{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T16:08:42Z","timestamp":1775059722207,"version":"3.50.1"},"reference-count":46,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2023,3,14]],"date-time":"2023-03-14T00:00:00Z","timestamp":1678752000000},"content-version":"unspecified","delay-in-days":72,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100013076","name":"National Major Science and Technology Projects of China","doi-asserted-by":"publisher","award":["2018ZX10201002-003-005"],"award-info":[{"award-number":["2018ZX10201002-003-005"]}],"id":[{"id":"10.13039\/501100013076","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["2021YFC2301603"],"award-info":[{"award-number":["2021YFC2301603"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Epidemiol. Infect."],"published-print":{"date-parts":[[2023]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Hand, foot and mouth disease (HFMD) is a common infection in the world, and its epidemics result in heavy disease burdens. Over the past decade, HFMD has been widespread among children in China, with Shanxi Province being a severely affected northern province. Located in the temperate monsoon climate, Shanxi has a GDP of over 2.5 trillion yuan. It is important to have a comprehensive understanding of the basic features of HFMD in those areas that have similar meteorological and economic backgrounds to northern China. We aimed to investigate epidemiological characteristics, identify spatial clusters and predict monthly incidence of HFMD. All reported HFMD cases were obtained from the Shanxi Center for Disease Control and Prevention. Overall HFMD incidence showed a significant downward trend from 2017 to 2020, increasing again in 2021. Children aged &lt; 5 years were primarily affected, with a high incidence of HFMD in male patients (relative risk: 1.316). The distribution showed a seasonal trend, with major peaks in June and July and secondary peaks in October and November with the exception of 2020. Other enteroviruses were the predominant causative agents of HFMD in most years. Areas with large numbers of HFMD cases were primarily in central Shanxi, and spatial clusters in 2017 and 2018 showed a positive global spatial correlation. Local spatial autocorrelation analysis showed that hot spots and secondary hot spots were concentrated in Jinzhong and Yangquan in 2018. Based on monthly incidence from September 2021 to August 2022, the mean absolute error (MAE), mean absolute percentage error (MAPE), and root mean square error (RMSE) of the long short-term memory (LSTM) and seasonal autoregressive integrated moving average (SARIMA) models were 386.58<jats:italic>vs.<\/jats:italic>838.25, 2.25<jats:italic>vs.<\/jats:italic>3.08, and 461.96<jats:italic>vs.<\/jats:italic>963.13, respectively, indicating that the predictive accuracy of LSTM was better than that of SARIMA. The LSTM model may be useful in predicting monthly incidences of HFMD, which may provide early warnings of HFMD epidemics.<\/jats:p>","DOI":"10.1017\/s0950268823000389","type":"journal-article","created":{"date-parts":[[2023,3,14]],"date-time":"2023-03-14T06:39:54Z","timestamp":1678775994000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":6,"title":["Epidemiological characteristics, spatial clusters and monthly incidence prediction of hand, foot and mouth disease from 2017 to 2022 in Shanxi Province, China"],"prefix":"10.1017","volume":"151","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4011-0277","authenticated-orcid":false,"given":"Yifei","family":"Ma","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shujun","family":"Xu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ali","family":"Dong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jianhua","family":"An","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yao","family":"Qin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hui","family":"Yang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9852-2485","authenticated-orcid":false,"given":"Hongmei","family":"Yu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2023,3,14]]},"reference":[{"key":"S0950268823000389_ref9","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1186\/1743-422X-7-94","article-title":"An emerging recombinant human enterovirus 71 responsible for the 2008 outbreak of hand foot and mouth disease in Fuyang city of China","volume":"7","author":"Yan","year":"2010","journal-title":"Virology Journal"},{"key":"S0950268823000389_ref22","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1017\/S0950268815001144","article-title":"Predicting the incidence of hand, foot and mouth disease in Sichuan province, China using the ARIMA model","volume":"144","author":"Liu","year":"2016","journal-title":"Epidemiology and Infection"},{"key":"S0950268823000389_ref29","doi-asserted-by":"crossref","first-page":"989","DOI":"10.1038\/s41598-020-57807-z","article-title":"Pathogenic characteristics of hand, foot and mouth disease in Shaanxi Province, China, 2010\u20132016","volume":"10","author":"Xu","year":"2020","journal-title":"Scientific Reports"},{"key":"S0950268823000389_ref34","doi-asserted-by":"crossref","first-page":"4934","DOI":"10.1002\/jmv.27906","article-title":"Epidemiological characteristics of hand, foot, and mouth disease clusters during 2016\u20132020 in Beijing, China","volume":"94","author":"Cui","year":"2022","journal-title":"Journal of Medical Virology"},{"key":"S0950268823000389_ref39","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1111\/ijd.14188","article-title":"Temperature and humidity affect the incidence of hand, foot, and mouth disease: a systematic review of the literature - 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