Epidemiology and economic burden of herpes zoster and post-herpetic neuralgia in Italy: A retrospective, population-based study

<p>Abstract</p> <p>Background</p> <p>Data on the epidemiology and cost of herpes zoster (HZ) and post-herpetic neuralgia (PHN) in Italy are limited. This retrospective, population-based study was designed to determine the incidence of HZ and the proportion developing PHN in Italy and the associated medical resource utilisation and costs. It focused primarily on immunocompetent patients aged ≥50 years who would be eligible for preventive vaccination.</p> <p>Method</p> <p>Data were extracted from a primary-care database and national hospital-discharge records covering four major regions in Italy for 2003-2005. Cases of HZ and PHN (1 and 3 months' duration; PHN1 and PHN3) were identified by ICD9-CM codes and, additionally for PHN, prescription of neuropathic pain medication.</p> <p>Results</p> <p>Over 3 years, 5675 incident cases of HZ were documented in adults, of which 3620 occurred in immunocompetent patients aged ≥50 years (incidence of 6.31 per 1000 person-years [95% CI: 6.01-6.62]). Of the immunocompetent patients aged ≥50 years with HZ, 9.4% (95% CI: 8.2-10.7) and 7.2% (95% CI: 6.2-8.2) developed PHN1 and PHN3, respectively. Increasing age, female sex, and being immunologically compromised conferred increased risk for both HZ and PHN. Overall, about 1.3% of HZ and almost 2% of PHN cases required inpatient care, with 16.9% of all HZ-related hospitalisations due specifically to PHN. In patients aged ≥50 years, mean stay was 7.8 ± 5.4 days for HZ and 10.2 ± 8.6 days for PHN, and direct costs associated with inpatient care were more than 20 times outpatient costs per HZ case (mean ± SD: €2592 ± €1313 vs. €122.68 ± €97.51) and over 5 times more per episode of PHN (mean ± SD: €2806 ± €2641 vs. €446.10 ± €442.97). Total annual costs were €41.2 million, of which €28.2 million were direct costs and €13.0 million indirect costs.</p> <p>Conclusions</p> <p>This study, the largest to date on the epidemiology and economic impact of HZ and PHN in Italy, confirms the considerable disease and economic burden posed by HZ. As HZ and PHN disproportionately affect the elderly, without intervention this problem is likely to grow as the proportion of elderly in the Italian population continues to increase.</p

Compliance with herpes zoster vaccination in young and adult individuals in two regions of Italy

Background: The purpose of this work was to explore the knowledge and acceptance of Varicella Zoster Virus (VZV)- Herpes Zoster (HZ) vaccination in the general Italian population, where the HZ vaccine has not yet been distributed, using a prevalence study of subjects from two regions in Italy. Methods: A group of 3,173 individuals were interviewed using a questionnaire. The youngest age group (≤ 20 year) was composed of students interviewed at university. The middle age group (21-40 years) and the older age group (≥ 41 years) were interviewed by general practitioners in their office. Results: In both regions, the majority of subjects had been infected with varicella, and only 165 (5.2%) subjects reported receiving the VZV vaccination. Regarding HZ, 2,749 (86.6%) individuals stated that they knew of the virus and 2,233 (70%) were willing to be vaccinated against HZ. The majority of people willing to be vaccinated were in the middle and older age groups (36.6% and 44.7%, respectively). Conclusion: Compliance versus vaccination results were satisfactory and probably, with the upcoming availability of the HZ vaccine in Italy, adults will be favourably disposed towards vaccination

La Consulta degli Specializzandi SItI: quali aspettative?

INTRODUZIONE E OBIETTIVO: La Consulta Nazionale degli Specializzandi SItI, coerentemente con la propria missione di promuovere tematiche d\u2019interesse per gli specializzandi, nel corso del 2006, ha realizzato un\u2019indagine sui bisogni formativi dello specializzando i cui principali risultati preliminari sono stati oggetto di presentazione in occasione del 42\ub0 Congresso Nazionale SItI. Nell\u2019ambito di tale indagine sono state anche sondate esplicitamente le attese degli specializzandi in merito al ruolo della Consulta allo scopo di sperimentare un meccanismo di feedback e di coinvolgimento diretto degli specializzandi nella formulazione delle proposte di lavoro. MATERIALI E METODI: L\u2019indagine \ue8 stata realizzata con la somministrazione di un questionario anonimo a tutti gli specializzandi iscritti al 2\ub0, 3\ub0 e 4\ub0 anno. Sono stati raccolti 390 questionari (tasso di restituzione del 82%). Nella prima parte del questionario \ue8 stato inserita, la seguente domanda aperta: Cosa ti aspetti dalla Consulta? Quali iniziative/progetti di lavoro dovrebbe portare avanti la Consulta in futuro? Le risposte sono state raggruppate in ambiti principali che le potessero accomunare. RISULTATI: Il quesito \ue8 stato risposto nel 23% dei questionari raccolti. Tra gli ambiti emersi come pi\uf9 importanti per l\u2019operativit\ue0 della Consulta, peraltro, in parte fra loro sovrapponibili, vi sono stati i seguenti: miglioramento della qualit\ue0 dei percorsi formativi nelle varie scuole, potenziamento delle attivit\ue0 di comunicazione, scambio e confronto tra le scuole di specializzazione, tutela dei diritti degli specializzandi ed impegno nel rendere le attivit\ue0 formative impartite nelle scuole pi\uf9 in grado di rispondere alle esigenze del mondo del lavoro. CONCLUSIONI: Tale studio ha permesso di programmare la successiva attivit\ue0 tenendo conto delle priorit\ue0 fatte emergere dagli specializzandi. Inoltre le tematiche evidenziate dai principali stakeholders rafforzano la missione della Consulta e ne valorizzano il ruolo