{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,1,25]],"date-time":"2025-01-25T05:28:38Z","timestamp":1737782918715,"version":"3.33.0"},"reference-count":21,"publisher":"Public Library of Science (PLoS)","issue":"1","license":[{"start":{"date-parts":[[2025,1,24]],"date-time":"2025-01-24T00:00:00Z","timestamp":1737676800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100022752","name":"MSD Sharp and Dohme","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100022752","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosglobalpublichealth.org"],"crossmark-restriction":false},"short-container-title":["PLOS Glob Public Health"],"abstract":"<jats:p>Varicella presents a public health challenge in Guatemala, with limited evidence regarding its impact; vaccine is currently absent from the national immunization program. Generating local data on the economic and health burden can support immunization policies. This study describes the use of hospital resources, costs of care, clinical and demographic characteristics, and complications in children with varicella. A retrospective review of medical records from patients admitted in four public institutions in Guatemala between January 2015 and December 2019, with diagnosis of varicella was performed. A total of 124 hospitalized patients, aged 0 to 14 years, were analyzed, of whom 46% had cancer. The average cost of hospitalization was USD 3,793.24 for complicated cases and USD 1,131.11 for uncomplicated cases. The average hospital stay was 11 days for patients with complications and 5 days for those without complications. In total, 66.1% of patients presented complications, with related infection complications being the most common. In conclusion, hospitalizations for varicella impose a significant economic and clinical burden in Guatemala. Complications increase the cost of care by three times, highlighting the importance of considering the inclusion of the varicella vaccine in the National Immunization Program to prevent the disease.<\/jats:p>","DOI":"10.1371\/journal.pgph.0004165","type":"journal-article","created":{"date-parts":[[2025,1,24]],"date-time":"2025-01-24T19:21:12Z","timestamp":1737746472000},"page":"e0004165","update-policy":"https:\/\/doi.org\/10.1371\/journal.pgph.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical and economic burden of varicella in pediatric patients hospitalized in four institutions in Guatemala"],"prefix":"10.1371","volume":"5","author":[{"given":"Mario","family":"Melgar","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-9685-5478","authenticated-orcid":true,"given":"Ingrid","family":"Sajmolo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andr\u00e9","family":"Choc\u00f3","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lidia","family":"Ortiz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana Gabriela","family":"Cordova","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luis","family":"Hern\u00e1ndez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Irwing","family":"Rivera","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashly","family":"Zu\u00f1iga","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudia","family":"Beltr\u00e1n","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1590-4304","authenticated-orcid":true,"given":"Sebastian","family":"Medina","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcel","family":"Marcano-Lozada","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2025,1,24]]},"reference":[{"key":"pgph.0004165.ref001","first-page":"235","volume-title":"Varicella-zoster virus infections","author":"RJ Whitley","year":"2012"},{"issue":"12","key":"pgph.0004165.ref002","doi-asserted-by":"crossref","first-page":"1263","DOI":"10.1097\/INF.0b013e31826ff3a5","article-title":"Incidence and use of resources for chickenpox and herpes zoster in Latin America and the Caribbean--a systematic review and meta-analysis","volume":"31","author":"A Bardach","year":"2012","journal-title":"Pediatr Infect Dis J"},{"key":"pgph.0004165.ref003","first-page":"831","volume-title":"Red book: 2021 report of the committee on infectious diseases","author":"American Academy of Pediatrics","year":"2021"},{"issue":"4","key":"pgph.0004165.ref004","doi-asserted-by":"crossref","first-page":"416","DOI":"10.1080\/13696998.2018.1431919","article-title":"Economic burden of varicella in children 1-12 years of age in Argentina, 2009-2014","volume":"21","author":"N Giglio","year":"2018","journal-title":"J Med Econ"},{"key":"pgph.0004165.ref005","author":"Sistema Nacional de Vigilancia Epidemiol\u00f3gica (SINAVE)","year":"2018"},{"issue":"2","key":"pgph.0004165.ref006","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1016\/S0163-4453(03)00079-3","article-title":"Cost containment analysis of childhood vaccination against varicella in Israel","volume":"48","author":"GM Ginsberg","year":"2004","journal-title":"J Infect"},{"issue":"1","key":"pgph.0004165.ref007","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1542\/peds.104.1.1","article-title":"Cost of chickenpox in Canada: part I. Cost of uncomplicated cases","volume":"104","author":"B Law","year":"1999","journal-title":"Pediatrics"},{"key":"pgph.0004165.ref008","unstructured":"Ministerio de Trabajo y Previsi\u00f3n Social. Guatemala. Salario M\u00ednimo. 