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Epidemiological features and spatial clusters of hand, foot, and mouth disease in Qinghai Province, China, 2009–2015

BACKGROUND: Hand, Foot, and Mouth Disease (HFMD) is most frequently caused by Enterovirus71 (EV-A71) or Coxsackie virus A16 (CV-A16), infants and young children are at greatest risk. Describing the epidemiology of HFMD can help develop and better target interventions, including the use of pediatric...

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Autores principales: Xu, Lili, Shi, Yan, Rainey, Jeanette J., Zhang, Zhijie, Zhang, Huayi, Zhao, Jinhua, Li, Yonghong, Rao, Huaxiang, Li, Yanming, Liao, Qiaohong, Ma, Yongcheng
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6280489/
https://www.ncbi.nlm.nih.gov/pubmed/30518329
http://dx.doi.org/10.1186/s12879-018-3509-7
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author Xu, Lili
Shi, Yan
Rainey, Jeanette J.
Zhang, Zhijie
Zhang, Huayi
Zhao, Jinhua
Li, Yonghong
Rao, Huaxiang
Li, Yanming
Liao, Qiaohong
Ma, Yongcheng
author_facet Xu, Lili
Shi, Yan
Rainey, Jeanette J.
Zhang, Zhijie
Zhang, Huayi
Zhao, Jinhua
Li, Yonghong
Rao, Huaxiang
Li, Yanming
Liao, Qiaohong
Ma, Yongcheng
author_sort Xu, Lili
collection PubMed
description BACKGROUND: Hand, Foot, and Mouth Disease (HFMD) is most frequently caused by Enterovirus71 (EV-A71) or Coxsackie virus A16 (CV-A16), infants and young children are at greatest risk. Describing the epidemiology of HFMD can help develop and better target interventions, including the use of pediatric EV-A71 vaccination. METHODS: We obtained data from the national surveillance system for HFMD cases with onset dates from 2009 to 2015. We defined probable cases as patient with skin papular or vesicular rashes on the hands, feet, mouth, or buttocks and confirmed cases as patients with the above symptoms along with laboratory-based enterovirus detection. We generated overall and age-specific annual incidence rates and described the temporal variability and seasonality of HFMD in Qinghai Province. We identified spatial clustering of HFMD incidence at the county level using the Local Indicator of Spatial Associationand an alpha level of 0.05. RESULTS: During the study period, 14,480 HFMD probable or confirmed cases were reported in Qinghai Province. Of the 2158 (14.9%) with laboratory confirmation, 924 (42.6%) were caused by CV-A16 and 830 (38.2%) were caused by EV-A71. The majority (89%) of all case-patients were ≤ 5 years of age and male (61.5%). The overall mean annual HFMD incidence rate was 36.4 cases per 100,000 populations, while the incidence rate for children ≤5 years of age was 379.5 cases per 100,000. Case reports peaked during the months of May through July. HFMD was predominantly caused by EV-A71, except in 2010 and 2014 when CV-A16 was the predominant causative agent. High incidence rates of HFMD were clustered (Moran’s I = 0.59, P < 0.05) in the eastern region of the province. CONCLUSION: HFMD remains an important cause of childhood disease in Qinghai Province, occurring in an acyclical pattern of increased incidence, primarily due to CV-A16 circulation every three years. Incidence is also seasonal and tends to spatially cluster in the eastern region of the province. Since approximately 40% of confirmed HFMD cases were due to EV-A71, EV-A71 vaccination is likely to have a positive impact on the HFMD disease burden. Routine analysis of local surveillance data is crucial for describing disease occurrence and changes in etiology. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12879-018-3509-7) contains supplementary material, which is available to authorized users.
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spelling pubmed-62804892018-12-10 Epidemiological features and spatial clusters of hand, foot, and mouth disease in Qinghai Province, China, 2009–2015 Xu, Lili Shi, Yan Rainey, Jeanette J. Zhang, Zhijie Zhang, Huayi Zhao, Jinhua Li, Yonghong Rao, Huaxiang Li, Yanming Liao, Qiaohong Ma, Yongcheng BMC Infect Dis Research Article BACKGROUND: Hand, Foot, and Mouth Disease (HFMD) is most frequently caused by Enterovirus71 (EV-A71) or Coxsackie virus A16 (CV-A16), infants and young children are at greatest risk. Describing the epidemiology of HFMD can help develop and better target interventions, including the use of pediatric EV-A71 vaccination. METHODS: We obtained data from the national surveillance system for HFMD cases with onset dates from 2009 to 2015. We defined probable cases as patient with skin papular or vesicular rashes on the hands, feet, mouth, or buttocks and confirmed cases as patients with the above symptoms along with laboratory-based enterovirus detection. We generated overall and age-specific annual incidence rates and described the temporal variability and seasonality of HFMD in Qinghai Province. We identified spatial clustering of HFMD incidence at the county level using the Local Indicator of Spatial Associationand an alpha level of 0.05. RESULTS: During the study period, 14,480 HFMD probable or confirmed cases were reported in Qinghai Province. Of the 2158 (14.9%) with laboratory confirmation, 924 (42.6%) were caused by CV-A16 and 830 (38.2%) were caused by EV-A71. The majority (89%) of all case-patients were ≤ 5 years of age and male (61.5%). The overall mean annual HFMD incidence rate was 36.4 cases per 100,000 populations, while the incidence rate for children ≤5 years of age was 379.5 cases per 100,000. Case reports peaked during the months of May through July. HFMD was predominantly caused by EV-A71, except in 2010 and 2014 when CV-A16 was the predominant causative agent. High incidence rates of HFMD were clustered (Moran’s I = 0.59, P < 0.05) in the eastern region of the province. CONCLUSION: HFMD remains an important cause of childhood disease in Qinghai Province, occurring in an acyclical pattern of increased incidence, primarily due to CV-A16 circulation every three years. Incidence is also seasonal and tends to spatially cluster in the eastern region of the province. Since approximately 40% of confirmed HFMD cases were due to EV-A71, EV-A71 vaccination is likely to have a positive impact on the HFMD disease burden. Routine analysis of local surveillance data is crucial for describing disease occurrence and changes in etiology. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12879-018-3509-7) contains supplementary material, which is available to authorized users. BioMed Central 2018-12-05 /pmc/articles/PMC6280489/ /pubmed/30518329 http://dx.doi.org/10.1186/s12879-018-3509-7 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Xu, Lili
Shi, Yan
Rainey, Jeanette J.
Zhang, Zhijie
Zhang, Huayi
Zhao, Jinhua
Li, Yonghong
Rao, Huaxiang
Li, Yanming
Liao, Qiaohong
Ma, Yongcheng
Epidemiological features and spatial clusters of hand, foot, and mouth disease in Qinghai Province, China, 2009–2015
title Epidemiological features and spatial clusters of hand, foot, and mouth disease in Qinghai Province, China, 2009–2015
title_full Epidemiological features and spatial clusters of hand, foot, and mouth disease in Qinghai Province, China, 2009–2015
title_fullStr Epidemiological features and spatial clusters of hand, foot, and mouth disease in Qinghai Province, China, 2009–2015
title_full_unstemmed Epidemiological features and spatial clusters of hand, foot, and mouth disease in Qinghai Province, China, 2009–2015
title_short Epidemiological features and spatial clusters of hand, foot, and mouth disease in Qinghai Province, China, 2009–2015
title_sort epidemiological features and spatial clusters of hand, foot, and mouth disease in qinghai province, china, 2009–2015
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6280489/
https://www.ncbi.nlm.nih.gov/pubmed/30518329
http://dx.doi.org/10.1186/s12879-018-3509-7
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