{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T17:54:04Z","timestamp":1777312444794,"version":"3.51.4"},"reference-count":50,"publisher":"Hamad bin Khalifa University Press (HBKU Press)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025]]},"abstract":"<jats:p>\n                    <jats:bold>Background:<\/jats:bold>\n                    Herpes zoster (HZ) is a secondary viral infection that results from the reactivation of latent varicella zoster virus, characterized by dermatological manifestations and neurological sequelae. The incidence of HZ increases with age and is higher among immunocompromised individuals. While the global literature extensively documents HZ disease and its impact, there is a paucity of data in regional studies. Despite the availability of vaccines, HZ poses a public health challenge, especially in regions with limited healthcare access, underscoring the need for better surveillance and management strategies globally, regionally, and nationally.\n                  <\/jats:p>\n                  <jats:p>The study aims to estimate the incidence of HZ among attendees of primary healthcare facilities in the Kingdom of Bahrain, analyze the demographic distribution of patients based on age, sex, and risk factors, and gain insights into the clinical presentation and the most common complications within the local society.<\/jats:p>\n                  <jats:p>\n                    <jats:bold>Methods:<\/jats:bold>\n                    This study used a retrospective cross-sectional design, targeting all patients who visited governmental healthcare facilities and were reported to have been diagnosed with HZ in 2021, according to electronic medical records. Patients were contacted via phone to collect specific information related to the episodes they experienced, while additional information was retrieved from electronic health records (EHR). Informed consent was obtained from all participants. During the calls, five patients declined to provide details about the episodes; their decision was respected, and only the information available in their EHR was used. All collected data were systematically recorded in an Excel spreadsheet for analysis.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results:<\/jats:bold>\n                    The total incidence of HZ was 59.09 per 100,000 population. The median age was 42.8 \u00b119 years, with a higher prevalence observed in males (53.4%). Of the study participants 79.1% were Bahrainis, 22.3% had diabetes, and 3% had other comorbidities. The most frequently reported clinical manifestations were rash (79.9%) and pain (15.8%). The trunk (30.5%), back (19.5%), and abdomen (13.9%) were the most commonly reported locations affected by HZ. Antiviral treatment was administered to 65.2% of the patients. The most commonly reported complications included post-herpetic neuralgia (6.7%) and cellulitis (4.4%).\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusion:<\/jats:bold>\n                    Individuals in older age groups exhibit a significantly higher likelihood of developing HZ infection along with the associated post-infection complications. This finding aligns with those from other studies. It is recommended to implement interventions aimed at reducing both the incidence and morbidity of HZ, particularly targeting those at higher risk.\n                  <\/jats:p>","DOI":"10.5339\/qmj.2025.72","type":"journal-article","created":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T06:30:37Z","timestamp":1755757837000},"source":"Crossref","is-referenced-by-count":0,"title":["Incidence and clinical profile of herpes zoster in primary care in Bahrain \u2013 A cross-sectional study"],"prefix":"10.5339","volume":"2025","author":[{"given":"Zahra","family":"Zabar","sequence":"first","affiliation":[{"name":"Primary Healthcare Centers, Manama, Bahrain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zahra","family":"Ayoob","sequence":"additional","affiliation":[{"name":"Ministry of Health, Manama, Bahrain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huda","family":"Malalla","sequence":"additional","affiliation":[{"name":"Primary Healthcare Centers, Manama, Bahrain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maryam","family":"Jadeed","sequence":"additional","affiliation":[{"name":"Primary Healthcare Centers, Manama, Bahrain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Afaf","family":"Merza","sequence":"additional","affiliation":[{"name":"Ministry of Health, Manama, Bahrain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adel","family":"AlSayyad","sequence":"additional","affiliation":[{"name":"Epidemiology & Public Health, Ministry