Key result
Lack of EV-A71 vaccination was independently associated with a significantly increased risk of mortality (OR 4.98) among children with severe hand, foot, and mouth disease.
Why the study?
The study was conducted to understand the factors influencing clinical outcomes of severe hand, foot, and mouth disease and to provide scientific evidence for reducing mortality risk.
Does EV-A71 vaccination reduce mortality in children with severe hand, foot, and mouth disease?
Observational (n=1,565)
Yes
Does EV-A71 vaccination reduce mortality in children with severe hand, foot, and mouth disease?
Odds Ratio: 4.98 (95% CI 2.63–9.43)
Absolute Event Rate: 7.24% vs 2.23%
p-value: p=<0.01
EV-A71 vaccination and timely, correct diagnosis significantly reduce the mortality risk among children with severe hand, foot, and mouth disease.
Supports vaccination in severe HFMD; hypothesis-generating and requires randomized confirmation.
BACKGROUND: To understand the factors influencing clinical outcomes of severe hand, foot, and mouth diseases (HFMD), and to provide scientific evidence for reducing the mortality risk of severe HFMD. METHODS: From 2014 to 2018, children diagnosed with severe HFMD cases in Guangxi, China, were enrolled in this hospital-based study. The epidemiological data obtained through face-to-face interviews with the parents and guardians. Univariate and multivariate logistics regression models were used to analyze the factors influencing the clinical outcomes of severe HFMD. The impact of the EV-A71 vaccination on inpatient mortality was analyzed by a comparison approach. RESULTS: A total of 1565 severe HFMD cases were enrolled in this survey, including 1474 (94.19%) survival cases and 91 (5.81%) death cases. The multivariate logistic analysis demonstrated that HFMD history of playmates in the last three months, first visit to the village hospital, time from the first visit to admission less than two days, no correct diagnosis for HFMD at the first visit, and having no rash symptoms were the independent risk factors for severe HFMD cases (all p < 0.05). While EV-A71 vaccination was a protective factor (p < 0.05). The EV-A71 vaccination group versus the non-vaccination group showed 2.23% of death in the vaccination group and 7.24% of death in the non-vaccination group. The EV-A71 vaccination protected 70.80% of the death of severe HFMD cases, with an effective index of 4.79. CONCLUSIONS: The mortality risk of severe HFMD in Guangxi was related to playmates had HFMD history in last 3 months, hospital grade, EV-A71 vaccination, patients visit hospital previously, and rash symptom. EV-A71 vaccination can significantly reduce mortality among severe HFMD. The findings are of great significance for the effective prevention and control of HFMD in Guangxi, southern China.
No takes yet. Share an insight, caveat, or question.
Peng et al. (2023) conducted an observational in Severe hand, foot, and mouth disease (HFMD) (n=1,565). No EV-A71 vaccination vs. EV-A71 vaccination was evaluated on Mortality (OR 4.98, 95% CI 2.63-9.43, p=<0.01). Lack of EV-A71 vaccination was independently associated with a significantly increased risk of mortality (OR 4.98) among children with severe hand, foot, and mouth disease.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: