Knowledge, attitudes, and practices status among caregivers of infants and toddlers towards hand, foot and mouth disease: a cross-sectional study

BACKGROUND: Hand, foot and mouth disease (HFMD) is a common infectious disease in children, and caregivers' awareness of the disease is key to reducing its incidence. This study aims to investigate the Knowledge, Attitude, and Practice (KAP) levels of caregivers in Guangzhou regarding HFMD and to analyze the association of their demographic characteristics and family situations. METHODS: This cross-sectional study used face-to-face interviews with caregivers of infants and toddlers to assess their KAP status regarding HFMD through a structured questionnaire. The dependent variables were the scores for KAP, while independent variables included caregivers' demographic characteristics, household size, etc. Univariate analysis was performed initially to identify potential predictors, and variables with a P-value ≤ 0.10 were included in the multivariate logistic regression model. Adjusted odds ratios and 95% confidence intervals were calculated to determine the strength of associations, with statistical significance set at P ≤ 0.05. RESULTS: A total of 1,094 survey responses were included. Among the primary caregivers, 655 (59.87%) were mothers, 411 (37.57%) had a college degree or higher, and 298 (27.24%) were homemakers or unemployed. The scores for knowledge, attitude, and behavior were 5.6 ± 1.5 (range 0-8), 18.88 ± 3.44 (range 6-30), and 31.91 ± 4.14 (range 8-40). Caregivers show a relatively low level of concern regarding isolation measures and the risk of recurrent infections. The caregivers identity, age, education level, household size, number of children in childcare, place of residence, and history of illness were significantly associated with KAP levels. CONCLUSION: The primary caregivers generally exhibit good levels of knowledge and practices regarding HFMD, but the level of attitude is relatively low. Health promotion activities should be strengthened for caregivers who are elderly or have lower education levels, as well as for families with fewer permanent residents or those living in sub-central urban areas.