{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T22:57:26Z","timestamp":1787698646032,"version":"build-2784847793"},"reference-count":45,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2021,2,17]],"date-time":"2021-02-17T00:00:00Z","timestamp":1613520000000},"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":["No. U1603241"],"award-info":[{"award-number":["No. U1603241"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["No. 4186010245"],"award-info":[{"award-number":["No. 4186010245"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Background: As the global climate changes, the number of cases of hand-foot-and-mouth disease (HFMD) is increasing year by year. This study comprehensively considers the association of time and space by analyzing the temporal and spatial distribution changes of HFMD in the Ili River Valley in terms of what climate factors could affect HFMD and in what way. Methods: HFMD cases were obtained from the National Public Health Science Data Center from 2013 to 2018. Monthly climate data, including average temperature (MAT), average relative humidity (MARH), average wind speed (MAWS), cumulative precipitation (MCP), and average air pressure (MAAP), were obtained from the National Meteorological Information Center. The temporal and spatial distribution characteristics of HFMD from 2013 to 2018 were obtained using kernel density estimation (KDE) and spatiotemporal scan statistics. A regression model of the incidence of HFMD and climate factors was established based on a geographically and temporally weighted regression (GTWR) model and a generalized additive model (GAM). Results: The KDE results show that the highest density was from north to south of the central region, gradually spreading to the whole region throughout the study period. Spatiotemporal cluster analysis revealed that clusters were distributed along the Ili and Gongnaisi river basins. The fitted curves of MAT and MARH were an inverted V-shape from February to August, and the fitted curves of MAAP and MAWS showed a U-shaped change and negative correlation from February to May. Among the individual climate factors, MCP coefficient values varied the most while MAWS values varied less from place to place. There was a partial similarity in the spatial distribution of coefficients for MARH and MAT, as evidenced by a significant degree of fit performance in the whole region. MCP showed a significant positive correlation in the range of 15\u201335 mm, and MAAP showed a positive correlation in the range of 925\u2013945 hPa. HFMD incidence increased with MAT in the range of 15\u201323 \u00b0C, and the effective value of MAWS was in the range of 1.3\u20131.7 m\/s, which was positively correlated with incidences of HFMD. Conclusions: HFMD incidence and climate factors were found to be spatiotemporally associated, and climate factors are mostly non-linearly associated with HFMD incidence.<\/jats:p>","DOI":"10.3390\/ijerph18041954","type":"journal-article","created":{"date-parts":[[2021,2,17]],"date-time":"2021-02-17T21:35:42Z","timestamp":1613597742000},"page":"1954","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Spatial and Temporal Characteristics of Hand-Foot-and-Mouth Disease and Its Response to Climate Factors in the Ili River Valley Region of China"],"prefix":"10.3390","volume":"18","author":[{"given":"Suyan","family":"Yi","sequence":"first","affiliation":[{"name":"College of Resources and Environmental Sciences, Xinjiang University, Urumqi 830046, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongwei","family":"Wang","sequence":"additional","affiliation":[{"name":"College of Resources and Environmental Sciences, Xinjiang University, Urumqi 830046, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shengtian","family":"Yang","sequence":"additional","affiliation":[{"name":"Beijing Key Laboratory of Urban Hydrological Cycle and Sponge City Technology, College of Water Sciences, Beijing Normal University, Beijing 100875, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ling","family":"Xie","sequence":"additional","affiliation":[{"name":"College of Resources and Environmental Sciences, Xinjiang University, Urumqi 830046, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7730-8036","authenticated-orcid":false,"given":"Yibo","family":"Gao","sequence":"additional","affiliation":[{"name":"College of Resources and Environmental Sciences, Xinjiang University, Urumqi 830046, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chen","family":"Ma","sequence":"additional","affiliation":[{"name":"College of Resources and Environmental Sciences, Xinjiang University, Urumqi 830046, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,2,17]]},"reference":[{"key":"ref_1","first-page":"615","article-title":"Report of an outbreak of febrile illness with pharyngeal lesions and exanthem: Toronto, summer 1957; isolation of group A Coxsackie virus","volume":"79","author":"Robinson","year":"1958","journal-title":"Can. Med. Assoc. J."