Key result
Logistic differential equation model identifies regional early warning signals for HFMD transmission across China.
Why the study?
Hand, foot, and mouth disease (HFMD) has a high disease burden in China, prompting the need to explore its temporal and spatial distribution and calculate early warning signals.
Observational (n=1,802,800)
Yes
An LDE model successfully identified heterogeneous early warning signals for HFMD transmission across northern and southern regions of China, aiding in epidemic preparedness.
Answers are grounded in this paper and cite their sources.
May aid regional HFMD preparedness in China; leaves open prospective validation before broader use.
BACKGROUND: Hand, foot, and mouth disease (HFMD) is a global infectious disease; particularly, it has a high disease burden in China. This study was aimed to explore the temporal and spatial distribution of the disease by analyzing its epidemiological characteristics, and to calculate the early warning signals of HFMD by using a logistic differential equation (LDE) model. METHODS: This study included datasets of HFMD cases reported in seven regions in Mainland China. The early warning time (week) was calculated using the LDE model with the key parameters estimated by fitting with the data. Two key time points, "epidemic acceleration week (EAW)" and "recommended warning week (RWW)", were calculated to show the early warning time. RESULTS: The mean annual incidence of HFMD cases per 100,000 per year was 218, 360, 223, 124, and 359 in Hunan Province, Shenzhen City, Xiamen City, Chuxiong Prefecture, Yunxiao County across the southern regions, respectively and 60 and 34 in Jilin Province and Longde County across the northern regions, respectively. The LDE model fitted well with the reported data (R2 > 0.65, P < 0.001). Distinct temporal patterns were found across geographical regions: two early warning signals emerged in spring and autumn every year across southern regions while one early warning signals in summer every year across northern regions. CONCLUSIONS: The disease burden of HFMD in China is still high, with more cases occurring in the southern regions. The early warning of HFMD across the seven regions is heterogeneous. In the northern regions, it has a high incidence during summer and peaks in June every year; in the southern regions, it has two waves every year with the first wave during spring spreading faster than the second wave during autumn. Our findings can help predict and prepare for active periods of HFMD.
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Rui et al. (2021) conducted an observational in Hand, foot, and mouth disease (HFMD) (n=1,802,800). Logistic differential equation (LDE) model was evaluated on Model fit (R-squared) for early warning time of HFMD transmission (p=<0.001). A logistic differential equation model successfully fitted HFMD incidence data across seven regions in China, identifying two annual early warning signals in southern regions and one in northern regions.
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