Journal of Jilin University Medicine Edition ›› 2015, Vol. 41 ›› Issue (05): 974-979.doi: 10.13481/j.1671-587x.20150517

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Main risk factors of severe hand-foot-mouth disease: A Meta-analysis

FENG Huifen1, ZHAO Qiumin2, DUAN Guangcai3, ZHU Guang1   

  1. 1. Department of Infectious Diseases, Fifth Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, China;
    2. Editorial Board of Journal of Zhengzhou University, Zhengzhou 450001, China;
    3. Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
  • Received:2015-02-02 Online:2015-09-28 Published:2015-09-29

Abstract:

Objective To investigate the main risk factors of severe hand-foot-mouth disease (HFMD), and to provide the evidence for the prevention and treatment of HFMD. Methods The case-control studies on the risk factors of patients with severe HFMD from 1994 to 2014 were collected.Meta-analysis was performed to analyze the data.After the heterogeneity test,the fixed and random models were used to calculate the combined odds ratio (OR) and its 95% confidence interval (95%CI),then the sensitivity analysis was performed and the publish bias was evaluated. Results A total of 19 papers involving 2 868 cases (severe HFMD patients) and 6 676 controls (mild HFMD patients) were included in the review.The heterogeneity test results about I2 was showed as follows:age ≤3 years was 70%,rural residence was 0%,duration onset to admission ≥3 d was 23%,enterovirus 71 (EV71) infection was 75%,degree of fever ≥38.5℃ was 0%,duration of fever ≥3 d was 14%,withdrawnness and lethargy was 0%, and hyperglycaemia (≥6.11 mmol·L-1) was 51%.The pooled OR and 95%CI of the risk factors of severe HFMD were 2.90(2.14-3.3.94),2.21(1.66-2.93),2.02(1.46-2.79),2.90(1.24-6.81),3.13(1.99-4.94),5.48 (3.56-8.45),4.25(2.45-7.37),and 2.87(1.49-5.52). The sensitivity analysis showed that the results calculated by the fixed and random models were consistent.The publish bias evaluating results showed that there was no obvious publish bias. Conclusion The rural younger children,diagnosis and treatment delay,EV71 infection,high fever duration,withdrawnness and lethargy,and hyperglycemia might be the risk factors of the patients with severe HFMD.

Key words: severe hand-foot-mouth disease, case-control study, Meta-analysis, risk factor

CLC Number: 

  • R512.5