Short-term effects of meteorological factors on pediatric hand, foot, and mouth disease in Guangdong, China: a multi-city time-series analysis

Guo, Cui, Yang, Jun, Guo, Yuming, Ou, Qiao-Qun, Shen, Shuang-Quan, Ou, Chun-Quan and Liu, Qi-Yong (2016) Short-term effects of meteorological factors on pediatric hand, foot, and mouth disease in Guangdong, China: a multi-city time-series analysis. BMC Infectious Diseases, 16 1: 524. doi:10.1186/s12879-016-1846-y


Author Guo, Cui
Yang, Jun
Guo, Yuming
Ou, Qiao-Qun
Shen, Shuang-Quan
Ou, Chun-Quan
Liu, Qi-Yong
Title Short-term effects of meteorological factors on pediatric hand, foot, and mouth disease in Guangdong, China: a multi-city time-series analysis
Journal name BMC Infectious Diseases   Check publisher's open access policy
ISSN 1471-2334
Publication date 2016-09-29
Sub-type Article (original research)
DOI 10.1186/s12879-016-1846-y
Open Access Status DOI
Volume 16
Issue 1
Start page 524
Total pages 9
Place of publication London, United Kingdom
Publisher BioMed Central
Language eng
Subject 2725 Infectious Diseases
Abstract Background: Literature shows inconsistency in meteorological effects on Hand, foot, and mouth disease (HFMD) in different cities. This multi-city study aims to investigate the meteorological effects on pediatric HFMD occurrences and the potential effect modification by geographic factors. Methods: Based on daily time-series data in eight major cities in Guangdong, China during 2009-2013, mixed generalized additive models were employed to estimate city-specific meteorological effects on pediatric HFMD. Then, a random-effect multivariate meta-analysis was conducted to obtain the pooled risks and to explore heterogeneity explained by city-level factors. Results: There were a total of 400,408 pediatric HFMD cases (children aged 0-14 years old) with an annual incidence rate of 16.6 cases per 1,000 children, clustered in males and children under 3 years old. Daily average temperature was positively associated with pediatric HFMD cases with the highest pooled relative risk (RR) of 1.52 (95 % CI: 1.30-1.77) at the 95th percentile of temperature (30.5 °C) as compared to the median temperature (23.5 °C). Significant non-linear positive effects of high relative humidity were also observed with a 13 % increase (RR = 1.13, 95 % CI: 1.00-1.28) in the risk of HFMD at the 99th percentile of relative humidity (86.9 %) as compared to the median value (78 %). The effect estimates showed geographic variations among the cities which was significantly associated with city's latitude and longitude with an explained heterogeneity of 32 %. Conclusions: Daily average temperature and relative humidity had non-linear and delayed effects on pediatric HFMD and the effects varied across different cities. These findings provide important evidence for comprehensive understanding of the climatic effects on pediatric HFMD and for the authority to take targeted interventions and measures to control the occurrence and transmission of HFMD.
Formatted abstract
Background: Literature shows inconsistency in meteorological effects on Hand, foot, and mouth disease (HFMD) in different cities. This multi-city study aims to investigate the meteorological effects on pediatric HFMD occurrences and the potential effect modification by geographic factors.

Methods: Based on daily time-series data in eight major cities in Guangdong, China during 2009–2013, mixed generalized additive models were employed to estimate city-specific meteorological effects on pediatric HFMD. Then, a random-effect multivariate meta-analysis was conducted to obtain the pooled risks and to explore heterogeneity explained by city-level factors.

Results: There were a total of 400,408 pediatric HFMD cases (children aged 0–14 years old) with an annual incidence rate of 16.6 cases per 1,000 children, clustered in males and children under 3 years old. Daily average temperature was positively associated with pediatric HFMD cases with the highest pooled relative risk (RR) of 1.52 (95 % CI: 1.30–1.77) at the 95th percentile of temperature (30.5 °C) as compared to the median temperature (23.5 °C). Significant non-linear positive effects of high relative humidity were also observed with a 13 % increase (RR = 1.13, 95 % CI: 1.00–1.28) in the risk of HFMD at the 99th percentile of relative humidity (86.9 %) as compared to the median value (78 %). The effect estimates showed geographic variations among the cities which was significantly associated with city’s latitude and longitude with an explained heterogeneity of 32 %.

Conclusions: Daily average temperature and relative humidity had non-linear and delayed effects on pediatric HFMD and the effects varied across different cities. These findings provide important evidence for comprehensive understanding of the climatic effects on pediatric HFMD and for the authority to take targeted interventions and measures to control the occurrence and transmission of HFMD.
Keyword Hand, foot, and mouth disease
Meteorological factors
Mixed generalized additive model
China
Q-Index Code C1
Q-Index Status Provisional Code
Grant ID 81573249
Institutional Status UQ
Additional Notes Article number 524

Document type: Journal Article
Sub-type: Article (original research)
Collections: HERDC Pre-Audit
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Created: Mon, 03 Oct 2016, 04:25:11 EST by Yuming Guo on behalf of School of Public Health