Case-control study on risk factors of hand-foot-mouth disease in 1570 children / 中华传染病杂志

ABSTRACT

Objective To study the risk factors of severe hand-foot-mouth disease (HFMD) among children.Methods The clinical data of 1 570 children with HFMD at Linyi People's Hospital in Shandong Province in 2011 were collected,retrospectively.The data were analyzed using univariate and multivariate Logistic regression.Results The mean age of severe HFMD (including severe and critical HFMD) was (25.0± 14.0) months old,predominantely aged between 1 and 5 years old,while mild HFMD was (27.1±15.8) months (t'=-2.717,P=0.007).There were 61.0％ and 65.9％ boys in two groups,respectively (x2 =3.894,P=0.048).Fever,convulsion,tremor,nausea and vomiting were more frequently seen in severe HFMD.The neutrophil count and the level of creatine kinase in severe HFMD were both significantly higher than that in mild HFMD.Univariate analysis revealed that age (odds ratio [OR]=1.799,95％CI0.984-1.997),girl sex (OR=1.234,95％CI1.001-1.522),high fever (OR=2.110,95％CI1.816-2.452),convulsion (OR=1.878,95％CI1.578-2.236),nausea and vomiting (OR=1.760,95％CI1.456-2.128),neutrophil count (OR=1.031,95％CI1.025-1.037) and creatine kinase (OR=1.002,95％CI1.001-1.003) were risk factors for severe HFMD.Multivariate Logistic regression showed that high fever (OR =1.751,95％ CI1.487-2.062),convulsion (OR=1.451,95％CI1.204-1.749),nausea and vomiting (OR=1.269,95％CI1.027-1.568),neutrophil count (OR=1.028,95％CI1.021-1.035) were independent risk factors.Conclusions Body temperature,neurological manifestations and trend of neutrophil counts should be carefully monitored in children with HFMD.Prevention of the development of severe HFMD mainly relies on the identification of risk factors and adoption of precautions in time.