Spatial association of the incidence of Hand Foot Mouth disease and its related factors in Guizhou province, China 2019 – 2021

Background: Hand, Foot, and Mouth disease is a common infectious disease, mainly involve Enterovirus 71 and Coxsackievirus A-16 serotypes. In China especially Guizhou province, research and literature related to spatial pattern and its spatial association with the factors were very limited. Therefore, we analyzed the data of population, highway mileage, forest coverage, GDP, air quality, temperature and humidity, medical institutions, and primary schools in 82 counties of Guizhou Province to understand the spatial correlation of incidence rate and its related factors. Objectives: This study aimed to determine the spatial association of incidence of hand-foot-mouth disease and its related factors in Guizhou province, China from 2019 to 2021. Methods: This study used the global Moran’s I and local Moran I or LISA to analyze the incidence of hand foot mouth disease and the spatial correlation of multiple factors reported in Guizhou province. Results: This study clearly concluded that the incidence rate of HFMD in children under 6 years old in Guizhou province of China was negatively correlated with forest coverage with Moran’s I of -0.131, -0.117, -0.111 and positively correlated with GDP with 0.091, 0.118, in 2019 and 2020 respectively. However, the correlation between the incidence rate of HFMD and temperature, humidity, the number of primary schools and other factors were not spatially significant. Conclusion: There was a significant spatial correlation between the incidence rate of HFMD and socio-economic and environmental meteorological factors in Guizhou province. It is suggested to take policy intervention to prevent the large-scale spread of HFMD and reduce the incidence rate and transmission rate of HFMD.