| Hand,foot and mouth disease(HFMD)is the infectious disease which is mostly caused by enterovirus infection in children.It is manifested by ulcers in hands,mouth and feet.Recently,hand,foot and mouth disease(HFMD)was at a high incidence in the world.In China,the incidence of HFMD ranks first among infectious diseases.Guangxi is located in the coastal area of southern China,which is one of the high incidence areas for hand,foot and mouth disease.Therefore,effective prevention of hand,foot and mouth disease has posed an important challenge to the health and medical departments in Guangxi.In this study,based on the hospitalized cases of HFMD among children under 5 years old in Guangxi from January 1 to December 31,2015,the temporal and spatial distribution characteristics of HFMD were firstly analyzed by using global autocorrelation(Moran I)method and time series analysis.Geodetector was used to detect the effects of climatic factors(PRE,TEM,PRS,RHU,WIN)and air quality factors(AQI,PM2.5 and PM10)on spatial variation of HFMD.Finally,based on Distributed Lag Non-linear Model(DLNM),lag effects of climate and air quality factors on HFMD were analyzed.The main results are as follows:(1)HFMD incidence in Guangxi Province in 2015 has obvious seasonality.The high HFMD incidence appeared in spring and autumn.The incidence of HFMD has two peaks in May-June and September-October,respectively.In terms of the spatial distribution,there are obvious regional differences among counties and districts in Guangxi.The high incidence regions are concentrated in Baise City in the western part of Guangxi.The high HFMD incidence regions includes Tianyang County,Tiandong County,Pingguo County,Jingxi County,Lingyun County and Yulin City.The highest HFMD incidence of Tianyang County is 1918.5/10000.(2)Geodetector showed that:(1)annual average precipitation had the greatest impact on the spatial distribution of HFMD,with a q value of 0.24.The explanatory power of other factors from high to low is annual average pressure(0.11),annual average wind speed(0.10),annual average temperature(0.09),annual average relative humidity(0.04).(2)Explanatory power of PM2.5 on the spatial distribution of HFMD was 0.15,while the explanatory power of AQI and PM10 was relatively weak,both of which were 0.01.The interaction of two factors was enhanced.(3)Interaction between two meteorological factors has significantly enhanced the impact of hand,foot and mouth disease.In particular,the single factor of annual average temperature and annual relative humidity has little influence,but the interaction between the two factors is the strongest explanatory power for HFMD,which is 0.73.The interaction effect between annual average temperature and annual average precipitation on HFMD is also significantly enhanced.(4)Interaction between climate factors and air quality factors has enhanced the explanatory power of HFMD.PM2.5 and annual average precipitation have the strongest interaction,explanatory power is 0.47,which is higher than that of single factor.(5)Interaction of each factor has more influence on the distribution of HFMD in Guangxi than that of single factor.Therefore,the interaction effect between different environment factors should be paid more attention when considering the impact factors.(3)Based on the analysis of DLNM hysteresis effect,the lag effect of environmental factors on the risk of HFMD is found,and the lag effect of different environmental factors on HFMD is different.When the temperature is 6℃,the lag of 1 day is the biggest;when the precipitation is 519 mm,the lag of 2 days is the biggest effect;when the relative humidity is 54%,the lag of 1 day is the greatest;when the wind speed is 40 km/h-60 km/h,the lag of 2-4 days is the greatest;when the air pressure is 10006 Pa,the lag of 2 days is the greatest;when PM2.5 is 153μg/m~3,the lag of 7 days is the greatest;AQI is 243,the lag of 7 days is the greatest;when PM10 is 196 mg/m~3,the lag of 2 days is the greatest. |
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