[Summary of research in economic burden of hand, foot, and mouth disease in China]

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

BACKGROUND

Hand, foot, and mouth disease (HFMD) is an infectious disease with high morbidity and mortality rates among children under 5 years old. This study aimed to explore the health-related quality of life (HRQOL), economic burden, and related influencing factors among Chinese HFMD patients.

METHODS

From January to October 2019, a longitudinal cohort study of 296 hospitalized patients (≤ 5 years old) with HFMD and their guardians was conducted using the proxy version of the 5-level EQ-5D-Y (EQ-5D-Y-5L, Y-5L) in face-to-face interviews in Shanghai, Zhengzhou, and Kunming, representing three regions with different economic development levels. Multiple linear regression was used to explore the factors associated with HRQOL and costs.

RESULTS

The mean Y-5L health utility score (HUS) (standard deviation, SD), and visual analogue scale (VAS) score (SD) were 0.730 (0.140) and 60.33 (16.52) at admission and increased to 0.920 (0.120) and 89.95 (11.88) at discharge, respectively. The children from Shanghai had the lowest HUSs at admission and had the best health improvement. The mean hospitalization cost and total cost were 4037 CNY and 5157 CNY, respectively. The children from Shanghai had the highest hospitalization cost (4559 CNY) and total cost (5491 CNY). Multiple regression analysis suggested that medical insurance status, type of employment, residence type, and religious status were significantly associated with the baseline HUS and improvement in the HUS after treatment. Region, loss of work time, and length of stay had a significant impact on the hospitalization cost and total cost.

CONCLUSION

Our findings demonstrate that HFMD could lead to poor HRQOL and the economic burden varies in different regions in China. Many pediatric patients still have physical or mental health problems shortly after treatment.

Research on hand, foot and mouth disease incidence forecasting using hybrid model in mainland China

BACKGROUND

This study aimed to construct a more accurate model to forecast the incidence of hand, foot, and mouth disease (HFMD) in mainland China from January 2008 to December 2019 and to provide a reference for the surveillance and early warning of HFMD.

METHODS

We collected data on the incidence of HFMD in mainland China between January 2008 and December 2019. The SARIMA, SARIMA-BPNN, and SARIMA-PSO-BPNN hybrid models were used to predict the incidence of HFMD. The prediction performance was compared using the mean absolute error(MAE), mean squared error(MSE), root mean square error (RMSE), mean absolute percentage error (MAPE), and correlation analysis.

RESULTS

The incidence of HFMD in mainland China from January 2008 to December 2019 showed fluctuating downward trends with clear seasonality and periodicity. The optimal SARIMA model was SARIMA(1,0,1)(2,1,2)_[12], with Akaike information criterion (AIC) and Bayesian Schwarz information criterion (BIC) values of this model were 638.72, 661.02, respectively. The optimal SARIMA-BPNN hybrid model was a 3-layer BPNN neural network with nodes of 1, 10, and 1 in the input, hidden, and output layers, and the R-squared, MAE, and RMSE values were 0.78, 3.30, and 4.15, respectively. For the optimal SARIMA-PSO-BPNN hybrid model, the number of particles is 10, the acceleration coefficients c1 and c2 are both 1, the inertia weight is 1, the probability of change is 0.95, and the values of R-squared, MAE, and RMSE are 0.86, 2.89, and 3.57, respectively.

CONCLUSIONS

Compared with the SARIMA and SARIMA-BPNN hybrid models, the SARIMA-PSO-BPNN model can effectively forecast the change in observed HFMD incidence, which can serve as a reference for the prevention and control of HFMD.

Control measures during the COVID-19 outbreak reduced the transmission of hand, foot, and mouth disease

Control measures during the coronavirus disease 2019 (COVID-19) outbreak may have limited the spread of infectious diseases. This study aimed to analyze the impact of COVID-19 on the spread of hand, foot, and mouth disease (HFMD) in China. A mathematical model was established to fit the reported data of HFMD in six selected cities in mainland China from 2015 to 2020. The absolute difference (AD) and relative difference (RD) between the reported incidence in 2020, and simulated maximum, minimum, or median incidence of HFMD in 2015–2019 were calculated. The incidence and R_eff of HFMD have decreased in six selected cities since the outbreak of COVID-19, and in the second half of 2020, the incidence and R_eff of HFMD have rebounded. The results show that the total attack rate (TAR) in 2020 was lower than the maximum, minimum, and median TAR fitted in previous years in six selected cities (except Changsha City). For the maximum, median, minimum fitted TAR, the range of RD (%) is 42·20–99·20%, 36·35–98·41% 48·35–96·23% (except Changsha City) respectively. The preventive and control measures of COVID-19 have significantly contributed to the containment of HFMD transmission.