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1586\/14760584.2016.1138862","article-title":"EV71 vaccine, a new tool to control outbreaks of hand, foot and mouth disease (HFMD)","volume":"15","author":"Mao","year":"2016","journal-title":"Expert Rev. Vaccines"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1016\/j.jcv.2009.02.002","article-title":"An outbreak of hand, foot, and mouth disease associated with subgenotype C4 of human enterovirus 71 in Shandong, China","volume":"44","author":"Zhang","year":"2009","journal-title":"J. Clin. Virol."},{"key":"ref_4","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\u20132012: An epidemiological study","volume":"14","author":"Xing","year":"2014","journal-title":"Lancet Infect. Dis."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"432","DOI":"10.3201\/eid2403.171303","article-title":"Epidemiology of Recurrent Hand, Foot and Mouth Disease, China, 2008\u20132015","volume":"24","author":"Huang","year":"2018","journal-title":"Emerg. Infect. Dis."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"136103","DOI":"10.1016\/j.scitotenv.2019.136103","article-title":"The spatial heterogeneity of the associations between relative humidity and pediatric hand, foot and mouth disease: Evidence from a nation-wide multicity study from mainland China","volume":"707","author":"Bo","year":"2020","journal-title":"Sci.Total. Environ."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1007\/s11430-013-4635-0","article-title":"Impact of global change on transmission of human infectious diseases","volume":"57","author":"Wu","year":"2014","journal-title":"Sci. China Earth Sci."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Liu, Z., Meng, Y., Xiang, H., Lu, Y., and Liu, S. (2020). Association of Short-Term Exposure to Meteorological Factors and Risk of Hand, Foot, and Mouth Disease: A Systematic Review and Meta-Analysis. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17218017"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e285","DOI":"10.1097\/INF.0000000000001242","article-title":"The Epidemiology of Hand, Foot and Mouth Disease in Asia: A Systematic Review and Analysis","volume":"35","author":"Koh","year":"2016","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Song, C., He, Y., Bo, Y., Wang, J., Ren, Z., and Yang, H. (2018). Risk Assessment and Mapping of Hand, Foot, and Mouth Disease at the County Level in Mainland China Using Spatiotemporal Zero-Inflated Bayesian Hierarchical Models. Int. J. Environ. Res. Public Health, 15.","DOI":"10.3390\/ijerph15071476"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"138548","DOI":"10.1016\/j.scitotenv.2020.138548","article-title":"Quantifying the risk of hand, foot, and mouth disease (HFMD) attributable to meteorological factors in East China: A time series modelling study","volume":"728","author":"Qi","year":"2020","journal-title":"Sci. Total Environ."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Xu, Z., Hu, W., Jiao, K., Ren, C., Jiang, B., and Ma, W. (2019). The effect of temperature on childhood hand, foot and mouth disease in Guangdong Province, China, 2010\u20132013: A multicity study. BMC Infect Dis., 19.","DOI":"10.1186\/s12879-019-4594-y"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Hao, J., Yang, Z., Yang, W., Huang, S., Tian, L., Zhu, Z., Lu, Y., Xiang, H., and Liu, S. (2020). Impact of Ambient Temperature and Relative Humidity on the Incidence of Hand-Foot-Mouth Disease in Wuhan, China. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17020428"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1605","DOI":"10.1007\/s00484-013-0764-6","article-title":"Short-term effects of meteorological factors on children hand, foot and mouth disease in Guangzhou, China","volume":"58","author":"Chen","year":"2014","journal-title":"Int. J. Biometeorol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"576","DOI":"10.1016\/j.scitotenv.2015.09.027","article-title":"Short-term effects of meteorological factors on hand, foot and mouth disease among children in Shenzhen, China: Non-linearity, threshold and interaction","volume":"539","author":"Zhang","year":"2016","journal-title":"Sci Total Environ."