Determinants of the incidence of hand, foot and mouth disease in China using geographically weighted regression models.
Determinants of the incidence of hand, foot and mouth disease in China using geographically weighted regression models.
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利用地理加权回归模型研究中国手足口病发病率的决定因素
DOI：
10.1371/journal.pone.0038978
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发表时间：
2012
期刊：
影响因子：
3.7
通讯作者：
Yang W
中科院分区：
文献类型：
--
作者：
Hu M;Li Z;Wang J;Jia L;Liao Y;Lai S;Guo Y;Zhao D;Yang W
背景在过去20年中，手足口病(HFMD)在西太平洋地区的大多数国家都发生了重大流行，造成数千名儿童死亡。然而，很少有研究考察手足口病发病率的潜在决定因素。方法收集2008年5月中国地区2912个县(市)手足口病报告病例。计算9岁及以下儿童的每月手足口病累积发病率。儿童人口密度(CPD)和6个气候因子(平均温度[AT]、平均最低温度[ATmin]、平均最高温度[ATmax]、平均温差[ATdiff]、平均相对湿度[ARH]和月降水量[MP])被选为研究的潜在解释变量。采用地理加权回归(GWR)模型探讨影响手足口病发病的因素与县级疫情的关系。结果调查县共报告手足口病病例176,111例。各县调整后的月累计发病率为0.26/10万儿童至2549.00/10万儿童。在当地单变量GWR模型中，手足口病发病率与7个因素中每一个有统计学意义的县百分比分别为：CPD 84.3%，ATmax 54.9%，AT 57.8%，ATmin 61.2%，ARH 54.4%，MP 50.3%，ATdiff 51.6%。7个因素单变量GWR模型的R2分别为CPD 0.56、ATmax 0.53、AT 0.52、MP 0.51、ATmin 0.52、ARH 0.51和ATdiff 0.51。进一步将CPD、MP、AT、ARH和ATdiff纳入多因素GWR模型，R2为0.62，各县市之间存在显著相关关系。结论儿童人口密度和气候因素是中国大部分地区手足口病发病的潜在影响因素。在当地地理水平上，这些因素与手足口病发病率之间的关联强度和方向在空间上是不同的，儿童人口密度对手足口病发病率的影响大于气候因素。
Background Over the past two decades, major epidemics of hand, foot, and mouth disease (HFMD) have occurred throughout most of the West-Pacific Region countries, causing thousands of deaths among children. However, few studies have examined potential determinants of the incidence of HFMD. Methods Reported HFMD cases from 2912 counties in China were obtained for May 2008. The monthly HFMD cumulative incidence was calculated for children aged 9 years and younger. Child population density (CPD) and six climate factors (average-temperature [AT], average-minimum-temperature [ATmin], average-maximum-temperature [ATmax], average-temperature-difference [ATdiff], average-relative-humidity [ARH], and monthly precipitation [MP]) were selected as potential explanatory variables for the study. Geographically weighted regression (GWR) models were used to explore the associations between the selected factors and HFMD incidence at county level. Results There were 176,111 HFMD cases reported in the studied counties. The adjusted monthly cumulative incidence by county ranged from 0.26 cases per 100,000 children to 2549.00 per 100,000 children. For local univariate GWR models, the percentage of counties with statistical significance (p<0.05) between HFMD incidence and each of the seven factors were: CPD 84.3%, ATmax 54.9%, AT 57.8%, ATmin 61.2%, ARH 54.4%, MP 50.3%, and ATdiff 51.6%. The R 2 for the seven factors’ univariate GWR models are CPD 0.56, ATmax 0.53, AT 0.52, MP 0.51, ATmin 0.52, ARH 0.51, and ATdiff 0.51, respectively. CPD, MP, AT, ARH and ATdiff were further included in the multivariate GWR model, with R 2 0.62, and all counties show statistically significant relationship. Conclusion Child population density and climate factors are potential determinants of the HFMD incidence in most areas in China. The strength and direction of association between these factors and the incidence of HFDM is spatially heterogeneous at the local geographic level, and child population density has a greater influence on the incidence of HFMD than the climate factors.
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DOI：
10.1080/02693799508902045
发表时间：
1995-07-01
期刊：
INTERNATIONAL JOURNAL OF GEOGRAPHICAL INFORMATION SYSTEMS
影响因子：
--
作者：
HUTCHINSON, MF
通讯作者：
HUTCHINSON, MF
影响因子：
4.4
作者：
ABAD, FX;PINTO, RM;BOSCH, A
通讯作者：
BOSCH, A
影响因子：
2.5
作者：
Gilbert, Angela;Chakraborty, Jayajit
通讯作者：
Chakraborty, Jayajit
2010年，中国南昌的手，脚和口腔疾病的爆发表征。
影响因子：
3.7
作者：
Liu MY;Liu W;Luo J;Liu Y;Zhu Y;Berman H;Wu J
通讯作者：
Wu J
影响因子：
3.7
作者：
Hii, Yien Ling;Rocklov, Joacim;Ng, Nawi
通讯作者：
Ng, Nawi