The Risk Factors of Acquiring Severe Hand, Foot, and Mouth Disease: A Meta-Analysis

Objectives. The incidence of severe hand, foot, and mouth disease (HFMD) is not low, especially in mainland China in almost every year recently. In this study, we conducted a meta-analysis to generate large-scale evidence on the risk factors of severe HFMD to provide suggestions on prevention and co...

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Main Authors: Bai Jun Sun, Hui Jie Chen, Ye Chen, Xiang Dong An, Bao Sen Zhou
Format: Article
Language:English
Published: Wiley 2018-01-01
Series:Canadian Journal of Infectious Diseases and Medical Microbiology
Online Access:http://dx.doi.org/10.1155/2018/2751457
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author Bai Jun Sun
Hui Jie Chen
Ye Chen
Xiang Dong An
Bao Sen Zhou
author_facet Bai Jun Sun
Hui Jie Chen
Ye Chen
Xiang Dong An
Bao Sen Zhou
author_sort Bai Jun Sun
collection DOAJ
description Objectives. The incidence of severe hand, foot, and mouth disease (HFMD) is not low, especially in mainland China in almost every year recently. In this study, we conducted a meta-analysis to generate large-scale evidence on the risk factors of severe HFMD to provide suggestions on prevention and controlling. Methods. PubMed, Web of Science, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), and Wanfang (Chinese) were searched to identify relevant articles. All analyses were performed using Stata 14.0. Results. We conducted a meta-analysis of 11 separate studies. Fever (odds ratio (OR) 7.396, 95% confidence interval (CI) 3.565–15.342), fever for more than 3 days (OR 5.773, 95% CI 4.199–7.939), vomiting (OR 6.023, 95% CI 2.598–13.963), limb trembling (OR 42.348, 95% CI 11.765–152.437), dyspnea (OR 12.869, 95% CI 1.948–85.017), contact with HFMD children (OR 5.326, 95% CI 1.263–22.466), rashes on the hips (OR 1.650, 95% CI 1.303–2.090), pathologic reflexes (OR 3057.064, 95% CI 494.409–19000), Lethargy (OR 31.791, 95% CI 3.369–300.020), convulsions (OR 23.652, 95% CI 1.973–283.592), and EV71 infection (OR 9.056, 95% CI 4.102–19.996) were significantly related to the risk of severe HFMD. We did not find an association between female sex (OR 0.918, 95% CI 0.738–1.142), scatter-lived children (OR 1.347, 95% CI 0.245–7.397), floating population (OR 0.847, 95% CI 0.202–3.549), rash on the hands (OR 0.740, 95% CI 0.292–1.874), rash on the foot (OR 0.905, 95% CI 0.645–1.272), the level of the clinic visited first (below the country level) (OR 5.276, 95% CI 0.781–35.630), breast feeding (OR 0.523, 95% CI 0.167–1.643), and the risk of severe HFMD. Conclusions. Fever, fever for more than 3 days, vomiting, limb trembling, dyspnea, contact with HFMD children, rashes on the hips, pathologic reflexes, lethargy, convulsions, and EV71 infection are risk factors for severe HFMD.
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spelling doaj-art-6605c2bc404e4274a9b37b399b5d41bc2025-08-20T03:34:17ZengWileyCanadian Journal of Infectious Diseases and Medical Microbiology1712-95321918-14932018-01-01201810.1155/2018/27514572751457The Risk Factors of Acquiring Severe Hand, Foot, and Mouth Disease: A Meta-AnalysisBai Jun Sun0Hui Jie Chen1Ye Chen2Xiang Dong An3Bao Sen Zhou4Department of Epidemiology, China Medical University, Shenyang, Liaoning 110000, ChinaDepartment of Infectious Disease, Shenyang Center for Disease Control and Prevention, Shenyang, Liaoning 110031, ChinaDepartment of Infectious Disease, Shenyang Center for Disease Control and Prevention, Shenyang, Liaoning 110031, ChinaDepartment of Infectious Disease, Shenyang Center for Disease Control and Prevention, Shenyang, Liaoning 110031, ChinaDepartment of Epidemiology, China Medical University, Shenyang, Liaoning 110000, ChinaObjectives. The incidence of severe hand, foot, and mouth disease (HFMD) is not low, especially in mainland China in almost every year recently. In this study, we conducted a meta-analysis to generate large-scale evidence on the risk factors of severe HFMD to provide suggestions on prevention and controlling. Methods. PubMed, Web of Science, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), and Wanfang (Chinese) were searched to identify relevant articles. All analyses were performed using Stata 14.0. Results. We conducted a meta-analysis of 11 separate studies. Fever (odds ratio (OR) 7.396, 95% confidence interval (CI) 3.565–15.342), fever for more than 3 days (OR 5.773, 95% CI 4.199–7.939), vomiting (OR 6.023, 95% CI 2.598–13.963), limb trembling (OR 42.348, 95% CI 11.765–152.437), dyspnea (OR 12.869, 95% CI 1.948–85.017), contact with HFMD children (OR 5.326, 95% CI 1.263–22.466), rashes on the hips (OR 1.650, 95% CI 1.303–2.090), pathologic reflexes (OR 3057.064, 95% CI 494.409–19000), Lethargy (OR 31.791, 95% CI 3.369–300.020), convulsions (OR 23.652, 95% CI 1.973–283.592), and EV71 infection (OR 9.056, 95% CI 4.102–19.996) were significantly related to the risk of severe HFMD. We did not find an association between female sex (OR 0.918, 95% CI 0.738–1.142), scatter-lived children (OR 1.347, 95% CI 0.245–7.397), floating population (OR 0.847, 95% CI 0.202–3.549), rash on the hands (OR 0.740, 95% CI 0.292–1.874), rash on the foot (OR 0.905, 95% CI 0.645–1.272), the level of the clinic visited first (below the country level) (OR 5.276, 95% CI 0.781–35.630), breast feeding (OR 0.523, 95% CI 0.167–1.643), and the risk of severe HFMD. Conclusions. Fever, fever for more than 3 days, vomiting, limb trembling, dyspnea, contact with HFMD children, rashes on the hips, pathologic reflexes, lethargy, convulsions, and EV71 infection are risk factors for severe HFMD.http://dx.doi.org/10.1155/2018/2751457
spellingShingle Bai Jun Sun
Hui Jie Chen
Ye Chen
Xiang Dong An
Bao Sen Zhou
The Risk Factors of Acquiring Severe Hand, Foot, and Mouth Disease: A Meta-Analysis
Canadian Journal of Infectious Diseases and Medical Microbiology
title The Risk Factors of Acquiring Severe Hand, Foot, and Mouth Disease: A Meta-Analysis
title_full The Risk Factors of Acquiring Severe Hand, Foot, and Mouth Disease: A Meta-Analysis
title_fullStr The Risk Factors of Acquiring Severe Hand, Foot, and Mouth Disease: A Meta-Analysis
title_full_unstemmed The Risk Factors of Acquiring Severe Hand, Foot, and Mouth Disease: A Meta-Analysis
title_short The Risk Factors of Acquiring Severe Hand, Foot, and Mouth Disease: A Meta-Analysis
title_sort risk factors of acquiring severe hand foot and mouth disease a meta analysis
url http://dx.doi.org/10.1155/2018/2751457
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