Biological and ecological determinants of Hand Foot and Mouth Disease (HFMD) in Coastal District of Northeastern Peninsular Malaysia: A 5-Year retrospective study 10.55131/jphd/2024/220321
Main Article Content
Abstract
Hand, foot, and mouth disease (HFMD) is a common viral communicable disease in Malaysia, characterized by its self-limiting nature, yet it leads to numerous outbreaks and fatalities, particularly among young children. The current study aimed to determine the prevalence, geographic distribution, temporal patterns, and associated factors of HFMD cases within the Bachok District of Kelantan, spanning the years 2018 to 2022. A retrospective cohort study analysed extract data on independent factors and notification status from the Communicable Disease Control Information System (CDCIS). Simple and multiple logistic regression analyses were employed on a cohort of 1351 HFMD’s notifications. The retrospective analysis reveals a predominant HFMD’s notification were males (56.7%). Outpatient care was common (98.4%), with primary health care being the main choice. Logistic regression indicates higher odds for HFMD in those attending primary health care or private practitioners, daycare attendees, during the Southwest Monsoon season, and before the Movement Control Order (MCO) implementation, emphasizing key risk factors for HFMD. This study’s integrative approach recognizes that health and disease are often influenced by a combination of factors spanning the ecological, biological, and clinical domains. Thus, emphasizing the need for a comprehensive understanding when formulating public health strategies particularly in primary healthcare settings and daycare facilities during the Southwest Monsoon season.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
References
Yu L, He J, Wang L, Yi H. Incidence, aetiology, and serotype spectrum analysis of adult hand, foot, and mouth disease patients: A retrospective observational cohort study in northern Zhejiang, China. Int J Infect Dis. 2019;85:28–36. doi: 10.1016/j.ijid.2019.05.016
Lailatannur L. Hand, Foot and Mouth Disease: A Review. Jurnal Kedokteran Diponegoro (Diponegoro Medical Journal). 2023;12(1):6–9. doi: 10.14710/dmj.v12i1.36775
Chen Y, Badaruddin H, Lee VJ, Cutter J, Cook AR. The Effect of School Closure on Hand, Foot, and Mouth Disease Transmission in Singapore: A Modeling Approach. Am J Trop Med Hyg. 2018;99(6): 1625-1632. doi: 10.4269/ajtmh.18-0099
Fong SY, Mori D, Rundi C, Yap JF, Jikal M, Latip ALLBA, et al. A five-year retrospective study on the epidemiology of hand, foot and mouth disease in Sabah, Malaysia. Sci Rep. 2021;11(1):17814. doi: 10.1038/s41598-021-96083-3
Esposito S, Principi N. Hand, foot and mouth disease: current knowledge on clinical manifestations, epidemiology, aetiology and prevention. Eur J Clin Microbiol Infect Dis. 2018;37(3): 391–398. doi: 10.1007/s10096-018-3206-x
NikNadia NMN, Sam IC, Rampal S, WanNorAmalina WMZ, NurAtifah G, Verasahib K, et al. Cyclical Patterns of Hand, Foot and Mouth Disease Caused by Enterovirus A71 in Malaysia. PLoS Negl Trop Dis. 2016;10(3):e0004562. doi: 10.1371/ journal.pntd.0004562
Song C, He Y, Bo Y, Wang J, Ren Z, Yang H. Risk Assessment and Mapping of Hand, Foot, and Mouth Disease at the County Level in Mainland China Using Spatiotemporal Zero-Inflated Bayesian Hierarchical Models. Int J Environ Res Public Health. 2018; 15:(7):1476. doi: 10.3390/ijerph 15071476
Pham H Van, Phan UTN, Pham ANQ. Meteorological factors associated with hand, foot and mouth disease in a Central Highlands province in Viet Nam: an ecological study. Western Pac Surveill Response J. 2019;10(4):18-23. doi: 10.5365/wpsar.2017.8.1.003
Gay L, Melenotte C, Lakbar I, Mezouar S, Devaux C, Raoult D, et al. Sexual Dimorphism and Gender in Infectious Diseases. Front Immunol. 2021;12:698121. doi: 10.3389/ fimmu.2021.698121
Li AM. Ecological determinants of health: food and environment on human health. Environ Sci Pollut Res Int. 2017;24(10):9002-9015. doi: 10.1007/s11356-015-5707-9
Ebi KL, Boyer C, Bowen KJ, Frumkin H, Hess J. Monitoring and Evaluation Indicators for Climate Change-Related Health Impacts, Risks, Adaptation, and Resilience. Int J Environ Res Public Health. 2018;15(9):1943. doi: 10.3390/ ijerph1509194
Duan C, Zhang X, Jin H, Cheng X, Wang D, Bao C, et al. Meteorological factors and its association with hand, foot and mouth disease in Southeast and East Asia areas: a meta-analysis. Epidemiol Infect. 2019;147. doi: 10.1017/S0950268818003035.
