Table 1.
Characteristics of the included studies on the associations between meteorological factors and the risk of HFMD.
| Reference | Study Location | Study Period | Population | Ages | Exposure Variable | Statistical Model | Temporal Lags | Resolution | Climate Group | Measure Index | HDI Rank | Quality Scores | Outcome |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Zhu et al. (2015) [29] | Shandong, China | 2007–2012 | 108,377 | 0–5 years | Cumulative maximum temperature; cumulative minimum temperature | Distributed lag non-linear model (DLNM) with Poisson distribution, adjusting for relative humidity, rainfall, sunshine duration, DOW, public holidays, seasonal trend, and long trend | 0–14 days | Daily | Temperate climate | RR | High | 8 | Reported HFMD |
| Chen et al. (2014) [19] | Guangzhou, China | 2009–2011 | 34,527 | 0–14 years | Mean temperature; relative humidity | Generalized additive model (GAM), adjusting for long-term trend, seasonal trend, day of week, and public holidays | 0–10 days | Daily | Temperate climate | IRR | High | 7 | Reported HFMD |
| Yang et al. (2018) [12] | Hefei, China | 2011–2016 | NA | All | Mean temperature; rainfall; cumulative mean relative humidity | DLNM, adjusting for long-term trend, seasonal trend, and day of week | 0–20 days | Daily | Temperate climate | RR | High | 8 | Reported HFMD |
| Xu et al. (2015) [37] | Beijing, China | 2010–2012 | 113,475 | 6–15 years | Mean temperature; relative humidity; cumulative maximum temperature; cumulative minimum temperature | A newly developed case-crossover design with DLNM, adjusting for day of week, public holidays, long-term trend, and seasonal trend | 0–13 days | Daily | Temperate climate | RRs | High | 7 | Reported HFMD |
| Yu et al. (2018) [28] | Guilin, China | 2014–2016 | 88,742 | 0–14 years | Relative humidity; sunshine duration; wind speed; rainfall; cumulative maximum temperature; cumulative minimum temperature; cumulative maximum relative humidity; cumulative minimum relative humidity; | DLNM, adjusting for long-term trends, seasonality, differences in the annual at-risk population; day of week, and public holidays | 0–14 days | Daily | Temperate climate | RR | High | 7 | Reported HFMD |
| Zhang et al. (2018) [38] | Henan, China | 2012–2013 | NA | 0–5 years | Mean temperature; relative humidity; rainfall; sunshine duration; wind speed | Bayesian space–time hierarchy mode, Poisson with log link regression and GeoDetector, adjusting for long-term trend and autocorrelation | None | None | Temperate climate | RR | High | 6 | Reported HFMD |
| Qi et al. (2018) [9] | Shanghai, China | 2009–2015 | 51,776 | 0–15 years | Mean temperature; relative humidity | DLNM, adjusting for potential confounders of long time trend, DOW, and public holidays | 0–14 days | Daily | Temperate climate | RR | High | 8 | Reported HFMD |
| Zhu et al. (2016) [21] | Shandong, China | 2007–2012 | 504,017 | 0–5 years | Mean temperature | DLNM, adjusting for seasonal trend, long time trend, DOW, and public holidays | 0–21 days | Daily | Temperate climate | RR | High | 9 | Reported HFMD |
| Bo et al. (2020) [22] | 143city, China | 2009–2014 | 3,060,450 | 0–12 years | Relative humidity | DLNM, adjusting for long-term trends, seasonality, autocorrelation, DOW public holidays | 0–18 days | Daily | None | RR | High | 9 | Reported HFMD |
| Wang et al. (2016) [39] | Hong Kong, China | 2009–2014 | 1534 | All | Rainfall; wind speed; sunshine duration; cumulative mean temperature: cumulative maximum relative cumulative minimum relative humidity | A combination of negative binomial generalized additive models and DLNM, adjusting for multiple environmental factors, long-term trends, and seasonality | 0–30 days | Daily | Tropical climate | RR | High | 7 | Reported HFMD |
| Yin et al. (2016) [18] | Chengdu, China | 2010–2013 | 76,403 | 0–14 years | Mean temperature | DLNM, adjusting for seasonal trend, long time trend, DOW, and holidays | 0–13 days | Daily | Temperate climate | RR | High | 7 | Reported HFMD |
| Guo et al. (2016) [26] | Guangdong, China | 2009–2013 | 400,408 | 0–14 years | Relative humidity; cumulative mean temperature; cumulative mean relative humidity | A mixed generalized additive models (MGAM), adjusting for seasonal trend, long time trend, DOW, and holidays | 0–14 days | Daily | Temperate climate | RR | High | 7 | Reported HFMD |
| Hao et al. (2020) [13] | Wuhan, China | 2013–2017 | NA | All | Mean temperature; cumulative maximum temperature; cumulative minimum temperature; relative humidity; cumulative maximum relative humidity; cumulative minimum relative humidity | DLNM combined with Poisson regression, adjusting for DOW, seasonality, and long-term time trend | 0–14 days | Daily | Temperate climate | RR | High | 7 | Reported HFMD |
