A systematic review of the statistical methodology used in establishing the link between climate factors and HFMD incidence

Abstract

Hand, foot, and mouth disease (HFMD) is a common infectious disease caused by two main viruses, namely Coxsackievirus A16 and Human Enterovirus 71. It has been a significant public health disease and a substantial burden all over the world since 1969. Prior studies have shown that climate factors are significantly associated with HFMD cases by using various statistical methods. Therefore, this study aims to review the scientific studies related to climate and HFMD and hence, address the analytical techniques used. This study only includes quantitative studies from peer-reviewed and original papers published in international and national journals from the years 1957 to 2020. In total, there were 522 articles identified; however, there were only 29 studies that linked climate change and HFMD. Based on the articles reviewed, the modelling analysis technique, which includes the Generalized Linear Model (GLM), the Generalized Additive Model (GAM), and the Generalized Additive Mixed Model (GAMM), represents the most popular analysis in identifying the association between HFMD and climate factors. The temperature and humidity showed the greatest impact on the occurrence of HFMD, and the suitable incubation period for all climatic factors was not more than three weeks.