Abstract

This study aimed to analyze cases of complicated varicella and the impact of varicella vaccination in Minas Gerais, Brazil. This was a time series study of a territorial basis using data on varicella cases from 2010 to 2016, which was provided by the State Health Department of Minas Gerais on . Descriptive statistics were used for the analysis, and the generalized linear regression model proposed by Prais-Winsten was used for the time tendency, adopting a significance level of 5% and the integrated autoregressive modeling of moving averages. There were 1,635 cases of varicella; out of which cellulitis (44%) was the predominant complication. The home-acquired cases were 38.9% and 464 cases (40.6%) were not previously vaccinated. There was a significant decrease in the incidence coefficient when comparing the pre- and post- immunization periods, from 1.95 cases/100,000 inhabitants in 2010 to 0.24 cases/100.000 inhabitants in 2016 (p<0.05). There was a higher incidence of cases recorded among males, with higher prevalence in the age group of 1-4 years (54.7%). Lethality was higher between 5-9 years of age (44%). Mortality was higher in the age group of 0-4 years and among females (2.58/100,000 inhabitants/year). The overall trend of the incidence coefficient was a decreasing one, with an annual percentage variation. The number of complicated varicella cases notified decreased, coincidentally, in the post-immunization period. However, the immunization coverage period was restricted for the assessment of the correlation between immunization coverage and incidence.

Highlights

  • This study aimed to analyze cases of complicated varicella and the impact of varicella vaccination in Minas Gerais, Brazil

  • Between 2010 and 2016, 1,635 cases of complicated varicella were recorded in the state of Minas Gerais

  • A higher risk was observed for males to have complicated varicella than for females, and the gender ratio for incidence was 1.2

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Summary

Introduction

This study aimed to analyze cases of complicated varicella and the impact of varicella vaccination in Minas Gerais, Brazil. According to Bastos et al, the distribution of the disease caused by the varicella zoster virus in South America has been the least investigated among all the populated continents. They mentioned that studies carried out in South America could add valuable information on transmission patterns and global trends for this common viral situation[2]. In relation to South American countries, Uruguay adopted the vaccine against varicella in its immunization calendar in 1999, with a single dose schedule at 12 months of age, and with an immunization coverage of 88-96%. Thereby, the country reduced the rate of hospitalization due to the disease in the population in general by 81% and the number of hospitalizations due to varicella in kids between 1-4 years of age by 94%, from 1999 to 20055

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