{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,26]],"date-time":"2026-04-26T06:13:38Z","timestamp":1777184018234,"version":"3.51.4"},"reference-count":26,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2018,10,11]],"date-time":"2018-10-11T00:00:00Z","timestamp":1539216000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2018,10,11]],"date-time":"2018-10-11T00:00:00Z","timestamp":1539216000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81473064"],"award-info":[{"award-number":["81473064"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Hand, foot, and mouth disease (HFMD) remains a significant public health and economic burden in parts of China, particularly Guangdong Province. Although the association between meteorological factors and HFMD has been well documented, significant gaps remain in our understanding of the potential impact of environmental factors. Using county-level monthly HFMD data from China CDC and environmental data from multiple sources, we used spatiotemporal Bayesian models to evaluate the association between HFMD and environmental factors including vegetation index, proportion of artificial surface, road capacity, temperature and humidity, and assessed the spatial and temporal dynamic of the association. Statistically significant correlation coefficients from \u22120.056 to 0.36 (all\n                    <jats:italic>P<\/jats:italic>\n                    \u2009&lt;\u20090.05) were found between HFMD incidence and all environmental factors. The contributions of these factors for HFMD incidence were estimated to be 16.32%, 12.31%, 14.61%, 13.53%, and 2.63%. All environmental factors including vegetation index (Relative Risk: 0.889; Credible Interval: 0.883\u20130.895), artificial surface (1.028; 1.022\u20131.034), road capacity (1.033; 1.028\u20131.038), temperature (1.039; 1.028\u20131.05), and relative humidity (1.015; 1.01\u20131.021) were statistically retained in the final spatiotemporal model. More comprehensive environmental factors were identified as associating with HFMD incidence. Taking these environmental factors into consideration for prevention and control strategy might be of great practical significance.\n                  <\/jats:p>","DOI":"10.1038\/s41598-018-33109-3","type":"journal-article","created":{"date-parts":[[2018,10,5]],"date-time":"2018-10-05T06:40:50Z","timestamp":1538721650000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Bayesian spatiotemporal analysis for association of environmental factors with hand, foot, and mouth disease in Guangdong, China"],"prefix":"10.1038","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1155-8443","authenticated-orcid":false,"given":"Zhicheng","family":"Du","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2992-5897","authenticated-orcid":false,"given":"Wayne R.","family":"Lawrence","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wangjian","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dingmei","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shicheng","family":"Yu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuantao","family":"Hao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2018,10,11]]},"reference":[{"key":"33109_CR1","unstructured":"National Health and Family Planning Commission of China, The National Statutory Epidemic Situation of Infectious Diseases of China. http:\/\/www.nhfpc.gov.cn\/jkj\/s2907\/new_list.shtml (Accessed at 2017-11-18) (2016)."},{"key":"33109_CR2","unstructured":"Health Department of Guangdong Province, The National Statutory Epidemic Situation of Infectious Diseases of Guangdong Province, China. http:\/\/www.gdwst.gov.cn\/a\/yiqingxx\/. (Accessed at 2017-11-18) (2016)."},{"key":"33109_CR3","doi-asserted-by":"publisher","first-page":"315","DOI":"10.1007\/s00705-014-2294-x","volume":"160","author":"Z Chen","year":"2015","unstructured":"Chen, Z. et al. Epidemiological Profiles of Hand, Foot, and Mouth Disease, Including Meteorological Factors, in Suzhou, China. ARCH VIROL. 160, 315\u2013321 (2015).","journal-title":"ARCH VIROL."},{"key":"33109_CR4","first-page":"23","volume":"1","author":"G Ma","year":"2015","unstructured":"Ma, G., Gao, L., Yang, Y., Xiao, H. & Tian, H. Spatial and Temporal Statistical Modeling of Hand, Foot, and Mouth Disease and its Characteristics in China: A Review. Infectious Diseases and Translational Medicine. 