Outcomes following severe hand foot and mouth disease: A systematic review and meta-analysis
<h4>Background</h4> <p>Hand, foot and mouth disease (HFMD) caused by enterovirus A71 (EV-A71) is associated with acute neurological disease in children.</p> <p>This study aimed to estimate the burden of long-term sequelae and death following severe HFMD.</p> <...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Journal article |
| Language: | English |
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Elsevier
2018
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| _version_ | 1797051108579868672 |
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| author | Jones, E Pillay, T Liu, F Luo, L Bazo-Alvarez, J Yuan, C Zhao, S Chen, Q Li, Y Liao, Q Yu, H Van Doorn, H Sabanathan, S |
| author_facet | Jones, E Pillay, T Liu, F Luo, L Bazo-Alvarez, J Yuan, C Zhao, S Chen, Q Li, Y Liao, Q Yu, H Van Doorn, H Sabanathan, S |
| author_sort | Jones, E |
| collection | OXFORD |
| description | <h4>Background</h4> <p>Hand, foot and mouth disease (HFMD) caused by enterovirus A71 (EV-A71) is associated with acute neurological disease in children.</p> <p>This study aimed to estimate the burden of long-term sequelae and death following severe HFMD.</p> <h4>Methods</h4> <p>This systematic review and meta-analysis pooled all reports from English and Chinese databases including MEDLINE and Wangfang on outbreaks of clinically diagnosed HFMD and/or laboratory-confirmed EV-A71 with at least 7 days' follow-up published between 1st January 1966 and 19th October 2015.</p> <p>Two independent reviewers assessed the literature.</p> <p>We used a random effects meta-analysis to estimate cumulative incidence of neurological sequelae or death.</p> <p>Studies were assessed for methodological and reporting quality.</p> <p>PROSPERO registration number: 10.15124/CRD42015021981.</p> <h4>Findings</h4> <p>43 studies were included in the review, and 599 children from 9 studies were included in the primary analysis.</p> <p>Estimated cumulative incidence of death or neurological sequelae at maximum follow up was 19.8% (95% CI:10.2%, 31.3%).</p> <p>Heterogeneity (I^2) was 88.57%, partly accounted for by year of data collection and reporting quality of studies.</p> <p>Incidence by acute disease severity was 0.00% (0.00, 0.00) for grade IIa; 17.0% (7.9, 28.2) for grade IIb/III; 81.6% (65.1, 94.5) for grade IV (p ¼ 0.00) disease.</p> <h4>Conclusions</h4> <p>HFMD with neurological involvement is associated with a substantial burden of long-term neurological sequelae. Grade of acute disease severity was a strong predictor of outcome.</p> <p>Strengths of this study include its bilingual approach and clinical applicability.</p> <p>Future prospective and interventional studies must use rigorous methodology to assess long-term outcomes in survivors.</p> |
| first_indexed | 2024-03-06T18:15:11Z |
| format | Journal article |
| id | oxford-uuid:045e353a-802b-4c8f-b8c0-49d4fd058984 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T18:15:11Z |
| publishDate | 2018 |
| publisher | Elsevier |
| record_format | dspace |
| spelling | oxford-uuid:045e353a-802b-4c8f-b8c0-49d4fd0589842022-03-26T08:51:25ZOutcomes following severe hand foot and mouth disease: A systematic review and meta-analysisJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:045e353a-802b-4c8f-b8c0-49d4fd058984EnglishSymplectic Elements at OxfordElsevier2018Jones, EPillay, TLiu, FLuo, LBazo-Alvarez, JYuan, CZhao, SChen, QLi, YLiao, QYu, HVan Doorn, HSabanathan, S <h4>Background</h4> <p>Hand, foot and mouth disease (HFMD) caused by enterovirus A71 (EV-A71) is associated with acute neurological disease in children.</p> <p>This study aimed to estimate the burden of long-term sequelae and death following severe HFMD.</p> <h4>Methods</h4> <p>This systematic review and meta-analysis pooled all reports from English and Chinese databases including MEDLINE and Wangfang on outbreaks of clinically diagnosed HFMD and/or laboratory-confirmed EV-A71 with at least 7 days' follow-up published between 1st January 1966 and 19th October 2015.</p> <p>Two independent reviewers assessed the literature.</p> <p>We used a random effects meta-analysis to estimate cumulative incidence of neurological sequelae or death.</p> <p>Studies were assessed for methodological and reporting quality.</p> <p>PROSPERO registration number: 10.15124/CRD42015021981.</p> <h4>Findings</h4> <p>43 studies were included in the review, and 599 children from 9 studies were included in the primary analysis.</p> <p>Estimated cumulative incidence of death or neurological sequelae at maximum follow up was 19.8% (95% CI:10.2%, 31.3%).</p> <p>Heterogeneity (I^2) was 88.57%, partly accounted for by year of data collection and reporting quality of studies.</p> <p>Incidence by acute disease severity was 0.00% (0.00, 0.00) for grade IIa; 17.0% (7.9, 28.2) for grade IIb/III; 81.6% (65.1, 94.5) for grade IV (p ¼ 0.00) disease.</p> <h4>Conclusions</h4> <p>HFMD with neurological involvement is associated with a substantial burden of long-term neurological sequelae. Grade of acute disease severity was a strong predictor of outcome.</p> <p>Strengths of this study include its bilingual approach and clinical applicability.</p> <p>Future prospective and interventional studies must use rigorous methodology to assess long-term outcomes in survivors.</p> |
| spellingShingle | Jones, E Pillay, T Liu, F Luo, L Bazo-Alvarez, J Yuan, C Zhao, S Chen, Q Li, Y Liao, Q Yu, H Van Doorn, H Sabanathan, S Outcomes following severe hand foot and mouth disease: A systematic review and meta-analysis |
| title | Outcomes following severe hand foot and mouth disease: A systematic review and meta-analysis |
| title_full | Outcomes following severe hand foot and mouth disease: A systematic review and meta-analysis |
| title_fullStr | Outcomes following severe hand foot and mouth disease: A systematic review and meta-analysis |
| title_full_unstemmed | Outcomes following severe hand foot and mouth disease: A systematic review and meta-analysis |
| title_short | Outcomes following severe hand foot and mouth disease: A systematic review and meta-analysis |
| title_sort | outcomes following severe hand foot and mouth disease a systematic review and meta analysis |
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