occupation, 90.56% (4298) of total cases were reported among
scattered children. Descriptive statistics for the number of
HFMD cases based on districts and weather variables are
summarized in Table 1.
Fig. 2 shows the monthly distribution of TCN from 1
January 2012 to 31 December 2014 in Huainan, China, indicating
that the number of HFMD was greater in the months of
March to June than other months. By analysing the incidence
of childhood HFMD in each district, it suggested that the
higher incidences of childhood HFMD were in three districts
(FTX, TJA and PJQ) (Fig. 1). Fig. 3 presents the time-series distribution
of total cases, daily mean temperature, DTR, TCN
from 1 January 2012 to 31 December 2014 in Huainan, showing
a distinct seasonality in these variables.
This study presents the cumulative effects of TCN or DTR
on the total up to 10 days respectively (Fig. 4). It suggests that
the temperature decrease from one day to the next
(TCN < 0 C) was statistically associated with childhood
HFMD. In contrast, no significant association between DTR
and childhood HFMD was observed, though positive linear
slope with increasing DTR. We also provide the relationship
between TCN and childhood HFMD by age, gender, occupation
and morbidity at five days lag (Fig. 5). The evident association
between decrease of TCN and HFMD on male children, children
aged 0e5 years, scattered children and children in highrisk
area was observed, respectively.
Wealso identified the RR of HFMD by TCN using distributed
lag nonlinear models by lag at specific TCN (3 C, 10th
percentile) (Table 2), suggesting that the effect was the
greatest at five days lag. In particular, a 3 C decrease in mean
temperature between neighbouring days led to an increase of
10% (95% CI: 4%e15%) in the daily number of cases in the 0e14
years age group. We also observed that temperature change
was more likely to affect HFMD occurrence among male
children, 0e5 years children, scattered children, and children
in high-risk areas.
occupation, 90.56% (4298) of total cases were reported amongscattered children. Descriptive statistics for the number ofHFMD cases based on districts and weather variables aresummarized in Table 1.Fig. 2 shows the monthly distribution of TCN from 1January 2012 to 31 December 2014 in Huainan, China, indicatingthat the number of HFMD was greater in the months ofMarch to June than other months. By analysing the incidenceof childhood HFMD in each district, it suggested that thehigher incidences of childhood HFMD were in three districts(FTX, TJA and PJQ) (Fig. 1). Fig. 3 presents the time-series distributionof total cases, daily mean temperature, DTR, TCNfrom 1 January 2012 to 31 December 2014 in Huainan, showinga distinct seasonality in these variables.This study presents the cumulative effects of TCN or DTRon the total up to 10 days respectively (Fig. 4). It suggests thatthe temperature decrease from one day to the next(TCN < 0 C) was statistically associated with childhoodHFMD. In contrast, no significant association between DTRand childhood HFMD was observed, though positive linearslope with increasing DTR. We also provide the relationshipbetween TCN and childhood HFMD by age, gender, occupationand morbidity at five days lag (Fig. 5). The evident associationbetween decrease of TCN and HFMD on male children, childrenaged 0e5 years, scattered children and children in highriskarea was observed, respectively.Wealso identified the RR of HFMD by TCN using distributedlag nonlinear models by lag at specific TCN (3 C, 10thpercentile) (Table 2), suggesting that the effect was thegreatest at five days lag. In particular, a 3 C decrease in meantemperature between neighbouring days led to an increase of10% (95% CI: 4%e15%) in the daily number of cases in the 0e14years age group. We also observed that temperature changewas more likely to affect HFMD occurrence among malechildren, 0e5 years children, scattered children, and childrenin high-risk areas.
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