Epidemiological characteristics and spatiotemporal clustering analysis of hand- foot-mouth disease in Guiyang City from 2018 to 2022

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Author:  ZHANG Juntao ¹ XU Degan ² YANG Jun ¹

Affiliation: 1. Department of Health Emergency Response for Sudden Incidents, Guiyang Center for Disease Control and Prevention, Guiyang 550018, China 2. Department of Disease Control and Prevention Development, Guiyang Center for Disease Control and Prevention, Guiyang 550018, China

Keywords: Hand-foot-mouth disease Epidemiological characteristics Spatial autocorrelation Local autocorrelation Spatio-temporal scanning statistic

DOI: 10.12173/j.issn.1004-4337.202502035

Reference: Zhang JT, Xu DG, Yang J. Epidemiological characteristics and spatiotemporal clustering analysis of hand-foot-mouth disease in Guiyang City from 2018 to 2022[J]. Journal of Mathematical Medicine, 2025, 38(8): 573-580. DOI: 10.12173/j.issn.1004-4337.202502035[Article in Chinese]  Copied

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Abstract

Objective To analyze the epidemiological characteristics and spatiotemporal clustering of hand-foot-mouth disease (HFMD) in Guiyang City from 2018 to 2022, and to provide a scientific basis for the prevention and control of HFMD.

Methods Descriptive epidemiological methods were used to analyze the surveillance data of HFMD in Guiyang City from 2018 to 2022. ArcMap 10.5 software was used for spatial autocorrelation analysis, and SaTScan 9.5 software was used for spatiotemporal clustering analysis.

Results A total of 120 138 cases of HFMD were reported in Guiyang City from 2018 to 2022, with an incidence rate ranging from 254.15/100 000 to 767.20/100 000, and an average annual incidence rate of 477.19/100 000, showing a decreasing trend year by year. The temporal distribution of HFMD in Guiyang City exhibited a clear seasonal pattern. The months of onset present a bipeak distribution, with a major peak from April to July and a minor peak in October. The age of onset was mainly between 0 to 5 years old, with a male-to-female ratio of 1.33 ∶ 1. The incidence rate of HFMD in various districts and counties of Guiyang City showed an overall decreasing trend. The proportion of children living in scattered communities showed a decreasing trend (χ²_trend=5 784.702, P<0.001), while the proportion of children in kindergartens and nurseries showed an increasing trend (χ²_trend=6 147.585, P<0.001), which was significantly positively correlated with the clustering number of outbreaks in kindergartens and nurseries in Guiyang City (r=0.955 3, P=0.011). The results of global spatial autocorrelation analysis of HFMD incidence in Guiyang City from 2018 to 2022 were not statistically significant (P>0.05), but the local spatial autocorrelation analysis showed a "low-high" pattern, mainly in Baiyun district and Qingzhen City. The results of spatio-temporal scanning analysis revealed significant clustering from April 2018 to July 2019, and the first type of aggregation area was Guanshanhu district. Other enteroviruses were the dominant strains of HFMD in Guiyang City from 2019 to 2022, but the proportion of CV-A16 showed an upward trend (P<0.001).

Conclusion When the incidence of HFMD in Guiyang city is at a high level, attention should be focused on spatial clustering. Although the incidence rate has decreased by 2022, the proportion of children in kindergartens and nurseries has increased year by year, and it is related to the clustering of outbreaks in kindergartens and nurseries, suggesting that the prevention and control of clustered epidemics of HFMD in kindergartens and nurseries should be strengthened. Changes in the dominant types of CV-A16 circulation may affect the epidemic trend and severity, and it is necessary to enhance the pathogenic surveillance.

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