| Objective: 1.Analysing the epidemic characteristics of hand-foot-mouth disease(HFMD)in Baoan district of Shenzhen from 2008 to 2017 as well as mastering the seasonal,regional and populational distribution of HFMD,and compare the changes in the epidemic characteristics of HFMD before and after the use of EV-A71 vaccine.2.Exploring the risk factors account for the deterioration of HFMD caused by CV-A6 and provide scientific basis for the prevention and control of HFMD in order to reduce its morbidity and mortality.Method: 1.Collecting the epidemic data of HFMD in Shenzhen Baoan district from Chinese information system of disease prevention and control(from January 1,2008-December 31,2017),utilizing descriptive epidemiological method to analyse the seasonal,regional characteristic as well as the gender,age and disease type distribution of HFMD,and simultaneously analysing the epidemic characteristics of HFMD before and after the use of EV-A71 vaccine.2.Collecting the clinical date of patients received by Shenzhen Baoan people’s hospitals and were confirmed by laboratory as CV-A6 infected HFMD,mild patients were counted as control group,while severe patients served as study group,two variable including gender and age were brought into frequency matching,290 cases of HFMD patients caused by CV-A6 were selected,the questionnaire survey focused on investigating content including general situation,clinical manifestation,birth,exposure history,etc.The collected data were analysed by single factor and multiple factors unconditioned logistic regression in order to determine the risk factors of severe HFMD caused by CV-A6.Results: 1.The reported HFMD incidence from 2008 to 2017 in Shenzhen Baoan district are 26.89,11.13,30.05,30.05,42.66,82.32,82.32,327.97,278.43,278.43 per one hundred thousand,respectively.The number of reported severe cases are 3,9,25,12,14,17,9,7,2,respectively.During 10 years,the reported severe HFMD cases were amounted to 98.One death case was reported both in 2010 and 2013,accounting for 2 reported death of HFMD altogether in ten years.2.There are two obvious seasonal peak of HFMD seasonal distribution characteristics in Shenzhen Baoan district from 2008-2017.The highest peak appeared between April and July each year,the second highest peak appeared among September and November each year,seasonal distribution of serious illness case were not obvious.3.Xixiang and Xinan streets are two streets with high HFMD incidence in Shenzhen baoan district from 2008-2011.During 2013 and 2014 the HFMD incidence in Songgang street were the highest before Xixiang street took its place between 2014 and 2017.The severe HFMD cases were occurring sporadically in each streets.2014-2017 average annual incidence is highest,severe cases happen in the streets.4.The male incidence was higher than that of women,with the gender ratio between 1.46-2.31 from 2008 to 2017 in Baoan district of Shenzhen.The incidence was highest in the 1~2 age group,with a constituent ratio of 27.43%-40.69%.The scattered children are the major group of high prevalence population and accounted for 71.91%-89.87% of the reported cases.No obvious characteristics were found in distribution of population among the severe cases.5.The incidence of severe HFMD was reduced from 0.09% to 0.01% after EV-A71 vaccination(P<0.001).6.Univariable logistic regression shows that birth complications(OR=3.30,95%CI:1.40-7.82),usage of saliva(OR=2.75,95%CI:1.24-6.11)are the probable risk factors for severe HFMD caused by CV-A6;dignosed hospital not lower than district leve(OR=0.51,,95%CI: 0.29-0.92),delay to seeing the doctor over one day(OR=0.33,95%CI:0.17-0.67),delay to dignose HFMD over one day(OR=0.38,95%CI:0.23-0.61),the second or more child in the home(OR=0.37,95%CI:0.22-0.60),breastfeeding(OR=0.42,95%CI:0.26-0.67),frequent hand-washing(OR=0.59,95%CI:0.37-0.95)are the probable protective factors for severe HFMD caused by CV-A6.7.Multivariable logistic regression shows that birth complications(OR=3.84,95%CI:1.51-9.79),usage of saliva pad(OR=2.78,95%CI:1.17-6.59)are the risk factors for severe HFMD caused by CV-A6,the second or more child in the home(OR=0.42,95%CI:0.25-0.73),breastfeeding(OR=0.52,95%CI:0.31-0.87),seeking first medical treatment and advise from hospital not lower than district level(OR=0.58,95%CI:0.36-0.95)are the protective factor.Conclusion:The incidence of HFMD in Shenzhen baoan district is increasing every year,the peak seasons are mainly from April to July and from September to November,the peak areas comprise Xixiang and Xinan streets,with higher male incidence rate than female,the cases are highly concentrated in children aged from 1~2 years,scattered children account for the largest proportion of population type.Birth complications,usage of saliva pad are the risk factors for severe HFMD caused by CV-A6,on the contrary,the second child in the home,breastfeeding,seeking first medical treatment and advise from hospital not lower than district level can reduce the risk of such serious illness. |
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