title: Socio-ecological factors and hand, foot and mouth disease in dry climate regions: a Bayesian spatial approach in Gansu, China.
abstract: The influence of socio-ecological factors on hand, foot and mouth disease (HFMD) were explored in this study using Bayesian spatial modeling and spatial patterns identified in dry regions of Gansu, China. Notified HFMD cases and socio-ecological data were obtained from the China Information System for Disease Control and Prevention, Gansu Yearbook and Gansu Meteorological Bureau. A Bayesian spatial conditional autoregressive model was used to quantify the effects of socio-ecological factors on the HFMD and explore spatial patterns, with the consideration of its socio-ecological effects. Our non-spatial model suggests temperature (relative risk (RR) 1.15, 95 % CI 1.01-1.31), GDP per capita (RR 1.19, 95 % CI 1.01-1.39) and population density (RR 1.98, 95 % CI 1.19-3.17) to have a significant effect on HFMD transmission. However, after controlling for spatial random effects, only temperature (RR 1.25, 95 % CI 1.04-1.53) showed significant association with HFMD. The spatial model demonstrates temperature to play a major role in the transmission of HFMD in dry regions. Estimated residual variation after taking into account the socio-ecological variables indicated that high incidences of HFMD were mainly clustered in the northwest of Gansu. And, spatial structure showed a unique distribution after taking account of socio-ecological effects.
authors.affiliation: Institute for communicable disease control and prevention, Gansu Center for Diseases Prevention and Control, Lanzhou, Gansu, China.
authors.forename: Faxiang
authors.initials: F
authors.lastname: Gou
authors.affiliation: Institute for communicable disease control and prevention, Gansu Center for Diseases Prevention and Control, Lanzhou, Gansu, China.
authors.forename: Xinfeng
authors.initials: X
authors.lastname: Liu
authors.affiliation: Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu, China.
authors.forename: Xiaowei
authors.initials: X
authors.lastname: Ren
authors.affiliation: Institute for communicable disease control and prevention, Gansu Center for Diseases Prevention and Control, Lanzhou, Gansu, China.
authors.forename: Dongpeng
authors.initials: D
authors.lastname: Liu
authors.affiliation: Institute for communicable disease control and prevention, Gansu Center for Diseases Prevention and Control, Lanzhou, Gansu, China.
authors.forename: Haixia
authors.initials: H
authors.lastname: Liu
authors.affiliation: Institute for communicable disease control and prevention, Gansu Center for Diseases Prevention and Control, Lanzhou, Gansu, China.
authors.forename: Kongfu
authors.initials: K
authors.lastname: Wei
authors.affiliation: Institute for communicable disease control and prevention, Gansu Center for Diseases Prevention and Control, Lanzhou, Gansu, China.
authors.forename: Xiaoting
authors.initials: X
authors.lastname: Yang
authors.affiliation: Institute for communicable disease control and prevention, Gansu Center for Diseases Prevention and Control, Lanzhou, Gansu, China.
authors.forename: Yao
authors.initials: Y
authors.lastname: Cheng
authors.affiliation: Institute for communicable disease control and prevention, Gansu Center for Diseases Prevention and Control, Lanzhou, Gansu, China.
authors.forename: Yunhe
authors.initials: Y
authors.lastname: Zheng
authors.affiliation: Institute for communicable disease control and prevention, Gansu Center for Diseases Prevention and Control, Lanzhou, Gansu, China.
authors.forename: Xiaojuan
authors.initials: X
authors.lastname: Jiang
authors.affiliation: Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu, China.
authors.forename: Juansheng
authors.initials: J
authors.lastname: Li
authors.affiliation: Institute for communicable disease control and prevention, Gansu Center for Diseases Prevention and Control, Lanzhou, Gansu, China. ccdcusc101@163.com.
authors.forename: Lei
authors.initials: L
authors.lastname: Meng
authors.affiliation: Faculty of Health, Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia. w2.hu@qut.edu.au.
authors.forename: Wenbiao
authors.initials: W
authors.lastname: Hu
mesh_terms: D001499:Bayes Theorem; D002681:China / Q000453:epidemiology; D002980:Climate; D005260:Female; D006232:Hand, Foot and Mouth Disease / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008297:Male; D015233:Models, Statistical; D011156:Population Density; D062206:Spatial Analysis; D014887:Weather