1, 23\u201329 (2015).","journal-title":"Infectious Diseases and Translational Medicine."},{"key":"33109_CR5","doi-asserted-by":"publisher","first-page":"308","DOI":"10.1016\/S1473-3099(13)70342-6","volume":"14","author":"W Xing","year":"2014","unstructured":"Xing, W. et al. Hand, Foot, and Mouth Disease in China, 2008-12: An Epidemiological Study. Lancet Infect Dis. 14, 308\u2013318 (2014).","journal-title":"Lancet Infect Dis."},{"key":"33109_CR6","doi-asserted-by":"publisher","first-page":"453","DOI":"10.1007\/s00484-016-1225-9","volume":"61","author":"D Zhao","year":"2017","unstructured":"Zhao, D. et al. Impact of Weather Factors On Hand, Foot and Mouth Disease, and its Role in Short-Term Incidence Trend Forecast in Huainan City, Anhui Province. Int J Biometeorol. 61, 453\u2013461 (2017).","journal-title":"Int J Biometeorol."},{"key":"33109_CR7","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1007\/s00484-016-1197-9","volume":"61","author":"F Gou","year":"2016","unstructured":"Gou, F. et al. Socio-Ecological Factors and Hand, Foot and Mouth Disease in Dry Climate Regions: A Bayesian Spatial Approach in Gansu, China. Int J Biometeorol. 61, 137\u2013147 (2016).","journal-title":"Int J Biometeorol."},{"key":"33109_CR8","doi-asserted-by":"publisher","DOI":"10.1038\/srep36351","volume":"6","author":"Z Du","year":"2016","unstructured":"Du, Z., Zhang, W., Zhang, D., Yu, S. & Hao, Y. The Threshold Effects of Meteorological Factors On Hand, Foot, and Mouth Disease (HFMD) in China, 2011. Sci Rep. 6, 36351 (2016).","journal-title":"Sci Rep."},{"key":"33109_CR9","unstructured":"Wolf, J. P. A., Carlos, F. C., Bos, R. & Purificaci\u00f3n, N. M. Preventing Disease through Healthy Environments: A Global Assessment of the Burden of Disease From Environmental Risks, http:\/\/www.who.int\/quantifying_ehimpacts\/publications\/preventing-disease\/en\/. (Accessed at 2018-01-17) (2016)."},{"key":"33109_CR10","doi-asserted-by":"publisher","first-page":"7","DOI":"10.3201\/eid0101.950102","volume":"1","author":"SS Morse","year":"1995","unstructured":"Morse, S. S. Factors in the Emergence of Infectious Diseases. Emerg Infect Dis. 1, 7\u201315 (1995).","journal-title":"Emerg Infect Dis."},{"key":"33109_CR11","doi-asserted-by":"publisher","first-page":"179","DOI":"10.4081\/gh.2010.199","volume":"4","author":"NM Wayant","year":"2010","unstructured":"Wayant, N. M., Maldonado, D., Arias, A. R. D., Cousi\u00f1o, B. & Goodin, D. G. Correlation Between Normalized Difference Vegetation Index and Malaria in a Subtropical Rain Forest Undergoing Rapid Anthropogenic Alteration. Geospatial Health. 4, 179\u2013190 (2010).","journal-title":"Geospatial Health."},{"key":"33109_CR12","doi-asserted-by":"crossref","unstructured":"Barbour, A. & Fish, D. The Biological and Social Phenomenon of Lyme Disease. 260, 1610\u20131616 (1993).","DOI":"10.1126\/science.8503006"},{"key":"33109_CR13","unstructured":"McNeill, W. Plagues and PeoplesAnchor Press, New York (1976)."},{"key":"33109_CR14","doi-asserted-by":"publisher","first-page":"274","DOI":"10.1186\/s12889-018-5169-3","volume":"18","author":"L Li","year":"2018","unstructured":"Li, L., Qiu, W., Xu, C. & Wang, J. A Spatiotemporal Mixed Model to Assess the Influence of Environmental and Socioeconomic Factors On the Incidence of Hand, Foot and Mouth Disease. Bmc Pubic Health. 18, 274 (2018).","journal-title":"Bmc Pubic Health."},{"key":"33109_CR15","doi-asserted-by":"crossref","unstructured":"C., C. et al. Research On the Environmental Impact Factors of Hand-Foot-Mouth Disease in Shenzhen, China Using RS and GIS Technologies. 2012 IEEE International Geoscience and Remote Sensing Symposium. 7240\u20137243 (2012).","DOI":"10.1109\/IGARSS.2012.6351991"},{"key":"33109_CR16","doi-asserted-by":"publisher","first-page":"366","DOI":"10.1016\/j.scitotenv.2016.02.023","volume":"553","author":"W Zhang","year":"2016","unstructured":"Zhang, W., Du, Z., Zhang, D., Yu, S. & Hao, Y. Boosted Regression Tree Model-Based Assessment of the Impacts of Meteorological Drivers of Hand, Foot and Mouth Disease in Guangdong, China. Sci Total Environ. 