Epidemiological Characteristics And Time Series Analysis Of Hand,Foot And Mouth Disease (HFMD) In Wuzhou City From 2014 To 2018

Objective:This study aims to comprehensively analyze the epidemic situation,severe and death cases,pathogenic surveillance results of HFMD in Wuzhou City from 2014 to 2018,and analyze the epidemiological characteristics and the pathogenic composition of severe cases of HFMD.Exploring the risk factors for critical illness of HFMD,to investigate the sequelae of severe cases preliminary and establish a model that predicts the trend of HFMD epidemics,and provide scientific basis for the prevention and control strategies of HFMD,so as to achieve the goal of reducing cases of HFMD in Wuzhou City.Methods:Data on HFMD cases,severe deaths and pathogens in Wuzhou City from 2014 to 2018 were collected and analyzed,and then use descriptive epidemiology to analysis.Data collation and charting were performed using EXCEL 2016.0,Model establishment and statistical analysis were using SPSS25.0,rate or composition ratio were used to description data,chi-square test for comparison between two or more groups,and multivariate analysis using conditional logistic regression analysis,?=0.05.Results:1.From 2014 to 2018,Wuzhou City reported a total of 67,653cases of HFMD,with an average annual incidence rate of 441.11/100,000.The incidence of HFMD has obvious seasonality in each year.Except for 2016,the other years are bimodal distribution.The high-incidence areas are concentrated in Changzhou and Cenxi,and the gender ratio is 1.51:1.The age distribution is mainly for children aged 5 years and younger?92.74%?,mainly scattered children?76.75%?.2.There were 4,213 severe cases of HFMD from 2014 to 2018 in Wuzhou,the severe incidence rate was 27.08/100,000.The highest rate was 86.02/100,000in 2017.The time distribution is consistent with the overall epidemic,showing a seasonal distribution of bimodal epidemics;the regional distribution is mainly in Cenxi?69.55%?,and the male-female ratio is 1.55:1,focusing on children aged 3years and younger?84.72%?,scattered children accounted for 92.76%.3.In the severe cases of HFMD in Wuzhou City from 2014 to 2018,a total of 3,985 laboratory specimens were tested,accounting for 94.59%,and 3154 cases were positive,with a positive rate of 79.15%.In 3,154 positive specimens,1,774cases?56.25%?of other enteric viruses;followed by 1,122 cases?35.57%?of EV71 type virus;258 cases?8.18%?of CVA16.The factors that led to critical cases of HFMD were profession?P=0.005?,feeding pattern?P=0.009?,type of residence?P=0.035?and virus test results?P=0.035?,it was statistically significant.4.In the investigation of sequelae,468 severe cases were followed up,and296 respondents,so the response rate was 63.25%.Of the 296 responders,only 1patient showed left upper limb weakness,and the rest showed no significant sequelae.5.In 2014²018,15 cases of HFMD deaths were reported in Wuzhou City,11 cases of males,all of whom were 6 months to 3 years old,all of whom died of EV71 infection.6.Time series analysis results show that ARIMA?2,0,0??0,1,1?₁₂ is the optimal model for predicting the short-term development trend of HFMD cases in Wuzhou City.The Liung-Box test results are Q=10.884,P=0.761,and the autocorrelation and partial autocorrelation coefficients in the residual sequence graph are within the 95%confidence interval,BIC is 14.037,and stationary R²=0.792.From July to December 2018 in Wuzhou City,the average relative error between fitted cases and actual cases were 18.28%,and the number of actual cases was within the 95%confidence interval of the number of predicted cases by the model.Conclusion:1.The time distribution of HFMD in Wuzhou City from 2014to 2018 showed obvious seasonal distribution,and it was a bimodal epidemic.The onset time was mainly from April to June and from August to October.In the regional distribution,the area with high incidence is mainly in Changzhou,and the number of cases is mainly concentrated in Cenxi.In the distribution of the population,males are higher than females,and scattered children under the age of5 are the mainstays.2.The time distribution of severe cases of HFMD in Wuzhou City from2014 to 2018 was the same as that of the overall epidemic.It showed obvious seasonal distribution characteristics,showing the characteristics of bimodal distribution in summer and autumn.The area with high incidence of severe disease was mainly WanXiu District and Cenxi City,the number of severe cases in Cenxi City accounted for 69.55%of Wuzhou City;the population distribution was mainly male,mainly concentrated in scattered children aged 3 years and younger.3.The pathogens of severe cases of HFMD in Wuzhou City from 2014 to2018 were mainly composed of other enteroviruses,followed by EV71,and the proportion of CVA16 was the least.The overall proportion of EV71 decreased year by year,and the proportion of other enteroviruses was increasing year after year,CVA16 was the least.The factors that lead to critical cases of HFMD include profession,feeding methods,type of living,and virus test results.4.From 2014 to 2018,among the deaths of HFMD in Wuzhou City,males was higher than that of females,and it was mainly concentrated in children of low age from 6 months to 3 years old,all of which were caused by infection with EV71 virus.5.Time series analysis of the number of cases of HFMD in Wuzhou City from 2014 to 2018.The model ARIMA?2,0,0??0,1,1?₁₂ is the best model for predicting the development trend of HFMD cases in Wuzhou City in a short period of time.It is highly accurate for predicting the cases of HFMD in Wuzhou City of2019.