Impact of temperature variability on childhood hand, foot and mouth disease in Huainan, China

• Time-series analysis was conducted to quantify the impacts of both TCN and DTR on childhood HFMD.
• Large temperature drop (−3° C) between adjacent days was significantly associated with childhood HFMD. However, non-significant association between DTR and childhood HFMD was observed.
• The effects of TCN on childhood HFMD may be modified by high-risk area or not.
• This study quantified the impacts of both TCN and DTR on childhood HFMD.

ObjectivesThe short-term temperature variation has been shown to be significantly associated with human health. However, little is known about whether temperature change between neighbouring days (TCN) and diurnal temperature range (DTR) have any effect on childhood hand, foot and mouth disease (HFMD). This study aims to explore whether temperature variability has any effect on childhood HFMD.Study designEcological study.MethodsThe association between meteorological variables and HFMD cases in Huainan, China, from January 1st 2012 to December 31st 2014 was analysed using Poisson generalized linear regression combined with distributed lag non-linear model (DLNM) after controlling for long-term trend and seasonality, mean temperature and relative humidity.ResultsAn adverse effect of TCN on childhood HFMD was observed, and the impact of TCN was the greatest at five days lag, with a 10% (95% CI: 4%–15%) increase of daily number of HFMD cases per 3 °C (10th percentile) decrease of TCN. Male children, children aged 0–5 years, scattered children and children in high-risk areas appeared to be more vulnerable to the TCN effect than others. However, there was no significant association between DTR and childhood HFMD.ConclusionsOur findings indicate that TCN drops may increase the incidence of childhood HFMD in Huainan, highlighting the importance of protecting children from forthcoming TCN drops, particularly for those who are male, young, scattered and from high-risk areas.