Mao Q, Wang Y, Bian L, Xu M, Liang Z. EV71 vaccine, a new tool to control outbreaks of hand, foot and mouth disease (HFMD). Expert Rev Vaccines. 2016;15(5):599–606. doi: 10.1586/14760584.2016.1138862
Pejabat Tanah dan Jajahan Bachok. Profail Jajahan [Internet]. [Cited 2023 December 29]. Available from: https://ptjb.kelantan.gov.my/index.php/ms/profail/infojajahan/profail-jajahan.
Ministry of Health Malaysia. Case definitions for infectious diseases in Malaysia 3rd. Ministry of Health Malaysia. 2017.
Arifin WN. Sample size calculator (web) [Internet]. [Cited 2023 December 1]. Available from: https://wnarifin.github.io/ssc/ss1prop.html.
Arifin WN. Introduction to sample size calculation. Educ Med J. 2013;5(2):e89-e96. doi: 10.5959/ eimj.v5i2.130
Chew SP, Chong SL, Barbier S, Matthew A, Lee JH, Chan YH. Risk factors for severe hand foot mouth disease in Singapore: A case control study. BMC Infect Dis. 2015;15:486. doi: 10.1186/s12879-015-1195-2.
Malaysian Meteorological Department. METMalaysia - Weather Phenomena [Internet]. [Cited 2023 December 25]. Available from: https://www.met.gov.my/en/ pendidikan/fenomena-cuaca/.
Aziz NA, Othman J, Lugova H, Suleiman A. Malaysia’s approach in handling COVID-19 onslaught: Report on the Movement Control Order (MCO) and targeted screening to reduce community infection rate and impact on public health and economy. J Infect Public Health. 2020;13(12):1823-1829. doi: 10.1016/j.jiph.2020.08.007
R Core Team. R: A Language and Environment for Statistical Computing. R Foundation for Statistical Computing, Vienna. 2023.
QGIS Development Team. QGIS Geographic Information System. 2023.
Wang J, Ding S, Xie W, Wang T, Qin Y, Zheng J, et al. Epidemiological and etiological characteristics of mild hand, foot and mouth disease in children under 7 years old, Nanjing, China, 2010–2019. Arch Public Health. 2022;80(1):220. doi: 10.1186/s13690-022-00974-4
Wu Y, Wang T, Zhao M, Dong S, Wang S, Shi J. Spatiotemporal cluster patterns of hand, foot, and mouth disease at the province level in mainland China, 2011–2018. PLoS One. 2022;17(8):e0270061. doi: 10.1371/journal.pone.0270061
Said ZM, Chen XW, Aziz WAAA, Wahab A, Musa KI. Hand, Foot and Mouth Disease (HFMD): Prevalence and its Spatial Relationship with Vaccine Refusal Cases in Terengganu, Malaysia. IJG. 2021; 17(5):11–20. doi: 10.52939/ijg. v17i5.2001
Ong SM, Lim MT, Tong SF, Kamaliah MN, Groenewegen P, Sivasampu S. Comparative performance of public and private primary care service delivery in Malaysia: An analysis of findings from QUALICOPC. PLoS One. 2022;17(10):e0276480. doi: 10.1371/ journal.pone.0276480
Sangrador CO, Sánchez MVB, Martín BM. Relationship between child day-care attendance and acute infectious disease. A systematic review. Rev Esp Salud Publica. 2007;81(2):113-129. Spanish. doi: 10.1590/s1135-57272007000200003
Laor P, Apidechkul T, Khunthason S, Keawdounglek V, Sudsandee S, Fakkaew K, et al. Association of environmental factors and high HFMD occurrence in northern Thailand. BMC Public Health. 2020; 20(1):1829. doi: 10.1186/s12889-020-09905-w
Koh WM, Bogich T, Siegel K, Jin J, Chong EY, Tan CY, et al. The Epidemiology of Hand, Foot and Mouth Disease in Asia. Pediatr Infect Dis J. 2016;35(10):e285-300. doi: 10.1097/INF.0000000000001242
Wahid NAA, Suhaila J, Rahman HA, Sulekan A. Effect of climate factors on Hand-Foot-Mouth Disease: A generalized additive model approach. J Phys: Conf Ser. 2021;1988:012102. doi: 10.1088/1742-6596/1988/1/ 012102
Salo RJ, Cliver DO. Effect of acid pH, salts, and temperature on the infectivity and physical integrity of enteroviruses. Arch Virol. 1976; 52(4):269–282. doi: 10.1007/ BF01315616
Zhao J, Hu X. The complex transmission seasonality of hand, foot, and mouth disease and its driving factors. BMC Infect Dis. 2019 Jun 13;19(1):521. doi: 10.1186/s12879-019-4153-6