Key result
The pooled case-fatality rate of hand, foot and mouth disease associated with enterovirus 71 was 1.7%, with the highest rate of 1.8% observed in mainland China.
Why the study?
What is the case-fatality rate of hand, foot and mouth disease associated with EV71?
Meta-Analysis (n=112,546)
What is the case-fatality rate of hand, foot and mouth disease associated with EV71?
The pooled case-fatality rate for EV71-associated HFMD is 1.7%, with rates appearing to increase over time, highlighting the need for effective control measures.
Pooled EV71-HFMD case-fatality informs outbreak response and vaccination priorities; extends prior reports via global synthesis.
Hand, foot and mouth disease (HFMD) associated with enterovirus 71 (EV71) is a growing public health concern. This study aimed to estimate the case-fatality of HFMD associated with EV71 on the basis of a meta-analysis. We searched PubMed, Cochrane, Web of Science, Elsevier, CNKI, Wanfang, and VIP databases. Two authors independently selected relevant studies. The pooled estimate of case-fatality was calculated using a random-effects model. Potential sources of heterogeneity were explored using subgroup analysis, sensitivity analysis and meta-regression. We identified 14 eligible studies with a total population of 112 546. The random-effects pooled case-fatality was 1·7% (95% confidence interval 1·2-2·4). The funnel plot was asymmetrical. The estimate of case-fatality was highest in mainland China (1·8%). Removal of eight local Chinese studies decreased the original estimate. The pooled case-fatality in the period of 1998-2007 (1·5%) was lower than that in the period 2008-2012 (1·8%). Control measures for HFMD associated with EV71 are essential because of the increased case-fatality over time, especially in East Asia.
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Zhao et al. (2015) conducted a meta-analysis in Hand, foot and mouth disease (HFMD) associated with enterovirus 71 (EV71) (n=112,546). Enterovirus 71 (EV71) infection was evaluated on Pooled case-fatality rate (95% CI 1.2-2.4). The pooled case-fatality rate of hand, foot and mouth disease associated with enterovirus 71 was 1.7%, with the highest rate of 1.8% observed in mainland China.
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