06/04/content_1332078.htm). Accessed 2014 March 28.
12. Hui, F, et al. Spatio-temporal distribution of malaria in Yunnan Province, China. American Journal of Tropical Medicine and Hygiene 2009; 81: 503509.
13. Kulldorff, M, et al. Breast cancer clusters in the northeast United States: a geographic analysis. American Journal of Epidemiology 1997; 146: 161170.
14. Hu, M, et al. Determinants of the incidence of hand, foot and mouth disease in China using geographically weighted regression models. PLoS One 2012; 7: e38978.
15. Huang, Y, et al. Effect of meteorological variables on the incidence of hand, foot, and mouth disease in children: a time-series analysis in Guangzhou, China. BMC Infectious Diseases 2013; 13: 134.
16. Wang, J, et al. Spatial dynamic patterns of hand-foot-mouth disease in the People's Republic of China. Geospatial Health 2013; 7: 381390.
17. Onozuka, D, Hashizume, M. The influence of temperature and humidity on the incidence of hand, foot, and mouth disease in Japan. Science of the Total Environment 2011; 410: 119125.
18. Ma, E, et al. Changing epidemiology of hand, foot, and mouth disease in Hong Kong, 2001–2009. Japanese Journal of Infectious Diseases 2010; 63: 422426.
19. Bie, QQ, et al. Spatial and temporal distribution characteristics of hand-foot-mouth disease in China. Journal of Geo-Information Science 2010; 12: 380384.
20. Robertson, C, Nelson, TA. Review of software for space-time disease surveillance. International Journal of Health Geographics 2010; 9: 101186.
21. Chen, J, et al. Geovisual analytics to enhance spatial scan statistic interpretation: an analysis of US cervical cancer mortality. International Journal of Health Geographics 2008; 7: 57.
22. Yang, C, et al. Use of mobile phones in an emergency reporting system for infectious disease surveillance after the Sichuan earthquake in China. Bulletin of the World Health Organization 2009; 87: 619623.

Keywords

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed