Evidence map›Paper›PMID 42116129›Full record

ArticleInfectious diseases of poverty2026

Estimating the nationwide incidence of coxsackievirus A6-associated hand, foot and mouth disease in China, 2008-2022.

Yuanhua Liu, Na Wang, Fengfeng Liu, Ke Li, Michael P Ward, Nicholas C Grassly, Wei Tu, Jinming Yu, Wenjin Li, Yu Zhao and 6 more

Abstract read
In one paragraph

Article in Infectious diseases of poverty, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Yuanhua Liu *Department of Epidemiology and Health Statistics, School of Public Health, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai, 200032, China.
Na Wang *Department of Epidemiology and Health Statistics, School of Public Health, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai, 200032, China.
Fengfeng Liu *Division of Infectious Disease, Key Laboratory of Surveillance and Early-Warning on Infectious Disease, National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, 102206, China.
Ke LiShanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, China.
Michael P WardSydney School of Veterinary Science, The University of Sydney, Camden, Australia.
Nicholas C GrasslyMRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, UK.
Wei TuDepartment of Geology and Geography, Georgia Southern University, Statesboro, USA.
Jinming YuDepartment of Epidemiology and Health Statistics, School of Public Health, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai, 200032, China.
Wenjin LiShanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, China.
Yu ZhaoDepartment of Epidemiology and Health Statistics, School of Public Health, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai, 200032, China.
Jidan ZhangDepartment of Epidemiology and Health Statistics, School of Public Health, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai, 200032, China.
Jiawen DongDepartment of Epidemiology and Health Statistics, School of Public Health, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai, 200032, China.
Tianren LuDepartment of Epidemiology and Health Statistics, School of Public Health, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai, 200032, China.
Mengxin LiuDepartment of Epidemiology and Health Statistics, School of Public Health, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai, 200032, China.
Zhaorui ChangDivision of Infectious Disease, Key Laboratory of Surveillance and Early-Warning on Infectious Disease, National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, 102206, China. changzr@chinacdc.cn.
Zhijie ZhangDepartment of Epidemiology and Health Statistics, School of Public Health, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai, 200032, China. epistat@gmail.com.

Funding

National Key Research and Development Program of China 2022YFC2602900National Natural Science Foundation of China 82473736Natural Science Foundation of Shanghai 24ZR1414700
6 · The paper itself

Abstract

backgroundDue to insufficient routine surveillance, the nationwide disease burden of hand, foot and mouth disease (HFMD) caused by coxsackievirus A6 (CVA6), an emerging serotype, in China remains unclear. This study aimed to estimate the incidence of CVA6-associated HFMD across the Chinese mainland.

methodsCVA6 positive data from 511 locations across the Chinese mainland during 2008-2022 were integrated from the national pathogen surveillance system and literature, and reported HFMD cases during the same period were obtained from the national infectious disease surveillance system. The predicted positivity rate and incidence of CVA6-associated HFMD in children under five years of age across the Chinese mainland were estimated using a Bayesian geostatistical Gaussian model based on positivity data, reported cases, and environmental, socioeconomic, demographic, and vaccination factors.

resultsThe model estimated that the average positivity rate of CVA6 in the Chinese mainland from 2008 to 2022 was 24.1%, with a 95% Bayesian credible interval (BCI) of 11.9-43.3%. The corresponding average annual incidence of CVA6-associated HFMD in children under five years of age was 506 (95% BCI: 272-805) per 100,000. The yearly incidence of CVA6-associated HFMD in children under five years of age peaked in 2018 (873 per 100,000; 95% BCI: 513-1309) before a subsequent decline after 2020. The incidence was highest in South China (1571 per 100,000; 95% BCI: 890-2420) and lowest in Northeast China (208 per 100,000; 95% BCI: 106-340). The estimated CVA6-associated HFMD incidence showed a consistent upward trend across different economic level groups before 2020, and tended to be higher in high-gross domestic product (GDP) per capita regions than in medium- and low-GDP regions.

conclusionsModel-based estimates indicate a potentially high incidence of CVA6-associated HFMD on the Chinese mainland, particularly in South China, highlighting the need for enhanced surveillance of CVA6 and targeted control efforts in high-incidence regions.

Indexed as

Enterovirus A, HumanHand, Foot and Mouth DiseaseBayes TheoremChild, PreschoolChinaFemaleHumansIncidenceInfantMaleCoxsackievirus A6Disease burdenGeostatistical modelHand, foot and mouth disease

Identifiers

PMID42116129
PMCPMC13159216

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.