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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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. 中华人民共和国卫生部. 手足口病诊疗指南(2014 年版)[J]. 中国医药导报, 2015, 6(2) : 1-4.
2. 中华人民共和国卫生部. 卫生部办公厅关于印发<手足口病诊疗指南(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, 贾蕾, 等. 北京市2012年手足口病病原学监测重症病例危险因素分析[J]. 国际病毒学杂志, 2013,20(6) : 258-261.
4. 卢联合, 陈志海, 徐艳利, 等. 分析手足口病重症的危险因素及临床治疗方案[J]. 中国医药导报, 2013, 10(32) : 63-65.
5. 孙大鹏. 山东省手足口病流行特征及重症危险因素研究[D]. 济南: 山东大学, 2011．.
6. 潘浩, 郑雅旭, 毛盛华, 等. 上海市手足口病重症病例危险因素研究[J]. 中华流行病学杂志, 2012, 33(8) : 763-767.
7. 王美芬, 陈韬, 杜曾庆, 等. 2010年昆明及周边地区普通型与重型手足口病病原学分析[J]. 中国实用医刊, 2013, 14(1) : 30-32.
8. 杨德华, 曾义岚, 陈竹, 等. 2010至2012年成都市手足口病的流行病学与临床特点分析[J]. 中华实验和临床感染病杂志, 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. 刘丹, 苏豪浩, 王建红, 等. 手足口病重症病例的流行特征及危险因素[J]. 实用医学杂志, 2013, 29(6) : 995-998.
12. 张爱平, 刘凤仁, 李刚, 等. 2009－2012年深圳市龙岗区手足口病流行特征及其危险因素分析[J]. 实用预防医学, 2013, 20(7) : 789-791.
13. 杨璠. 儿童重症手足口病危险因素分析[J]. 检验医学与临床, 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. 第四军医大学军事预防医学院成功研制我国首个手足口病疫苗[N]. 解放军报, 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. 陈祥鹏, 檀晓娟, 许文波. 柯萨奇病毒A组16型分子流行病学和疫苗研究进展[J]. 病毒学报, 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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