Saw Swee Hock School of Public Health, National University of Singapore, Tahir Foundation Building, 12 Science Drive 2, Singapore, 117549, Singapore.
Saw Swee Hock School of Public Health, National University Health System, Tahir Foundation Building, 12 Science Drive 2, Singapore, 117549, Singapore.
J Public Health Policy. 2017 May;38(2):271-287. doi: 10.1057/s41271-017-0066-z.
Hand foot and mouth disease (HFMD) is a widespread pediatric disease in Asia. Most cases are relatively mild and caused by Coxsackie viruses, but in epidemics caused by Enterovirus 71, severe complications can occur. In response to the deaths of dozens of children in a 1997 outbreak (Podin in BMC Public Health 6:180,1 Abubakar in Virus Res 61(1):1-9,2 WHO in3), Singapore practices childcare centre surveillance, case-isolation, and short-term closure of centres. We conducted 44 in-depth interviews with teachers, principals, and parents at four childcare centres in Singapore to better understand experiences with current control policies. We used applied thematic analysis to identify recurrent and unique themes. Participants were conflicted by perceiving HFMD as a severe illness and reported a sense of helplessness when hygiene and social-isolation efforts failed. They perceived that severity of HFMD influenced Singapore's choice of existing policies despite a lack of evidence of their effectiveness. Documenting stakeholders' perspectives clarifies the impact of control measures and how to communicate policy changes.
手足口病（HFMD）是亚洲广泛流行的儿科疾病。大多数病例相对较轻，由柯萨奇病毒引起，但在由肠道病毒 71 引起的流行中，可能会出现严重并发症。为应对 1997 年爆发的数十名儿童死亡事件（Podin 在 BMC 公共卫生 6:180，1 Abubakar 在病毒研究 61(1):1-9，2 WHO 在 3），新加坡实施了托儿所监测、病例隔离和短期关闭中心的措施。我们在新加坡的四个托儿所对教师、校长和家长进行了 44 次深入访谈，以更好地了解当前控制政策的经验。我们使用应用主题分析来识别反复出现和独特的主题。参与者对手足口病视为严重疾病感到矛盾，并在卫生和社会隔离措施失败时感到无助。他们认为，尽管缺乏有效性证据，但手足口病的严重程度影响了新加坡对现有政策的选择。记录利益相关者的观点可以明确控制措施的影响以及如何传达政策变化。
