Epidemiology of hand, foot, and mouth disease in Southern Vietnam in 2012-2022

다국어 초록 (Multilingual Abstract)

Background: With a 50-year history, Hand, foot, and mouth disease (HFMD) remains a significant public health issue in the Western Pacific, ranking in Vietnam's top 5 communicable diseases. This study analyzes surveillance data in southern Vietnam, the country's highest HFMD burden region.
Methods: An ecological study examined HFMD epidemiological characteristics and factors contributing to severe cases across all 20 provinces in southern Vietnam from 2012 to 2022, using national notifiable diseases surveillance system data.
Results: Southern Vietnam reported 686,358 HFMD cases, including 104 fatalities, with an incidence rate of 175 cases per 100,000 population. Cases peaked in April during the COVID-19 pandemic. Over 90% occurred in children under three, with males comprising 59%. The Mekong River Delta showed higher severity and mortality risks (OR 2.64, 95% CI: 2.44-2.86 and OR 2.48, 95% CI: 1.10-5.95). Individual factors associated with a higher incidence of severe cases included younger age, male gender, and ethnic minority status. At the provincial level, lower proportions of the population using clean water, and lower numbers of hospital beds per 10,000 population were associated with a higher incidence of severe cases (OR 0.98, 95% CI: 0.97-0.99; and OR 0.99, 95% CI: 0.98-0.99, respectively).
Conclusion: HFMD's epidemiology in southern Vietnam aligns with the Western Pacific. Post-COVID-19, adaptive surveillance is vital, and addressing severe cases requires multifaceted interventions, emphasizing healthcare infrastructure, and improved water hygiene.

목차 (Table of Contents)

• LIST OF TABLES iv
• LIST OF FIGURES v
• ABBREVIATION vi
• ABSTRACT vii
• I. INTRODUCTION 1
• 1.1. Background 1
• 1.2. Statement of the problem 2
• 1.3. Significance of the study 2
• 1.4. Research questions 2
• 1.5. Purposes 3
• 1.5.1. General objectives 3
• 1.5.2. Specific objectives 3
• 1.6. Operational definition: HFMD case definition 3
• II. LITERATURE REVIEW 4
• 2.1. Overview of hand, foot, and mouth disease 4
• 2.2. Epidemiology of hand, foot, and mouth disease in the world 5
• 2.3. Hand, foot, and mouth disease in Vietnam 7
• 2.3.1. History and legal frameworks 7
• 2.3.2. Epidemiology of hand, foot, and mouth disease in Vietnam 8
• 2.4. Conceptual framework 12
• III. METHODS 13
• 3.1. Study design 13
• 3.2. Population and setting 13
• 3.3. Sampling and sample size 13
• 3.4. Variables 13
• 3.5. Measurement tool 17
• 3.5.1. Case definition 17
• 3.5.2. Clinical grading 17
• 3.6. Data collection 18
• 3.7. Data analysis 19
• 3.8. Ethical statement 19
• IV. RESULTS 21
• 4.1. Incidence of hand, foot, and mouth disease in Southern Vietnam in 2012-2022 21
• 4.2. Epidemiological characteristics of hand, foot, and mouth disease in southern Vietnam in 2012-2022 23
• 4.2.1. Distribution by time 23
• 4.2.2. Distribution by place 26
• 4.2.3. Distribution by patient characteristics 31
• 4.3. Factors relating to severe HFMD cases 37
• 4.4. HFMD-related deaths 43
• V. DISCUSSION 46
• VI. CONCLUSION 52
• REFERENCES 53
• APPENDIX 1. ETHICAL APPROVAL 59
• APPENDIX 2. ABSTRACT IN KOREAN 62