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. 2019 Jan 30;19(1):99.
doi: 10.1186/s12879-019-3691-2.

Herpes zoster incidence in Germany - an indirect validation study for self-reported disease data from pretest studies of the population-based German National Cohort

Mahrrouz Caputo  1 , Johannes Horn  2 , André Karch  1   3   4 , Manas K Akmatov  1   5 , Heiko Becher  6   7 , Bettina Braun  4 , Hermann Brenner  8   9 , Stefanie Castell  1 , Beate Fischer  10 , Guido Giani  11 , Kathrin Günther  12 , Barbara Hoffmann  13 , Karl-Heinz Jöckel  14 , Thomas Keil  15 , Birgit Klüppelholz  11 , Lilian Krist  15 , Michael F Leitzmann  10 , Wolfgang Lieb  16 , Jakob Linseisen  17   18 , Christa Meisinger  17 , Susanne Moebus  19 , Nadia Obi  20 , Tobias Pischon  21 , Sabine Schipf  22 , Börge Schmidt  14 , Claudia Sievers  1 , Astrid Steinbrecher  21 , Henry Völzke  22 , Rafael Mikolajczyk  23   24
Affiliations

Herpes zoster incidence in Germany - an indirect validation study for self-reported disease data from pretest studies of the population-based German National Cohort

Mahrrouz Caputo et al. BMC Infect Dis. .

Abstract

Background: Until now, herpes zoster (HZ)-related disease burden in Germany has been estimated based on health insurance data and clinical findings. However, the validity of self-reported HZ is unclear. This study investigated the validity of self-reported herpes zoster (HZ) and its complication postherpetic neuralgia (PHN) using data from the pretest studies of the German National Cohort (GNC) in comparison with estimates based on health insurance data.

Methods: Data of 4751 participants aged between 20 and 69 years from two pretest studies of the GNC carried out in 2011 and 2012 were used. Based on self-reports of physician-diagnosed HZ and PHN, age- and sex-specific HZ incidence rates and PHN proportions were estimated. For comparison, estimates based on statutory health insurance data from the German population were considered.

Results: Eleven percent (95%-CI, 10.4 to 12.3, n = 539) of the participants reported at least one HZ episode in their lifetime. Our estimated age-specific HZ incidence rates were lower than previous estimates based on statutory health insurance data. The PHN proportion in participants older than 50 years was 5.9% (1.9 to 13.9%), which was in line with estimates based on health insurance data.

Conclusion: As age- and sex-specific patterns were comparable with that in health insurance data, self-reported diagnosis of HZ seems to be a valid instrument for overall disease trends. Possible reasons for observed differences in incidence rates are recall bias in self-reported data or overestimation in health insurance data.

Keywords: German National Cohort; Herpes zoster; Incidence; Postherpetic neuralgia; Self-reports; Validity.

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Conflict of interest statement

Ethics approval and consent to participate

All studies on humans described in the present manuscript were carried out in accordance with national law and the Helsinki Declaration of 1975 (in its current, revised form). The pretest studies were approved by the responsible ethics committee of the German Federal States of each of the 18 study centers (such as for Augsburg: Ethics Committee of the State Board of Physicians of the German federal state of Bavaria; Bremen: Ethics Committee of the University of Bremen; Essen: Ethics Committee of the University Clinics of Essen; Hannover: Ethics Committee of the State Board of Physicians of the German federal state of Lower Saxony; Hamburg: Ethics Committee of the State Board of Physicians of the federal state of Hamburg; and Heidelberg: Ethics Committee of the Medical Faculty of Heidelberg). Written informed consent was obtained from all participants included in the studies.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Flow chart of the study population
Fig. 2
Fig. 2
Cumulative incidence of HZ up to a given age by sex (left) and by birth-cohort (right)
Fig. 3
Fig. 3
Comparison of incidence rates of HZ from GNC pretest studies with German health insurance data. GNC: German National Cohort; PY: Person-years; Depending on the study, 5- or 10-year age-groups were used. The whiskers indicate 95%-CI
See this image and copyright information in PMC

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