| Xuan et al. (2017) [6] | Can Tho, Vietnam | 2012–2014 | NA | All | Mean temperature; relative humidity | Time-series regression analysis, adjusting for seasonality, long-term time trend, DOW, and the offset of population | 0–6 days | Daily | Tropical climate | ER | Low | 7 | Reported HFMD |
| Gou et al. (2018) [23] | Gansu, China | 2010–2014 | NA | All | Mean temperature; relative humidity | Generalized linear regression models (GLM) with Poisson link and classification and regression trees (CART), adjusting for seasonality | 0–12 weeks | Weekly | Temperate climate | ER | High | 6 | Reported HFMD |
| Onozuka et al. (2011) [24] | Fukuoka, Japan | 2000–2010 | 73,684 | All | Mean temperature; relative humidity | Negative binomial regression, adjusting for seasonal and inter-annual variations | 0–3 weeks | Weekly | Temperate climate | RR | High | 7 | Reported HFMD |
| Hii et al. (2011) [11] | Singapore | 2001–2008 | NA | All | Maximum temperature minimum temperature | Time series Poisson regression models, adjusting for seasonality, long-term time trend, and autocorrelation | 0–2 weeks | Weekly | Temperate climate | RR | High | 8 | Reported HFMD |
| Tian et al. (2018) [40] | Beijing, China | 2010–2012 | 114,777 | 0–4 years | Mean temperature; relative humidity; wind speed; sunshine duration | Bayesian spatiotemporal Poisson regression models; adjusting for seasonality and inter-annual variations | None | None | Temperate climate | RR | High | 7 | Reported HFMD |
| Kim et al. (2016) [25] | South Korea | 2010–2013 | 214,642 | All | Mean temperature; relative humidity | GAM and Poisson distribution, controlling for seasonality, long-term time trend, and autocorrelation | 0–2 weeks | Weekly | Temperate climate | RR | High | 8 | Reported HFMD |
| Xuan et al. (2019) [14] | Mekong Delta region, Vietnam | 2014–2016 | NA | 0–5 years | Mean temperature; humidity; cumulative rainfall | DLNM with quasi-Poisson, controlling for long-term trend and autocorrelation | 0–20 days | Daily | Temperate climate | RR | High | 7 | Reported HFMD |
| Li et al. (2014) [7] | Guangzhou, China | 2009–2012 | 166,770 | All | Mean temperature; relative humidity | Negative binomial multivariable regression, adjusting for long-term trend and autocorrelation | None | Weekly | Temperate climate | ER | High | 6 | Reported HFMD |
| Xu et al. (2019) [10] | Guangdong, China | 2010–2013 | 1,048,574 | 0–5 years | Mean temperature; maximum temperature; minimum temperature; mean relative humidity; mean wind speed; rainfall; sunshine duration; cumulative maximum temperature; cumulative minimum temperature; cumulative mean temperature | DLNM with quasi-Poisson, controlling for long-term trend and autocorrelation | 0–21 days | Daily | Temperate climate | RR | High | 7 | Reported HFMD |
| Yang et al. (2015) [41] | Hefei, China | 2010-2012 | 21,634 | 0–14 years | Relative humidity | Poisson linear regression model and DLNM, adjusting for mean temperature, seasonal patterns, and long-term trends, day of week | 0–21 days | Daily | Temperate climate | ER | High | 7 | Reported HFMD |
| Zhu et al. (2019) [8] | Xiamen, China | 2013–2017 | 36,464 | All | Mean temperature; relative humidity; sunshine duration | DLNM with quasi-Poisson, adjusting for long-term time trend, DOW, and public holidays | 0–20 days | Daily | Temperate climate | RR | High | 7 | Reported HFMD |
| Wang et al. (2019) [27] | Guangdong, China | 2009–2012 | 911,640 | All | Mean temperature; mean relative humidity; mean rainfall | Bayesian spatiotemporal model autocorrelation, adjusting for long-term time trend and autocorrelation | None | Monthly | Temperate climate | RR | High | 7 | Reported HFMD |
| Zhu et al. (2020) [42] | Wuxi, China | 2011–2017 | 107,906 | All | Cumulative maximum temperature; cumulative minimum temperature | DLNM, adjusting for time-varying factors and other meteorological factors | 0–16 days | Daily | Temperate climate | RR | High | 7 | Reported HFMD |
| Ji et al. (2020) [43] | Tianjin, China | 2014–2018 | 70,027 | 0–15 years | Cumulative mean temperature | DLNM and a susceptible infectious recovery models, adjusting for long-term trends, seasonality, DOW | 0–14 days | Daily | Temperate climate | RR | High | 8 | Reported HFMD |
| Guo et al. (2020) [44] | Xi’an, China | 2009–2018 | 31,2018 | All | Maximum temperature; cumulative maximum temperature | DLNM, combined with the GAM, adjusting for long-term trends and seasonality, and week | 0–8 weeks | Weekly | Temperate climate | RR | High | 6 | Reported HFMD |