SynthesisThe Pediatric infectious disease journal2016
The Epidemiology of Hand, Foot and Mouth Disease in Asia: A Systematic Review and Analysis.
Synthesis in The Pediatric infectious disease journal, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 130 papers, 4 of them syntheses that pooled 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.
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.
Who cites it
130 citing papers in PubMed, 4 syntheses or guidelines pooled it, 245 citations in OpenAlex.
- A Meta-Analysis of Influencing Factors for Reinfection of Hand, Foot and Mouth Disease in China, Based on Adjusted Effect Estimates.Pathogens (Basel, Switzerland) · 2026Pooled it
- Historical evolution, research hotspots and emerging trends of pediatric hand, foot, and mouth disease: a bibliometric worldview since the 21st century.Frontiers in medicine · 2025Pooled it
- Pooled it
- Temporal relationships between climate variables and hand-foot-mouth disease: a multi-province study in the Mekong Delta Region, Vietnam.International journal of biometeorology · 2020Pooled it
- Immunogenicity and safety of an inactivated enterovirus 71 vaccine co-administered with measles-mumps-rubella vaccine and live-attenuated Japanese encephalitis vaccine: a phase 4, single-center, randomized controlled trial.Human vaccines & immunotherapeutics · 2021Trial
- RNF31 restricts EV-A71 replication through innate immune activation and VP4 degradation, and is antagonized by viral 3C proteases.PLoS pathogens · 2026Article
- Epidemiological characteristics and spatiotemporal analysis of hand-foot-mouth disease in Shandong Province, China.International health · 2026Article
- Enterovirus A71 3AB protein facilitates immune evasion by blocking cGAS recognition of mtDNA.EMBO reports · 2026Article
- Seasonal Trends of Major Respiratory, Gastrointestinal, and Other Viral Infections in Korea: An Analysis Before, During, and After the Coronavirus Disease 2019 Pandemic.Annals of laboratory medicine · 2026Review
- Regional and facility-type variations in infectious diseases in childcare and early childhood education facilities in Japan during the COVID-19 pandemic: A nationwide cross-sectional questionnaire survey.Global health & medicine · 2026Article
- Interactive and joint effects of multiple meteorological and air pollution exposures on hand, foot and mouth disease risk in western China: a time-series analysis.BMJ public health · 2026Article
- Hand, foot and mouth disease incidence in mainland China: temporal trends and projections to 2030.BMC public health · 2025Article
- Transmission components of hand, foot, and mouth disease in Guangdong Province and their association with meteorological factors: a modelling study.BMC infectious diseases · 2025Article
- Ambient Temperature Increases the Hand, Foot, and Mouth Disease Incidence: A Time Series Analysis in Tokyo, Japan, 2000-2019.Iranian journal of public health · 2025Article
- Risk Factors for Hand, Foot and Mouth Disease Reinfection in Qingdao, China, from 2014 to 2022.Iranian journal of public health · 2025Article
- Epidemiology of hand, foot, and mouth disease outbreaks before and during availability of EV-A71 vaccine in China's mainland: analysis of outbreak surveillance data from 2011 to 2023.The Lancet regional health. Western Pacific · 2025Article
- Spatio-temporal dynamics of hand, foot and mouth disease in Malaysia, 2009-2019.PLoS neglected tropical diseases · 2025Article
- Parents' divorce and early child development: a population-based study in China.BMJ paediatrics open · 2025Article
- Effects of temperature and environmental covariates on the dynamic transmission of hand, foot, and mouth disease in Zhejiang, China.PLoS neglected tropical diseases · 2025Article
- Seasonal and Meteorological Drivers of Hand, Foot, and Mouth Disease Outbreaks Using Data-Driven Machine Learning Models.Tropical medicine and infectious disease · 2025Article
70 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 5 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
contextHand, foot and mouth disease (HFMD) is a widespread pediatric disease caused primarily by human enterovirus 71 (EV-A71) and Coxsackievirus A16 (CV-A16).
objectiveThis study reports a systematic review of the epidemiology of HFMD in Asia. DATA SOURCES: PubMed, Web of Science and Google Scholar were searched up to December 2014. STUDY SELECTION: Two reviewers independently assessed studies for epidemiologic and serologic information about prevalence and incidence of HFMD against predetermined inclusion/exclusion criteria. DATA EXTRACTION: Two reviewers extracted answers for 8 specific research questions on HFMD epidemiology. The results are checked by 3 others.
resultsHFMD is found to be seasonal in temperate Asia with a summer peak and in subtropical Asia with spring and fall peaks, but not in tropical Asia; evidence of a climatic role was identified for temperate Japan. Risk factors for HFMD include hygiene, age, gender and social contacts, but most studies were underpowered to adjust rigorously for confounding variables. Both community-level and school-level transmission have been implicated, but their relative importance for HFMD is inconclusive. Epidemiologic indices are poorly understood: No supporting quantitative evidence was found for the incubation period of EV-A71; the symptomatic rate of EV-A71/Coxsackievirus A16 infection was from 10% to 71% in 4 studies; while the basic reproduction number was between 1.1 and 5.5 in 3 studies. The uncertainty in these estimates inhibits their use for further analysis. LIMITATIONS: Diversity of study designs complicates attempts to identify features of HFMD epidemiology.
conclusionsKnowledge on HFMD remains insufficient to guide interventions such as the incorporation of an EV-A71 vaccine in pediatric vaccination schedules. Research is urgently needed to fill these gaps.
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Registered trials
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.