The epidemiology and economic impact of varicella-related hospitalizations in Turkey from 2008 to 2010: a nationwide survey during the pre-vaccine era (VARICOMP study)

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• 作者：Ener Cagri Dinleyici (1) (29)
  Zafer Kurugol (2)
  Ozden Turel (3)
  Nevin Hatipoglu (3)
  Ilker Devrim (4)
  Hasan Agin (4)
  Ilker Gunay (4)
  Olcay Yasa (5)
  Muferet Erguven (5)
  Nuri Bayram (6)
  Ali Kizildemir (6)
  Emre Alhan (7)
  Emine Kocabas (7)
  Hasan Tezer (8)
  H. Hakan Aykan (8)
  Nazan Dalgic (9)
  Betul Kilic (9)
  Gulnar Sensoy (10)
  Nursen Belet (10)
  Nihan Uygur Kulcu (11)
  Aysu Say (11)
  Mehmet Ali Tas (12)
  Ergin Ciftci (13)
  Erdal Ince (13)
  Halil Ozdemir (13)
  Melike Emiroglu (14)
  Dursun Odabas (14)
  Zeynel Abidin Yargic (1)
  Cagatay Nuhoglu (15)
  Kursat Bora Carman (16)
  Solmaz Celebi (17)
  Mustafa Hacimustafaoglu (17)
  Murat Elevli (18)
  Zahide Ekici (18)
  Umit Celik (19)
  Meda Kondolot (20)
  Mustafa Ozturk (20)
  Anil Tapisiz (21)
  Metehan Ozen (22)
  Harun Tepeli (22)
  Aslinur Parlakay (23)
  Ates Kara (23)
  Ayper Somer (24)
  Bahar Caliskan (24)
  Sevtap Velipasalioglu (25)
  Selim Oncel (26)
  Emin Sami Arisoy (26)
  Ekrem Guler (27)
  Tahir Dalkiran (27)
  Denizmen Aygun (28)
  Saadet Akarsu (28)
  
• 关键词：Varicella ; Turkey ; Varicella ; related hospitalization ; Varicella vaccine
• 刊名：European Journal of Pediatrics
• 出版年：2012
• 出版时间：May 2012
• 年：2012
• 卷：171
• 期：5
• 页码：817-825
• 全文大小：409KB
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• 作者单位：Ener Cagri Dinleyici (1) (29)
  Zafer Kurugol (2)
  Ozden Turel (3)
  Nevin Hatipoglu (3)
  Ilker Devrim (4)
  Hasan Agin (4)
  Ilker Gunay (4)
  Olcay Yasa (5)
  Muferet Erguven (5)
  Nuri Bayram (6)
  Ali Kizildemir (6)
  Emre Alhan (7)
  Emine Kocabas (7)
  Hasan Tezer (8)
  H. Hakan Aykan (8)
  Nazan Dalgic (9)
  Betul Kilic (9)
  Gulnar Sensoy (10)
  Nursen Belet (10)
  Nihan Uygur Kulcu (11)
  Aysu Say (11)
  Mehmet Ali Tas (12)
  Ergin Ciftci (13)
  Erdal Ince (13)
  Halil Ozdemir (13)
  Melike Emiroglu (14)
  Dursun Odabas (14)
  Zeynel Abidin Yargic (1)
  Cagatay Nuhoglu (15)
  Kursat Bora Carman (16)
  Solmaz Celebi (17)
  Mustafa Hacimustafaoglu (17)
  Murat Elevli (18)
  Zahide Ekici (18)
  Umit Celik (19)
  Meda Kondolot (20)
  Mustafa Ozturk (20)
  Anil Tapisiz (21)
  Metehan Ozen (22)
  Harun Tepeli (22)
  Aslinur Parlakay (23)
  Ates Kara (23)
  Ayper Somer (24)
  Bahar Caliskan (24)
  Sevtap Velipasalioglu (25)
  Selim Oncel (26)
  Emin Sami Arisoy (26)
  Ekrem Guler (27)
  Tahir Dalkiran (27)
  Denizmen Aygun (28)
  Saadet Akarsu (28)
  
