Cross-sectional Survey On Morbidity And Prevention And Control Of Hand-foot-mouth Disease In Zhabei District

BackgroundHand-foot-mouth Disease (HFMD) is a common childhood infectious disease caused by a variety of human enteroviruses.lt is our statutory report management class C infectious diseases in china. Most patients have mild symptoms. The main symptoms are fever and the rash or herpes on hand, foot, mouth and other parts of body. HFMD is popular in most parts of the world. Monitoring data in recent years show that HFMD is not high levels in zhabei district in terms of shanghai. But monitoring data are more scattered and not be systematically analyzed and summarized in zhabei. This project aims to systematically organize, summarize, analyze HFMD incidence in zhabei district, combined with the routine work. Probeing the epidemic regular pattern and mastering the difficulties and deficiencies in the prevention and control work by way of descriptive epidemiology and in-depth interviews.ObjectivesThe objective is to analyze the status quo of the incidence of HFMD and to investigate the cognitive of prevention and control status of HFMD in various relevant population in Zhabei District. And to describe the incidence trends and epidemiological characteristics of HFMD.Concluding the regular pattern of disease occurrence and development and mastering the difficulties and deficiencies in the prevention and control work. Provide the scientific basis of perfect work plans and processes and effective control of the prevalence and spread of HFMD.MethodsBoth qualitative analyses and quantitative analyses were used in the survey. Quantitative analyses included collecting routine network report data, and case questionnaire survey.The data would be analyzed and statistically described by using software Excel2010. Qualitative analyses included in-depth interview,field interview notes material collection,Inductive analysis in accordance with the content framework.Main resultsHFMD morbidity Continued to rise in recent years. The incidence rate increased from8.95/10million of2006to71.15/10million of2010. The childcare institutions gathered epidemic is gradually increasing in recent years.The foreign population incidence was significantly higher than the household population of the city. More men than women. Morbidity in children under5years of age accounted for almost90%.Case reports in every month of the year,but the morbidity principally occurred in May-July,The morbidity is principally in sporadic. Some nurseries occurred clusters of disease and outbreaks In some areas. aggregation morbidity mainly in April-June. The incidence of kindergarten children accounted for nearly60%. Cases mild dominated. CoxA16, EV71and other enteroviruses simultaneously exist in HFMD cases. Light cases Infection CoxA16more common. Severe cases Infection EV71more common.Aggregation of the epidemic occurred in nurseries, onset number of classes are the most in small classes and child care classes. Child care classes have the highest density of cases. Case density decrease with the rising of grade. Demonstration nurseries have the lowest incidence of aggregation of the epidemic.The private nurseries have the highest incidence of aggregation of the epidemic. There are differences in different degree of spread of the case between different levels nurseries.The second level of the nurseries have lowest diffusionless percentage. Prevalence control the sooner the better, with the relevant class time.Outpatient doctors of various medical institutions are still inadequate understanding of the diagnosis, prevention and control of HFMD. The specialist outpatient building is inadequate;Follow-up and management of relevance and effectiveness is not enough for the cases by community health service centers;Method of health education measures is single. scientific, acceptance is not high;Long-term mechanism for communication and collaboration between the education and health sectors is not perfect;Impact assessment of prevention and control measures for HFMD is lacking. The vaccine for the prevention and control of HFMD get more recognition. Conclusions1. Hand, foot and mouth disease continued high incidence in zhabei district.The peak incidence of hand-foot-mouth disease is in5-7months. The major pathogen si enterovirus CoxA16and EV71in zhabei district.2. HFMD cases mild dominated,but severe cases and deaths is rising.3. Epidemic situation is not the same between different levels of aggregation nurseries.Childcare institutions is the key units of the HFMD prevention and control work.4. Outpatient doctors of various medical institutions are still inadequate understanding of the diagnosis, prevention and control of HFMD.5. Follow-up and management of relevance and effectiveness is not enough for the cases by community health service centers.6. HFMD prevention and control is still facing many difficulties and challenges.SuggestionsOn the basis of steps to improve the understanding, tighten up the management, strengthen the medical system, focus more attention on popularizing the hazard and prevention and controlling knowledge of HFMD, get prepared for the emergency and control of safety measurement, according to the current situation, problems that existed and the available condition, Suggestions may take the following measures.1. To implement the scientific prevention and control measures. To strengthen the management of preschools. To improve health education coverage and acceptance. To assess the effects of prevention and control measures.2. Increase investment,improve personnel structure,improve team capabilities and management level.3. Standardize the clinic construction of hand, foot and mouth disease, regulate the clinic behavior of the medical staff.4. Develop fast diagnosis reagent, accelerate vaccine development.