Risk Factors for Severe Hand-Foot-Mouth Disease in China: A Systematic Review and Meta-Analysis

Background: This study aimed to identify potential risk factors for severe hand-foot-mouth disease (HFMD).Methods: The PubMed, Embase, the Cochrane Library, Sinomed, WanFang, CNKI, and VIP databases were searched (up to August 2021).Results: Twenty-nine studies (9,241 and 927,355 patients with sever...

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Autores principales:	Peiqing Li, Yuge Huang, Danping Zhu, Sida Yang, Dandan Hu
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	hand-foot-mouth disease infection meta-analysis risk factors disease severity Pediatrics RJ1-570
Acceso en línea:	https://doaj.org/article/7568a0ddd54b4bb1bd203af80aa501c0
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spelling	oai:doaj.org-article:7568a0ddd54b4bb1bd203af80aa501c02021-11-10T07:36:14ZRisk Factors for Severe Hand-Foot-Mouth Disease in China: A Systematic Review and Meta-Analysis2296-236010.3389/fped.2021.716039https://doaj.org/article/7568a0ddd54b4bb1bd203af80aa501c02021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fped.2021.716039/fullhttps://doaj.org/toc/2296-2360Background: This study aimed to identify potential risk factors for severe hand-foot-mouth disease (HFMD).Methods: The PubMed, Embase, the Cochrane Library, Sinomed, WanFang, CNKI, and VIP databases were searched (up to August 2021).Results: Twenty-nine studies (9,241 and 927,355 patients with severe HFMD and controls, respectively; all from China) were included. EV71 was associated with higher odds of severe HFMD compared with other agents (OR = 4.44, 95%CI: 3.12–6.33, p < 0.001). Being home-raised (OR = 1.99, 95%CI: 1.59–2.50, p < 0.001), higher number of children in the family (OR = 2.09, 95%CI: 1.93–2.27, p < 0.001), poor hand hygiene (OR = 2.74, 95%CI: 1.78–4.23, p < 0.001), and no breastfeeding (OR = 2.01, 95%CI: 1.45–2.79, p < 0.001) were risk factors for severe HFMD. First consulting to a district-level or above hospital (OR = 0.34, 95%CI: 0.25–0.45, p < 0.001) and diagnosis of HFMD at baseline (OR = 0.17, 95%CI: 0.13–0.24, p < 0.001) were protective factors against severe HFMD. Fever, long fever duration, vomiting, lethargy, leukocytosis, tic, and convulsions were each associated with severe HFMD (all p < 0.05), while rash was not.Conclusions: EV71, lifestyle habits, frequent hospital visits, and symptoms are risk factors for severe HFMD in children in China, while early diagnosis and admission to higher-level hospitals are protective factors.Peiqing LiYuge HuangDanping ZhuSida YangDandan HuFrontiers Media S.A.articlehand-foot-mouth diseaseinfectionmeta-analysisrisk factorsdisease severityPediatricsRJ1-570ENFrontiers in Pediatrics, Vol 9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	hand-foot-mouth disease infection meta-analysis risk factors disease severity Pediatrics RJ1-570
spellingShingle	hand-foot-mouth disease infection meta-analysis risk factors disease severity Pediatrics RJ1-570 Peiqing Li Yuge Huang Danping Zhu Sida Yang Dandan Hu Risk Factors for Severe Hand-Foot-Mouth Disease in China: A Systematic Review and Meta-Analysis
description	Background: This study aimed to identify potential risk factors for severe hand-foot-mouth disease (HFMD).Methods: The PubMed, Embase, the Cochrane Library, Sinomed, WanFang, CNKI, and VIP databases were searched (up to August 2021).Results: Twenty-nine studies (9,241 and 927,355 patients with severe HFMD and controls, respectively; all from China) were included. EV71 was associated with higher odds of severe HFMD compared with other agents (OR = 4.44, 95%CI: 3.12–6.33, p < 0.001). Being home-raised (OR = 1.99, 95%CI: 1.59–2.50, p < 0.001), higher number of children in the family (OR = 2.09, 95%CI: 1.93–2.27, p < 0.001), poor hand hygiene (OR = 2.74, 95%CI: 1.78–4.23, p < 0.001), and no breastfeeding (OR = 2.01, 95%CI: 1.45–2.79, p < 0.001) were risk factors for severe HFMD. First consulting to a district-level or above hospital (OR = 0.34, 95%CI: 0.25–0.45, p < 0.001) and diagnosis of HFMD at baseline (OR = 0.17, 95%CI: 0.13–0.24, p < 0.001) were protective factors against severe HFMD. Fever, long fever duration, vomiting, lethargy, leukocytosis, tic, and convulsions were each associated with severe HFMD (all p < 0.05), while rash was not.Conclusions: EV71, lifestyle habits, frequent hospital visits, and symptoms are risk factors for severe HFMD in children in China, while early diagnosis and admission to higher-level hospitals are protective factors.
format	article
author	Peiqing Li Yuge Huang Danping Zhu Sida Yang Dandan Hu
author_facet	Peiqing Li Yuge Huang Danping Zhu Sida Yang Dandan Hu
author_sort	Peiqing Li
title	Risk Factors for Severe Hand-Foot-Mouth Disease in China: A Systematic Review and Meta-Analysis
title_short	Risk Factors for Severe Hand-Foot-Mouth Disease in China: A Systematic Review and Meta-Analysis
title_full	Risk Factors for Severe Hand-Foot-Mouth Disease in China: A Systematic Review and Meta-Analysis
title_fullStr	Risk Factors for Severe Hand-Foot-Mouth Disease in China: A Systematic Review and Meta-Analysis
title_full_unstemmed	Risk Factors for Severe Hand-Foot-Mouth Disease in China: A Systematic Review and Meta-Analysis
title_sort	risk factors for severe hand-foot-mouth disease in china: a systematic review and meta-analysis
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/7568a0ddd54b4bb1bd203af80aa501c0
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Risk Factors for Severe Hand-Foot-Mouth Disease in China: A Systematic Review and Meta-Analysis

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