Analysis on epidemiological characteristics and spatiotemporal clustering of hand, foot and mouth disease in children under 6 years old in Yangzhou, Jiangsu, 2008−2023

Objective To understand the epidemiological characteristics and spatialotemporal clustering of hand, foot and mouth disease (HFMD) in children under 6 years old in Yangzhou, Jiangsu province, and provide reference for the prevention and control of HFMD.

Methods The incidence data of HFMD in children under 6 years old in Yangzhou from 2008 to 2023 were collected through China Disease Control and Prevention Information System, and software ArcGIS 10.8 was used for trend analysis, spatial autocorrelation analysis and result visualization. Software SaTScan 10.1 was used for spatiotemporal scanning analysis.

Results From 2008 to 2023, a total of 81 378 cases of HFMD in children under 6 years old were reported in Yangzhou, with an average annual incidence of 111.18/100 000. More boys were affected, and the cases in boys accounted for 60.39% of the total. Two incidence peaks were observed during this period. The results of the incidence trend showed that it incrased first and then decreased from west to east, and continued to increase from north to south. The global spatial autocorrelation analysis showed that there was a significant spatial clustering of HFMD in Yangzhou (Moran's I was 0.15– 0.33, P<0.01), and the local autocorrelation analysis showed that the high-high clustering was always distributed in Guangling, Hanjiang and the townships bordering Yizheng. Year-by-year spatiotemporal scanning analysis showed that there were multiple clustering in Wenhe, Xincheng, Hangji and surrounding townships around June and November from 2008 to 2023, similar to the results of local autocorrelation analysis.

Conclusion The incidence of HFMD in children under 6 years old showed spatiotemporal clustering in Yangzhou. It is necessary to strengthen the intervention in main clustering areas before the epidemic peak.