Spatiotemporal Patterns And Determinants Of Potential Impact Factors To Hand,foot And Mouth Disease In Henan Province,China

From the late 19 th century to the early 20 th century,based on the rapid development of computer and its technologies,geographic information system(GIS)and its related industries ushered in a rare opportunity for development.It has played an excellent role in many fields,such as,disaster prediction,road management,urban planning and so on.In recent years,GIS has become more effective in the practice of health.For example,the relationship between pollution,meteorological,socio-economic and other influencing factors and human health is paid more and more attention from multi-perspectives spatially and temporally.The hand,foot and mouth disease(HFMD)incidence in Henan Province is higher in China,and due to its great population base,and millions of migrants,mainly flow to other provinces in China.Therefore,from multi-perspectives,calculating the spatial and temporal heterogeneity of HFMD in Henan Province and quantifying the determinants power of potential impact factors and the interaction of random two risk factors among them,which is helpful to prevent and control of HFMD in the study area,and rationally allocate the medical resources in practice.This study applies geographic information system technology and space-time statistical analysis to epidemiological research,which can provide reference for public health research.The research results can be used to provide the prevention and control policies and decisive supports of HFMD risk for public health related departments from a scientific perspective in the study area.In this study,data on HFMD in children under 5 years old among 126 administrative units of Henan Province from 2009 to 2013 was used.The time and space database between HFMD data and impact factors was established by ArcGIS,then the temporal and spatial characteristics of HFMD distribution in Henan Province were analyzed by descriptive analysis and ArcGIS.The representative space-time patterns are identified,using an Empirical Orthogonal Function(EOF)method,from multiple perspectives.In light of these results,the GeoDetector is introduced to quantify the determinant power of selected factors,including meteorological factors,socio-economic variables and their interactions to the incidence of HFMD,and to detect the dominant risk factors corresponding to each spatial-temporal pattern.In this study,the main conclusions follow as:(1)Detecting the temporal and spatial heterogeneity of the incidence of HFMD.The first space-time pattern accounted for 56.21% of the total variance,and the areas with higher risk were mainly concentrated in large cities(such as provincial capitals and municipal districts),and the peak of incidence occurred in April to June.At the same time,the second space-time pattern explained 10.52% of the total variance,and the areas with higher risk were mainly distributed in the counties that around the big cities,and the peak of incidence occurred from April to June.(2)Quantified the determinant power of the risk factors that influenced time-space heterogeneity of HFMD incidence.There are different dominant factors with different determinant powers in different geographical locations.Taking some examples,the dominant factors of the first spatial pattern are the per capita GDP and the ratio of urban and rural population,which exert a strong impact on the spatial heterogeneity of the HFMD incidence,and the determinant power are 62% and 56% respectively,and the interaction between the two factors is 71%.And in the second spatial pattern,the excellent factors are the ratio of urban and rural population and per capita income of farmers.The determinant powers of them,respectively,are 26% and 23%,and the determinant power of interaction between these two factors is 46%.The interaction between random two socioeconomic factors in the first two spatial patterns is remarkably greater than the individual effects of each factor.In addition,precipitation and relative humidity are the dominant factors in the first time pattern,and the meteorological factors present a significant effect on the temporal heterogeneity of the HFMD incidence,the determinant power of them are 46%,44%,respectively,and determinant power of interaction between the two factors is 95%.Corresponding to the second temporal pattern,the dominant factors are relative humidity and wind speed,with a determinant power of them are 58% and 50%,respectively,and the interaction between the two factors is 91%.In addition,the interaction between the random two meteorological factors in the second temporal pattern is also significantly stronger than the individual effects of the selected factors.