Risk factors of severe hand, foot and mouth disease in Shantou, China: a case-control study

INTRODUCTION: In clinical perspectives, how to distinguish a small proportion of children at risk of developing neurological complications from a large number of children with mild symptoms still remains a challenge for primary care doctors. METHODOLOGY: From January 2012 to December 2015, 225 cases with severe hand, foot and mouth disease (HFMD) matched with 492 controls were enrolled in the age-matched, case-control study. Continuous variables were examined by univariate analysis using a chi-squared or Fisher's exact test, and categorical variables were reported by relative risks (odd's ratio). Multivariate logistic regression was used to analyze the independent risk factors for severe HFMD. RESULTS: Peak body temperature over 37.5℃，total duration of fever over 3 days, lethargy, enterovirus 71 (EV71) infection were independent risk factors for severe HFMD. CONCLUSIONS: Peak body temperature over 37.5℃，total duration of fever over 3 days, lethargy, EV71 infection were independent risk factors for severe HFMD.