Study On Health Education And Behavior Intervention Of Hand,Foot And Mouth Disease Among Children' Parents In The Kindergarten

Objective:Through the scientific and effective health education and behavior intervention,this study encourage parents to form good health habits and deepen the understanding about HFMD related knowledge,and then reduce the incidence of HFMD and the number of severe and fatal cases.The ultimate aim of the study is to prevent and control of HFMD,as well as serve as reference for further researches on health education and behavior intervention in Henan Provence.Methods:In this health education and behavioral intervention study,the investigation sites were set up in Minquan County,Shangqiu City,Henan Provence,covering 30 kindergartens in 19 townships.Twenty-nine kindergartens of 20 townships in Suixian were used as control group.Before the implementation of the intervention,a baseline survey was conducted on the parents in both the intervention and control group with self-designed questionnaires.During the stage of intervention,we provided health education for parents by carrying out collective lectures and distributing HFMD knowledge related foldouts,while our investigators followed up children about washing hands and public facilities disinfection every week.Case investigations were conducted on the children who were found to be HFMD patients.Moreover,the fecal specimens of the patients were collected during case investigations process.After the intervention,another questionnaire survey was carried out in both groups.The content of the survey was consistent with the first questionnaire before the intervention.The specimens were typed by qRT-PCR.The positive samples were detected by RT-PCR.The results were judged by agarose gelelectrophoresis,and the RT-PCR products would be sequenced if they are positive.Results:The baseline survey indicated that there was no significant difference(P>0.05)between the intervention group and the control group,in all 8 aspects: children's gender,age,HFMD history,whether vaccinated with EV71 vaccine,parents' age,gender,occupation(Whether or not engaging in medical related job),educational level of parents.After the intervention,in the intervention group,health habits and HFMD knowledge score of parents increased from 76.99 ± 9.89,57.87 ± 25.79 to82.22±9.00,67.35±20.38,and the differences were statistically significant(P<0.05);Health habits and HFMD knowledge passing rate increased from 70.89%,49.45% to90.69%,54.59%,and the differences were statistically significant(P<0.05).However,in control group,when compared health habits and HFMD knowledge score and passing rate with the data before intervention,the differences were not statistically significant(P>0.05).A total of 125 cases of HFMD were found during the study,48 cases in intervention group and 77 cases in control group.The incidence was 1.56% and2.44% respectively and the differences were statistically significant(P<0.05)between intervention group and control group.The protective rate(PR)of the intervention measures was 36.07%,and the index of effectiveness(IE)was 1.56.There are 81 positive results in 125 specimens by the qRT-PCR.The number of EV71,CA16 and some other enterovirus were respectively 32,12 and 37.There are 20 EV71 and 7CA16 positive results by RT-PCR.The RT-PCR products were sequenced.The nucleotide homology is higher than 88% among 20 isolated EV71 strains.There is the highest homology between 20 isolated EV71 strains and the C4 a genotypes(higher than 91%).The nucleotide homology is higher than 93% among 7 isolated CA16 strains.There is the highest homology between 7 isolated CA16 strains and the B1 b genotypes(higher than 92%).Phylogenetic analysis showed that 20 EV71 stains belong to C4 a genotype,and 7 CA16 strains belong to B1 b genotype.Conclusion:1.The health education and behavior intervention on HFMD can promote the children's parents to form good behavior habits and enhance their cognition on the HFMD related knowledge.2.The health education and behavioral intervention can reduce the incidence of HFMD and protect dangerous population.3.The EV71 strains isolated from the patients during the study belong to C4 a genotypes,and the CA16 strains belong to B1 b genotypes.