| [Object] To analyze epidemiological characters and trend in hand-foot-mouth disease (HFMD) during 2010-2013 in Yancheng city, to assess economical burden of HFMD in 2013 through retrospective investigation, to improve the prevention and control measures, and to provide a basis to reduce the burden of disease.[Methods] China Information System for Disease Control and Prevention was used to collect the epidemic situation data and describe the epidemiological characters for 2010 -2013.Cases of HFMD from urban and rural were selected in accordance with the stratified random sampling method, extract 472 cases of hand, foot and mouth disease cases in 2013, they were obtained by questionnaire survey, telephone follow-up, and the hospital records checking in burden investigation. Describe foot and mouth disease distribution characteristics such as gender, age, place of residence.Descriptive analysis was used in etiology monitoring results; Spearman rank correlation analysis was used in the relationship between HFMD incidence and the temperature; Non parametric test was used in comparison of the economic burden in different patients. The SAS 8.1 was used in statistical analysis, and test level was a=0.05.[Results] In epidemiological investigation, there were 24378 cases of HFMD and 2 death cases of 2010-2013 in Yancheng City. The numbers of cases reported were 4276,7140,7273, and 5689 over the years, and the incidence rate was 52.39/100,000,87.00/100,000,88.44/100,000, and 69.06/100,000 over the years, respectively, the average incidence rate of every year was 74.22/10 million. The epidemic situation of HFMD in the central region was higher than other regions in Yancheng City. The average annual incidence rates of the top three were Yandu District, Tinghu District, and Dafeng City. The annual incidence rate was 245.33/100,000,166.51/100,000, and 73.79/100,000 respectively. Cases were reported throughout the whole year, seasonal incidence trend was obvious. The peak incidence was 4-6 months in whole year except in 2011. There were two incidence peaks in 2011, and the peak months were July and November. The incidence ratio of male and female was 1.83:1.0-5 years old of preschool children were the main disease groups, and accounting for the total incidence of 91.83%. The main patients were children live scattered (62.99%) and kindergarten children (33.17%). In the climate, there was correlation between the incidence of foot and mouth disease and temperature (rs=0.27, P=0.07), and the fitting curve model was statistically significant (F=4.75, P=0.01).941 positive samples were detected in 4 years totally, and the major virus types were EV71 (52.18%) and Cox A16 (19.87%). In addition to fever, skin rash, herpes angina (24.64%) was also one of the most important symptoms of HFMD.In the burden of disease,491 cases of HFMD were chosen as the sample of the economic burden investigation in 2013, in which 308 cases (62.73%) were outpatients,183 cases (37.27%) were hospitalized patients (including 26 cases of severe cases). The median of total economic burden in Yancheng City of 296 outpatients of HFMD was 478.21 yuan in 2013, and the X25～X75 was 382.54～557.31 yuan, of which the median of the direct economic burden was 262.50 yuan, and the X25～X75 was 186.27～338.35 yuan; the median of indirect economic burden was 208.47 yuan, and the X25～X75 was 181.27～244.35. The median of total economic burden in Yancheng City of 176 hospitalized patients of HFMD was 3479.82 yuan, and the X25～X75 was 2994.57～4018.35 yuan, of which the median of the direct economic burden was 3046.25 yuan,and the X25～X75 was 2602.23～3633.51 yuan; the median of indirect economic burden was 439.47 yuan, and the X25-X75 was 391.27～491.35 yuan. There was no significant difference between different gender cases, and between younger than age 3 compared with age 3 and older patients no matter the outpatients or hospitalized patients in the total economic burden by the Wilcoxon rank test (P>0.05). But there were differences between under the age of 3 and 3 years old and above in direct medical costs and direct non-medical cost (P>0.05). The economic burden of cases from urban area were higher than rural cases, and the difference was statistically significant (P<0.05). The economic burden of scattered children and kindergarten children were higher than the students, and the difference was statistically significant (P<0.05). The economic burden of severe cases were higher than that of ordinary patients, the difference was statistically significant (P<0.001).[Conclusions] There were regional differences in the incidence of HFMD in Yancheng City, and the incidence of HFMD in central region was higher than other regions. Seasonal incidence trend was obvious. The incidence peak was 4-6 month.2011 was the peak year of HFMD incidence, and with two peak incidence months. The key population of prevention and control were aged 3 and below, the scattered children and kindergarten children, besides boys are more susceptible than girls. Cox EV71 and A16 were the main advantage pathogens of HFMD in Yancheng area, and showed an alternate dominance. The incidence of HFMD has correlation with temperature. In the economic burden, urban cases were higher than rural case. Scattered children and kindergarten children were higher than the student cases. Hospitalized patients were higher than that of outpatients; severe cases were higher than that of normal cases. The study proved that early discovery, early diagnosis, early treatment is the key to reduce the economic burden of HFMD. |
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