The clinical and economic burden of varicella in the Middle East: a systematic literature review

Abstract

This systematic literature review was conducted to better understand the epidemiology and burden of varicella across the Middle East, gain insight into the evidence to support using universal varicella vaccination (UVV), and identify potential data gaps. Both epidemiology and economic data on the burden of varicella were limited and varied significantly. Most of the data focussed on varicella burden in the absence of a UVV program. In the absence of UVV, varicella incidence is increasing across this region with varicella infection associated with substantial morbidity. Although limited, data on the impact of vaccination at a population level indicated UVV programs reduce varicella incidence and hospitalizations, in line with global experience. Further research and action are needed to better understand varicella epidemiology in the Middle East, increase awareness and understanding in the region, and provide local data to support national public-health decisions regarding the implementation of UVV programs.

Keywords: Middle East; seroprevalence; systematic literature review; vaccination; varicella.

Figure 1.

PRISMA flow chart for the global search with regional-level outcomes.

Figure 2.

Seroprevalence by age in Iran (a), Turkey (b), and the UAE (c). References: Alp 2005,⁴⁶ Kurugol 2007,¹⁴ Motemedifar 2006,³³ Pourahmad 2010,³⁴ Uduman 2001,⁵⁹ Vojgani 2013³¹ UAE, the United Arab Emirates.

Figure 3.

Common complications of varicella reported in hospitalized patients in Turkey. References: Koturoglu 2005,⁶³ Turel 2013,⁶⁴ Dinleyici 2012,¹⁵ Dinleyici 2015¹⁰.