Abstract：Objective To explore the risk factors of critical cases of Hand-foot-mouth disease (HFMD) by comparing with severe cases. Methods Thirty-eight critical HFMD cases and 75 severe cases from Shenzhen were selected from Shenzhen Children's Hospital between January and August 2012. All cases were diagnosed according "Diagnosis and Treatment Guideline on Hand-foot-mouth disease (2010)", established by Ministry of Health, the People's Republic of China. Questionnaire survey and intestinal virus nucleic acid detection were carried out. Logistic regression and Chi square test were used in data analysis. Results The results of univariate analysis showed that living in no-residence community, having no health insurance, spontaneous birth, longer duration (>2 days) between incidence and have a diagnosis of severe case, once treated in private clinics and community health center were risk factors of critical HFMD, with an OR (95 % CI) of 8.40 (2.95-23.89), 10.72 (2.40-48.00), 3.40 (1.24-9.33), 3.48 (1.47-8.27), 3.57 (1.16-10.94) and 4.50 (1.06-19.13), respectively. Based on multivariate non-conditional logistic regression analysis, risk factors associated with critical HFMD included living in no-residence community, and having no health insurance. The EV71 positive rate of critical HFMD was 87.9% (29/33), which was significantly higher than severe HFMD (33.3%, 8/24). Conclusion To reduce the incidence of critical HFMD, more attention should be paid to children of families with low social-economic status and children infected by EV71 virus.
