Measuring herpes zoster disease burden in São Paulo, Brazil: a clinico-epidemiological single-center study

Abstract

OBJECTIVES:Herpes zoster is characterized by acute neuritis and post-herpetic neuralgia. Currently, data concerning the zoster-associated impact on quality of life and healthcare resource utilization in Brazil are scarce. This study measured the zoster-associated burden in a Brazilian population.METHODS:This was a prospective, observational, single-cohort study conducted in a primary hospital’s emergency room in São Paulo, Brazil. Patients enrolled at various timepoints during a zoster episode were followed over 180 days. The Zoster Brief Pain Inventory and the Initial Zoster Impact Questionnaire assessed zoster-associated pain. The EuroQoL assessed the impact of herpes zoster and/or zoster-associated pain on quality of life. Healthcare resource utilization was assessed by patient-reported questionnaires.RESULTS:One-hundred forty-six zoster patients were enrolled [mean (SD) age of 69.9 (10.9) years]. Mean (SD) worst pain scores decreased from 5.3 (3.5) at baseline to 1.9 (3.0) 180 days following rash onset. Mean (SD) EuroQoL scores significantly decreased from 0.9 (0.2) before rash appearance to 0.7 (0.2) after rash onset (p<0.001), followed by gradual improvements in quality of life over 180 days, with pre-herpes zoster quality of life achieved at the end of the observation period. The majority of patients purchased prescription medications (89.7%) and required doctor’s office visits (65.8%) for zoster episodes.CONCLUSIONS:Herpes zoster is associated with a significant disease burden, including zoster-associated pain, impaired quality of life and increased healthcare resource utilization in Brazil. These results support the implementation of early intervention and prevention programs such as vaccinations to reduce the herpes zoster-associated disease burden in Brazil.

Health state utility values in people living with HTLV-1 and in patients with HAM/TSP: The impact of a neglected disease on the quality of life

“…This result is much higher than the values reported here for HAM/TSP or even for HTLV-1 AC. Brazilian patients affected with Herpes Zoster (shingles) have a lower EQ-5D-3L Index when compared to baseline (prior to Herpes Zoster rash onset) (0.7 vs 0.9) [ 36 ], these values are however higher than those observed here for AC and for patients with HAM/TSP. Interestingly, patients with HAM/TSP also had a lower average for both EQ-5D-3L Index and VAS Score than patients with multiple sclerosis in Brazil (VAS Score Mean (SD) = 67.9, EQ-5D-3L Index Mean (SD) = 0.58 (0.26))[ 37 ] or patients with neuropathic pain (EQ-5D-3L Index varying from 0.4–0.6, according to the subtype and VAS score of 47–67.3) [ 38 ].…”

Densitometria Óssea: Idade E Sexo Versus Percentual De Pacientes Osteopênicos E Osteoporóticos

“…Com isso, observou-se uma maior prevalência da categoria Bem estar Psicológico, correspondendo a, aproximadamente, 46,8% (n=7) das publicações. MIZUKAMI et al, 2017;, bem estar psicológico (JOHNSON et al, 2010;SERPELL et al, 2014;KAWAI et al, 2015;MIZUKAMI et al, 2017;AVIJGAN et al, 2017;TONIOLO-NETO et al, 2018) e relações sociais (SERPELL et al, 2014;TORCEL-PAGNON et al, 2016;TONIOLO-NETO et al, 2018).…”

“…O quadro clínico inicial do HZ costuma ser mais intenso com diminuição considerável dos escores de dor moderada/grave para dor leve ao final de 180 dias após a erupção cutânea. Do mesmo modo, há uma melhoria gradual do escore de qualidade de vida após essa erupção, mesmo havendo um pico de piora entre os sintomas prodrômicos e aqueles relacionados aos dias após o acometimento cutâneo (TONIOLO-NETO et al, 2018).…”

“…Nesse caso, a taxa de utilização do serviço público é equivalente entre as visitas ao pronto-socorro e ao ambulatório médico, chengando a ultrapassar a faixa dos 60% devido aos sintomas do HZ. Ainda, a internação devido aos sintomas graves chega a duração aproximada de seis dias que interfere no psíquico e nas relações sociais indivíduo (TONIOLO-NETO et al, 2018).…”

Хроническая Боль Среди Факторов Суицидального Риска

“…Риск заболеваемости обусловлен преимущественно иммуносупрессией [83,84] и тяжелой соматической патологией: при сахарном диабете заболеваемость составляет 15,3 на 1000 пациентов, от 11,0 до 11,4 при ХОБЛ и сердечно-сосудистой патологии, 10,0при раке, 12,5 -СПИДе, от 6,6 до 27,0 при ревматических заболеваниях, от 5,0 до 240,0 после трансплантации органов [81,85]. Пик заболеваемости в возрасте 60-79 лет [82,86]: в США -62,6 [87], в Бразилии -69,9 года [88], в Японии -70-74 лет [84].…”