Abstract:Objective To explore the regional differences and seasonal evolution characteristics of the impact of meteorological factors on the incidence of hand-foot-and-mouth disease (HFMD) in the mainland of China, and provide theoretical support for different provinces to develop HFMD prevention and control measures in response to seasonal changes. Methods HFMD incidence data and corresponding meteorological data across 31 provinces in the mainland of China (excluding Hong Kong, Macao, and Taiwan) from January 2011 to December 2020 were collec-ted. The geographically and temporally weighted regression (GTWR) model was employed to quantitatively analyze the regional differences and seasonality of meteorological impacts on HFMD incidence. Results From 2011 to 2020, the average annual incidence of HFMD in the mainland of China displayed periodicity with even years a higher incidence than odd years, and an initial increase followed by a decreasing trend. The incidence in different provinces showed significant seasonal characteristics, peaking from May to July and September to October. High-incidence provinces of HFMD were predominantly located in the southern region, and exhibiting significant spatial clustering characteristics of HFMD in each province. GTWR model analysis results indicated that the average wind speed promoted the incidence of HFMD in Inner Mongolia, Beijing, and the northeastern region, but inhibited the incidence in other provinces. In addition, the regional evolution characteristics of the average wind speed were divergent and weakened from southwest China, showing a "parabolic" changing trend in seasonality. Except for Heilongjiang and Jilin, the average temperature and cumulative precipitation generally promoted HFMD incidence of each province, presenting regional changing characteristics of weakening gradually from south to north, as well as "M"-shaped seasonal effects of wind speed and "W"-shaped effects of cumulative precipitation. Cumulative sunlight exposure had an inhibitory effect on HFMD incidence of each province, presenting regional characteristics of weakening gradually from southeast to northwest and a "U"-shaped seasonal pattern. Conclusion The impact of meteorological factors on HFMD incidence in the mainland of China exhibits significant spatiotemporal heterogeneity. It is recommended that different provinces formulate distinct HFMD prevention and control measures in response to seasonal changes, so as to reduce the incidence of HFMD effectively.