Objective  To understand the epidemiological and etiological characteristics of hand foot and mouth disease (HFMD) in Liuzhou, Guangxi, from 2014 to 2018, and provide evidences for the prevention and control of HFMD.

  Methods  Descriptive and spatial analyses were used to analyze the epidemiological characteristics of HFMD in Liuzhou. Global and local spatial autocorrelation analysis was used to analyze the spatial clustering of HFMD. The trend surface analysis was used to evaluate the spatial distribution trend of HFMD, and the annual etiological test results of HFMD were analyzed.

  Results  The annual average incidence rate of HFMD was 821.59/100 000 in Liuzhou from 2014 to 2018. Most cases were aged 0–5 years (95.90%), and 64.58% of them were children outside child care settings. The incidence rate and severe case number of HFMD showed decline trends from 2014 to 2018 (P<0.01), and the epidemic season was from April to July and September to November. EV71 and other enteroviruses were the main pathogens in 2014. Other enteroviruses were the main pathogens in 2015 and 2017 (＞80%). Cox A16 was the main pathogen in 2016 and 2018, followed by other enteroviruses, and EV71 accounted for a relatively low proportion. There was spatial clustering with hot spots in the southern part of Liuzhou and cold spots in Rongshui Miao autonomous county. The high-incidence areas were in Liunan, Yufeng, Liubei, Chengzhong districts, and Labao, Luzhai, Luorong, Sandu, Jinde, Chengtuan, Shatang, Sipai and Guyi townships. The trend surface analysis showed that the incidence of HFMD increased gradually from north to south, and from east and west to central area.

  Conclusion  HFMD mainly occurred in children under 5 years old in Liuzhou with the seasonal incidence peaks in summer and autumn, and had obviously spatial clustering distribution. The predominant pathogens were different in different years. It is necessary to further explore the risk factors in high-risk areas to provide scientific evidences for the development of HFMD prevention and control strategies and the allocation of public health resources.