2022. [cited 2023 Mar 14]. Available from: https:\/\/www.mintrabajo.gob.gt\/index.php\/dgt\/salario-minimo"},{"issue":"3","key":"pgph.0004165.ref009","doi-asserted-by":"crossref","first-page":"159","DOI":"10.22354\/in.v22i3.728","article-title":"Hospitalization costs due to Severe Acute Respiratory Infection (SARI) in three Central American countries","volume":"22","author":"N Alvis-Guzm\u00e1n","year":"2018","journal-title":"Infect"},{"key":"pgph.0004165.ref010","unstructured":"Recursos humanos Ministerio de Salud P\u00fablica y Asistencia Social. Guatemala, Guatemala. Articulo 10. Informaci\u00f3n p\u00fablica de Oficio. 2022. [cited 2022 Feb 9]. Available from: https:\/\/hospitalroosevelt.gob.gt\/articulo-10-informacion-publica-de-oficio\/"},{"issue":"4","key":"pgph.0004165.ref011","doi-asserted-by":"crossref","first-page":"932","DOI":"10.1080\/21645515.2018.1559687","article-title":"Varicella healthcare resource utilization in middle income countries: a pooled analysis of the multi-country MARVEL study in Latin America & Europe.","volume":"15","author":"L Wolfson","year":"2019","journal-title":"Hum Vaccin Immunother"},{"issue":"9","key":"pgph.0004165.ref012","doi-asserted-by":"crossref","first-page":"A855","DOI":"10.1016\/j.jval.2017.08.2446","article-title":"The economic burden of varicella in peru","volume":"20","author":"M Castillo","year":"2017","journal-title":"Value in Health"},{"issue":"1","key":"pgph.0004165.ref013","doi-asserted-by":"crossref","first-page":"528","DOI":"10.1186\/s12889-019-6795-0","article-title":"Burden of varicella in Latin America and the Caribbean: findings from a systematic literature review","volume":"19","author":"LHF Arlant","year":"2019","journal-title":"BMC Public Health"},{"issue":"35","key":"pgph.0004165.ref014","doi-asserted-by":"crossref","first-page":"5095","DOI":"10.1016\/j.vaccine.2022.07.012","article-title":"The impact of universal varicella vaccination on the clinical burden of varicella in Colombia: a national database analysis, 2008\u20132019","volume":"40","author":"M Pawaskar","year":"2022","journal-title":"Vaccine"},{"issue":"7","key":"pgph.0004165.ref015","doi-asserted-by":"crossref","first-page":"1056","DOI":"10.1182\/blood-2014-03-560847","article-title":"Infection-related mortality in children with acute lymphoblastic leukemia: an analysis of infectious deaths on UKALL2003","volume":"124","author":"D O\u2019Connor","year":"2014","journal-title":"Blood"},{"issue":"3","key":"pgph.0004165.ref016","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1007\/s12519-016-0025-y","article-title":"Incidence and consequences of varicella in children treated for cancer in Guatemala","volume":"12","author":"AEC Brown","year":"2016","journal-title":"World J Pediatr"},{"issue":"25","key":"pgph.0004165.ref017","first-page":"265","article-title":"Varicella and herpes zoster vaccines: WHO position paper, June 2014","volume":"89","author":"World Health Organization.","year":"2014","journal-title":"Wkly Epidemiol Rec"},{"issue":"3","key":"pgph.0004165.ref018","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1080\/14760584.2017.1247700","article-title":"Varicella prevention in Costa Rica: impact of a one-dose schedule universal vaccination","volume":"16","author":"ML Avila-Aguero","year":"2017","journal-title":"Expert Rev Vaccines"},{"issue":"5","key":"pgph.0004165.ref019","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1097\/INF.0000000000003448","article-title":"Economic evaluation of universal varicella vaccination in Mexico","volume":"41","author":"E Chacon-Cruz","year":"2022","journal-title":"Pediatr Infec Dis J"},{"issue":"4","key":"pgph.0004165.ref020","doi-asserted-by":"crossref","first-page":"597","DOI":"10.1007\/s40121-019-00273-6","article-title":"Specific varicella-related complications and their decrease in hospitalized children after the introduction of general varicella vaccination: results from a multicenter pediatric hospital surveillance study in Bavaria (Germany)","volume":"8","author":"C Hagemann","year":"2019","journal-title":"Infect Dis Ther"},{"issue":"7","key":"pgph.0004165.ref021","doi-asserted-by":"crossref","first-page":"1151","DOI":"10.3390\/vaccines10071151","article-title":"Trends in varicella burden of disease following introduction of routine childhood varicella vaccination in argentina: a 12-year time series analysis","volume":"10","author":"N Giglio","year":"2022","journal-title":"Vaccines (Basel)"}],"container-title":["PLOS Global Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pgph.0004165","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,24]],"date-time":"2025-01-24T19:21:22Z","timestamp":1737746482000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pgph.0004165"}},"subtitle":[],"editor":[{"given":"W. Alton","family":"Russell","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2025,1,24]]},"references-count":21,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,1,24]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pgph.0004165","relation":{},"ISSN":["2767-3375"],"issn-type":[{"value":"2767-3375","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,24]]}}}