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To address this gap, this study investigated the spatiotemporal dynamics of pediatric MPP across 46 urban subdistricts in Fuzhou, China. Using global and local spatial autocorrelation, space\u2013time scan statistics, and interpretable machine learning models, we assessed both incidence patterns and progression to severe disease, as well as their built-environment correlates. Key findings include: (1) A pronounced seasonality of MPP is observed, with autumn\u2013winter peaks and summer troughs. High-risk clusters are concentrated in central urban areas, whereas peripheral regions exhibit weaker clustering. These patterns are consistent with variations in climate, population density, transport networks, greenspace, and school-term cycles. (2) The autumn\u2013winter period represents the critical risk window, encompassing a large share of cases and repeatedly centering on repeatedly high-incidence subdistricts. Demographically, boys and children aged 5\u20139\u00a0years face the highest risk, whereas the 10\u201314 age group\u2014particularly girls\u2014shows the lowest incidence. (3) Machine learning identified age, near-road exposure, and selected land-use\/amenity intensities as core predictors, especially for severe MPP cases. Age exhibits a non-monotonic incidence profile, while distance from primary roads follows a steep inverse gradient, with elevated risk confined to a 100\u2013150\u00a0m roadside buffer zone. School density shows a monotonic positive association, whereas greenspace is a broadly negative association. These findings may help inform seasonally tailored, microscale interventions, strengthened school health monitoring, and targeted urban design in high-prevalence corridors.<\/jats:p>","DOI":"10.1186\/s12887-026-06993-2","type":"journal-article","created":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T05:46:54Z","timestamp":1780292814000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Urban environmental and climatic correlates of pediatric respiratory infection: microscale spatiotemporal evidence from Fuzhou, China"],"prefix":"10.1186","volume":"26","author":[{"given":"Yangbin","family":"Dong","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanying","family":"Rao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiuyu","family":"Tang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhanyong","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,30]]},"reference":[{"key":"6993_CR1","doi-asserted-by":"publisher","unstructured":"Song Z, Jia G, Luo, G, et al. 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The Ethics Committee of Fujian Children\u2019s Hospital (Fujian Branch of Shanghai Children\u2019s Medical Center) reviewed and approved the study (approval No. 2025ETKLRK04006). The study followed the ethical standards of the hospital ethics committee and the 1964 Declaration of Helsinki and its later amendments. The study used routinely collected clinical records for secondary analysis. The researchers removed all personal identifiers before the analysis. The study posed minimal risk to the participants. Therefore, the Ethics Committee of Fujian Children\u2019s Hospital (Fujian Branch of Shanghai Children\u2019s Medical Center) waived the requirement for written informed consent to participate from parents or legal guardians.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"704"}}