Int J Health Geogr - Hand, foot and mouth disease: spatiotemporal transmission and climate.

Tópicos

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Resumo

CKGROUND: The Hand-Foot-Mouth Disease (HFMD) is the most common infectious disease in China, its total incidence being around 500,000~1,000,000 cases per year. The composite space-time disease variation is the result of underlining attribute mechanisms that could provide clues about the physiologic and demographic determinants of disease transmission and also guide the appropriate allocation of medical resources to control the disease.METHODS AND FINDINGS: HFMD cases were aggregated into 1456 counties and during a period of 11 months. Suspected climate attributes to HFMD were recorded monthly at 674 stations throughout the country and subsequently interpolated within 1456 ? 11 cells across space-time (same as the number of HFMD cases) using the Bayesian Maximum Entropy (BME) method while taking into consideration the relevant uncertainty sources. The dimensionalities of the two datasets together with the integrated dataset combining the two previous ones are very high when the topologies of the space-time relationships between cells are taken into account. Using a self-organizing map (SOM) algorithm the dataset dimensionality was effectively reduced into 2 dimensions, while the spatiotemporal attribute structure was maintained. 16 types of spatiotemporal HFMD transmission were identified, and 3-4 high spatial incidence clusters of the HFMD types were found throughout China, which are basically within the scope of the monthly climate (precipitation) types.CONCLUSIONS: HFMD propagates in a composite space-time domain rather than showing a purely spatial and purely temporal variation. There is a clear relationship between HFMD occurrence and climate. HFMD cases are geographically clustered and closely linked to the monthly precipitation types of the region. The occurrence of the former depends on the later.

Resumo Limpo

ckground handfootmouth diseas hfmd common infecti diseas china total incid around case per year composit spacetim diseas variat result underlin attribut mechan provid clue physiolog demograph determin diseas transmiss also guid appropri alloc medic resourc control diseasemethod find hfmd case aggreg counti period month suspect climat attribut hfmd record month station throughout countri subsequ interpol within cell across spacetim number hfmd case use bayesian maximum entropi bme method take consider relev uncertainti sourc dimension two dataset togeth integr dataset combin two previous one high topolog spacetim relationship cell taken account use selforgan map som algorithm dataset dimension effect reduc dimens spatiotempor attribut structur maintain type spatiotempor hfmd transmiss identifi high spatial incid cluster hfmd type found throughout china basic within scope month climat precipit typesconclus hfmd propag composit spacetim domain rather show pure spatial pure tempor variat clear relationship hfmd occurr climat hfmd case geograph cluster close link month precipit type region occurr former depend later

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