Patient Delay in Hospital Visiting and the Weekend Effect of Surveillance Report on Hand-Foot-and-Mouth Disease and Epidemic Parotitis in Hanzhong City, China.

backgroundWe 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.

methodsDaily 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

resultsA 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

conclusionsThe 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.