JMIR Publications

ABSTRACT

Background:

In recent years, the number of reported cases of hand, foot, and mouth disease (HFMD) has increased in Guangzhou, China, posing a major public health threat to children under 5 years old. It is necessary to conduct an in-depth analysis to understand the epidemiological pattern and related influencing factors of HFMD in this region.

Objective:

This study aims to describe the epidemiological characteristics, spatiotemporal distribution of HFMD cases in Guangzhou from 2013 to 2022 and explore the relationship between sociodemographic factors and HFMD incidence.

Methods:

The data of HFMD cases in Guangzhou come from the Infectious Disease Information Management System of the Guangzhou Center for Disease Control and Prevention. Spatial analysis and space-time scan statistics were used to visualize the spatiotemporal distribution of HFMD cases. Multi-factor ordinary minimum regression model and geographically weighted regression were used to analyze the influencing factors, including population, economy, education, medical care.

Results:

From 2013 to 2022, 599,353 HFMD cases were reported in Guangzhou, with an average annual incidence rate of 403.62/100,000. Children aged 5 years and younger accounted for 93.64% of all cases (561,218/599,353). HFMD cases show obvious bimodal distribution characteristics, with the peak period from May to July and the secondary peak period from August to October. HFMD in Guangzhou exhibited a spatial aggregation trend, with the central urban area characterized by low-low aggregation area and the peripheral urban area demonstrating high-high aggregation area. High-risk areas show a dynamic trend of shifting from the west to the east of peripheral urban areas, with coverage first increasing and then decreasing. Population density and average annual income of employees were protective factors for HFMD incidence, while the average number of students in each primary school and kindergarten was a risk factor.

Conclusions:

HFMD cases in Guangzhou were mainly infants and young children, and there were obvious differences in time and space. HFMD is highly prevalent in summer and autumn, and peripheral urban areas were identified as high-risk areas. Improving the economic level of peripheral urban areas and reducing the number of students in preschool education institutions are the keys to controlling HFMD.