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Modeling the Present and Future Incidence of Pediatric Hand, Foot, and Mouth Disease Associated with Ambient Temperature in Mainland China

BACKGROUND: There is limited evidence about the association between ambient temperature and the incidence of pediatric hand, foot, and mouth disease (HFMD) nationwide in China. OBJECTIVES: We examined the childhood temperature-HFMD associations across mainland China, and we projected the change in H...

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Autores principales: Zhao, Qi, Li, Shanshan, Cao, Wei, Liu, De-Li, Qian, Quan, Ren, Hongyan, Ding, Fan, Williams, Gail, Huxley, Rachel, Zhang, Wenyi, Guo, Yuming
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Environmental Health Perspectives 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6071822/
https://www.ncbi.nlm.nih.gov/pubmed/29681142
http://dx.doi.org/10.1289/EHP3062
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author Zhao, Qi
Li, Shanshan
Cao, Wei
Liu, De-Li
Qian, Quan
Ren, Hongyan
Ding, Fan
Williams, Gail
Huxley, Rachel
Zhang, Wenyi
Guo, Yuming
author_facet Zhao, Qi
Li, Shanshan
Cao, Wei
Liu, De-Li
Qian, Quan
Ren, Hongyan
Ding, Fan
Williams, Gail
Huxley, Rachel
Zhang, Wenyi
Guo, Yuming
author_sort Zhao, Qi
collection PubMed
description BACKGROUND: There is limited evidence about the association between ambient temperature and the incidence of pediatric hand, foot, and mouth disease (HFMD) nationwide in China. OBJECTIVES: We examined the childhood temperature-HFMD associations across mainland China, and we projected the change in HFMD cases due to projected temperature change by the 2090s. METHODS: Data on daily HFMD (children 0–14 y old) counts and weather were collected from 362 sites during 2009–2014. Daily temperature by the 2090s was downscaled under the Representative Concentration Pathway (RCP) 4.5 and 8.5 scenarios. Temperature-HFMD associations were quantified using a two-stage Poisson regression with a distributed lag nonlinear model. The impact of changes in temperature on the incidence of HFMD was estimated by combining the fitted temperature-HFMD associations with projected temperatures under each scenario, assuming a constant population structure. Sensitivity analyses were performed to assess the influence of primary model assumptions. RESULTS: During 2009–2014, [Formula: see text] HFMD cases were reported. In most regions, the temperature-HFMD association had an inverted U shape with a peak at approximately [Formula: see text] , but the association leveled off or continued to increase in the Inner Mongolia and Northeast regions. When estimates were pooled across all regions and the population size was held constant, the projected incidence of HFMD increased by 3.2% [95% empirical confidence interval (eCI): [Formula: see text] , 20.0%] and 5.3% (95% eCI: [Formula: see text] , 44.0%) by the 2090s under the RCP 4.5 and 8.5 scenarios, respectively. However, regional projections suggest that HFMD may decrease with climate change in temperate areas of central and eastern China. CONCLUSION: Our estimates suggest that the association between temperature and HFMD varies across China and that the future impact of climate change on HFMD incidence will vary as well. Other factors, including changes in the size of the population at risk (children 0–14 y old) will also influence future HFMD trends. https://doi.org/10.1289/EHP3062
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spelling pubmed-60718222018-08-07 Modeling the Present and Future Incidence of Pediatric Hand, Foot, and Mouth Disease Associated with Ambient Temperature in Mainland China Zhao, Qi Li, Shanshan Cao, Wei Liu, De-Li Qian, Quan Ren, Hongyan Ding, Fan Williams, Gail Huxley, Rachel Zhang, Wenyi Guo, Yuming Environ Health Perspect Research BACKGROUND: There is limited evidence about the association between ambient temperature and the incidence of pediatric hand, foot, and mouth disease (HFMD) nationwide in China. OBJECTIVES: We examined the childhood temperature-HFMD associations across mainland China, and we projected the change in HFMD cases due to projected temperature change by the 2090s. METHODS: Data on daily HFMD (children 0–14 y old) counts and weather were collected from 362 sites during 2009–2014. Daily temperature by the 2090s was downscaled under the Representative Concentration Pathway (RCP) 4.5 and 8.5 scenarios. Temperature-HFMD associations were quantified using a two-stage Poisson regression with a distributed lag nonlinear model. The impact of changes in temperature on the incidence of HFMD was estimated by combining the fitted temperature-HFMD associations with projected temperatures under each scenario, assuming a constant population structure. Sensitivity analyses were performed to assess the influence of primary model assumptions. RESULTS: During 2009–2014, [Formula: see text] HFMD cases were reported. In most regions, the temperature-HFMD association had an inverted U shape with a peak at approximately [Formula: see text] , but the association leveled off or continued to increase in the Inner Mongolia and Northeast regions. When estimates were pooled across all regions and the population size was held constant, the projected incidence of HFMD increased by 3.2% [95% empirical confidence interval (eCI): [Formula: see text] , 20.0%] and 5.3% (95% eCI: [Formula: see text] , 44.0%) by the 2090s under the RCP 4.5 and 8.5 scenarios, respectively. However, regional projections suggest that HFMD may decrease with climate change in temperate areas of central and eastern China. CONCLUSION: Our estimates suggest that the association between temperature and HFMD varies across China and that the future impact of climate change on HFMD incidence will vary as well. Other factors, including changes in the size of the population at risk (children 0–14 y old) will also influence future HFMD trends. https://doi.org/10.1289/EHP3062 Environmental Health Perspectives 2018-04-20 /pmc/articles/PMC6071822/ /pubmed/29681142 http://dx.doi.org/10.1289/EHP3062 Text en EHP is an open-access journal published with support from the National Institute of Environmental Health Sciences, National Institutes of Health. All content is public domain unless otherwise noted.
spellingShingle Research
Zhao, Qi
Li, Shanshan
Cao, Wei
Liu, De-Li
Qian, Quan
Ren, Hongyan
Ding, Fan
Williams, Gail
Huxley, Rachel
Zhang, Wenyi
Guo, Yuming
Modeling the Present and Future Incidence of Pediatric Hand, Foot, and Mouth Disease Associated with Ambient Temperature in Mainland China
title Modeling the Present and Future Incidence of Pediatric Hand, Foot, and Mouth Disease Associated with Ambient Temperature in Mainland China
title_full Modeling the Present and Future Incidence of Pediatric Hand, Foot, and Mouth Disease Associated with Ambient Temperature in Mainland China
title_fullStr Modeling the Present and Future Incidence of Pediatric Hand, Foot, and Mouth Disease Associated with Ambient Temperature in Mainland China
title_full_unstemmed Modeling the Present and Future Incidence of Pediatric Hand, Foot, and Mouth Disease Associated with Ambient Temperature in Mainland China
title_short Modeling the Present and Future Incidence of Pediatric Hand, Foot, and Mouth Disease Associated with Ambient Temperature in Mainland China
title_sort modeling the present and future incidence of pediatric hand, foot, and mouth disease associated with ambient temperature in mainland china
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6071822/
https://www.ncbi.nlm.nih.gov/pubmed/29681142
http://dx.doi.org/10.1289/EHP3062
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