Disease burden in patients with severe hand, foot, and mouth disease in Jiangsu Province: a cross-sectional study

Abstract

This study aimed to estimate the disease burden and health-related quality of life (HRQOL) among patients with severe hand, foot, and mouth disease (HFMD) in Jiangsu Province, China. We analyzed the surveillance data of HFMD cases in Jiangsu Province from 2009 to 2020. Moreover, a cross-sectional study was conducted in Nanjing and Suzhou, China, between January 2017 and May 2018. Patients with severe HFMD and their parents were recruited from selected hospitals. Questionnaires and hospital management systems were used to collect data on direct economic burden. The HRQOL of children was assessed using the TNO-AZL Preschool Quality of Life (TAPQOL) scale. A total of 1,348,737 confirmed cases of HFMD were reported to the NNDRS in Jiangsu province during 2009–2020. Of these, 9,622 were severe cases, with 62 (.64%) of these being fatal. From January 2017 to May 2018, data was collected from 362 severe HFMD cases using a structured questionnaire. The median per capita direct economic burden was RMB 16142.88, and was associated with the region and length of hospital stay ( P < .05). The direct economic burden for all cases of severe HFMD in Jiangsu province between 2017 and 2018 was approximately RMB 16.64 million. Finally, the median (IQR) of the TAPQOL scale for children with severe HFMD was 69.23 (56.20, 82.27). Severe HFMD infection is a relatively large burden for individuals, and the burden of EV-A71 infection was seen to be even greater for the population. Prevention of severe HFMD should strengthen hygiene habits and targeted measures for EV-A71 vaccination.

Health-Related Quality of Life and Economic Burden Among Hospitalized Children with Hand, Foot, and Mouth Disease: A Multiregional Study in China

“…Several studies have explored the economic burden of HFMD patients in China [ 4 , 10 – 12 , 20 ]. Compared with the studies that included inpatients with worse conditions [ 4 , 10 , 20 ], in our study, lower average hospitalization and total costs were reported.…”

“…The three-level EuroQol-five dimensions (EQ-5D-3L) proxy 2 questionnaire [ 9 ] and TNO-AZL Preschool Quality of Life (TAPQOL) scale [ 10 ] were used to assess the health-related quality of life (HRQOL) of pediatric patients with HFMD. The results suggested that HFMD impaired the patients’ health in terms of both psychological and physical aspects [ 9 , 10 ], and thus reduced their HRQOL. However, few studies have used child-specific HRQOL instruments and compared health status changes before and after treatment.…”

Age-specific transmission for different virus serotypes of hand, foot and mouth disease and the impact of interventions in East China, 2009–2015

“…However, the current rate of EV-A71 vaccination still needed to be promoted, and Han et al. revealed that the overall vaccination rate for children in the birth cohort reached 19.63–28.63% from 2016 to 2019 in Jiangsu Province [ 36 ]. Although there is currently no licensed CV-A16 vaccine for use in humans, Sun et al.…”

Quality of life in children with diseases causing central airway obstruction: Reliability and validity of the TAPQOL questionnaire

“…12,17 and has been used to measure HRQoL in different pathologies, on occasions not specifying the psychometric properties of those populations. 10,13,[21][22][23][24][25][26][27] Given that the reliability and validity are not intrinsic properties of questionnaires, but depend on the target population of the measure, the purpose of this study was the psychometric assessment of the TAPQOL questionnaire in patients with CAO that guarantees the results when applied to this population. The statistics used, Cronbach's α for the reliability analysis, and principal component analysis for the validity are endorsed by the bibliography.…”