  1. Eskisehir Osmangazi University Faculty of Medicine, Eskisehir, Turkey
  29. Department of Pediatrics, Eskisehir Osmangazi University Faculty of Medicine, Eskisehir, TR-26480, Turkey
  2. Ege University Faculty of Medicine, Izmir, Turkey
  3. Bakirkoy Maternity and Children’s Research Hospital, Istanbul, Turkey
  4. Dr Behcet Uz Children’s Training and Research Hospital, Izmir, Turkey
  5. Goztepe Training and Research Hospital, Istanbul, Turkey
  6. Izmir Tepecik Training and Research Hospital, Izmir, Turkey
  7. Cukurova University Faculty of Medicine, Adana, Turkey
  8. Ankara Diskapi Children’s Training and Research Hospital, Ankara, Turkey
  9. Sisli Etfal Training and Research Hospital, Istanbul, Turkey
  10. Ondokuz May?s University Hospital, Samsun, Turkey
  11. Zeynep Kamil Maternity and Childrens-Diseases Training and Research Hospital, Istanbul, Turkey
  12. Dicle University Faculty of Medicine, Diyarbakir, Turkey
  13. Ankara University Faculty of Medicine, Ankara, Turkey
  14. Konya Training and Research Hospital, Konya, Turkey
  15. Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
  16. Gaziantep Children’s Hospital, Gaziantep, Turkey
  17. Uludag University Faculty of Medicine, Bursa, Turkey
  18. Haseki Educational and Research Hospital, Istanbul, Turkey
  19. Adana Numune Education and Research Hospital, Adana, Turkey
  20. Erciyes University Faculty of Medicine, Kayseri, Turkey
  21. Gazi University Faculty of Medicine, Ankara, Turkey
  22. Suleyman Demirel University Faculty of Medicine, Isparta, Turkey
  23. Hacettepe University Faculty of Medicine, Ankara, Turkey
  24. Istanbul University Istanbul Medical Faculty, Istanbul, Turkey
  25. Akdeniz University Faculty of Medicine, Antalya, Turkey
  26. Kocaeli University Faculty of Medicine, Kocaeli, Turkey
  27. Sutcu Imam University Faculty of Medicine, Kahramanmaras, Turkey
  28. Firat University School of Medicine, Elazig, Turkey
  

文摘

Varicella can cause complications that are potentially serious and require hospitalization. Our current understanding of the causes and incidence of varicella-related hospitalization in Turkey is limited and sufficiently accurate epidemiological and economical information is lacking. The aim of this study was to estimate the annual incidence of varicella-related hospitalizations, describe the complications, and estimate the annual mortality and cost of varicella in children. VARICOMP is a multi-center study that was performed to provide epidemiological and economic data on hospitalization for varicella in children between 0 and 15?years of age from October 2008 to September 2010 in Turkey. According to medical records from 27 health care centers in 14 cities (representing 49.3% of the childhood population in Turkey), 824 children (73% previously healthy) were hospitalized for varicella over the 2-year period. Most cases occurred in the spring and early summer months. Most cases were in children under 5?years of age, and 29.5% were in children under 1?year of age. The estimated incidence of varicella-related hospitalization was 5.29-.89 per 100,000 in all children between 0-5?years of age in Turkey, 21.7 to 28 per 100,000 children under 1?year of age, 9.8-3.8 per 100,000 children under 5?years of age, 3.96-.52 per 100,000 children between 5 and 10?years of age and 0.42 to 0.71 per 100,000 children between 10 and 15?years of age. Among the 824 children, 212 (25.7%) were hospitalized because of primary varicella infection. The most common complications in children were secondary bacterial infection (23%), neurological (19.1%), and respiratory (17.5%) complications. Secondary bacterial infections (p-lt;-.001) and neurological complications (p-lt;-.001) were significantly more common in previously healthy children, whereas hematological complications (p-lt;-.001) were more commonly observed in children with underlying conditions. The median length of the hospital stay was 6?days, and it was longer in children with underlying conditions (<0.001). The median cost of hospitalization per patient was $338 and was significantly higher in children with underlying conditions (p-lt;-.001). The estimated direct annual cost (not including the loss of parental work time and school absence) of varicella-related hospitalization in children under the age of 15?years in Turkey was $856,190 to $1,407,006. According to our estimates, 882 to 1,450 children are hospitalized for varicella each year, reflecting a population-wide occurrence of 466-68 varicella cases per 100,000 children. In conclusion, this study confirms that varicella-related hospitalizations are not uncommon in children, and two thirds of these children are otherwise healthy. The annual cost of hospitalization for varicella reflects only a small part of the overall cost of this disease, as only a very few cases require hospital admission. The incidence of this disease was higher in children <1?year of age, and there are no prevention strategies for these children other than population-wide vaccination. Universal vaccination is therefore the only realistic option for the prevention of severe complications and deaths. The surveillance of varicella-associated complications is essential for monitoring of the impact of varicella immunization.