Estimating the basic reproduction rate of HFMD using the time series SIR model in Guangdong, China

<div><p>Hand, foot, and mouth disease (HFMD) has caused a substantial burden of disease in China, especially in Guangdong Province. Based on notifiable cases, we use the time series Susceptible-Infected-Recovered model to estimate the basic reproduction rate (R0) and the herd immunity threshold, understanding the transmission and persistence of HFMD more completely for efficient intervention in this province. The standardized difference between the reported and fitted time series of HFMD was 0.009 (<0.2). The median basic reproduction rate of total, enterovirus 71, and coxsackievirus 16 cases in Guangdong were 4.621 (IQR: 3.907–5.823), 3.023 (IQR: 2.289–4.292) and 7.767 (IQR: 6.903–10.353), respectively. The heatmap of R0 showed semiannual peaks of activity, including a major peak in spring and early summer (about the 12^th week) followed by a smaller peak in autumn (about the 36^th week). The county-level model showed that Longchuan (R0 = 33), Gaozhou (R0 = 24), Huazhou (R0 = 23) and Qingxin (R0 = 19) counties have higher basic reproduction rate than other counties in the province. The epidemic of HFMD in Guangdong Province is still grim, and strategies like the World Health Organization’s expanded program on immunization need to be implemented. An elimination of HFMD in Guangdong might need a Herd Immunity Threshold of 78%.</p></div

Heatmap of bi-weekly R0 by city.

<p>The dendrogram on the left side was the result of the clustering analysis.</p

Serotype-specific R0 and HIT of HFMD in Guangdong.

<p>Serotype-specific R0 and HIT of HFMD in Guangdong.</p

City-specific R0 and HIT of HFMD in Guangdong.

<p>City-specific R0 and HIT of HFMD in Guangdong.</p

County-specific R0 of HFMD in Guangdong.

<p>This map was downloaded from OpenStreetMap (OpenStreetMap Foundation, London, United Kingdom) and processed by and R version 3.3.2 (R Core Team, Vienna, Austria).</p

Additional file 2: Figure S2. of Syphilis in the economic center of South China: results from a real-time, web-based surveillance program

Age-specific latent syphilis cases in Guangzhou from 2005 to 2013. (TIFF 1471 kb

Additional file 1: of Types of health care facilities and the quality of primary care: a study of characteristics and experiences of Chinese patients in Guangdong Province, China

Multistage Cluster Sampling Method. (DOCX 125 kb

Additional file 1: Figure S1. of Syphilis in the economic center of South China: results from a real-time, web-based surveillance program

Stage-specific syphilis incidence in Guangzhou from 2005 to 2013. (TIFF 1713 kb

Additional file 1: Table S1. of Attitudes of consumers and live-poultry workers to central slaughtering in controlling H7N9: a cross-sectional study

Summarizes the survey protocols. Table S2. shows detailed information on the enrolled cities, live-poultry-restricted areas and sample size for each survey. Table S3. shows attitudes and preventive behaviors among consumers and live-poultry workers. Table S4. shows perception of the policy among consumers. Table S5. shows acceptability rate of the policy among consumers in different cities selected. Table S6. shows results of univariate analysis for policy acceptability among consumers. Table S7. shows results of univariate analysis for policy acceptability among live-poultry workers. Q1. shows the questionnaire used for investigating consumers. Q2. shows the questionnaire used for investigating live-poultry traders. Q3. shows the questionnaire used for investigating poultry farm workers (DOCX 90 kb)

Data_Sheet_1_The impact of monthly air pollution exposure and its interaction with individual factors: Insight from a large cohort study of comprehensive hospitalizations in Guangzhou area.pdf

BackgroundAlthough the association between short-term air pollution exposure and certain hospitalizations has been well documented, evidence on the effect of longer-term (e. g., monthly) air pollution on a comprehensive set of outcomes is still limited.MethodA total of 68,416 people in South China were enrolled and followed up during 2019–2020. Monthly air pollution level was estimated using a validated ordinary Kriging method and assigned to individuals. Time-dependent Cox models were developed to estimate the relationship between monthly PM10 and O3 exposures and the all-cause and cause-specific hospitalizations after adjusting for confounders. The interaction between air pollution and individual factors was also investigated.ResultsOverall, each 10 μg/m3 increase in PM10 concentration was associated with a 3.1% (95%CI: 1.3%−4.9%) increment in the risk of all-cause hospitalization. The estimate was even greater following O3 exposure (6.8%, 5.5%−8.2%). Furthermore, each 10 μg/m3 increase in PM10 was associated with a 2.3%-9.1% elevation in all the cause-specific hospitalizations except for those related to respiratory and digestive diseases. The same increment in O3 was relevant to a 4.7%−22.8% elevation in the risk except for respiratory diseases. Additionally, the older individuals tended to be more vulnerable to PM10 exposure (Pinteraction: 0.002), while the alcohol abused and those with an abnormal BMI were more vulnerable to the impact of O3 (Pinteraction: 0.052 and 0.011). However, the heavy smokers were less vulnerable to O3 exposure (Pinteraction: 0.032).ConclusionWe provide comprehensive evidence on the hospitalization hazard of monthly PM10 and O3 exposure and their interaction with individual factors.</p