| ObjectiveHand foot and mouth disease(HFMD)is a common infectious disease in children.It is a global disease that occurs throughout the country.The pathogen of HFMD is enterovirus(EV),which belongs to the genus Enterovirus of the picornavirus family.The main clinical symptoms are fever,rash,papules,and herpes on the hands,feet,mouth,and buttocks.In a few cases,damage to the central nervous system may occur.This study used spatial epidemiology and statistical methods to analyze the spatial and temporal distribution of HFMD in Haining City from 2010 to 2014,and to explore the spatial and temporal hotspots of HFMD in the study area.Exploring the problem of aggregation,providing a basis for formulating a targeted prevention and control strategy,with a view to providing public health monitoring levels and rational and effective allocation of health emergency resources.MethodsAccording to the "Infectious Disease Reporting Information Management System"in the "China Disease Prevention and Control Information System",according to the date of onset and the time of final review,the report of hand,foot and mouth disease from January 1,2010 to December 31,2014 is exported.According to the "Zhejiang Hand,Foot and Mouth Disease Monitoring Program",a monitoring hospital was set up in Haining City to collect throat swab specimens;a vector map was obtained from the Zhejiang Provincial Center for Disease Control.The epidemiological characteristics of hand-foot-mouth disease in Haining City from 2010 to 2014 were analyzed by epidemiological methods.Spatial data visualization method was used to produce the distribution map of hand-foot-mouth disease incidence in Haining from 2010 to 2014.The seasonal distribution characteristics of hand,foot and mouth disease epidemics were analyzed by using the concentration method and the circular distribution method.Intestinal virus,EV71 and CoxA16 were performed by reverse transcription-polymerize chain reaction(RT-PCR)according to the Hand,Foot and Mouth Disease Prevention and Control Guide(2009).Global and local spatial auto correlation analysis was performed using Geoda 1.2.0 software,and time,space and spatio-temporal scanning analysis was performed using SaTScan 9.3 software.Results1.There are a total of 7076 cases reported from 2010 to 2014 in Haining City,1 case of severe cases and 1 case of death.Every year,the incidence of HFMD disease ranks first.Concentration analysis showed that the incidence of HFMD in Haining City in 2010 had obvious seasonality.In 2011,2012 and 2014,the incidence of hand,foot and mouth in Haining City had a certain seasonality.In 2013,the incidence of hand,foot and mouth in Haining City had a weaker season.The peak incidence was calculated on the 30th of June using the circular distribution principle,and the peak incidence period was from April 1 to September 25.2.The age of onset was the lowest in January,the largest was 50 years old,and 5938 children<4 years old,accounting for 83.92%.4218 males,accounting for 59.61%of the total number of cases,2858 females,accounting for 40.39%of the total number of cases,male-female ratio of 1.48:1,occupational distribution of 4,483 children(63.36%)and 2256 children of young children(accounting for 31.88%).3.A total of 332 samples of throat swabs were collected within 5 years,and 210 positive cases were detected.The overall positive rate was 63.25%.The pathogen composition is mainly EV71 and Cox A16.The EV71 positive rate trend test showed a downward trend(X2=2.51,P=0.01),and the Cox A16 positive rate showed a downward trend(trend test X2 =5.81,P<0.01),and other enterovirus positive rates showed an upward trend(trend test)X2 = 2.58,P<0.01).4.In 2010,2011,2012 and 2014,the Moran’s I of HFMD incidence in Haining City was higher than 0.The incidence rate of Moran’s I was less than 0 in 2013.In 2012 and 2014,the incidence of HFMD in Haining City was spatially positively correlated and spatial clustering.5.The auto correlation analysis of local space shows that in 2010,Xieqiao Town belongs to the high-high area,Maqiao Street and Huangwan Town belong to the low-high area;in 2012,Haichang Street and Lanshi Street belong to the high-high area,Yanguan Town And Huangwan Town belong to the low-low area;in 2013,Yanguan Town belongs to the low-low area,and Yanshi Street belongs to the low-high area;in 2014,Dingqiao Town belongs to the low-low area.6.Statistical analysis of spatio-temporal scans showed that the distribution of hand,foot and mouth disease cases in Haining City in 2010-2014 was not random,but obvious clustering(P<0.001),and the analysis was divided into five grades.There are 2 first-level gathering areas,Chang’an Town and Zhouwangmiao Town,from 2014/5/1 to 2014/11/30,and 2 secondary gathering areas,which are Lanshi Street and Haichang Street,time is 2012./5/1 to 2012/7/31;one of the three-level gathering area is Xucun Town,the time is from 2014/9/1 to 2014/12/31;the fourth-level gathering area is 3,which is Huangwan Town and Yuanhua Town and Dingqiao Town,time from 2010/5/1 to 2010/7/31;two level five gathering areas,namely Xieqiao Town and Haizhou Street,from 2010/4/1 to 2010/7/31.Conclusions1.HFMD in Haining City has a certain seasonal distribution in 2010-2014.More men than women,mostly scattered children,the main strains of virus are EV71 and CoxA6.2.The spatial and temporal distribution of hand,foot and mouth disease in Haining City from 2010 to 201.In 2012 and 2014,the incidence of hand,foot and mouth disease in Haining City was spatially positively correlated as a whole,with spatial aggregation rather than random distribution;In the spatial dimension,there are high-incidence areas in general,but the high-incidence areas in the past years are not fixed,but in a changing state;in the space-time dimension,there is obvious space-time clustering,and the high-incidence areas occur under a certain time and space,suggesting high-level aggregation.There are related popular factors in the region.3.In view of the spatio-temporal characteristics of hand-foot-mouth disease in Haining City,it is necessary to pay attention to the hot spot areas of prevention and control in prevention and control.In these areas,joint prevention and control measures should be formulated,and at the same time,attention should be paid to spatial change trends and timely health emergency measures should be taken. |
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