Effect of climate factors on hand-foot-mouth disease: a generalized additive model approach

Abstract

Hand, foot, and mouth disease (HFMD) has become an endemic childhood disease in Asia, including Malaysia, over the last few decades. This infectious disease caused by the Entero and Coxsackie viruses has been a major public health threat in Malaysia since 1997. Climate change has been considered an influential factor in HFMD cases and has been explored in other countries using various statistical analyses. The most popular is the Generalized Linear Model (GLM). However, GLM often fails to capture the non-linearity effect of the variables. The study, therefore, proposes to use the Generalized Additive Model (GAM) to analyse the non-linear effects of temperature, humidity, rainfall, and wind speed at varying time lags of HFMD in Selangor. In summary, the result indicates that the weekly temperature, humidity, and rainfall were significantly associated with HFMD cases in Selangor and clarified with two weeks of lag time. This disease's risk increased in the subsequent two weeks with a temperature range of 27C to 30C, 70% to 85% of humidity, and 5mm to 20mm of rainfall. Besides, this study also found that the seasonal distribution of HFMD in Selangor has a large peak during the Southwest monsoon. A small peak was observed at the end of the year during the Northeast monsoon. The findings of this study could be a practical guide for HFMD intervention strategies, especially in Malaysia.