Epidemic Characteristcs And Incidence Prediction Of Hand Foot And Mouth Disease In Guilin City From 2010 To 2018

ObjectiveTo elucidate the epidemic characteristics and rules of hand-foot-mouth disease(HFMD)in Guilin city from 2010 to 2018,explore the incidence characteristics of HFMD under the influence of meteorological factors,grasp the pathogenic spectrum of HFMD and the change rules of endemic dominant strains preliminarily,and construct a model to predict the incidence of HFMD,so as to provide scientific basis for the prevention and control of HFMD.Methods1.Epidemiological characteristics:1.1 Descriptive epidemiological method was adopted to summarize the epidemic situation.According to the epidemiological data of HFMD in Guilin city from 2010 to 2018,the epidemiological distribution,incidence(the number of new cases and the incidence rate),severity(the number of mild cases,severe cases and dead cases)and other indicators were described.1.2 Linear correlation analysis was applied to analyze the relationship between the HFMD incidence rate and meteorological factors in Guilin.Thecorrelation between HFMD incidence and the monthly average pressure(hPa),mean monthly temperature(℃),monthly rainfall(mm),monthly average relative humidity(1%),monthly sunshine hours(1 h),monthly average wind speed(m/s),and other meteorological factors during 2010 to 2017 were analyzed.1.3 Etiological description and analysis were used to reveal the dynamic changes of enterovirus pathogen spectrum and the dominant epidemic viruses of HFMD in Guilin from 2010 to 2018.2.Prediction for HFMD incidence: Autoregegressive integrated maving average model(ARIMA)was established to fit with the monthly HFMD incidence rate during 2010-2017.The monthly incidence rate in 2018 was predicted and evaluated by ARIMA.After that,the HFMD incidence rate in2019 was predicted,too.Results1.Total incidence.From 2010 to 2018,a total of 219 980 cases of HFMD occurred in Guilin city,with an average annual incidence of 526.76/100,000,2,275 severe cases and 83 deaths.2.Three-dimension distribution.2.1 Time distribution: the incidence of HFMD was enhanced every other year during 2010 to 2016.The monthly HFMD incidence showed seasonal characteristics obviously.The first incidence peak was from March to July,and the second was from August to November.The average monthly rainfall,maximum daily precipitation,average water pressure,average air temperature,minimum air temperature,maximum air temperature and average relative humidity(P<0.001)were positively correlated with the incidence of HFMD in Guilin city.While monthly mean wind speed and air pressure were negativelycorrelated with the incidence of HFMD.2.2 Population distribution: The patients aged 0 to 5 years old accounted for95.98%(211,138/219,980)cases.The gender ratio of HFMD patients was1.43:1(129,442/90,538)male to female.The majority of the patients were scattered children(152,442),accounting for 69.30% of the total cases,followed by 58 696 childcare children(26.70%).Scattered children and childcare children accounted for 96% of the total cases.2.3 Regional distribution: the areas with high HFMD prevalence were concentrated in Quanzhou,Xing’an and Lingchuan counties,while the areas with low HFMD prevalence were Longsheng autonomous county of all ethnic groups,Guanyang county and Yanshan district.3.Analysis of pathogenic monitoring.EV71 and Cox A16 were the main circulating enteroviruses among HFMD patients in Guilin city.4.Analysis of severe cases and deaths.Severe cases of HFMD in Guilin from 2014 to 2018 were mainly infected by EV71 enterovirus in May and June.The severe HFMD cases were found in Lingchuan county,Xing’an county,Lingui district,Gongcheng Yao autonomous county and Diecai district.The correct rate of first diagnosis of HFMD increases with the increase of medical level.5.Incidence prediction.The predicted value of the monthly incidence of HFMD in Guilin city in 2018 is basically within the 95% confidence interval of the predicted value of ARIMA(0,0,2)(0,1,1)12 model.The predicted value based on this model basically conforms to the actual incidence of HFMD in2018.Conclusions1.HFMD occurs frequently every other year in Guilin city,withdouble-peak every year.The majority of the infected children are scattered children under 5 years old.In addition,meteorological factors can influence the severity of HFMD epidemic.2.Quanzhou county,Xing’an county,Lingchuan county,Diecai district and Qixing district of Guilin are high HFMD epidemic areas,and prevention and control efforts should be strengthened.3.ARIMA model can well fit the monthly incidence of HFMD,and to be further used for short-term prediction of the prevalence of HFMD in Guilin,in order to provide scientific basis for HFMD targeted prevention and control measures.