Factors related to severe hand, foot, and mouth disease among Vietnamese children patients

Abstract

Tram Van Ta, Thanh Quang Do, Nam Thanh Nguyen

Background: Hand, foot, and mouth disease (HFMD) is mostly benign, with patients recovering within a week. However, if the disease is caused by enterovirus A71 (EV-A71), it can cause major epidemics or outbreaks and can cause rapid death in children, and especially in young children. The aim of this study was to determine the association of clinical, laboratory characteristics, and viral infections with severe HFMD in children. Materials and methods: This case-control study was conducted on 280 pediatric patients diagnosed with HFMD admitted to The Children Hospital 1 and Tien Giang General Central Hospital. The study used a convenience method. Results: Clinical symptoms associated with severe HFMD included vomiting, high fever >39oC, rapid breathing, convulsions, rapid pulse >130 beats per minute, flounder, lethargy, drowsiness/coma, myoclonus/stumbling, apnea, and hiccup breathing. Laboratory features associated with severe HFMD included platelet count >400,000 cells/mm3 and blood glucose >180 mg/dL. The EV-A71 strain was associated with severe cases. The independent factors associated with severe HFMD were identified through the multivariate logistic regression model and including the carrier’s gender, high fever >39oC, rapid pulse >130 beats/minute, platelet count >400,000/mm3 , blood glucose >180 mg/dL, and EV-A71 infection. Conclusion: Implications are indicated for clinical and laboratory characteristics and viral types with severe hand, foot, and mouth disease in children.