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Tian, L., Liang, F., Xu, M., Jia, L., Pan, X., and Clements, A.C.A. (2018). Spatio-temporal analysis of the relationship between meteorological factors and hand-foot-mouth disease in Beijing, China. BMC Infect. Dis., 18.","DOI":"10.1186\/s12879-018-3071-3"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Deng, T., Huang, Y., Yu, S., Gu, J., Huang, C., Xiao, G., and Hao, Y. (2013). Spatial-temporal clusters and risk factors of hand, foot, and mouth disease at the district level in Guangdong Province, China. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0056943"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"832","DOI":"10.1214\/aoms\/1177728190","article-title":"Remarks on Some Nonparametric Estimates of a Density Function","volume":"27","author":"Rosenblatt","year":"1956","journal-title":"Ann. Math. Statist."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1007\/s10742-007-0022-7","article-title":"Kernel density estimation as a technique for assessing availability of health services in Nicaragua","volume":"7","author":"Spencer","year":"2007","journal-title":"Health Serv. Outcomes Res. Methodol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1377","DOI":"10.2105\/AJPH.88.9.1377","article-title":"Evaluating cluster alarms: A space-time scan statistic and brain cancer in Los Alamos, New Mexico","volume":"88","author":"Kulldorff","year":"1998","journal-title":"Am. J. Public Health"},{"key":"ref_21","unstructured":"Fotheringham, A.S., Brunsdon, C., and Charlton, M. (2002). Geographically Weighted Regression: The Analysis of SpatiallyVarying Relationships, John Wiley & Sons Ltd."},{"key":"ref_22","first-page":"383","article-title":"Geographically and temporally weighted regression for modeling spatio-temporal variation in house prices","volume":"24","author":"Huang","year":"2010","journal-title":"Int. J. GIS."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1186\/1476-072X-8-27","article-title":"Spatial analysis of MODIS aerosol optical depth, PM2.5, and chronic coronary heart disease","volume":"8","author":"Hu","year":"2009","journal-title":"Int. J. Health Geogr."},{"key":"ref_24","unstructured":"Hastie, T., and Tibshirani, R. (1990). Generalized Additive Models, Chapman & Hall\/CRC Press. [2nd ed.]."},{"key":"ref_25","unstructured":"R Development Core Team (2020). A Language and Environment for Statistical Computing, R Foundation for Statistical Computing. Available online: http:\/\/www.rproject.org\/."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Kim, B.I., Ki, H., Park, S., Cho, E., and Chun, B.C. (2016). Effect of Climatic Factors on Hand, Foot, and Mouth Disease in South Korea, 2010\u20132013. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0157500"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Wang, Y., Lai, Y., Du, Z., Zhang, W., Feng, C., Li, R., and Hao, Y. (2019). Spatiotemporal Distribution of Hand, Foot, and Mouth Disease in Guangdong Province, China and Potential Predictors, 2009\u20132012. Int. J. Environ. Res. Public Health, 16.","DOI":"10.3390\/ijerph16071191"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1411","DOI":"10.1007\/s00484-017-1318-0","article-title":"Seasonal modeling of hand, foot, and mouth disease as a function of meteorological variations in Chongqing, China","volume":"61","author":"Wang","year":"2017","journal-title":"Int. J. Biometeorol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1071","DOI":"10.1017\/S0950268809991555","article-title":"Human enterovirus 71 and hand, foot and mouth disease","volume":"138","author":"Wong","year":"2010","journal-title":"Epidemiol. Infect."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1016\/j.scitotenv.2011.09.055","article-title":"The influence of temperature and humidity on the incidence of hand, foot, and mouth disease in Japan","volume":"410\u2013411","author":"Onozuka","year":"2011","journal-title":"Sci. Total Environ."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"460","DOI":"10.1016\/j.scitotenv.2018.07.329","article-title":"Short-term effects of meteorological factors and air pollution on childhood hand-foot-mouth disease in Guilin, China","volume":"646","author":"Yu","year":"2019","journal-title":"Sci. Total Environ."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"839","DOI":"10.1016\/j.scitotenv.2018.10.349","article-title":"Short-term effects of extreme meteorological factors on childhood hand, foot, and mouth disease reinfection in Hefei, China: A distributed lag non-linear analysis","volume":"653","author":"Zhang","year":"2019","journal-title":"Sci. Total Environ."