Analysis and forecast of hand, foot, and mouth disease epidemic trends in Guangzhou, China, 2013–2023

Hand, foot, and mouth disease (HFMD) primarily affects children under the age of five and has emerged as a significant public health concern in China. This study examines HFMD incidence trends across various gender and age demographics in Guangzhou from 2013 to 2023, providing a comprehensive overview to inform future prevention and management strategies. Utilizing epidemiological data from the National Notifiable Infectious Disease Reporting Information System, we employed Joinpoint regression modeling to assess variations in incidence rates among different demographic cohorts and developed a Seasonal Autoregressive Integrated Moving Average (SARIMA) model to analyze case trends and project future occurrences. The findings revealed biennial peaks and notable seasonality, indicating cases across all age groups, though predominantly among children under five. Joinpoint regression analysis demonstrated a significant decrease in incidence rates for children younger than one year (Average Annual Percent Change [AAPC]=-13.50%, P < 0.001) and those aged one year (AAPC = -10.35%, P = 0.002), while incidence remained stable for children aged two to five years. Conversely, a significant upward trend was identified in children aged six years and older (AAPC = 13.09%, P = 0.019). Gender-specific trends closely resembled these overall patterns, with both males and females experiencing similar percentage changes in incidence rates. The SARIMA model indicates a projected decline in HFMD cases for 2024, followed by a phase of relative stability characterized by minor fluctuations. These results offer crucial insights into HFMD trends, illustrating the effectiveness of current preventive measures in reducing incidence among younger children while underscoring the necessity for targeted interventions to address the rising trends in older age groups. By leveraging these findings, health authorities can refine control strategies and prioritize public health responses to effectively mitigate HFMD outbreaks.