Abstract:
Objective To understand the spatial distribution of hand, foot and mouth (HFMD) and related influence factors in Shaanxi province, and provide evidence for the prevention and control of HFMD. Methods The incidence data of HFMD in all counties in Shaanxi in 2015 were collected from National Disease Reporting Information System, the spatial autocorrelation was analyzed by using Geoda 1.6.7, and SaTScan 9.4.2 was used to conduct spatial scan statistics.In addition, ArcGIS 10.2 and Stata 12.0 were used to visualize and fit linear regression model respectively. Results The reported HFMD incidence in Shaanxi in 2015 had spatial autocorrelation statistically (P=0.001). The results from local spatial autocorrelation analysis identified high-high pattern area (parts of Xi'an and Xianyang) and low-low pattern area (Yulin and Yan'an). In addition, the results from SaTScan statistics analysis indicated four clustering areas in parts of Xi'an, Xianyang and Weinan respectively. The results of multivariate analysis demonstrated that the macro economy and health system were associated with incidence of HFMD. In detail, urban and rural income ratio was positively associated with the incidence of HFMD (=0.264,P=0.001), but more number of health facilities (=-15.506, P=0.018) and beds in hospitals (=-5.108, P=0.029) were negatively associated with the incidence of HFMD. Conclusion The HFMD cases were not distributed randomly in Shaanxi in 2015,the clustering of the disease were found in Xi'an, Xianyang and Weinan, indicating the prevention and control of HFMD should be strengthened in these areas. It is important to make effort to decrease urban and rural income difference and improve health facilities, including hospital beds, to reduce the incidence of HFMD in Shaanxi.