| ObjectiveTo investigate the levels of Coxsachievirus A16(CV-A16)and enterovirus 71(EV-A71)antibody Ig G in healthy children and children of hand-foot-mouth disease in Baoan District,Shenzhen in 2019,and to analyze the past infection and immune status of hand-foot-mouth disease and its epidemiological characteristics,so as to provide scientific basis for the prevention and treatment of hand-foot-mouth disease.To investigate the cognition and vaccination willingness of parents of 3-5 year old children in floating population in Bao’an District,Shenzhen,and to analyze the influencing factors,so as to provide theoretical basis for better HFMD prevention and EV-A71 vaccine vaccination.MethodAntibody analysis of HFMD in healthy nurseries and children:Using the method of current situation study,728 nurseries and children were selected by volume proportion probability sampling method from nurseries in Bao’an District,Shenzhen,and the levels of CV-A16Ig G and EV-A71Ig G antibodies against HFMD were detected and basic information was collected.The titer of Ig G antibody was quantitatively detected by enzyme-linked immunosorbent assay(ELISA)and the antibody concentration was calculated.The antibody levels were divided according to the concentration level(positive and protective).Quantitative variables according to the f test and normality test and decided to use rank test is analyzed,the qualitative variable analysis usingc~2inspection and unconditioned logistic regression analysis.Nursery children HFMD EV-A71 vaccine will influence factors analysis:using stratified random sampling method,baoan district can be divided into the urban district and two layers of village inside city,according to the two layers of population proportion in all the childcare facilities in each layer of random 3 and 2,respectively,for a total of five as,deals on the survey of 606 parents.The self-made questionnaire was compiled based on the theory of knowledge,belief,behavior and planning behavior.The content adopted general classification questions and Likert3 and Likert5 grading method.Professional teams participated in the investigation based on the actual situation of the nurseries.Hand,foot and mouth disease knowledge and vaccination will adoptc~2test,rank and inspection,unconditioned logistic regression analysis and combined with known nobuyuki application of structural equation model and planned behavior theory,to analyze its influencing factors.ResultsStudy on the immune status of hand-foot-mouth disease in nurseries and young children:the positive rate and protection rate of CV-A16Ig G antibody in the investigated nurseries and young children were 96.29%and 57.69%,respectively,with GMC=39.10ng/ml.The positive rate and protection rate of EV-A71 antibody were 86.68%and47.94%,respectively,with GMC=13.42ng/m L.There were statistically significant differences in the positive rate and protection rate of CV-A16Ig G antibody among children’s gender,region and residence type(P<0.05),and there were statistically significant differences in the protection rate among children’s age and household registration(P<0.05).There were statistically significant differences in the positive rate and protection rate of EV-A71 Ig G antibody in children’s age,residence type and immunization history(P<0.05),and there were statistically significant differences in the positive rate of EV-A71 Ig G antibody in the region(P<0.05).Multivariate analysis showed that the protective factors for CV-A16 Ig G positive in healthy nurseries were girls(OR=2.685)and living in an urban village(OR=3.098).The protective factors for EV-A71 Ig G positive in healthy nurseries were children’s age,living in an urban village(OR=1.947)and having a history of EV-A71 vaccination(OR=8.825).Analysis of the influencing factors of vaccination willingness of hand-foot-mouth disease EV-A71 vaccine in nurseries and children:The awareness rate of hand foot disease knowledge among parents was58.42%,and parents were more willing to accept relevant knowledge through vaccination hospitals and kindergartens.Knowledge was the positive influencing factor of belief(standardized path coefficient=0.35,P<0.001),and belief was the positive influencing factor of behavior(standardized path coefficient=0.40,P<0.001).Logistic regression analysis showed that the higher the educational level of parents,the gender of parents was female(OR=2.215,95%CI:1.567～3.257),and they lived in urban village area(OR=2.610,95%CI:1.787～3.812),children’s history of hand foot mouth disease(OR=2.398,95%CI:1.424～4.037),health education knowledge related to hand foot mouth disease(OR=3.206,95%CI:2.132～4.822)were protective factors for parents to know more about hand foot mouth disease knowledge(P<0.05).61.55%of parents were willing to vaccinate their children with EV-A71 vaccine.The main subjective reasons for parents’refusal or wait-and-see attitude were that they did not think the vaccine was effective(63.09%)and they were worried about the safety of the vaccine(51.93%).Logistic regression showed that higher education level was associated with higher living in urban community(OR=1.873,95%CI:1.128～3.110),knowledge of hand,foot and mouth disease (OR=2.912,95%CI:1.727～4.882),behavioral attitude(OR=3.458,95%CI:2.099～5.685),subjective norms(OR=1.832,95%CI:1.160～2.894)and perceived behavioral control(OR=17.228,95%CI:10.322～28.954)high scores were protective factors for parents’preference to vaccinate their children against EV-A71.Structural equation model analysis showed that nursery children parents attitude toward behavior,subjective norm and perceived behavioral control are to have a positive influence on behavior intention(P<0.001),in the case of other factors unchanged from big to small order in the strength of the influence is perceived behavior control(standardized path coefficient=0.510,P<0.001),behavior,attitude,standardized path coefficient=0.380,P<0.001),and subjective norm(standardized path coefficient=0.281,P<0.001).Conclusion1.The previous infection rate of HFMD CV-A16 and EV-A71among healthy childcare children in Baoan District,Shenzhen in 2019was very high,and the children still had a high risk of getting sick again.In the five years before 2019,recessive infections caused by HFMD CV-A16 and EV-A71 were prevalent in children in Baoan District of Shenzhen,and CV-A16 had a slight advantage over EV-A71 in infecting children..2.The awareness rate of HFMD among parents of children and children in Shenzhen is not high,and the vaccination willingness is not ideal.Therefore,it is necessary to further strengthen the health education and vaccine promotion related to HFMD.The TPB model of EV-A71 vaccination intention can better explain parents’willingness to vaccinate TPB vaccine,and it should focus on parents’perceptual behavioral control. |
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