Spatial heterogeneity in the temperature-hand, foot, and mouth disease association among children: A multicounty time-series study in western China.

ABSTRACT: While meteorological and socioeconomic factors are well-documented modifiers of spatial heterogeneity in temperature-hand, foot, and mouth disease (HFMD) associations, substantial unexplained heterogeneity remains. This study investigates underexplored environmental modifiers-including extreme temperature events (heat waves and cold spells), air pollution, and normalized difference vegetation index (NDVI)-by analyzing 484,928 HFMD cases among children under six years old in western China (2013-2019) using distributed lag nonlinear models and meta-regression. We found that cold spells (accounted for 3.84% of the spatial heterogeneity attributable above the baseline level), PM2.5 (3.06%), heat waves (2.72%), PM10 (2.08%), NDVI (1.57%) and O3 (0.78%) were statistically significant modifiers o

SUBMITTER: Sun J 

PROVIDER: S-EPMC12758769 | biostudies-literature | 2026 Jan

REPOSITORIES: biostudies-literature