{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T10:41:49Z","timestamp":1778755309438,"version":"3.51.4"},"reference-count":22,"publisher":"Cambridge University Press (CUP)","issue":"4","license":[{"start":{"date-parts":[[2014,6,24]],"date-time":"2014-06-24T00:00:00Z","timestamp":1403568000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["journals.cambridge.org"],"crossmark-restriction":true},"short-container-title":["Epidemiol. Infect."],"published-print":{"date-parts":[[2015,3]]},"abstract":"<jats:title>SUMMARY<\/jats:title><jats:p>China has recently experienced a marked increase in the incidence of hand, foot and mouth disease (HFMD). Effective spatio-temporal monitoring of HFMD incidence is important for successful implementation of control and prevention measures. This study monitored county-level HFMD reported incidence rates for Sichuan province, China by examining spatio-temporal patterns. County-level data on HFMD daily cases between January 2008 and December 2013 were obtained from the China Information System for Disease Control and Prevention. We first conducted purely temporal and purely spatial descriptive analyses to characterize the distribution patterns of HFMD. Then, the global Moran's<jats:italic>I<\/jats:italic>statistic and space\u2013time scan statistic were used to detect the spatial autocorrelation and identify the high-risk clusters in each year, respectively. A total of 212267 HFMD cases were reported in Sichuan province during the study period (annual average incidence 43\u00b765\/100000), and the incidence seasonal peak was between April and July. Relatively high incidence rates appeared in the northeastern\u2013southwestern belt. HFMD had positive spatial autocorrelation at the county level with global Moran's<jats:italic>I<\/jats:italic>increasing from 0\u00b727 to 0\u00b752 (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00\u00b7001). Spatio-temporal cluster analysis detected six most-likely clusters and several secondary clusters from 2008 to 2013. The centres of the six most-likely clusters were all located in the provincial capital city Chengdu. Chengdu and its neighbouring cities had always been spatio-temporal clusters, which indicated the need for further intensive space\u2013time surveillance. Allocating more resources to these areas at suitable times might help to reduce HFMD incidence more effectively.<\/jats:p>","DOI":"10.1017\/s0950268814001587","type":"journal-article","created":{"date-parts":[[2014,6,25]],"date-time":"2014-06-25T10:38:09Z","timestamp":1403692689000},"page":"831-838","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":29,"title":["Spatio-temporal clustering of hand, foot and mouth disease at the county level in Sichuan province, China, 2008\u20132013"],"prefix":"10.1017","volume":"143","author":[{"given":"L.","family":"LIU","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"X.","family":"ZHAO","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F.","family":"YIN","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Q.","family":"LV","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2014,6,24]]},"reference":[{"key":"S0950268814001587_ref17","doi-asserted-by":"publisher","DOI":"10.1016\/j.scitotenv.2011.09.055"},{"key":"S0950268814001587_ref10","article-title":"Spatio-temporal clustering of hand, foot, and mouth disease at the county level in Guangxi, China","volume":"9","author":"Xie","year":"2014","journal-title":"PLoS One"},{"key":"S0950268814001587_ref15","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-13-134"},{"key":"S0950268814001587_ref20","doi-asserted-by":"publisher","DOI":"10.1186\/1476-072X-9-16"},{"key":"S0950268814001587_ref12","doi-asserted-by":"crossref","first-page":"503","DOI":"10.4269\/ajtmh.2009.81.503","article-title":"Spatio-temporal distribution of malaria in Yunnan Province, China","volume":"81","author":"Hui","year":"2009","journal-title":"American Journal of Tropical Medicine and Hygiene"},{"key":"S0950268814001587_ref22","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.08.060905"},{"key":"S0950268814001587_ref9","doi-asserted-by":"publisher","DOI":"10.3201\/eid1802.111147"},{"key":"S0950268814001587_ref14","article-title":"Determinants of the incidence of hand, foot and mouth disease in China using geographically weighted regression models","volume":"7","author":"Hu","year":"2012","journal-title":"PLoS One"},{"key":"S0950268814001587_ref7","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcv.2010.02.002"},{"key":"S0950268814001587_ref1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc1110981"},{"key":"S0950268814001587_ref13","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a009247"},{"key":"S0950268814001587_ref2","volume-title":"A Guide to Clinical Management and Public Health Response for Hand, Foot and Mouth Disease (HFMD)","year":"2011"},{"key":"S0950268814001587_ref5","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph110100312"},{"key":"S0950268814001587_ref19","doi-asserted-by":"publisher","DOI":"10.3724\/SP.J.1047.2010.00380"},{"key":"S0950268814001587_ref8","doi-asserted-by":"publisher","DOI":"10.1007\/s12250-011-3195-8"},{"key":"S0950268814001587_ref3","article-title":"Detecting Spatial-temporal clusters of HFMD from 2007 to 2011 in Shandong province, China","volume":"8","author":"Liu","year":"2013","journal-title":"PLoS One"},{"key":"S0950268814001587_ref16","doi-asserted-by":"publisher","DOI":"10.4081\/gh.2013.95"},{"key":"S0950268814001587_ref6","first-page":"349","article-title":"Surveillance of hand, foot, and mouth disease in mainland China (2008\u20132009)","volume":"24","author":"ZHU","year":"2011","journal-title":"Biomedical and Environmental Sciences"},{"key":"S0950268814001587_ref21","doi-asserted-by":"publisher","DOI":"10.1186\/1476-072X-7-57"},{"key":"S0950268814001587_ref18","doi-asserted-by":"crossref","first-page":"422","DOI":"10.7883\/yoken.63.422","article-title":"Changing epidemiology of hand, foot, and mouth disease in Hong Kong, 2001\u20132009","volume":"63","author":"Ma","year":"2010","journal-title":"Japanese Journal of Infectious Diseases"},{"key":"S0950268814001587_ref4","article-title":"Spatial-temporal clusters and risk factors of hand, foot, and mouth disease at the district level in Guangdong Province, China","volume":"8","author":"Deng","year":"2013","journal-title":"PLoS One"},{"key":"S0950268814001587_ref11","unstructured":"The Ministry of Health of China. Hand, foot and mouth disease prevention and control guideline, China (2009 version) (http:\/\/www.gov.cn\/gzdt\/2009-06\/04\/content_1332078.htm). Accessed 2014 March 28."}],"container-title":["Epidemiology and Infection"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0950268814001587","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,4,9]],"date-time":"2022-04-09T07:23:41Z","timestamp":1649489021000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0950268814001587\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,6,24]]},"references-count":22,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2015,3]]}},"alternative-id":["S0950268814001587"],"URL":"https:\/\/doi.org\/10.1017\/s0950268814001587","relation":{},"ISSN":["0950-2688","1469-4409"],"issn-type":[{"value":"0950-2688","type":"print"},{"value":"1469-4409","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,6,24]]},"assertion":[{"value":"Copyright \u00a9 Cambridge University Press 2014\u00a0","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}}]}}