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Yan, S., Wei, L., Duan, Y., Li, H., Liao, Y., Lv, Q., Zhu, F., Wang, Z., Lu, W., and Yin, P. (2019). Short-Term Effects of Meteorological Factors and Air Pollutants on Hand, Foot and Mouth Disease among Children in Shenzhen, China, 2009\u20132017. Int. J. Environ. Res. Public Health, 16.","DOI":"10.3390\/ijerph16193639"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"484","DOI":"10.1016\/j.scitotenv.2014.08.006","article-title":"Associations between extreme precipitation and childhood hand, foot and mouth disease in urban and rural areas in Hefei, China","volume":"497\u2013498","author":"Cheng","year":"2014","journal-title":"Sci. Total Environ."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1186\/s12940-015-0014-y","article-title":"Analytical studies assessing the association between extreme precipitation or temperature and drinking water-related waterborne infections: A review","volume":"14","author":"MacDonald","year":"2015","journal-title":"Environ. Health"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1186\/s40249-018-0388-5","article-title":"Impact of meteorological factors on the incidence of childhood hand, foot, and mouth disease (HFMD) analyzed by DLNMs-based time series approach","volume":"7","author":"Qi","year":"2018","journal-title":"Infect. Dis. Poverty"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1779","DOI":"10.1017\/S0950268810002256","article-title":"Is hand, foot and mouth disease associated with meteorological parameters?","volume":"138","author":"Ma","year":"2010","journal-title":"Epidemiol. Infect."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Escombe, A.R., Oeser, C.C., Gilman, R.H., Navincopa, M., Ticona, E., Pan, W., Mart\u00ednez, C., Chacaltana, J., Rodr\u00edguez, R., and Moore, D.A. (2007). Natural ventilation for the prevention of airborne contagion. PLoS Med., 4.","DOI":"10.1371\/journal.pmed.0040068"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1016\/j.envres.2019.03.041","article-title":"Impacts of tropical cyclones and accompanying precipitation and wind velocity on childhood hand, foot and mouth disease in Guangdong Province, China","volume":"173","author":"Jiao","year":"2019","journal-title":"Environ Res."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1590\/S0036-46652014000600014","article-title":"Hand-foot-and-mouth disease epidemiological status and relationship with meteorological variables in Guangzhou, southern China, 2008-2012","volume":"56","author":"Li","year":"2014","journal-title":"Rev. Inst. Med. Trop. Sao Paulo"},{"key":"ref_41","first-page":"127","article-title":"Relationships of climatic data to immune and hematologic variables in normal human","volume":"21","author":"Maes","year":"2000","journal-title":"Neuro Endocrinol. Lett."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"550","DOI":"10.1016\/j.scitotenv.2018.08.114","article-title":"Exploring spatiotemporal nonstationary effects of climate factors on hand, foot, and mouth disease using Bayesian Spatiotemporally Varying Coefficients (STVC) model in Sichuan, China","volume":"648","author":"Song","year":"2019","journal-title":"Sci. Total. Environ."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"17707","DOI":"10.1038\/s41598-018-35721-9","article-title":"Exploration of potential risks of Hand, Foot, and Mouth Disease in Inner Mongolia Autonomous Region, China Using Geographically Weighted Regression Model","volume":"8","author":"Hong","year":"2018","journal-title":"Sci. Rep."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"19247","DOI":"10.1038\/srep19247","article-title":"The Effects of Weather Factors on Hand, Foot and Mouth Disease in Beijing","volume":"6","author":"Dong","year":"2016","journal-title":"Sci. Rep."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"135481","DOI":"10.1016\/j.scitotenv.2019.135481","article-title":"The contributions of socioeconomic indicators to global PM2.5 based on the hybrid method of spatial econometric model and geographical and temporal weighted regression","volume":"703","author":"Fu","year":"2020","journal-title":"Sci. Total Environ."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/4\/1954\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T05:25:22Z","timestamp":1760160322000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/4\/1954"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2,17]]},"references-count":45,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2021,2]]}},"alternative-id":["ijerph18041954"],"URL":"https:\/\/doi.org\/10.3390\/ijerph18041954","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,2,17]]}}}