Pattern Classification of Enterovirus 71-Associated Hand, Foot, and Mouth Disease in Chinese Medicin

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Objective:To determine whether patterns of enterovirus 71 (EV71)-associated hand,foot,and mouth disease (HFMD) were classified based on symptoms and signs,and explore whether individual characteristics were correlated with membership in particular pattern.Methods:Symptom-based latent class analysis (LCA) was used to determine whether pattems of EV71-HFMD existed in a sample of 433 cases from a clinical data warehouse system.Logistic regression was then performed to explore whether demographic,and laboratory data were associated with pattem membership.Results:LCA demonstrated a two-subgroup solution with an optimal fit,deduced according to the Bayesian Information Criterion minima.Hot pattem (59.1% of all patients) was characterized by a very high fever and high endorsement rates for classical HFMD symptoms (i.e.,rash on the extremities,blisters,and oral mucosa lesions).Non-hot pattem (40.9% of all patients) was characterized by classical HFMD symptoms.The multiple logistic regression results suggest that whiteblood cell counts and aspartate transaminase were positively correlated with the hot pattem (adjust odds ratio=1.07,95% confidence interval:1.006-1.115;adjust odds ratio=1.051,95% confidence interval:1.019-1.084;respectively).Condusions:LCA on reported symptoms and signs in a retrospective study allowed different subgroups with meaningful clinical correlates to be defined.These findings provide evidence for targeted prevention and treatment interventions.
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