Clinical, aetiological, and epidemiological studies of outpatient cases of hand, foot, and mouth disease in Chengdu, China, from 2019 to 2022: a retrospective study
Abstract Background The introduction of the Enterovirus A71 (EV-A71) vaccine in China in 2016 has led to a considerable decline in severe hand, foot, and mouth disease (HFMD) cases, with mild outpatient instances now representing the majority of HFMD cases in the country. Nevertheless, epidemiologic...
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2024-12-01
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| Online Access: | https://doi.org/10.1186/s12889-024-20909-8 |
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| author | Maoyao Xia Yu Zhu Juan Liao Shirong Zhang Denghui Yang Peng Gong Shihang Zhang Guiyu Jiang Yue Cheng Jiantong Meng Zhenhua Chen Ye Liao Xiaojing Li Yilan Zeng Chaoyong Zhang Lu Long |
| author_facet | Maoyao Xia Yu Zhu Juan Liao Shirong Zhang Denghui Yang Peng Gong Shihang Zhang Guiyu Jiang Yue Cheng Jiantong Meng Zhenhua Chen Ye Liao Xiaojing Li Yilan Zeng Chaoyong Zhang Lu Long |
| author_sort | Maoyao Xia |
| collection | DOAJ |
| description | Abstract Background The introduction of the Enterovirus A71 (EV-A71) vaccine in China in 2016 has led to a considerable decline in severe hand, foot, and mouth disease (HFMD) cases, with mild outpatient instances now representing the majority of HFMD cases in the country. Nevertheless, epidemiological investigations concerning mild outpatient cases remain scarce, resulting in inadequate descriptions of their clinical, etiological, and epidemiological characteristics. Our study aimed to analyze the clinical, etiological, and epidemiological characteristics of HFMD outpatients in Chengdu from 2019 to 2022 while identifying potential risk factors associated with the progression of outpatients requiring hospitalization. Methods A retrospective study was conducted to summarize the clinical, etiological, and epidemiological characteristics of outpatient HFMD cases in Chengdu from 2019 to 2022. Risk factors associated with progression to hospitalization of HFMD outpatients were evaluated using binomial logistic regression analysis. Results The study included 1,073 coxsackievirus A6 (CVA6), coxsackievirus A10 (CVA10), and coxsackievirus A16 (CVA16) HFMD nucleic acid test-positive outpatients. Among these, only 45 outpatients (4.19%) progressed to hospitalization. The median ages for CVA6, CVA10, and CVA16 infections were 25.23, 28.13, and 38.45 months, respectively (P < 0.001). CVA6 (76.51%, 821/1,073) has become the main serotype among outpatients in Chengdu, with the proportions from the second half of 2019 to 2022 being 45.59%, 95.17%, 77.67% and 80.71% respectively. EV-A71 cases even disappeared. Patients infected with CVA10 had a significantly higher likelihood of hospitalization (P < 0.05), while the presence of oral rash served as a protective factor (P < 0.05). Conclusions Our study highlights the critical need for enhanced surveillance of multiple HFMD pathogens, predominantly caused by the prevalent serotype CVA6. Clinically, enhanced surveillance of CVA10 is imperative to mitigate the hospitalization rate associated with HFMD. |
| format | Article |
| id | doaj-art-737801b6593e42158cd199a35a98a484 |
| institution | DOAJ |
| issn | 1471-2458 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | BMC |
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| series | BMC Public Health |
| spelling | doaj-art-737801b6593e42158cd199a35a98a4842025-08-20T02:40:18ZengBMCBMC Public Health1471-24582024-12-0124111010.1186/s12889-024-20909-8Clinical, aetiological, and epidemiological studies of outpatient cases of hand, foot, and mouth disease in Chengdu, China, from 2019 to 2022: a retrospective studyMaoyao Xia0Yu Zhu1Juan Liao2Shirong Zhang3Denghui Yang4Peng Gong5Shihang Zhang6Guiyu Jiang7Yue Cheng8Jiantong Meng9Zhenhua Chen10Ye Liao11Xiaojing Li12Yilan Zeng13Chaoyong Zhang14Lu Long15Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan UniversityWest China Second University Hospital, Sichuan UniversityDepartment of Gastroenterology Institution, West China School of Public Health and West China Fourth Hospital, Sichuan UniversityDepartment of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan UniversityDepartment of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan UniversityDepartment of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan UniversitySchool of