{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T15:35:28Z","timestamp":1759332928153,"version":"build-2065373602"},"reference-count":42,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T00:00:00Z","timestamp":1759190400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Guangzhou Science and Technology Bureau School Enterprise Joint Funding Project","award":["2023A03J0939"],"award-info":[{"award-number":["2023A03J0939"]}]},{"name":"Guangzhou Science and Technology Bureau School Enterprise Joint Funding Project","award":["2024A03J0368"],"award-info":[{"award-number":["2024A03J0368"]}]},{"name":"The Key Project of Medicine Discipline of Guangzhou","award":["2025\u20132027-11"],"award-info":[{"award-number":["2025\u20132027-11"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:p>Hand, foot, and mouth disease (HFMD) primarily affects children under the age of five and has emerged as a significant public health concern in China. This study examines HFMD incidence trends across various gender and age demographics in Guangzhou from 2013 to 2023, providing a comprehensive overview to inform future prevention and management strategies. Utilizing epidemiological data from the National Notifiable Infectious Disease Reporting Information System, we employed Joinpoint regression modeling to assess variations in incidence rates among different demographic cohorts and developed a Seasonal Autoregressive Integrated Moving Average (SARIMA) model to analyze case trends and project future occurrences. The findings revealed biennial peaks and notable seasonality, indicating cases across all age groups, though predominantly among children under five. Joinpoint regression analysis demonstrated a significant decrease in incidence rates for children younger than one year (Average Annual Percent Change [AAPC]=\u221213.50%, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) and those aged one year (AAPC\u2009=\u2009\u221210.35%, <jats:italic>P<\/jats:italic>\u2009=\u20090.002), while incidence remained stable for children aged two to five years. Conversely, a significant upward trend was identified in children aged six years and older (AAPC\u2009=\u200913.09%, <jats:italic>P<\/jats:italic>\u2009=\u20090.019). Gender-specific trends closely resembled these overall patterns, with both males and females experiencing similar percentage changes in incidence rates. The SARIMA model indicates a projected decline in HFMD cases for 2024, followed by a phase of relative stability characterized by minor fluctuations. These results offer crucial insights into HFMD trends, illustrating the effectiveness of current preventive measures in reducing incidence among younger children while underscoring the necessity for targeted interventions to address the rising trends in older age groups. By leveraging these findings, health authorities can refine control strategies and prioritize public health responses to effectively mitigate HFMD outbreaks.<\/jats:p>","DOI":"10.1371\/journal.pone.0333544","type":"journal-article","created":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T17:35:06Z","timestamp":1759253706000},"page":"e0333544","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Analysis and forecast of hand, foot, and mouth disease epidemic trends in Guangzhou, China, 2013\u20132023"],"prefix":"10.1371","volume":"20","author":[{"given":"Haipeng","family":"Luo","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Siyi","family":"Zhong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiaojiao","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hui","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-6419-1924","authenticated-orcid":true,"given":"Zhoubin","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2025,9,30]]},"reference":[{"issue":"7","key":"pone.0333544.ref001","first-page":"408","article-title":"Hand-foot-and-mouth disease: rapid evidence review","volume":"100","author":"A Saguil","year":"2019","journal-title":"Am Fam Physician"},{"issue":"1","key":"pone.0333544.ref002","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1186\/s12929-023-00908-4","article-title":"Current status of hand-foot-and-mouth disease","volume":"30","author":"P Zhu","year":"2023","journal-title":"J Biomed Sci"},{"issue":"2","key":"pone.0333544.ref003","doi-asserted-by":"crossref","first-page":"77","DOI":"10.2174\/1570180820666221024095837","article-title":"Hand, foot, and mouth disease: a narrative review","volume":"16","author":"AKC Leung","year":"2022","journal-title":"Recent Adv Inflamm Allergy Drug Discov"},{"issue":"5606","key":"pone.0333544.ref004","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1136\/bmj.2.5606.661","article-title":"Hand-foot-and-mouth syndrome in humans: coxackie A10 infections in New Zealand","volume":"2","author":"MF Duff","year":"1968","journal-title":"Br Med J"},{"issue":"1","key":"pone.0333544.ref005","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1186\/s12929-019-0573-2","article-title":"The history of enterovirus A71 outbreaks and molecular epidemiology in the Asia-Pacific region","volume":"26","author":"J Puenpa","year":"2019","journal-title":"J Biomed Sci"},{"issue":"12","key":"pone.0333544.ref006","doi-asserted-by":"crossref","first-page":"6400","DOI":"10.3390\/v7122947","article-title":"Epidemiological research on hand, foot, and mouth disease in Mainland China","volume":"7","author":"Z-C Zhuang","year":"2015","journal-title":"Viruses"},{"issue":"146","key":"pone.0333544.ref007","doi-asserted-by":"crossref","first-page":"20180507","DOI":"10.1098\/rsif.2018.0507","article-title":"Epidemic dynamics, interactions and predictability of enteroviruses associated with hand, foot and mouth disease in Japan","volume":"15","author":"S Takahashi","year":"2018","journal-title":"J R Soc Interface"},{"issue":"1","key":"pone.0333544.ref008","doi-asserted-by":"crossref","first-page":"150","DOI":"10.47665\/tb.38.1.026","article-title":"Detection of enteroviruses during a 2018 hand, foot and mouth disease outbreak in Malaysia","volume":"38","author":"MH Lee","year":"2021","journal-title":"Trop Biomed"},{"issue":"4","key":"pone.0333544.ref009","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1016\/S1473-3099(13)70342-6","article-title":"Hand, foot, and mouth disease in China, 2008\u201312: an epidemiological study","volume":"14","author":"W Xing","year":"2014","journal-title":"Lancet Infectious Diseases"},{"issue":"9","key":"pone.0333544.ref010","article-title":"Trend of hand, foot, and mouth disease from 2010 to 2021 and estimation of the reduction in enterovirus 71 infection after vaccine use in Zhejiang Province, China","volume":"17","author":"H Wu","year":"2022","journal-title":"PLoS One"},{"key":"pone.0333544.ref011","first-page":"100370","article-title":"Changing epidemiology of hand, foot, and mouth disease in China, 2013-2019: a population-based study","volume":"20","author":"J Hong","year":"2022","journal-title":"Lancet Reg Health West Pac"},{"key":"pone.0333544.ref012","unstructured":"Guangzhou Municipal Bureau of Statistics. 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