Abstract
According to WHO estimates, varicella disease is responsible of a worldwide significant burden in terms of hospitalizations, complications, and deaths, with more than 90% of cases under 12 years old. This study aims at evaluating the clinical, epidemiological, and economic burden of varicella in Ligurian children, about comorbidities, organizational variables, and vaccination coverages from 2010 to 2017, in terms of Emergency Department accesses and hospitalizations. The overall hospitalization rate was 179.76 (per 100,000 inhab.), with a gradual but significant decline since 2015, when universal varicella vaccination was introduced in Liguria (p < 0.0001). The risk of being hospitalized for complicated varicella in subjects with at least one comorbidity was significantly higher than in subjects without comorbidities (p = 0.0016). The economic analysis showed higher costs in subjects with complicated varicella who were 0–3 years old. This age group showed higher costs also considering extra-hospital costs for both outpatient procedures and pharmaceutical costs (p < 0.0001). The results confirm the relevant burden of varicella, especially in the 0–3 age group and in children with comorbidities. Thus, vaccination with the achievement of adequate vaccination coverages is confirmed to be a necessary control strategy to reduce hospitalizations and associated complications with important economic benefits.
Highlights
The varicella-zoster virus (VZV) is a DNA virus of the herpes virus family
The highest incidence was observed in LHA2 (240.13 per 100,000 inhabitants), followed by LHA1 (206.27 per 100,000 inhabitants) considering the total events and emergency department (ED) accesses; instead for hospitalization preceded or not by ED access the highest incidence was observed in LHA3 (23.62), followed by LHA2 (17.25)
World Health Organization (WHO) advocates routine varicella immunization in countries where high vaccination coverage can be achieved [4]
Summary
The varicella-zoster virus (VZV) is a DNA virus of the herpes virus family. The primary infection leads to varicella disease; viral reactivation can cause herpes zoster [1,2,3].Nowadays, varicella is a vaccine-preventable infectious disease. The varicella-zoster virus (VZV) is a DNA virus of the herpes virus family. The primary infection leads to varicella disease; viral reactivation can cause herpes zoster [1,2,3]. According to the World Health Organization (WHO), the annual worldwide burden of varicella is estimated to be approximately 140 million cases with 4,200,000 severe complications that require hospitalization, and 4200 deaths [4]. The available epidemiological data report that 52–78% of the cases occur in children aged six years or under, and 89–95.9% of the cases occur before adolescence (i.e., under 12 years of age) [5,6]. It is known that 2–6% of varicella cases attending a pediatrician/medical practitioner develop complications
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