ABSTRACT
Background: In Turkey, varicella vaccine was introduced into routine childhood immunization in 2013, with a single dose administered to children aged 12 months. However, there is limited information on the morbidity [incidence and seroprevalence], mortality and burden of disease of varicella in the overall Turkish population.
Aim: To determine varicella seroprevalence and its social determinants in Manisa Province, Turkey in children aged > 2 years before single-dose varicella vaccination was introduced in 2013.
Methods: The presence of anti varicella-zoster virus IgG antibodies was determined using enzyme-linked immunosorbent assay in serum samples collected from 1250 participants.
Results: The overall seroprevalence was 92.8% and the seroprevalence was > 90% among all age groups except 29 years [55.7%]. Seroprevalence was significantly associated with family size, annual per capita equivalent income, number of people per room and education level. After adjusting by age, only education level remained significantly associated with seroprevalence, reflecting the early age effect.
Conclusion: High seroprevalance depends on natural exposure to the infectious agent itself and is not associated with social determinants. High vaccine coverage should be maintained for effective varicella control and switching to a 2-dose schedule may also be considered to reduce the number and size of outbreaks in the Turkish population
Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Seroepidemiologic Studies , Socioeconomic Factors , Chickenpox Vaccine , Cross-Sectional Studies , Chickenpox/diagnosisABSTRACT
Inequities in health need to be monitored and necessary actions should be taken to reduce them. This study aimed to determine the socioeconomic distribution of self-reported chronic diseases and self-assessed health [SAH] in Turkey and try to evaluate the determinants of such inequalities in terms of their contributions. Cross-sectional data from the Turkish Health Survey conducted during year 2008, covering 14,655 adults aged 15 or older were analyzed for the first time to assess socioeconomic inequalities in chronic disease and sub-optimal SAH prevalence by calculating concentration index [CI], which ranges from -1 to +1 [concentration of disease among lower and higher socioeconomic groups] and the relative index of inequality [RII], reflecting the prevalence ratio between the two extremes of wealth. Several diseases and sub-optimal SAH were more concentrated among those with lower incomes. The concentration indices of chronic obstructive pulmonary disease [COPD], arthritis, chronic bronchitis, migraine and poor SAH were-0.180 [95% CI = -0.241,-0.111], -0.126 [95% CI = -0.148,-0.105],-0.118 [95%CI = -0.149,-0.079], -0.248[95%CI = [-0.278,-0.219] respectively. Of all chronic diseases, COPD demonstrated the highest relative inequality with a RII value of 2.51 [95%CI: 1.57-4.01]. Income was the major contributor to inequality in occurrence of COPD [88.2%], migraine [80.4%] and arthritis [77.7%]. The findings indicate that majority of chronic diseases were more concentrated among less wealthy individuals in Turkey. Wealth and education had the largest contributions to observed inequalities. These inequalities need to be explicitly addressed and vulnerable subgroups should be targeted to reduce these socioeconomic disparities