Abstract
BackgroundThe adult population in Sri Lanka is having high level of susceptibility for Varicella Zoster Virus (VZV) infection. Among medical undergraduates, 47% are VZV seronegative. The purpose of the present study was to determine the incidence of VZV infection in medical undergraduates in Sri Lanka, and to describe the effects of VZV infection on their academic activities.MethodsA retrospective cohort of medical undergraduates' susceptible for VZV infection was selected from the University of Peradeniya, Sri Lanka. Data on the incidence of VZV infection (Chickenpox) during their undergraduate period was collected using a self-administered structured questionnaire. A second questionnaire was administered to collect data on the details of VZV infection and the impact of it on their academic activities. VZV incidence rate was calculated as the number of infections per 1,000 person years of exposure. Descriptive statistics were used to describe the impact of VZV infection on academic activities.ResultsOut of the 172 susceptible cohort, 153 medical undergraduates were followed up. 47 students reported VZV infection during the follow up period and 43 of them participated in the study. The cumulative incidence of VZV infection during the period of five and half years of medical training was 30.7%. Incidence density of VZV infection among medical undergraduates in this cohort was 65.1 per 1,000 person years of follow-up. A total of 377 working days were lost by 43 students due to the VZV infection, averaging 8.8 days per undergraduate. Total academic losses for the study cohort were; 205 lectures, 17 practicals, 13 dissection sessions, 11 tutorials, 124 days of clinical training and 107 days of professorial clinical appointments. According to their perception they lost 1,927 study hours due to the illness (Median 50 hours per undergraduate).ConclusionsThe incidence of VZV infection among Sri Lankan medical undergraduates is very high and the impact of this infection on academic activities causes severe disruption of their undergraduate life. VZV immunization for susceptible new entrant medical undergraduates is recommended.
Highlights
The adult population in Sri Lanka is having high level of susceptibility for Varicella Zoster Virus (VZV) infection
Tion was made a notifiable disease in Sri Lanka[6] and the Epidemiology Unit launched a passive surveillance system in order to provide baseline data on VZV morbidity
In the years 2002 and 2003, Faculty of Medicine, University of Peradeniya, Sri Lanka conducted a sero-epidemiological study to estimate the susceptibility of new-entrant university undergraduates to VZV infection
Summary
The adult population in Sri Lanka is having high level of susceptibility for Varicella Zoster Virus (VZV) infection. Sero-epidemiological reports[1,2,3] and reports from the Infectious Disease Hospital[4] in Sri Lanka demonstrate strong evidence of a high level of susceptibility for Varicella Zoster Virus (VZV) infection among the adult pop-. In 2007, the total number of notifications received by the Epidemiology Unit was 3,435[7] This number increased by 59.5% by 2008, with 5,493 patients contacting VZV infection[8]. In a tropical country with a population of 20 million, this is an under estimate of the actual incidence of VZV infection. It does not provide data on high-risk groups. The true incidence rate, which is of utmost importance in determining high-risk groups and generating vaccination policies is yet to be described for Sri Lanka
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