Disease burden in patients with severe hand, foot, and mouth disease in Jiangsu Province: a cross-sectional study

Ying Han; Hong Ji; Wenqi Shen; Chunxiao Duan; Tingting Cui; Liling Chen; Hui Hang; Zhong Zhang; Hongmin Sun; Xuefeng Zhang; Hui Jin

doi:10.1080/21645515.2022.2049168

Disease burden in patients with severe hand, foot, and mouth disease in Jiangsu Province: a cross-sectional study

Hum Vaccin Immunother. 2022 Nov 30;18(5):2049168. doi: 10.1080/21645515.2022.2049168. Epub 2022 Apr 27.

Authors

Ying Han^{1

2}, Hong Ji³, Wenqi Shen³, Chunxiao Duan³, Tingting Cui^{1

2}, Liling Chen⁴, Hui Hang⁴, Zhong Zhang⁵, Hongmin Sun⁵, Xuefeng Zhang³, Hui Jin^{1

2}

Affiliations

¹ Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China.
² Key Laboratory of Environmental Medicine Engineering, School of Public Health, Southeast University, Ministry of Education, Nanjing, China.
³ Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China.
⁴ Suzhou Center for Disease Control and Prevention, Suzhou, China.
⁵ Nanjing Center for Disease Control and Prevention, Nanjing, China.

Abstract

This study aimed to estimate the disease burden and health-related quality of life (HRQOL) among patients with severe hand, foot, and mouth disease (HFMD) in Jiangsu Province, China. We analyzed the surveillance data of HFMD cases in Jiangsu Province from 2009 to 2020. Moreover, a cross-sectional study was conducted in Nanjing and Suzhou, China, between January 2017 and May 2018. Patients with severe HFMD and their parents were recruited from selected hospitals. Questionnaires and hospital management systems were used to collect data on direct economic burden. The HRQOL of children was assessed using the TNO-AZL Preschool Quality of Life (TAPQOL) scale. A total of 1,348,737 confirmed cases of HFMD were reported to the NNDRS in Jiangsu province during 2009-2020. Of these, 9,622 were severe cases, with 62 (.64%) of these being fatal. From January 2017 to May 2018, data was collected from 362 severe HFMD cases using a structured questionnaire. The median per capita direct economic burden was RMB 16142.88, and was associated with the region and length of hospital stay (P < .05). The direct economic burden for all cases of severe HFMD in Jiangsu province between 2017 and 2018 was approximately RMB 16.64 million. Finally, the median (IQR) of the TAPQOL scale for children with severe HFMD was 69.23 (56.20, 82.27). Severe HFMD infection is a relatively large burden for individuals, and the burden of EV-A71 infection was seen to be even greater for the population. Prevention of severe HFMD should strengthen hygiene habits and targeted measures for EV-A71 vaccination.

Keywords: Severe hand, foot, and mouth disease; disease burden; economic burden; health-related quality of life.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Child
Child, Preschool
China / epidemiology
Cost of Illness
Cross-Sectional Studies
Enterovirus A, Human*
Enterovirus*
Hand, Foot and Mouth Disease* / epidemiology
Humans
Infant
Quality of Life

Grants and funding

This study was supported by Chinese National Natural Fund [81573258], Science Technology Demonstration Project for Emerging Infectious Diseases Control and Prevention [BE2017749], Jiangsu Provincial Six Talent Peak [WSN-002], and Jiangsu Provincial Key Medical Discipline [ZDXKA2016008].