title: Modeling and predicting hemorrhagic fever with renal syndrome trends based on meteorological factors in Hu County, China.
abstract: BACKGROUND
  Hu County is a serious hemorrhagic fever with renal syndrome (HFRS) epidemic area, with notable fluctuation of the HFRS epidemic in recent years. This study aimed to explore the optimal model for HFRS epidemic prediction in Hu.
  
  
  METHODS
  Three models were constructed and compared, including a generalized linear model (GLM), a generalized additive model (GAM), and a principal components regression model (PCRM). The fitting and predictive adjusted R2 of each model were calculated. Ljung-Box Q tests for fitted and predicted residuals of each model were conducted. The study period was stratified into before (1971-1993) and after (1994-2012) vaccine implementation epochs to avoid the confounding factor of vaccination.
  
  
  RESULTS
  The autocorrelation of fitted and predicted residuals of the GAM in the two epochs were not significant (Ljung-Box Q test, P>.05). The adjusted R2 for the predictive abilities of the GLM, GAM, and PCRM were 0.752, 0.799, and 0.665 in the early epoch, and 0.669, 0.756, and 0.574 in the recent epoch. The adjusted R2 values of the three models were lower in the early epoch than in the recent epoch.
  
  
  CONCLUSIONS
  GAM is superior to GLM and PCRM for monthly HFRS case number prediction in Hu County. A shift in model reliability coincident with vaccination implementation demonstrates the importance of vaccination in HFRS control and prevention.
authors: Department of Epidemiology, School of Public Health, Fourth Military Medical University, Xi'an, China.
authors: Dan
authors: D
authors: Xiao
authors: Department of Mathematics and Physics, School of Biomedical and Engineering, Fourth Military Medical University, Xi'an, China.
authors: Kejian
authors: K
authors: Wu
authors: Hu County Center for Disease Control and Prevention, Xi'an, China.
authors: Xin
authors: X
authors: Tan
authors: Hu County Meteorological Bureau, Xi'an, China.
authors: Jing
authors: J
authors: Le
authors: Department of Mathematics and Physics, School of Biomedical and Engineering, Fourth Military Medical University, Xi'an, China.
authors: Haitao
authors: H
authors: Li
authors: Department of Epidemiology, School of Public Health, Fourth Military Medical University, Xi'an, China.
authors: Yongping
authors: Y
authors: Yan
authors: Department of Microbiology, Fourth Military Medical University, Xi'an, China.
authors: Zhikai
authors: Z
authors: Xu
mesh_terms: D000465:Algorithms; D002681:China / Q000453:epidemiology; D006480:Hemorrhagic Fever with Renal Syndrome / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008685:Meteorological Concepts; D015233:Models, Statistical; D012621:Seasons