| BackgroundHerpes zoster is an infectious skin disease caused by the reactivation of the varicella-zoster virus latent in the sensory ganglia after primary infection of varicella.It usually causes skin lesions such as erythema and papules,accompanied by varying degrees of pain or nerve-related symptoms.It often occurs in the elderly,immunocompromised or immunosuppressed people,and has a serious impact on the quality of life of patients.Post herpetic neuralgia(PHN)is the most common complication of the disease,and its incidence is closely related to age.The older the patient,the higher the risk of developing herpes zoster and PHN.The incidence of herpes zoster in the Asia-Pacific region ranges from 3/1000 person-years to 10/1000 person-years,with increases of 2.5%to 5.0%per year.At present,there is no systematic surveillance of herpes zoster in China,and large-scale epidemiological studies are also lacking.With the aging of the population,the disease burden of herpes zoster in China is high,and the estimated incidence is comparable to that in other countries and regions of the world.Additionally,at present,most of the indicators for evaluating herpes zoster are traditional epidemiological indicators such as incidence.Studies using disability-adjusted life years(DALYs)as indicators is limited.Such research has important public health significance for comprehensively evaluating the harm of herpes zoster and optimizing the allocation of medical and health resources.ObjectivesThis study aims to comprehensively analyze the epidemiological characteristics,incidence trends,risk factors,and disease burden of herpes zoster in Shandong Province,understand the distribution of disease burden,and identify the high-risk groups and high-risk areas of the disease,so as to improve people’s awareness of herpes zoster and provide scientific evidence for reducing the disease burden of herpes zoster.MethodsThis study obtained the information of herpes zoster cases in Shandong Province from 2013 to 2017 based on the Shandong Provincial Health and Medical Big Data Platform.Descriptive analysis was used to explore the characteristic of the three-dimensional distributions of herpes zoster(time,space and population).Log-linear regression model was used to test the change trend of incidence density.A nested case-control study of herpes zoster was carried out and the conditional Logistic regression model was used to explore and quantify the impact of various target factors on the incidence of herpes zoster.The indicator of DALYs was used to estimate the disease burden of herpes zoster,and to describe the distribution characteristics of disease burden of herpes zoster in different age groups and different genders.Results1.During the study period,there were 10 636 reported cases of herpes zoster in Shandong Province with a total incidence density of 69.53/100 000 person-years.Among them,the number of reported cases in men was lower than that in women,and the number of urban cases was much higher than that of rural cases.The incidence density of herpes zoster increases with age,with the highest incidence in people over 50 years old.From 2013 to 2017,the incidence density of herpes zoster showed an upward trend,among which the incidence density of children aged 0-9 years increased most significantly,with an annual percentage change of 107.53%.The incidence density was higher in the southern and parts of the eastern coastal areas of Shandong Province.The center of gravity of incidence density first moved to the west and then gradually moved to the north.2.Patients with chronic diseases such as systemic lupus erythematosus,diabetes,hypertension,chronic obstructive pneumonia(COPD),depression,and asthma had a significantly higher risk of herpes zoster,with an odds ratio of 1.57 to 9.30(P<0.05).Among them,patients with systemic lupus erythematosus had the highest risk of developing herpes zoster(adjusted OR 9.30,95%CI:5.26,16.47),followed by patients with chronic kidney disease.In addition,the relative risk of herpes zoster in urban population was 1.34 times higher than that in rural population(95%CI:1.28,1.41).The results of stratified analysis by age were basically consistent with the above results.The relative effects of factors,such as diabetes,hypertension,asthma,and systemic lupus erythematosus,on herpes zoster decreased with age.3.Herpes zoster caused an average of 2380.62(95%CI:2076.00,2782.00)DALYs per year.The disease burden rate was 59.70/100000(95%CI:52.07/100000,69.77/100000).The disease burden of herpes zoster was mainly caused by the life loss due to premature death(YLL)and was the highest in the age group of 50-64.Conclusions1.The incidence density of herpes zoster in Shandong Province is on the rise.The incidence density of urban population is significantly higher than that of rural population.With the increase of age,the incidence density of herpes zoster increases.The center of gravity of incidence density of herpes zoster first moved westward and then gradually moved northward.It is necessary to pay more attention to the incidence of herpes zoster in the above-mentioned areas.2.Chronic diseases such as systemic lupus erythematosus,diabetes,hypertension,COPD,chronic kidney disease,depression,asthma,and living in cities are risk factors for herpes zoster.In addition,the relative risk was highest among those under the age of 50 with diabetes,hypertension,asthma,and systemic lupus erythematosus.Alternative risk reduction strategies are needed for this population in the absence of herpes zoster vaccine currently.3.The disease burden of herpes zoster in Shandong Province is mainly composed of life loss caused by premature death(YLL),and the 50-64 years age group has the highest disease burden. |
PDF Full Text Request