| Objective: To analyze the epidemiological characters and trend of hand-foot-mouth disease inHubei Province from2008to2012, and to research the superiority strain of HFMD betweenthis five years. To explore the risk factors associated with death cases of HFMD in HubeiProvince, so as to provide a scientific evidence for its prevention and control.Methods: China Disease Control and Prevention Information System were used to collect theepidemic situation data in in Hubei Province from2008to2012. The epidemic characters ofHFMD were analyzed by descriptive epidemiological method and Geographic informationsystem (MapInfo software). The63death cases of HFMD between2010and2012in HubeiProvince were selected as case group, and the189survival cases of serious HFMD, which wererandom selected with a ratio at3:1in the same period in Hubei as control group. The basicinformation, hospitalized experience, clinical symptoms and laboratory test results had beensurveyed and the relevant risk factors were analyzed by single factor and multi-factor logisticregression.Results:280327cases that matched the definition of surveillance case, including547severecases and74dead cases, were reported in13cities,3provincial tube city,1forest region and103counties in Hubei Province from2008to2012. HFMD had two seasonal peaks of incidence(57.97%%of the cases were reported from April to July, and17.46%were reported fromNovember to December). Severe and dead cases show unimodal distribution; April to July waspeak period,410cases of severe cases and54cases dead cases were distribution during thisperiod. Most of the cases were children under five years old, who accounted for95.67percentwith a total number of268184. Especially one years old group was largest number, whoaccounted for28.41percent. Most of the Severe and dead cases were children under three yearsold, especially under one years old, who accounted for35.47%percent and37.84%%percentrespectively. The number of HFMD cases in males was larger than females, the ratio was q.78:1,and most of the cases were scatter children. Etiological analysis revealed that enterovirus71(EV71) was the major pathogens of HFMD with the positive rate of73.18%, while thepositive rates of Coxsackie virus A16(Cox A16) and other enterovirus were16.62%and10.20%, respectively.EV71positive rates of severe and dead cases were76.91%and96.43%respectively. The results of single-factor logistic regression indicated that diagnosis of HFMDin the first visit to hospital and rash were two protective factors. While Age less than1year old,living in rural areas,breastfeed, rural clinics and township medical institutions as the first choice, medication of hormone, medication of antibiotics and EV71infection were nine riskfactors. The results of multi-factors logistic regression showed that diagnosis of HFMD in thefirst visit to hospital（OR=0.276，95%CI:0.082-0.937）were protective factors of death ofHFMD. Age less than1year old（OR=8.222，95%CI:1.875-36.046）, living in rural areas（OR=3.459，95%CI:1.051-11.388）,breastfeed（OR=2.451，95%CI:1.013-5.928）and EV71infection（OR=7.964，95%CI:2.504-25.330）were the risk factors of death of HFMD.Conclusion: The epidemic situation of HFMD in Hubei province is relatively seriously, andmore attention should be payed during April to July. Scatter children and preschool childrenyounger than5years old are the focus of prevention and control. It was necessary to improve thecapacity of clinical diagnosis, together with improvement pathogenic molecular diagnosis foridentifying the virus type of HFMD in order to diagnose the HFMD cases earlier. More attentionshould be paid to these HFMD severe cases with age less than1year old and EV71infection aswell as strengthened rural area knowledge propaganda and education. |
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