[Epidemiological situation and temporal-spatial clustering changes of hand-foot-mouth disease  from 2009 to 2015 in Hunan].
OBJECTIVE
To investigate the epidemiological situation and temporal-spatial clustering changes of hand-foot-mouth disease (HFMD) in Hunan.


METHODS
Spatial autocorrelation and temporal-spatial clustering analysis were used to analyze the HFMD in Hunan.


RESULTS
The incidence rates of HFMD ranged from 54.31/10 million to 318.06/10 million between 2009 and 2015 in Hunan. Cases mainly displayed in 5-year-old or even younger children and there were two epidemic periods each year. HFMD cases did not show a random distribution but with significant spatial aggregation. When local autocorrelation analysis was applied at the county/district level, 4 hot spots in Changsha, Yiyang, Loudi and Zhuzhou were discovered. The tendency for temporal and spatial clustering existed among HFMD cases in Hunan. The temporal dimension of HFMD was from April to July annually. Clustering areas gathered in the northern regions in 2009 and in the middle regions from 2010 to 2012. They moved to middle-southern regions in 2013 or 2014 and middle-western regions in 2015.


CONCLUSIONS
The HFMD incidence from 2009 to 2015 in Hunan showed temporal and spatial clustering tendency, with the shifting trend of clustered areas toward south and west.
Department of Epidemiolody and Health Statistics, Xiangya School of Public Health, Central South University, Changsha 410078, China.
Xinrui
X
Wu
Department of Epidemiolody and Health Statistics, Xiangya School of Public Health, Central South University, Changsha 410078, China.
Qi
Q
Li
Hunan Center for Disease Control and Prevention, Changsha 410005, China.
Kaiwei
K
Luo
Department of Epidemiolody and Health Statistics, Xiangya School of Public Health, Central South University, Changsha 410078, China.
Hongzhuan
H
Tan
D016000:Cluster Analysis; D006232:Hand, Foot and Mouth Disease; D006801:Humans; D015994:Incidence