title: Impact of temperature variability on childhood hand, foot and mouth disease in Huainan, China.
abstract: OBJECTIVE
  The short-term temperature variation has been shown to be significantly associated with human health. However, little is known about whether temperature change between neighbouring days (TCN) and diurnal temperature range (DTR) have any effect on childhood hand, foot and mouth disease (HFMD). This study aims to explore whether temperature variability has any effect on childhood HFMD.
  
  
  METHODS
  Ecological study.
  
  
  METHODS
  The association between meteorological variables and HFMD cases in Huainan, China, from January 1st 2012 to December 31st 2014 was analysed using Poisson generalized linear regression combined with distributed lag non-linear model (DLNM) after controlling for long-term trend and seasonality, mean temperature and relative humidity.
  
  
  RESULTS
  An adverse effect of TCN on childhood HFMD was observed, and the impact of TCN was the greatest at five days lag, with a 10% (95% CI: 4%-15%) increase of daily number of HFMD cases per 3 °C (10th percentile) decrease of TCN. Male children, children aged 0-5 years, scattered children and children in high-risk areas appeared to be more vulnerable to the TCN effect than others. However, there was no significant association between DTR and childhood HFMD.
  
  
  CONCLUSIONS
  Our findings indicate that TCN drops may increase the incidence of childhood HFMD in Huainan, highlighting the importance of protecting children from forthcoming TCN drops, particularly for those who are male, young, scattered and from high-risk areas.
authors.affiliation: Department of Clinical Laboratory, The Affiliated Provincial Hospital of Anhui Medical University, Hefei, Anhui, 230032, China.
authors.forename: J
authors.initials: J
authors.lastname: Xu
authors.affiliation: Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China.
authors.forename: D
authors.initials: D
authors.lastname: Zhao
authors.affiliation: Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China.
authors.forename: H
authors.initials: H
authors.lastname: Su
authors.affiliation: Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China.
authors.forename: M
authors.initials: M
authors.lastname: Xie
authors.affiliation: Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China.
authors.forename: J
authors.initials: J
authors.lastname: Cheng
authors.affiliation: Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China.
authors.forename: X
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China.
authors.forename: K
authors.initials: K
authors.lastname: Li
authors.affiliation: Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China.
authors.forename: H
authors.initials: H
authors.lastname: Yang
authors.affiliation: Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China.
authors.forename: L
authors.initials: L
authors.lastname: Wen
authors.affiliation: Department of Clinical Laboratory, The Affiliated Provincial Hospital of Anhui Medical University, Hefei, Anhui, 230032, China. Electronic address: wbl196555@163.com.
authors.forename: B
authors.initials: B
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D005260:Female; D006232:Hand, Foot and Mouth Disease / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011159:Population Surveillance; D012306:Risk; D013696:Temperature
keywords: Childhood; China; Hand, foot and mouth disease; Temperature variability