Abstract:Objective To explore the risk factors of severe cases of hand, foot and mouth disease (HFMD) in Jinan city so as to provide a scientific basis for early identifying the severe cases and reducing the incidence of severe HFMD. Methods A case-controlled study was conducted in 86 severe HFMD cases (the severe HFMD group) and 86 mild HFMD cases (the control group). A questionnaire survey was performed to collect their socio-demographic characteristics, contact history, history of treatment, clinical symptoms, laboratory diagnosis and other information. Single factor and multi-factor unconditional logistic regression analyses were performed to identify the risk factors of the severe HFMD cases. Results Single-factor logistic regression analysis indicated that the factors, including the time from onset of illness to visiting, initial diagnosis of HFMD by village-level medicalunits, fever, foot skin rash, oral herpes, hip skin rash, cough, vomiting, having a history of case exposure and enterovirus 71 (EV71) infection, showed statistically significant differences between the two groups. Multi-factor unconditional logistic regression analysis revealed that fever (R=89.38), oral herpes (OR=22.28), hip skin rash (OR=234.81), vomiting (OR=23.90), having a history of case exposure (OR=31.48) and EV71 infection (OR=71.65) were the risk factors influencing the incidence of severe HFMD. Conclusions Early identifying the cases with symptoms like fever, oral herpes, hip skin rash and vomiting has some referenced effects on decreasing the incidence of severe HFMD. Improving the coverage rate of EV71 vaccine can reduce the incidence rate of severe HFMD caused by EV71 infection.
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