Seroprevalence and Risk Factors of Varicella Zoster Infection in Iranian Adolescents: A Multilevel Analysis; The CASPIAN-III Study

Abstract

The objective of this study was to evaluate the varicella zoster virus (VZV) immunity in Iranian adolescents. It was conducted as a primary study for vaccine implementation, and to investigate the association of climatic and socioeconomic factors with the epidemiology of this infection. In this cross- sectional study, anti VZV antibodies were measured in serum samples obtained in a national school-based health survey (CASPIAN- III). Association of demographic, socio-economic, and climate of the living region with the frequency of VZV was investigated by multivariate multilevel analysis. Overall, sera of 2753 individuals aged 10–18 were tested for VZV antibodies, from those 87.4% were positive. The prevalence was statistically different in four socio-geographic regions (P<0.001), varying between 85.24% in West region (mostly mountainous areas with cold climate) to 94.59% in Southeast region (subtropical climate). Among variables studied, only age and mean daily temperature of the living area were positively associated with the VZV seroprevalence. Our findings show that most Iranians develop immunity to VZV before the age of 10, but a substantial proportion of them are yet susceptible to the infection. Therefore, it seems that the best strategy to reduce the burden of the disease is to vaccinate high- risk adults, i.e. those without a history of varicella infection. The regional temperature might be the only determinant of VZV epidemiology in Iran.

Varicella infection in the Middle East: Prevalence, complications, and vaccination

“…[ 59 ] Similarly, a national seroprevalence study of varicella infection was conducted between 2009 and 2010 among adolescents in different provinces in Iran, Central, West, North-Northeast, and Southeast. [ 60 ] Of 2753 individuals aged 10–18 years, 87.4% were positive for VZV antibodies. The prevalence of VZV antibodies varies between 85.24% in West region (mostly mountainous areas with cold climate) to 94.59% in Southeast region (subtropical climate).…”

“…The prevalence of VZV antibodies varies between 85.24% in West region (mostly mountainous areas with cold climate) to 94.59% in Southeast region (subtropical climate). [ 60 ]…”

Seroprevalence of Varicella Zoster Infection at Provincial Level in Iranian Adolescents: The CASPIAN-III Study

“…The overall prevalence of VZV in Iranian adolescents has been previously reported as 87.5% (8). Minimizing the burden of VZV infection can be achieved by vaccination; however, it is necessary to select an accurate and cost-effective vaccination strategy in each area.…”

Common Skin Lesions of the Face

“…In defining postherpetic neuralgia, there is a lack of consensus regarding the duration of pain persistence following the rash, although many investigators consider a minimum period of 1 to 3 months. Risk factors include female sex, older age, history of prodromal pain, moderate to severe rash and/or pain during the acute phase, and ophthalmic involvement (Figures 11 and 12) [23][24][25][26][27].…”