Abstract：
Hand, foot, and mouth disease (HFMD) is a common infectious disease in children. Enterovirus A71 (EV-A71) is one of the main pathogens, and coxsackievirus A6 (CVA6) has gradually become the dominant pathogen of HFMD in recent years. This study was conducted mainly to assess the serological prevalence of EV-A71 and CVA6 antibodies in people of different ages, sexes, and regions through a systematic review and meta-analysis. A comprehensive study was performed based on the EV-A71 and CVA6 serological literature published before May 2022. Heterogeneity analysis (Cochrane\'s Q test and the I2 statistic) and random effect models were adopted. Subgroup and meta-regression analyses were used to identify potential sources of heterogeneity in the data, and all analysis was performed using STATA version 16.0. This study included 71 studies involving 55,176 people from 13 countries that met the inclusion criteria. The serological prevalence of EV-A71 antibody in different studies was 4.31-88.8%, and that of CVA6 antibody was 40.8-80.9%. Meta-analysis results showed that the serum positive rate for EV-A71 antibody was 45.9% (95% CI: 37.6-54.1%). The rate in the Chinese population was 47.8% (95% CI: 42.4-53.2%), and in the other countries, it was 38% (95% CI: 23-55%). The serum positive rate for CVA6 antibody was 58.3% (95% CI: 46.5-70.2%). The rate in the Chinese population was 49.1% (95% CI: 38.3-59.9%), and in the other countries, it was 68% (95% CI: 51-83%). Subgroup analysis was also conducted. The seroprevalence of EV-A71 and CVA6 antibodies is related to age rather than gender or region. The rates of EV-A71 and CVA6 seropositivity are considerably lower in children younger than five years of age. However, the rates gradually increase with age. The findings of this study suggest that children under five years of age may be susceptible to EV-A71 and CVA6. Thus, safety education and vaccination should be strengthened accordingly. This study provides a basis for understanding the risk factors for EV-A71 and CVA6 infection in China and for deciding how to formulate standard preventive measures to prevent the spread of the virus.
摘要：
手,脚,口蹄疫(HFMD)是儿童常见的传染病。肠道病毒A71(EV-A71)是一种主要的病原,柯萨奇病毒A6(CVA6)近年来逐渐成为手足口病的优势病原。本研究主要评估EV-A71和CVA6抗体在不同年龄人群中的血清学患病率,性别,通过系统的回顾和荟萃分析和区域。基于2022年5月之前发表的EV-A71和CVA6血清学文献进行了综合研究。采用异质性分析（Cochrane的Q检验和I2统计量）和随机效应模型。亚组和荟萃回归分析用于识别数据中异质性的潜在来源，所有分析均使用STATA16.0版进行。这项研究包括71项研究，涉及来自13个国家的55,176人，符合纳入标准。不同研究中EV-A71抗体的血清学患病率为4.31-88.8%,CVA6抗体为40.8-80.9%。Meta分析结果显示，血清EV-A71抗体阳性率为45.9%（95%CI：37.6～54.1%）。中国人口的比率为47.8％（95％CI：42.4-53.2％），在其他国家，它是38％（95％CI：23-55％）。血清CVA6抗体阳性率为58.3％（95％CI：46.5-70.2％）。中国人口的比率为49.1%(95%CI:38.3-59.9%),在其他国家，它是68％（95％CI：51-83％）。还进行了亚组分析。EV-A71和CVA6抗体的血清阳性率与年龄有关，而与性别或地区有关。5岁以下儿童的EV-A71和CVA6血清阳性率要低得多。然而,比率随着年龄的增长而逐渐增加。这项研究的结果表明，五岁以下的儿童可能容易感染EV-A71和CVA6。因此，应相应加强安全教育和疫苗接种。本研究为了解我国EV-A71和CVA6感染的危险因素以及决定如何制定标准预防措施以防止病毒传播提供了依据。
