Herpes zoster epidemiology in Latin America: A systematic review and meta-analysis

The epidemiology and burden of Herpes Zoster (HZ) are largely unknown, and there are no recent reviews summarizing the available evidence from the Latin America and Caribbean (LAC) region. We conducted a systematic review and meta-analysis to characterize the epidemiology and burden of HZ in LAC. Bi...

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Bibliographic Details
Published in:PloS one 2021-08, Vol.16 (8), p.e0255877
Main Authors: Bardach, Ariel Esteban, Palermo, Carolina, Alconada, Tomás, Sandoval, Macarena, Balan, Darío Javier, Nieto Guevara, Javier, Gómez, Jorge, Ciapponi, Agustin
Format: Article
Language:English
Subjects:
Acyclovir
Age
Biology and Life Sciences
Care and treatment
Chicken pox
Complications
Cost of Illness
Databases, Factual
Density
Disease control
Distribution
Epidemiology
Health risks
Herpes zoster
Herpes Zoster - complications
Herpes Zoster - economics
Herpes Zoster - epidemiology
Herpes Zoster - pathology
Hospitalization - statistics & numerical data
Humans
Immunization
Immunocompromised Host
Latin America - epidemiology
Medicine and Health Sciences
Meta-analysis
Mortality
Neuralgia
Neuralgia - etiology
Pain
Patient outcomes
People and places
Physical Sciences
Prevalence
Prevention
Research and Analysis Methods
Risk analysis
Risk factors
Risk groups
Shingles (Disease)
Systematic review
Vaccines
Websites
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Summary:The epidemiology and burden of Herpes Zoster (HZ) are largely unknown, and there are no recent reviews summarizing the available evidence from the Latin America and Caribbean (LAC) region. We conducted a systematic review and meta-analysis to characterize the epidemiology and burden of HZ in LAC. Bibliographic databases and grey literature sources were consulted to find studies published (January 2000 -February 2020) with epidemiological endpoints: cumulative incidence and incidence density (HZ cases per 100,000 person-years), prevalence, case-fatality rates, HZ mortality, hospitalization rates, and rates of each HZ complication. Twenty-six studies were included with most studies coming from Brazil. No studies reported the incidence of HZ in the general population. In population at higher risk, the cumulative incidence ranged from 318-3,423 cases of HZ per 100,000 persons per year of follow-up. The incidence density was 6.4-36.5 cases per 1,000 person-years. Age was identified as a major risk factor towards HZ incidence which increase significantly in people >50 years of age. Hospitalization rates ranged from 3%-35.7%. The in-hospital HZ mortality rate ranged from 0%-36%. Overall, HZ mortality rates were found to be higher in females across all age groups and countries. The incidence of HZ complications (such as post-herpetic neuralgia, ophthalmic herpes zoster, and Ramsay Hunt syndrome) was higher in the immunosuppressed compared to the immunocompetent population. Acyclovir was the most frequently used therapy. Epidemiological data from Ministry of Health databases (Argentina, Brazil, Colombia, Chile y Mexico) and Institute for Health Metrics and Evaluation's Global Burden of Disease project reported stable rates of hospitalizations and deaths over the last 10 years. High-risk groups for HZ impose a considerable burden in LAC. They could benefit from directed healthcare initiatives, including adult immunization, to prevent HZ occurrence and its complications.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0255877