Determinants of the Transmission Variation of Hand, Foot and Mouth Disease in China

Severe outbreaks of hand, foot and mouth disease (HFMD) have occurred in China for decades. Our understanding of the HFMD transmission process and its determinants is still limited. In this paper, factors that affect the local variation of HFMD transmission process were studied. Three classes of fac...

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Bibliographic Details
Published in:PloS one 2016-10, Vol.11 (10), p.e0163789
Main Authors: Zhao, Jijun, Li, Xinmin
Format: Article
Language:English
Subjects:
Age
Analysis
Analysis of Variance
Biology and Life Sciences
China - epidemiology
Coefficient of variation
Correlation coefficient
Correlation coefficients
Coxsackievirus infections
Demographics
Determinants
Disease transmission
Earth Sciences
Epidemiology
Foot and mouth disease
Hand, Foot and Mouth Disease - epidemiology
Hand, Foot and Mouth Disease - transmission
Hand-foot-and-mouth disease
Health aspects
Health promotion
Humans
Humidity
Immunization
Infections
Infectious diseases
Measles
Medicine and Health Sciences
Outbreaks
People and Places
Poliomyelitis
Population Density
Population Surveillance
Public health
Regression analysis
Regression models
Relative humidity
Risk Factors
Rubella
Seasonal variations
Whooping cough
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Summary:Severe outbreaks of hand, foot and mouth disease (HFMD) have occurred in China for decades. Our understanding of the HFMD transmission process and its determinants is still limited. In this paper, factors that affect the local variation of HFMD transmission process were studied. Three classes of factors, including meteorological, demographic and public health intervention factors, were carefully selected and their effects on HFMD transmission were investigated with Pearson's correlation coefficient and multiple linear regression models. The determining factors for the variation of HFMD transmission were different for the southeastern and the northwestern regions of China. In the northwest, fadeouts occurred yearly, and the average age at infection and the fadeout were negatively correlated with the population density. In the southeast, HFMD transmission was governed by the combined effects of the birth rate, the relative humidity and the interaction of the Health System Performance and the log of the population density. When the Health System Performance was low, HFMD transmission increased with the population density, but when the Health System Performance was high, the better health performance counteracted the transmission increase due to the higher population density.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0163789