Abstract:

Objective  To investigate the clustering nature of hand-foot-mouth disease(HFMD) in kindergartens for scientific evidence to prevent and control this entity. Methods Descriptive epidemiological method was applied to analyze the area, properties and faculty composition of the kindergartens as well as prevention and control measures implemented during the clustering prevalence. Results Of all HFMD incidences in kindergartens in 2014, urban area had more cases than rural areas in general, and the incidence was 56.78%, 50.40% and 32.40%, respectively, within the first, second and third zone of the administrative area. A total of 59.75% cases occurred in the urban area, and 75.13% in private kindergartens. Each outbreak affected 4.62 children on average, and lasted for a mean of 6.9 days. Poor preventive and control measures were implemented in the kindergartens located in the semi-urban areas and private institutions compared with those in the urban areas and public kindergartens. The proportion of full-time health care providers, together with their service years was correlated with effective preventive and control measures implemented, epidemic duration and the scale of disease. Lower ratio of the full-time health care providers within kindergartens had led to weak implementation of the preventive and control measures upon outbreak(r = 0.202, P< 0.01), longer the duration of disease (r = 0.08, P <0.05) and larger cumulative cases (r = 0.06, P< 0.06), and shorter service years of the providers were also associated with poorly implemented preventive and control measures(r = 0.187, P< 0.01). Conclusion The competent authorities are proposed to facilitate improvement of the   kindergartens by policy support for appropriate allocation of the health care resources and stability as well as enhance the supervision over the private kindergartens in implementation of the preventive and control measures in order to reduce the clustering incidence of HFMD.

Key words: Kindergarten, Hand-foot-mouth disease, Distribution characteristics, Chengdu City