Abstract
Background We aimed at investigating the prevalence and associated factors of patient delay in hospital visiting and weekend effect of disease surveillance on hand-foot-and-mouth disease and epidemic parotitis/mumps. Methods Daily report data on hand-foot-and-mouth disease and epidemic parotitis cases between January 1, 2014, and December 31, 2017, in Hanzhong, Shaanxi, China, were collected. The patient delay in hospital visiting was defined by the date difference between disease onset and patient's visit to hospital. Differences of delayed durations and percentages were compared by using nonparametric or χ2 tests across gender, age, occupation, disease classification, epidemic and nonepidemic seasons, and years of disease onset. Additionally, to determine whether there existed a weekend effect of disease surveillance, the mean cases reported on weekdays and weekends were also compared. Results A total of 14,814 patients with hand-foot-and-mouth disease and 4013 with epidemic parotitis were recorded, respectively. We found that 43.1% of the hand-foot-and-mouth disease and 36.5% of the epidemic parotitis patients had delayed visiting to hospital. All patients were reported through the online surveillance system on the day of visiting hospital. The percentage of delayed visiting to hospital differed significantly by years and epidemic and nonepidemic seasons and between children in and not in childcare center (all p values <0.05). In addition, the reported numbers of both diseases fluctuated on weekdays but obviously decreased on weekends regardless of the epidemic or nonepidemic seasons. Conclusions The reported cases of HFMD and epidemic parotitis had an obvious weekend effect, with an increasing tendency of cases delaying in hospital visiting over the recent years in Hanzhong, China. Parents and caregivers rather than health systems should be primarily targeted for the prevention and control of infectious diseases and their local outbreaks such as community-based education on the second-dose vaccination of mumps and/or hand hygiene.
Highlights
We aimed at investigating the prevalence and associated factors of patient delay in hospital visiting and weekend effect of disease surveillance on hand-foot-and-mouth disease and epidemic parotitis/mumps
Durations of Delay between Disease Onset and Hospital Visiting. 43.1% of patients with hand-foot-and-mouth disease (HFMD) and 36.5% of patients with epidemic parotitis experienced delayed hospital visiting after disease onset. e percentages of durations of delay between disease onset and hospital visiting at 2-3, 4–7, and >7 days were 34.1%, 7.7%, and 1.3% for HFMD, respectively. e corresponding percentages for epidemic parotitis were 24.3%, 9.8%, and 2.3%, respectively
We found that 43.1% of patients with HFMD and 36.5% of patients with epidemic parotitis had delays in hospital visiting in nonepidemic seasons, which was slightly reduced, but similar issue still identified in epidemic seasons
Summary
We aimed at investigating the prevalence and associated factors of patient delay in hospital visiting and weekend effect of disease surveillance on hand-foot-and-mouth disease and epidemic parotitis/mumps. Patients in the early stage or recessively infected individuals are not identified resulting in a source of infection and may cause outbreaks or epidemic in collective units, such as schools and childcare centers [2]. China has included it in the disease surveillance information report management system since 2004 [3]. Key factors causing the constant epidemic include an insensitive surveillance system, improper implementation of relevant policies, and an inability to provide a timely diagnosis and reporting and effective quarantine for patients at the beginning of the disease onset [4]
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Schedule a callMore From: The Canadian journal of infectious diseases & medical microbiology = Journal canadien des maladies infectieuses et de la microbiologie medicale
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