{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T12:36:05Z","timestamp":1767357365173,"version":"3.48.0"},"reference-count":39,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T00:00:00Z","timestamp":1767312000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82073618"],"award-info":[{"award-number":["82073618"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100017700","name":"Henan Province Science and Technology Research Project","doi-asserted-by":"publisher","award":["242102311147"],"award-info":[{"award-number":["242102311147"]}],"id":[{"id":"10.13039\/501100017700","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>Background: Numerous studies have reported on the epidemiology of hand, foot and mouth disease (HFMD) reinfection and its potential influencing factors; however, findings regarding reinfection rates as well as determinants such as gender, age, residence, and pathogens remain inconsistent. Due to this heterogeneity in reported outcomes, a comprehensive systematic review and meta-analysis are warranted to consolidate existing evidence. Methods: Effect estimates were expressed as reinfection rates, odds ratio (OR)\/hazard ratio (HR) and 95% confidence intervals (CI). When necessary, data were converted to ensure consistency across comparison groups. Results: A thorough search was carried out using the predetermined literature retrieval approach across the PubMed, Web of Science, and Embase databases. Finally, 9 articles met the inclusion criteria and were included in this study. The results indicated that the overall reinfection rate for HFMD was 4.1% (95% CI: 2.0\u20136.2%). Males compared to females (overall effect = 1.256, 95% CI: 1.176\u20131.341), younger compared to older children (overall effect = 2.972, 95% CI: 1.512\u20135.843), scattered children compared to students (overall effect: 4.017, 95% CI: 1.560\u201310.344), and enterovirus 71 (EV71) compared to non-EV71 enteroviruses (overall effect = 0.71, 95% CI: 0.59\u20130.86) were associated with the HFMD reinfection. Conclusions: The overall HFMD reinfection rate was 4.1% (95% CI: 2.0\u20136.2%). Male, younger age, kindergarten children, and infection with non-EV71 enteroviruses (compared to EV71), were identified as significant risk factors for recurrent HFMD. Targeted intervention strategies should be developed for these high-risk populations to effectively reduce the incidence of reinfection.<\/jats:p>","DOI":"10.3390\/pathogens15010050","type":"journal-article","created":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T12:23:44Z","timestamp":1767356624000},"page":"50","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Meta-Analysis of Influencing Factors for Reinfection of Hand, Foot and Mouth Disease in China, Based on Adjusted Effect Estimates"],"prefix":"10.3390","volume":"15","author":[{"given":"Anmin","family":"Ge","sequence":"first","affiliation":[{"name":"College of Public Health, Zhengzhou University, Zhengzhou 450001, China"},{"name":"Penglai Center for Disease Control and Prevention, Yantai 265600, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Weihong","family":"Cui","sequence":"additional","affiliation":[{"name":"Department of Medicine, Shandong College of Traditional Chinese Medicine, Yantai 264199, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Siyu","family":"Qu","sequence":"additional","affiliation":[{"name":"Penglai Center for Disease Control and Prevention, Yantai 265600, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ning","family":"Wang","sequence":"additional","affiliation":[{"name":"Penglai Center for Disease Control and Prevention, Yantai 265600, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wenhua","family":"Zhang","sequence":"additional","affiliation":[{"name":"Penglai Center for Disease Control and Prevention, Yantai 265600, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lili","family":"Wei","sequence":"additional","affiliation":[{"name":"Penglai Center for Disease Control and Prevention, Yantai 265600, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuqin","family":"Zhou","sequence":"additional","affiliation":[{"name":"Penglai Center for Disease Control and Prevention, Yantai 265600, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4250-9713","authenticated-orcid":false,"given":"Quanman","family":"Hu","sequence":"additional","affiliation":[{"name":"College of Public Health, Zhengzhou University, Zhengzhou 450001, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liquan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Penglai Center for Disease Control and Prevention, Yantai 265600, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6129-0310","authenticated-orcid":false,"given":"Shuaiyin","family":"Chen","sequence":"additional","affiliation":[{"name":"College of Public Health, Zhengzhou University, Zhengzhou 450001, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1041","DOI":"10.1016\/S1473-3099(14)70973-9","article-title":"Hand, foot, and mouth disease in mainland China","volume":"14","author":"Lu","year":"2014","journal-title":"Lancet Infect. 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