Analysis of Risk Factors of Second Time Infection of Hand-Foot-and-Mouth Disease in China

Background Hand Foot Mouth Disease (HFMD) is one of the communicable diseases with high incidence in preschool aged children (kindergarten and scattered children) in China. HFMD can repeatedly infect children, but risk factors of repeated infection have not been reported by researchers.

Objective To explore the risk factors of second time infection of HFMD among preschool and scattered children in Jiang Tai County, Chaoyang district, Beijing, China     

Resource The surveillance data of HFMD was obtained through China National Diseases Reporting Information System and the social and behavioral information was provided by local health service center. There were 694 cases in total from 2008 to 2013.

Statistical Methods Bivariate analysis was conducted between whether had second time infection and potential risk factors of HFMD. The multivariable analysis was conducted using Logistic regression. Backward elimination method was used to select variables.

Results For the binary analysis, whether washing hand after outdoor activity every time was significantly associated with second time infection. For the multivariable analysis, three variables were stayed in the model, which were whether washing hand after outdoor activity every time, whether washing hand after stooling and before eating and the style of children (school, kindergarten or scattered). However, only the first variable was significant at 5% level, which means that children who did not wash hand after outdoor activity every time were 7.6 (95%CI: 1.28—45.44, p=0.026) times more likely to get HFMD again than children who did, controlling for the other two variables.

Conclusion The frequency and habit of washing hand (washing hand after outdoor activity every time) should be paid attention to prevent repeated infected with HFMD in children.