气象因素影响下中国手足口病时空演化特征研究

近年来,手足口病在我国感染者的数量仍然呈现逐渐增加的趋势,对公共健康造成很大的威胁,也对疾病防控提出严峻的挑战。为探讨气象因素（气温、降水）对我国手足口病（Hand Foot and Mouth Disease, HFMD）发病的时空影响特征及规律,本文以我国手足口病疫情平发年2017年为例,利用分地区、分月份疫情数据,采用地理探测器、空间自相关等分析方法分析各地气象（气温、降水）因素对手足口病发病影响及其时空分异。结果表明：① 在时间上,2017年我国各地中心城市手足口病发病有明显的季节差异,年内有单峰发病模式和双峰（高低峰、双高峰）发病模式,且2017年2、4、12月各地中心城市手足口病发病率有显著的空间相关;② 在空间上,2017年我国各省、市手足口病发病在空间上表现为东南各省市发病率高,西北各省市发病率低的特点,并随降水量由东南向西北呈现递减趋势;③ 2017年省、自治区、直辖市和地级市手足口病爆发热点时段（4—8月）时空演化分析,先由东南各省向西北各省蔓延,后又表现为由西向东退缩;④ 2017年我国各地中心城市手足口病月发病率分别与年均降水量、年均温,呈二次函数关系（R²=0.6623）和指数函数关系（R²=0.6469）;⑤ 气温和降水对手足口病交互作用结果表现为双因子非线性增强,气温和降水的交互作用对手足口病传播的影响更为显著。气象因素对我国手足口病发病存在影响,我国手足口病发病在时间和空间上均存在显著差异,分析结果在宏观尺度上可为我国手足口病防控提供参考。

Study on Spatiotemporal Evolution of Hand,Foot and Mouth Disease(HFMD)in China under the Influence of Meteorological Factors

The rising number of people infected by Hand-Foot-Mouth Disease(HFMD) in China poses a great threat to public health and a critical challenge to disease prevention and control in recent years. This paper used regional monthly statistics of HFMD in 2017 when HFMD was common in China. The GeoDetector, spatial autocorrelation, and other analysis methods were adopted to analyze the influence of meteorological factors(i.e.,temperature, precipitation) on the prevalence of HFMD and its spatial and temporal differentiation. The results show that:(1) Temporally, the prevalence of HFMD had significant seasonal differences in major cities of China in 2017, with a single prevalence peak or double prevalence peaks(i.e., high-low peak, double high peak).Moreover, the prevalence of HFMD in those cities had a significant spatial correlation in February, April, and December;(2) Spatially, the HFMD in China was characterized by high prevalence level in southeast provinces or cities and low prevalence level in northwest provinces or cities, showing a decreasing trend from southeast to northwest along precipitation gradient;(3) According to the spatial and temporal distribution of HFMD outbreak period(from April to August) at provincial and city level in 2017, HFMD spread from southeast to northwest,and then retreated from west to east;(4) The prevalence of HFMD in major cities in China was correlated with the average annual precipitation and average annual temperature, which were fitted by a quadratic function(R2=0.6623) and an exponential function(R2=0.6469), respectively;and(5) The interaction effect between temperature and precipitation on HFMD resulted in a double-factor nonlinear enhancement and was more significant than a single factor during the spread of HFMD. The prevalence of HFMD in China is influenced by meteorological factors and is significantly different at spatial and temporal scales. Our results can provide reference for the prevention and control of HFMD at national level.