Evidence map›Paper›PMID 27010319›Full record

ArticlePLoS neglected tropical diseases2016

Cyclical Patterns of Hand, Foot and Mouth Disease Caused by Enterovirus A71 in Malaysia.

Nmn NikNadia, I-Ching Sam, Sanjay Rampal, Wmz WanNorAmalina, Ghazali NurAtifah, Khebir Verasahib, Chia Ching Ong, MohdAidinniza MohdAdib, Yoke Fun Chan

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Article in PLoS neglected tropical diseases, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
44citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

44 citing papers in PubMed, 1 synthesis or guideline pooled it.

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  18. Analysis of the Complete Genomes of Enterovirus 71 Subtypes in China.The Canadian journal of infectious diseases & medical microbiology = Journal canadien des maladies infectieuses et de la microbiologie medicale · 2021
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Nmn NikNadiaDepartment of Medical Microbiology, Faculty of Medicine, University of Malaya, Malaysia.
I-Ching SamDepartment of Medical Microbiology, Faculty of Medicine, University of Malaya, Malaysia.
Sanjay RampalDepartment of Social and Preventive Medicine, Julius Centre University of Malaya, Faculty of Medicine, University of Malaya, Malaysia.
Wmz WanNorAmalinaDepartment of Medical Microbiology, Faculty of Medicine, University of Malaya, Malaysia.
Ghazali NurAtifahDepartment of Medical Microbiology, Faculty of Medicine, University of Malaya, Malaysia.
Khebir VerasahibNational Public Health Laboratory, Ministry of Health, Selangor, Malaysia.
Chia Ching OngKepong Health Office, Ministry of Health, Kuala Lumpur, Malaysia.
MohdAidinniza MohdAdibZoonosis Sector, Disease Control Division, Ministry of Health, Malaysia.
Yoke Fun ChanDepartment of Medical Microbiology, Faculty of Medicine, University of Malaya, Malaysia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Enterovirus A71 (EV-A71) is an important emerging pathogen causing large epidemics of hand, foot and mouth disease (HFMD) in children. In Malaysia, since the first EV-A71 epidemic in 1997, recurrent cyclical epidemics have occurred every 2-3 years for reasons that remain unclear. We hypothesize that this cyclical pattern is due to changes in population immunity in children (measured as seroprevalence). Neutralizing antibody titers against EV-A71 were measured in 2,141 residual serum samples collected from children ≤12 years old between 1995 and 2012 to determine the seroprevalence of EV-A71. Reported national HFMD incidence was highest in children <2 years, and decreased with age; in support of this, EV-A71 seroprevalence was significantly associated with age, indicating greater susceptibility in younger children. EV-A71 epidemics are also characterized by peaks of increased genetic diversity, often with genotype changes. Cross-sectional time series analysis was used to model the association between EV-A71 epidemic periods and EV-A71 seroprevalence adjusting for age and climatic variables (temperature, rainfall, rain days and ultraviolet radiance). A 10% increase in absolute monthly EV-A71 seroprevalence was associated with a 45% higher odds of an epidemic (adjusted odds ratio, aOR1.45; 95% CI 1.24-1.69; P<0.001). Every 10% decrease in seroprevalence between preceding and current months was associated with a 16% higher odds of an epidemic (aOR = 1.16; CI 1.01-1.34 P<0.034). In summary, the 2-3 year cyclical pattern of EV-A71 epidemics in Malaysia is mainly due to the fall of population immunity accompanying the accumulation of susceptible children between epidemics. This study will impact the future planning, timing and target populations for vaccine programs.

Indexed as

Enterovirus A, HumanChildChild, PreschoolCommunicable Diseases, EmergingHand, Foot and Mouth DiseaseHumansInfantMalaysiaTime Factors

Identifiers

PMID27010319
PMCPMC4806993

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.