of Health, Manama, Bahrain"},{"name":"Department of Family and Community Medicine, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain*Correspondence: Maryam Jadeed mariam.jadeed@gmail.com"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3277","reference":[{"key":"CIT0001","article-title":"Shingles (Herpes Zoster)"},{"issue":"(8)","key":"CIT0002","series-title":"BMC Med","article-title":"The impact of herpes zoster and post-herpetic neuralgia on quality of life","volume":"37","author":"Johnson\n \nRW","year":"2010;"},{"issue":"(6):","key":"CIT0003","series-title":"BMJ Open","first-page":"e004833","article-title":"Systematic review of incidence and complications of herpes zoster: Towards a global perspective","volume":"4","author":"Kawai\n \nK","year":"2014"},{"issue":"(4):","key":"CIT0004","series-title":"Infect Dis Clin North Am","first-page":"811\u201326","article-title":"Herpes Zoster in the older adult","volume":"31","author":"John\n \nAR","year":"2017"},{"issue":"(1):","key":"CIT0005","series-title":"BMC Infect Dis","first-page":"513","article-title":"Prevalence of and factors associated with herpes zoster in England: A cross-sectional analysis of the Health Survey for England","volume":"22","author":"Cadogan\n \nSL","year":"2022"},{"issue":"(9):","key":"CIT0006","series-title":"Ann Epidemiol","first-page":"692\u20135","article-title":"Gender as an independent risk factor for herpes zoster: A population-based prospective study","volume":"16","author":"Opstelten\n \nW","year":"2006"},{"issue":"(11):","key":"CIT0007","series-title":"Mayo Clin Proc","first-page":"1341-9","article-title":"A population-based study of the incidence and complication rates of herpes zoster before zoster vaccine introduction","volume":"82","author":"Yawn\n \nBP","year":"2007"},{"issue":"(1):","key":"CIT0008","series-title":"Epidemiol Infect","first-page":"38\u201347","article-title":"Epidemiology and cost of herpes zoster and post-herpetic neuralgia in the United Kingdom","volume":"137","author":"Gauthier\n \nA","year":"2009"},{"issue":"(7):","key":"CIT0009","series-title":"Hum Vaccin Immunother","first-page":"1807\u201314","article-title":"Trends in herpes zoster epidemiology in Germany based on primary care sentinel surveillance data, 2005\u20132016","volume":"14","author":"Zoch-Lesniak\n \nB","year":"2018"},{"issue":"(2):","key":"CIT0010","series-title":"Expert Rev Anti Infect Ther","first-page":"165\u201379","article-title":"A systematic literature review to assess the burden of herpes zoster disease in China","volume":"19","author":"Yin\n \nD","year":"2021"},{"issue":"(4):","key":"CIT0011","series-title":"Vaccine","first-page":"520\u20139","article-title":"Herpes zoster burden of illness and health care resource utilisation in the Australian population aged 50 years and older","volume":"27","author":"Stein\n \nAN","year":"2009"},{"issue":"(5):","key":"CIT0012","series-title":"J Infect","first-page":"463\u20139","article-title":"A population based study of the epidemiology of Herpes zoster and its complications","volume":"67","author":"Weitzman\n \nD","year":"2013"},{"issue":"(3):","key":"CIT0013","series-title":"Hum Vaccin Immunother","first-page":"731\u20137","article-title":"Incidence of varicella and herpes zoster after inclusion of varicella vaccine in national immunization schedule in Turkey: Time trend study","volume":"17","author":"Soysal\n \nA","year":"2021"},{"issue":"(1):","key":"CIT0014","series-title":"Qatar Med J","first-page":"1","article-title":"Epidemiology of herpes zoster in the State of Qatar, 2012\u20132017","volume":"2020","author":"Al-Dahshan\n \nA","year":"2020"},{"issue":"(5):","key":"CIT0015","series-title":"J Drugs Dermatol","first-page":"457\u201362","article-title":"Herpes zoster in eastern Saudi Arabia: Clinical presentation and management","volume":"7","author":"Alakloby\n \nOM","year":"2008"},{"issue":"(2):","key":"CIT0016","series-title":"Pain","first-page":"361\u20138","article-title":"Aggregate health and economic burden of herpes zoster in the United States: illustrative example of a pain condition","volume":"161","author":"Harvey\n \nM","year":"2020"},{"key":"CIT0017","series-title":"Ther Adv Vaccines Immunother","first-page":"25151355221084535","article-title":"Global herpes zoster incidence, burden of disease, and vaccine availability: A narrative review","volume":"10","author":"Pan\n \nCX","year":"2022"},{"key":"CIT0018","series-title":"CDC","article-title":"Prevention of Herpes Zoster recommendations of the Advisory Committee on Immunization Practices (ACIP)","author":"Harpaz\n \nR","year":"2008"},{"key":"CIT0019","series-title":"Shingles prevention study","article-title":"National Library