Risk Assessment and Mapping of Hand, Foot, and Mouth Disease at the County Level in Mainland China Using Spatiotemporal Zero-Inflated Bayesian Hierarchical Models

International Journal of Environmental Research and Public Health
Chao SongHuibin Yang

Abstract

Hand, foot, and mouth disease (HFMD) is a worldwide infectious disease, prominent in China. China's HFMD data are sparse with a large number of observed zeros across locations and over time. However, no previous studies have considered such a zero-inflated problem on HFMD's spatiotemporal risk analysis and mapping, not to mention for the entire Mainland China at county level. Monthly county-level HFMD cases data combined with related climate and socioeconomic variables were collected. We developed four models, including spatiotemporal Poisson, negative binomial, zero-inflated Poisson (ZIP), and zero-inflated negative binomial (ZINB) models under the Bayesian hierarchical modeling framework to explore disease spatiotemporal patterns. The results showed that the spatiotemporal ZINB model performed best. Both climate and socioeconomic variables were identified as significant risk factors for increasing HFMD incidence. The relative risk (RR) of HFMD at the local scale showed nonlinear temporal trends and was considerably spatially clustered in Mainland China. The first complete county-level spatiotemporal relative risk maps of HFMD were generated by this study. The new findings provide great potential for national county-level HFMD...Continue Reading

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Citations

Mar 3, 2019·International Journal of Environmental Research and Public Health·Antonio López-Quílez
Apr 17, 2020·The Science of the Total Environment·Pandji Wibawa DhewantaraRicardo J Soares Magalhães
Jun 3, 2021·International Journal of Environmental Research and Public Health·Yibo GaoYiming Wei
Sep 2, 2021·Infectious Disease Modelling·Nurmarni Athirah Abdul WahidHaliza Abd Rahman

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