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Prospective Study of Loss of Health-Related Quality Adjusted Life Years in Children and their Families due to Uncomplicated and Hospitalised Varicella

2023Journal article Open access
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dc.contributor.authorRodrigues, F
dc.contributor.authorMarlow, R
dc.contributor.authorGouveia, C
dc.contributor.authorCorreia, P
dc.contributor.authorBrett, A
dc.contributor.authorSilva, C
dc.contributor.authorGameiro, I
dc.contributor.authorRua, I
dc.contributor.authorDias, J
dc.contributor.authorMartins, M
dc.contributor.authorDiogo, R
dc.contributor.authorLopes, T
dc.contributor.authorHipólito, E
dc.contributor.authorMoreira, D
dc.contributor.authorCosta Alves, M
dc.contributor.authorPrata, F
dc.contributor.authorLabrusco, M
dc.contributor.authorGomes, S
dc.contributor.authorFernandes, A
dc.contributor.authorAndrade, A
dc.contributor.authorGranjo Morais, C
dc.contributor.authorJoão Virtuoso, M
dc.contributor.authorManuel Zarcos, M
dc.contributor.authorTeresa Raposo, A
dc.contributor.authorBoon, A
dc.contributor.authorFinn, A
dc.date.accessioned2023-05-22T10:53:42Z
dc.date.available2023-05-22T10:53:42Z
dc.date.issued2023
dc.description.abstractIntroduction and aims: Although usually benign, varicella can lead to serious complications and sometimes long-term sequelae. Vaccines are safe and effective but not yet included in immunisation programmes in many countries. We aimed to quantify the impact on health-related quality of life (HRQoL) in terms of quality-adjusted life years (QALY) in children with varicella and their families, key to assessing cost-utility in countries with low mortality due to this infection. Methods: Children with varicella in the community and admitted to hospitals in Portugal were included over 18 months from January 2019. Children's and carers' HRQoL losses were assessed prospectively using standard multi-attribute utility instruments for measuring HRQoL (EQ-5D and CHU9D), from presentation to recovery, allowing the calculation of QALYs. Results: Among 109 families with children with varicella recruited from attendees at a pediatric emergency service (community arm), the mean HRQoL loss/child was 2.0 days (95 % CI 1.9-2.2, n = 101) (mean 5.4 QALYs/1000 children (95 % CI 5.3-6.1) and 1.3 days/primary carer (95 % CI 1.2-1.6, n = 103) (mean 3.6 QALYs /1000 carers (95 % CI 3.4-4.4). Among 114 families with children admitted to hospital because of severe varicella or a complication (hospital arm), the mean HRQoL loss/child was 9.8 days (95 % CI 9.4-10.6, n = 114) (mean 26.8 QALYs /1000 children (95 % CI 25.8-29.0) and 8.5 days/primary carer (95 % CI 7.4-9.6, n = 114) (mean 23.4 QALYs/1000 carers (95 % CI 20.3-26.2). Mean QALY losses/1000 patients were particularly high for bone and joint infections [67.5 (95 % CI 43.9-97.6)]. Estimates for children's QALYs lost using the CHU9D tool were well correlated with those obtained using EQ-5D, but substantially lower. Conclusions: The impact of varicella on HRQoL is substantial. We report the first measurements of QALYs lost in hospitalised children and in the families of children both in the community and admitted to hospital, providing important information to guide vaccination policy recommendations.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationVaccine . 2023 Feb 3;41(6):1182-1189pt_PT
dc.identifier.doi10.1016/j.vaccine.2022.12.011pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/4522
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherElsevierpt_PT
dc.subjectChickenpox* / epidemiologypt_PT
dc.subjectChickenpox* / prevention & controlpt_PT
dc.subjectChildpt_PT
dc.subjectCost-Benefit Analysispt_PT
dc.subjectProspective Studiespt_PT
dc.subjectPortugalpt_PT
dc.subjectQuality of Life*pt_PT
dc.subjectQuality-Adjusted Life Yearspt_PT
dc.subjectHDE INF PEDpt_PT
dc.titleProspective Study of Loss of Health-Related Quality Adjusted Life Years in Children and their Families due to Uncomplicated and Hospitalised Varicellapt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage1189pt_PT
oaire.citation.issue6pt_PT
oaire.citation.startPage1182pt_PT
oaire.citation.titleVaccinept_PT
oaire.citation.volume41pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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