Environmental Temperature and the Risk of Hand, Foot, and Mouth Disease Transmission in the Yangtze River Region of China.

Yan Qing YANG; Min CHEN; Jin LI; Kai Qi LIU; Xue Yan GUO; Xin XU; Qian LIANG; Xing Lu WU; Su Wen LEI; Jing LI

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Environmental Temperature and the Risk of Hand, Foot, and Mouth Disease Transmission in the Yangtze River Region of China.

Author: Yan Qing YANG ¹ ; Min CHEN ² ; Jin LI ² ; Kai Qi LIU ³ ; Xue Yan GUO ⁴ ; Xin XU ⁵ ; Qian LIANG ¹ ; Xing Lu WU ¹ ; Su Wen LEI ³ ; Jing LI ¹
Author Information

1. School of Public Health, Shandong Second Medical University, Weifang 261053, Shandong, China.
2. Weifang People's Hospital, Shandong Second Medical University, Weifang 261000, Shandong, China.
3. Office of Health Standards, Chinese Center for Disease Control and Prevention, Beijing 102206, China.
4. Weifang Center for Disease Control and Prevention, Weifang 261053, Shandong, China.
5. School of Stomatology, Shandong Second Medical University, Weifang 261053, Shandong, China.
Publication Type:Meta-Analysis
Keywords: Concentration index; Hand foot and mouth disease; Meta-analysis; Temperature; Theil index
MeSH: Female; Humans; Male; China/epidemiology*; Cities/epidemiology*; Hand, Foot and Mouth Disease/transmission*; Incidence; Risk Factors; Temperature
From: Biomedical and Environmental Sciences 2025;38(3):290-302
CountryChina
Language:English
Abstract: OBJECTIVE:To assess health equity in the Yangtze River region to improve understanding of the correlation between hand, foot, and mouth disease (HFMD) and socioeconomic factors.
METHODS:From 2014-2016, data on HFMD incidence, population statistics, economic indicators, and meteorology from 26 cities along the Yangtze River were analyzed. A multi-city random-effects meta-analysis was performed to study the relationship between temperature and HFMD transmission, and health equity was assessed with respect to socio-economic impact.
RESULTS:Over the study period, 919,458 HFMD cases were reported, with Shanghai (162,303) having the highest incidence and Tongling (5,513) having the lowest. Males were more commonly affected (male-to-female ratio, 1.49:1). The exposure-response relationship had an M-shaped curve, with two HFMD peaks occurring at 4 °C and 26 °C. The relative risk had two peaks at 1.30 °C (1.834, 95% CI: 1.204-2.794) and 31.4 °C (1.143, 95% CI: 0.901-1.451), forming an M shape, with the first peak higher than the second. The most significant impact of temperature on HFMD was observed between -2 °C and 18.1 °C. The concentration index (0.2463) indicated moderate concentration differences, whereas the Theil index (0.0418) showed low inequality in distribution.
CONCLUSION:The incidence of HFMD varied across cities, particularly with changes in temperature. Economically prosperous areas showed higher risks, indicating disparities. Targeted interventions in these areas are crucial for mitigating the risk of HFMD.