Prevalence, implementation of preventive measures, and associated risk factors of hand, foot and mouth disease in early childhood development centers in Ban Du Subdistrict, Mueang District, Chiang Rai Province

Abstract

The incidence of hand, foot, and mouth disease (HFMD) in Thailand, particularly Chiang Rai province, is on an upward trend and the HFMD outbreaks mostly occur in early childhood development centers, most notably among children aged under 5 years, the most susceptible group. Factors contributing to the outbreaks of HFMD include personal hygiene of children, parents, and child caregivers in the centers, as well as hygiene practices and environmental management in early childhood development centers, which generally are required to follow the quality standards of the Department of Disease Control, Thailand Ministry of Public Health. This study aimed to determine the prevalence and identify factors associated with HFMD in Ban Du Subdistrict, Mueang District, Chiang Rai Province. A cross-sectional analytical study was conducted to collect the data using questionaries, environmental investigation was performed using the environmental checklists. A total of 389 parents, 49 child caregivers, and 11 early childhood development centers were included into the study. Descriptive statistics, which included number, percentage, and mean and standard deviation, and the following inferential statistics: chi-square tests and multiple binary logistic regression were applied to identify association between variables. The prevalence of HFMD was 26.7%. Factors associated with the transmission of HFMD were household incomes, primary caregivers, number of children in the household, level of parental knowledge and preventive behaviors on HFMD. Having two or more children in the household had 1.85 (95% CI=1.07-3.21) times greater odds of getting HFMD than those individuals who have one child. Environmental assessments of the 11 early childhood development centers revealed that 63.6% met the required standards. In the meantime, those non-compliant centers still continuously report HFMD cases every year. The prevalence of HFMD in early childhood development centers of Ban Du Municipality is high. Children whose families had higher incomes and grandparents served as primary caregivers were more likely to HFMD infection. Early childhood development centers should be continuously evaluated to prevent the outbreak of HFMD.