TY - JOUR
T1 - Assessment of temperature effect on childhood hand, foot and mouth disease incidence (0-years) and associated effect modifiers
T2 - A 17 cities study in Shandong Province, China, 2007-2012
AU - Zhu, Lin
AU - Wang, Xianjun
AU - Guo, Yuming
AU - Xu, Jing
AU - Xue, Fuzhong
AU - Liu, Yanxun
PY - 2016/5/1
Y1 - 2016/5/1
N2 - Background: Previous studies examining temperature-disease associations of hand, foot and mouth disease (HFMD) mainly focused on a single city. The results demonstrated great heterogeneity. A multi-city study is necessary to better understand temperature risk on the childhood incidence of HFMD and the associated modified factors. Objective: To assess the effect of ambient temperature on childhood HFMD incidence and explore the potential associated effect modifiers in the study area. Methods: Daily morbidity data and meteorological variables of the 17 cities were collected for the period from 2007 to 2012. Distributed lag non-linear model (DLNM) was used to estimate city-specific effects of temperature on HFMD incidence. A multivariate meta-analysis was then applied to pool the estimated city-specific effect. Potential effect modifiers were included in the multivariate meta-regression as meta-predictors. Results: A total of 504,017 childhood HFMD cases were included in the study. The high-incidence period of HFMD was detected in late spring and early summer (April to June). The temperature-disease associations of the 17 cities demonstrated great heterogeneity and the pooled exposure-response curve was an approximately inverted V-shape. Regional indicator, numbers of healthcare institution and annual household income were considered as associated modifiers. Conclusion: Our findings can provide a practical reference for the early warning and intervention strategies of HFMD. Different temperature-disease associations among different regions should be considered when formulating and optimizing public health policy.
AB - Background: Previous studies examining temperature-disease associations of hand, foot and mouth disease (HFMD) mainly focused on a single city. The results demonstrated great heterogeneity. A multi-city study is necessary to better understand temperature risk on the childhood incidence of HFMD and the associated modified factors. Objective: To assess the effect of ambient temperature on childhood HFMD incidence and explore the potential associated effect modifiers in the study area. Methods: Daily morbidity data and meteorological variables of the 17 cities were collected for the period from 2007 to 2012. Distributed lag non-linear model (DLNM) was used to estimate city-specific effects of temperature on HFMD incidence. A multivariate meta-analysis was then applied to pool the estimated city-specific effect. Potential effect modifiers were included in the multivariate meta-regression as meta-predictors. Results: A total of 504,017 childhood HFMD cases were included in the study. The high-incidence period of HFMD was detected in late spring and early summer (April to June). The temperature-disease associations of the 17 cities demonstrated great heterogeneity and the pooled exposure-response curve was an approximately inverted V-shape. Regional indicator, numbers of healthcare institution and annual household income were considered as associated modifiers. Conclusion: Our findings can provide a practical reference for the early warning and intervention strategies of HFMD. Different temperature-disease associations among different regions should be considered when formulating and optimizing public health policy.
KW - Child
KW - Hand, foot and mouth disease
KW - Multi-city
KW - Temperature-disease association
UR - http://www.scopus.com/inward/record.url?scp=84957927262&partnerID=8YFLogxK
U2 - 10.1016/j.scitotenv.2016.01.173
DO - 10.1016/j.scitotenv.2016.01.173
M3 - Article
AN - SCOPUS:84957927262
VL - 551-552
SP - 452
EP - 459
JO - Science of the Total Environment
JF - Science of the Total Environment
SN - 0048-9697
ER -