Mathematics, Sichuan UniversityDepartment of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan UniversityChengdu Center for Disease Control and PreventionChengdu Center for Disease Control and PreventionChengdu Center for Disease Control and PreventionDepartment of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan UniversityChengdu Jinjiang Center for Disease Control and PreventionPublic Health Clinical Center of ChengduPublic Health Clinical Center of ChengduDepartment of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan UniversityAbstract Background The introduction of the Enterovirus A71 (EV-A71) vaccine in China in 2016 has led to a considerable decline in severe hand, foot, and mouth disease (HFMD) cases, with mild outpatient instances now representing the majority of HFMD cases in the country. Nevertheless, epidemiological investigations concerning mild outpatient cases remain scarce, resulting in inadequate descriptions of their clinical, etiological, and epidemiological characteristics. Our study aimed to analyze the clinical, etiological, and epidemiological characteristics of HFMD outpatients in Chengdu from 2019 to 2022 while identifying potential risk factors associated with the progression of outpatients requiring hospitalization. Methods A retrospective study was conducted to summarize the clinical, etiological, and epidemiological characteristics of outpatient HFMD cases in Chengdu from 2019 to 2022. Risk factors associated with progression to hospitalization of HFMD outpatients were evaluated using binomial logistic regression analysis. Results The study included 1,073 coxsackievirus A6 (CVA6), coxsackievirus A10 (CVA10), and coxsackievirus A16 (CVA16) HFMD nucleic acid test-positive outpatients. Among these, only 45 outpatients (4.19%) progressed to hospitalization. The median ages for CVA6, CVA10, and CVA16 infections were 25.23, 28.13, and 38.45 months, respectively (P < 0.001). CVA6 (76.51%, 821/1,073) has become the main serotype among outpatients in Chengdu, with the proportions from the second half of 2019 to 2022 being 45.59%, 95.17%, 77.67% and 80.71% respectively. EV-A71 cases even disappeared. Patients infected with CVA10 had a significantly higher likelihood of hospitalization (P < 0.05), while the presence of oral rash served as a protective factor (P < 0.05). Conclusions Our study highlights the critical need for enhanced surveillance of multiple HFMD pathogens, predominantly caused by the prevalent serotype CVA6. Clinically, enhanced surveillance of CVA10 is imperative to mitigate the hospitalization rate associated with HFMD.https://doi.org/10.1186/s12889-024-20909-8Hand, foot, and mouth diseaseOutpatientsCoxsackievirusEpidemiologyRisk factors |
| spellingShingle | Maoyao Xia Yu Zhu Juan Liao Shirong Zhang Denghui Yang Peng Gong Shihang Zhang Guiyu Jiang Yue Cheng Jiantong Meng Zhenhua Chen Ye Liao Xiaojing Li Yilan Zeng Chaoyong Zhang Lu Long Clinical, aetiological, and epidemiological studies of outpatient cases of hand, foot, and mouth disease in Chengdu, China, from 2019 to 2022: a retrospective study BMC Public Health Hand, foot, and mouth disease Outpatients Coxsackievirus Epidemiology Risk factors |
| title | Clinical, aetiological, and epidemiological studies of outpatient cases of hand, foot, and mouth disease in Chengdu, China, from 2019 to 2022: a retrospective study |
| title_full | Clinical, aetiological, and epidemiological studies of outpatient cases of hand, foot, and mouth disease in Chengdu, China, from 2019 to 2022: a retrospective study |
| title_fullStr | Clinical, aetiological, and epidemiological studies of outpatient cases of hand, foot, and mouth disease in Chengdu, China, from 2019 to 2022: a retrospective study |
| title_full_unstemmed | Clinical, aetiological, and epidemiological studies of outpatient cases of hand, foot, and mouth disease in Chengdu, China, from 2019 to 2022: a retrospective study |
| title_short | Clinical, aetiological, and epidemiological studies of outpatient cases of hand, foot, and mouth disease in Chengdu, China, from 2019 to 2022: a retrospective study |
| title_sort | clinical aetiological and epidemiological studies of outpatient cases of hand foot and mouth disease in chengdu china from 2019 to 2022 a retrospective study |
| topic | Hand, foot, and mouth disease Outpatients Coxsackievirus Epidemiology Risk factors |
| url | https://doi.org/10.1186/s12889-024-20909-8 |
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