of Medicine US","year":"2013"},{"key":"CIT0020","series-title":"Neurol Res Int","first-page":"896098","article-title":"Clinical manifestations of herpes zoster, its comorbidities, and its complications in North of Iran from 2007 to 2013","volume":"2015","author":"Babamahmoodi\n \nF","year":"2015"},{"issue":"(6):","key":"CIT0021","series-title":"Hum Vaccin Immunother","first-page":"1650\u201360","article-title":"Sociodemographic characteristics and chronic medical conditions as risk factors for herpes zoster: A population-based study from primary care in Madrid (Spain)","volume":"10","author":"Esteban-Vasallo\n 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Dis","first-page":"513","article-title":"Prevalence of and factors associated with herpes zoster in England: A cross-sectional analysis of the Health Survey for England","volume":"22","author":"Cadogan\n \nSL","year":"2022"},{"issue":"(9):","key":"CIT0006","series-title":"Ann Epidemiol","first-page":"692\u20135","article-title":"Gender as an independent risk factor for herpes zoster: A population-based prospective study","volume":"16","author":"Opstelten\n \nW","year":"2006"},{"issue":"(11):","key":"CIT0007","series-title":"Mayo Clin Proc","first-page":"1341-9","article-title":"A population-based study of the incidence and complication rates of herpes zoster before zoster vaccine introduction","volume":"82","author":"Yawn\n \nBP","year":"2007"},{"issue":"(1):","key":"CIT0008","series-title":"Epidemiol Infect","first-page":"38\u201347","article-title":"Epidemiology and cost of herpes zoster and post-herpetic neuralgia in the United Kingdom","volume":"137","author":"Gauthier\n \nA","year":"2009"},{"issue":"(7):","key":"CIT0009","series-title":"Hum Vaccin Immunother","first-page":"1807\u201314","article-title":"Trends in herpes zoster epidemiology in Germany based on primary care sentinel surveillance data, 2005\u20132016","volume":"14","author":"Zoch-Lesniak\n \nB","year":"2018"},{"issue":"(2):","key":"CIT0010","series-title":"Expert Rev Anti Infect Ther","first-page":"165\u201379","article-title":"A systematic literature review to assess the burden of herpes zoster disease in China","volume":"19","author":"Yin\n \nD","year":"2021"},{"issue":"(4):","key":"CIT0011","series-title":"Vaccine","first-page":"520\u20139","article-title":"Herpes zoster burden of illness and health care resource utilisation in the Australian population aged 50 years and older","volume":"27","author":"Stein\n \nAN","year":"2009"},{"issue":"(5):","key":"CIT0012","series-title":"J Infect","first-page":"463\u20139","article-title":"A population based study of the epidemiology of Herpes zoster and its complications","volume":"67","author":"Weitzman\n \nD","year":"2013"},{"issue":"(3):","key":"CIT0013","series-title":"Hum Vaccin Immunother","first-page":"731\u20137","article-title":"Incidence of varicella and herpes zoster after inclusion of varicella vaccine in national immunization schedule in Turkey: Time trend study","volume":"17","author":"Soysal\n \nA","year":"2021"},{"issue":"(1):","key":"CIT0014","series-title":"Qatar Med J","first-page":"1","article-title":"Epidemiology of herpes zoster in the State of Qatar, 2012\u20132017","volume":"2020","author":"Al-Dahshan\n \nA","year":"2020"},{"issue":"(5):","key":"CIT0015","series-title":"J Drugs Dermatol","first-page":"457\u201362","article-title":"Herpes zoster in eastern Saudi Arabia: Clinical presentation and management","volume":"7","author":"Alakloby\n \nOM","year":"2008"},{"issue":"(2):","key":"CIT0016","series-title":"Pain","first-page":"361\u20138","article-title":"Aggregate health and economic burden of 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\nF","year":"2015"},{"issue":"(6):","key":"CIT0021","series-title":"Hum Vaccin Immunother","first-page":"1650\u201360","article-title":"Sociodemographic characteristics and chronic medical conditions as risk factors for herpes zoster: A population-based study from primary care in Madrid (Spain)","volume":"10","author":"Esteban-Vasallo\n \nMD","year":"2014;"},{"issue":"(12):","key":"CIT0022","series-title":"J Korean Med Sci","first-page":"1706\u201310","article-title":"Population-based study of the epidemiology of herpes zoster in Korea","volume":"29","author":"Kim\n \nYJ","year":"2014"},{"issue":"(4):","key":"CIT0023","series-title":"J Infect","first-page":"378\u201386","article-title":"Temporal trends in incidence rates of herpes zoster among patients treated in primary care centers in Madrid (Spain), 2005\u20132012","volume":"68","author":"Esteban-Vasallo\n \nMD","year":"2014"},{"issue":"(5):","key":"CIT0024","series-title":"Croat Med 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