A Case-control Study on the Risk Factors of Severe Hand-foot-mouth Disease in Chongqing City_West China Medical Journal

Authors：

 ZhangKe ^1,2 ,  HeJia ¹ , ZhouXiaolan ³ , ChenXiangang ² , YangHui ² , GuanLongzhi ⁴

1. Department of Social Medicine and Health Service Management, Academy of Military Preventive Medicine, the Third Military Medical University, Chongqing 400038, P. R. China;
2. 2. Disease Control and Prevention Center of Yuzhong District, Chongqing 400042, P. R. China;
3. Department of Medical Record Statistics, the Second Hospital Affiliated to Chongqing Medical University ,Chongqing 400010, R. R. China;
4. Department of Healthcare, Chongqing Children’s Hospital Affiliated to Chongqing Medical University, Chongqing 400038, P. R. China;

Corresponding?author：

HeJia, Email: hejiahj@126.com

Keywords：

Hand-foot-mouth disease; Severe cases; Risk factors

DOI：

10.7507/1002-0179.201600238

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To explore the risk factors associated with severe hand-food-mouth disease (HFMD) in Chongqing, in order to carry out intervention work in the future, provide reference for reducing the incidence and fatality rate of severe HFMD cases. Methods Ninety severe HFMD cases treated between 2011 and 2014 in Chongqing were enrolled as case group while another 90 mild HFMD cases were randomly selected as control group in the same period. All subjects’ parents or babysitters were asked to fill in a questionnaire which included demography, ways of babysitting, behavior and the like. All HFMD cases were diagnosed by both clinical symptoms and nuclear acid testing. Data were processed by EpiData 3.1 and analyzed by SPSS 13.0. Results Single-factor analysis showed that there were 14 risk factors of severe HFMD including virus type, registered residence type, current address type, cultural degree of their caregivers, season of the onset, existence of fever and rash, first hospital diagnosis type, and whether the first diagnosis was HFMD (P ＜ 0.05) . Multifactor analysis showed the risk factors included the current rural residence type [OR=27.29, 95%CI (3.71, 200.72) ], misdiagnosis as disease other than HFMD in the first visit to the hospital [OR=141.03, 95%CI (12.43, 1 599.70) ], and virus type of EV71 [OR=244.32, 95%CI (18.99, 3 143.74) ]. Conclusions Active surveillance should be carried out on the risk factors of severe HFMD. At the same time, active and effective preventive measures, and timely treatment of patients with severe HFMD can help to reduce the incidence and case fatality rate.

Citation： ZhangKe, HeJia, ZhouXiaolan, ChenXiangang, YangHui, GuanLongzhi. A Case-control Study on the Risk Factors of Severe Hand-foot-mouth Disease in Chongqing City. West China Medical Journal, 2016, 31(5): 875-879. doi: 10.7507/1002-0179.201600238 Copy

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1. 中華人民共和國衛生部. 手足口病診療指南(2014 年版)[J]. 中國醫藥導報, 2015, 6(2) : 1-4.
2. 中華人民共和國衛生部. 衛生部辦公廳關于印發<手足口病診療指南(2010年版)>的通知[EB/OL]. [2011-01-01]. http://www.moh.gov.cn/publicfilesbusiness,htmlfiles/mohyzs/s3586/20l004/46884.htm．.
3. 李爽, 黎新宇, 賈蕾, 等. 北京市2012年手足口病病原學監測重癥病例危險因素分析[J]. 國際病毒學雜志, 2013,20(6) : 258-261.
4. 盧聯合, 陳志海, 徐艷利, 等. 分析手足口病重癥的危險因素及臨床治療方案[J]. 中國醫藥導報, 2013, 10(32) : 63-65.
5. 孫大鵬. 山東省手足口病流行特征及重癥危險因素研究[D]. 濟南: 山東大學, 2011．.
6. 潘浩, 鄭雅旭, 毛盛華, 等. 上海市手足口病重癥病例危險因素研究[J]. 中華流行病學雜志, 2012, 33(8) : 763-767.
7. 王美芬, 陳韜, 杜曾慶, 等. 2010年昆明及周邊地區普通型與重型手足口病病原學分析[J]. 中國實用醫刊, 2013, 14(1) : 30-32.
8. 楊德華, 曾義嵐, 陳竹, 等. 2010至2012年成都市手足口病的流行病學與臨床特點分析[J]. 中華實驗和臨床感染病雜志, 2013, 7(4) : 588-590.
9. Chang LY, Tsao KC, Hsia SH, et al . Transmission and clinicalfeatures of enterovirus 71 infection in household contacts in Taiwan[J]. JAMA, 2004, 291(2) : 222-227．.
10. Chang LY. King CC, Hsu KH. et al. Risk factors of enterovims71 infection and associated hand, Foot, and moutll disease/herpangina in children during an epidemic in Taiwan[J]. Pedatries, 2002, 109(6) : 1-6．.
11. 劉丹, 蘇豪浩, 王建紅, 等. 手足口病重癥病例的流行特征及危險因素[J]. 實用醫學雜志, 2013, 29(6) : 995-998.
12. 張愛平, 劉鳳仁, 李剛, 等. 2009－2012年深圳市龍崗區手足口病流行特征及其危險因素分析[J]. 實用預防醫學, 2013, 20(7) : 789-791.
13. 楊璠. 兒童重癥手足口病危險因素分析[J]. 檢驗醫學與臨床, 20l4, 11(3) : 366-367．.
14. Chong CY. Hand foot and mouth disease in Singapore: a comparison of fatal and non-fatal cases[J]. Acts Pediatric, 2003, 92 (10) : 1163-1169．.
15. 第四軍醫大學軍事預防醫學院成功研制我國首個手足口病疫苗[N]. 解放軍報, 2014-03-20(02) .
16. Chong P, Guo M S, Lin F H, et al. Immunological and biochemical characterization of coxsackie virus A16 viral particles[J/OL]. PLoS One, 2012, 7: e49973 [2016-01-01]. http://journal.plos.org/plsone/article?id=10.B71/journal.pone.0049973.
17. CAI Y, Liu Q, Huang X, et al. Active immunization with a Coxsackievirus A16 experimental inactivated vaccine induces neutralizing antibodies and protects mice against lethal infection[J]. Vaccine, 2013, 31: 2215-2221.
18. 陳祥鵬, 檀曉娟, 許文波. 柯薩奇病毒A組16型分子流行病學和疫苗研究進展[J]. 病毒學報, 2014, 30(4) : 483-488.

West China Medical Journal

A Case-control Study on the Risk Factors of Severe Hand-foot-mouth Disease in Chongqing City

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