利用贝叶斯时空模型分析山东省手足口病时空变化及影响因素

手足口病是一种常见的传染病,多见于5岁以下儿童。近年来,中国手足口病发病人数逐年上升,疾病疫情也越来越受到公共卫生部门与社会大众的关注。虽然已有不少手足口病相关的研究,但对其时空变化及影响因素驱动效应的研究仍然较少。本文采用贝叶斯时空模型,对2008年山东省手足口病高发时间段（5-8月）的发病时空演变特征进行系统分析,并探究影响手足口病发病风险的气象因素。结果表明：① 空间上不同区县的手足口病发病风险存在一定差异,且区县间的发病风险随时间变化趋势也各不相同;② 5月和6月手足口病发病风险明显高于整个研究阶段（5-8月）平均发病风险;③ 对手足口病发病风险影响较大的气象因素依次是：周平均温度、平均风速和平均气压。本文针对山东省手足口病时空演化特征及气象影响因素的研究,能为高发时间段内手足口病的区域化防控提供科学依据。

Space-time Variability and Determinants of Hand,Foot and Mouth in Shandong Province: A Bayesian Spatio-temporal Modeling Approach

Hand, foot, and mouth disease (HFMD) is a common infectious disease, particularly for the 5 years aged and younger children. In recent years, there is a substantial increase in HFMD cases in China, and the outbreak of this disease has attracted the public and health authorities. Although many studies focus on the variation pattern of HFMD, only a few explored thoroughly on its variability at the space-time dimension and its determinants. Here we used a Bayesian spatio-temporal model to analyze the county-level data of HFMD in Shandong Province from May to August in 2008. The study cases of human disease were obtained from the Chinese Center for Disease Control and Prevention. Meteorological data were collected from the publicly available Chinese Meteorological Data Sharing Service System (http://cdc.cma.gov.cn/home.do). Our findings suggest that: (1) the hotspot region of HFMD covers counties located in Weihai, Yantai, Weifang, Dongying, Jining and Dezhou prefecture-level cities. The risk of getting HFMD in counties that located in Heze, Jining, Zaozhuang, Dongying, Weifang and Qingdao prefecture-level cities decreased faster than the overall trend. (2) The weekly relative risk of HFMD from May to June is higher than other time periods. (3) In the period of May-August, the average air temperature and average air pressure were negatively associated with the relative risk of HFMD, while a positive relationship between the average wind velocity and the relative risk of HFMD was found in our investigating period at the weekly temporal resolution. We only focus on the spatio-temporal variability and determinants of HFMD during epidemic periods that have high risks, therefore our results were not consistent with the previous studies that use an annual time series data. The results is very meaningful for the government departments to make an effective policy so that the health program could control and reduce the relative risk of HFMD in the regional scale during the high risk period within Shandong Province.