A spatiotemporal mixed model to assess the influence of environmental and socioeconomic factors on the incidence of hand, foot and mouth disease

doi:10.1186/s12889-018-5169-3

	A spatiotemporal mixed model to assess the influence of environmental and socioeconomic factors on the incidence of hand, foot and mouth disease
	Li, Lianfa 1,2; Qiu, Wenyang 1,2; Xu, Chengdong 1,2; Wang, Jinfeng 1,2
刊名	BMC PUBLIC HEALTH
	2018-02-20
卷号	18 页码:12
关键词	Spatiotemporal mixed model Spatial effect Non-linear effect Hand-foot-mouth disease Spatiotemporal scanning statistics
ISSN号	1471-2458
DOI	10.1186/s12889-018-5169-3
通讯作者	Li, Lianfa(lilf@lreis.ac.cn)
英文摘要	Background: As a common infectious disease, hand, foot and mouth disease (HFMD) is affected by multiple environmental and socioeconomic factors, and its pathogenesis is complex. Furthermore, the transmission of HFMD is characterized by strong spatial clustering and autocorrelation, and the classical statistical approach may be biased without consideration of spatial autocorrelation. In this paper, we propose to embed spatial characteristics into a spatiotemporal additive model to improve HFMD incidence assessment. Methods: Using incidence data (6439 samples from 137 monitoring district) for Shandong Province, China, along with meteorological, environmental and socioeconomic spatial and spatiotemporal covariate data, we proposed a spatiotemporal mixed model to estimate HFMD incidence. Geo-additive regression was used to model the non-linear effects of the covariates on the incidence risk of HFMD in univariate and multivariate models. Furthermore, the spatial effect was constructed to capture spatial autocorrelation at the sub-regional scale, and clusters (hotspots of high risk) were generated using spatiotemporal scanning statistics as a predictor. Linear and non-linear effects were compared to illustrate the usefulness of non-linear associations. Patterns of spatial effects and clusters were explored to illustrate the variation of the HFMD incidence across geographical sub-regions. To validate our approach, 10-fold cross-validation was conducted. Results: The results showed that there were significant non-linear associations of the temporal index, spatiotemporal meteorological factors and spatial environmental and socioeconomic factors with HFMD incidence. Furthermore, there were strong spatial autocorrelation and clusters for the HFMD incidence. Spatiotemporal meteorological parameters, the normalized difference vegetation index (NDVI), the temporal index, spatiotemporal clustering and spatial effects played important roles as predictors in the multivariate models. Efron's cross-validation R-2 of 0.83 was acquired using our approach. The spatial effect accounted for 23% of the R2, and notable patterns of the posterior spatial effect were captured. Conclusions: We developed a geo-additive mixed spatiotemporal model to assess the influence of meteorological, environmental and socioeconomic factors on HFMD incidence and explored spatiotemporal patterns of such incidence. Our approach achieved a competitive performance in cross-validation and revealed strong spatial patterns for the HFMD incidence rate, illustrating important implications for the epidemiology of HFMD.
资助项目	National Natural Science Foundation of China[41471376] ; National Natural Science Foundation of China[41171344] ; National Natural Science Foundation of China[41421001]
WOS关键词	METEOROLOGICAL FACTORS ; CHINA ; CHILDREN ; TEMPERATURE ; SURVIVAL ; SHENZHEN ; HUMIDITY
WOS研究方向	Public, Environmental & Occupational Health
语种	英语
出版者	BIOMED CENTRAL LTD
WOS记录号	WOS:000425553500006
资助机构	National Natural Science Foundation of China
内容类型	期刊论文
源URL	[http://ir.igsnrr.ac.cn/handle/311030/57150]
专题	中国科学院地理科学与资源研究所
通讯作者	Li, Lianfa
作者单位	1.Chinese Acad Sci, Inst Geog Sci & Nat Resources Res, ILREIS, Beijing, Peoples R China 2.Univ Chinese Acad Sci, Beijing 10049, Peoples R China
推荐引用方式 GB/T 7714	Li, Lianfa,Qiu, Wenyang,Xu, Chengdong,et al. A spatiotemporal mixed model to assess the influence of environmental and socioeconomic factors on the incidence of hand, foot and mouth disease[J]. BMC PUBLIC HEALTH,2018,18:12.
APA	Li, Lianfa,Qiu, Wenyang,Xu, Chengdong,&Wang, Jinfeng.(2018).A spatiotemporal mixed model to assess the influence of environmental and socioeconomic factors on the incidence of hand, foot and mouth disease.BMC PUBLIC HEALTH,18,12.
MLA	Li, Lianfa,et al."A spatiotemporal mixed model to assess the influence of environmental and socioeconomic factors on the incidence of hand, foot and mouth disease".BMC PUBLIC HEALTH 18(2018):12.