ABSTRACT
Varicella-zoster virus causes chickenpox (CP) and after reactivation herpes zoster (HZ). Vaccines are available against both diseases warranting an assessment of the pre-vaccination burden of disease. We collected data from relevant Belgian databases and performed five surveys of CP and HZ patients. The rates at which a general practitioner is visited at least once for CP and HZ are 346 and 378/100 000 person-years, respectively. The average CP and HZ hospitalization rates are 5·3 and 14·2/100 000 person-years respectively. The direct medical cost for HZ is about twice as large as the direct medical cost for CP. The quality-adjusted life years lost for ambulatory CP patients consulting a physician is more than double that of those not consulting a physician (0·010 vs. 0·004). In conclusion, both diseases cause a substantial burden in Belgium.
Subject(s)
Chickenpox , Cost of Illness , Herpes Zoster , Adolescent , Adult , Aged , Aged, 80 and over , Ambulatory Care/economics , Ambulatory Care/statistics & numerical data , Belgium/epidemiology , Chickenpox/economics , Chickenpox/mortality , Chickenpox/therapy , Child , Child, Preschool , Female , Health Care Costs/statistics & numerical data , Health Care Surveys , Health Surveys , Herpes Zoster/economics , Herpes Zoster/mortality , Herpes Zoster/therapy , Hospitalization/economics , Hospitalization/statistics & numerical data , Humans , Infant , Infant, Newborn , Male , Middle Aged , Quality of Life , Quality-Adjusted Life Years , Severity of Illness Index , Surveys and Questionnaires , Young AdultABSTRACT
The detection of human papillomavirus (HPV) DNA in urine, a specimen easily obtained by a non-invasive self-sampling method, has been the subject of a considerable number of studies. This review provides an overview of 41 published studies; assesses how different methods and settings may contribute to the sometimes contradictory outcomes; and discusses the potential relevance of using urine samples in vaccine trials, disease surveillance, epidemiological studies, and specific settings of cervical cancer screening. Urine sampling, storage conditions, sample preparation, DNA extraction, and DNA amplification may all have an important impact on HPV DNA detection and the form of viral DNA that is detected. Possible trends in HPV DNA prevalence in urine could be inferred from the presence of risk factors or the diagnosis of cervical lesions. HPV DNA detection in urine is feasible and may become a useful tool but necessitates further improvement and standardization.