553, 366\u2013371 (2016).","journal-title":"Sci Total Environ."},{"key":"33109_CR17","unstructured":"Kiang, R. & Soebiyanto, R. P. Estimating the Risk of Vector-Borne Infectious Disease & Acute Respiratory Infections Using Satellite Data, https:\/\/ntrs.nasa.gov\/archive\/nasa\/casi.ntrs.nasa.gov\/20120013505.pdf (Accessed at 2018-01-05) (2012)."},{"key":"33109_CR18","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1016\/S0065-308X(00)47006-5","volume":"47","author":"PJ Curran","year":"2000","unstructured":"Curran, P. J., Atkinson, P. M., Foody, G. M. & Milton, E. J. Linking Remote Sensing, Land Cover and Disease. Adv Parasitol. 47, 37\u201380 (2000).","journal-title":"Adv Parasitol."},{"key":"33109_CR19","doi-asserted-by":"publisher","first-page":"1286","DOI":"10.1289\/ehp.1104609","volume":"120","author":"P Dadvand","year":"2012","unstructured":"Dadvand, P. et al. Surrounding Greenness and Exposure to Air Pollution During Pregnancy: An Analysis of Personal Monitoring Data. Environ Health Perspect. 120, 1286\u20131290 (2012).","journal-title":"Environ Health Perspect."},{"key":"33109_CR20","unstructured":"Statistics Bureau Of Guangdong Province, Guangdong Statistical Yearbook, http:\/\/www.gdstats.gov.cn\/tjsj\/gdtjnj\/ (Accessed at 2017-1-1) (2015)."},{"key":"33109_CR21","unstructured":"Ministry of Transport of the People\u2019s Republic of China. Technical Standard of Highway Engineering. Beijing, China: China Communications Press Co., Ltd., 120 (2014)."},{"key":"33109_CR22","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1111\/j.2517-6161.1948.tb00012.x","volume":"10","author":"PAP Moran","year":"1948","unstructured":"Moran, P. A. P. The Interpretation of Statistical Maps. Journal of the Royal Statistical Society. Series B (Methodological). 10, 243\u2013251 (1948).","journal-title":"Series B (Methodological)."},{"key":"33109_CR23","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-13-134","volume":"13","author":"Y Huang","year":"2013","unstructured":"Huang, Y. et al. Effect of Meteorological Variables On the Incidence of Hand, Foot, and Mouth Disease in Children: A Time-Series Analysis in Guangzhou, China. BMC Infect Dis. 13, 134 (2013).","journal-title":"BMC Infect Dis."},{"key":"33109_CR24","unstructured":"Burnham, K. P. & Anderson, D. R. Model Selection and Multimodel InferenceSpringer, New York, USA (2002)."},{"key":"33109_CR25","doi-asserted-by":"publisher","first-page":"141","DOI":"10.1111\/rssc.12155","volume":"66","author":"A Rushworth","year":"2017","unstructured":"Rushworth, A., Lee, D. & Sarran, C. An Adaptive Spatiotemporal Smoothing Model for Estimating Trends and Step Changes in Disease Risk. Journal of the Royal Statistical society C. 66, 141\u2013157 (2017).","journal-title":"Journal of the Royal Statistical society C."},{"key":"33109_CR26","doi-asserted-by":"publisher","first-page":"179","DOI":"10.1007\/978-1-4612-1284-3_4","volume-title":"Statistical Models in Epidemiology, the Environment, and Clinical Trials","author":"Brian G. Leroux","year":"2000","unstructured":"Leroux, B. G., Lei, X. & Breslow, N. Estimation of Disease Rates in Small Areas: A new Mixed Model for Spatial Dependence. In: Halloran ME, Berry D, eds Statistical Models in Epidemiology, the Environment, and Clinical Trials. New York, NY: Springer New York, :179\u2013191 (2000)."}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-018-33109-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-018-33109-3","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-018-33109-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T15:07:57Z","timestamp":1772550477000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-018-33109-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,10,11]]},"references-count":26,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2018,12]]}},"alternative-id":["33109"],"URL":"https:\/\/doi.org\/10.1038\/s41598-018-33109-3","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,10,11]]},"assertion":[{"value":"8 June 2018","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 September 2018","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 October 2018","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing Interests"}}],"article-number":"15147"}}