Systematic Literature Review of Herpes Zoster Disease Burden in Southeast Asia

Peter San Martin; Kobkul Aunhachoke; Maria Christina Filomena Batac; Kris Lodrono-Lim; Chanida Kwanthitinan; Dicky Santoso; Thanabalan Fonseka; Minh Nguyen; Adriana Guzman-Holst

doi:10.1007/s40121-023-00822-0

Systematic Literature Review of Herpes Zoster Disease Burden in Southeast Asia

Infect Dis Ther. 2023 Jun;12(6):1553-1578. doi: 10.1007/s40121-023-00822-0. Epub 2023 Jun 14.

Authors

Peter San Martin¹, Kobkul Aunhachoke², Maria Christina Filomena Batac³, Kris Lodrono-Lim⁴, Chanida Kwanthitinan⁵, Dicky Santoso⁶, Thanabalan Fonseka⁷, Minh Nguyen⁸, Adriana Guzman-Holst⁹

Affiliations

¹ GSK Vaccines, 20 Avenue Fleming, 1300, Wavre, Belgium. peter.x.sanmartin@gsk.com.
² Phramongkutklao Hospital, Bangkok, Thailand.
³ University of the Philippines Manila, Manila, Philippines.
⁴ GSK, Manila, Philippines.
⁵ GSK, Bangkok, Thailand.
⁶ GSK, Jakarta, Indonesia.
⁷ GSK, Kuala Lumpur, Malaysia.
⁸ GSK, Ho Chi Minh City, Vietnam.
⁹ GSK, Wavre, Belgium.

Abstract

Introduction: Herpes zoster (HZ; i.e., shingles) is caused by the reactivation of varicella zoster virus leading to a painful dermatomal rash. An increasing trend in cases of HZ is evident worldwide; however, there is a lack of comprehensive reviews for Southeast Asian countries.

Methods: We performed a systematic literature review of articles published until May 2022 that reported HZ epidemiology, clinical management, and health economic data in six Southeast Asian countries: Indonesia, Malaysia, the Philippines, Singapore, Thailand, and Vietnam. Literature searches were conducted in Medline, Scopus, Embase, and gray literature. Articles written in English or local languages were considered for inclusion.

Results: In total, 72 publications were included in the study; 22 were case studies and over 60% originated in Singapore and Thailand. Only two studies (data from Thailand) reported incidence of HZ. The proportion of patients reported with HZ was 0.68-0.7% among dermatology clinics, 0.14% at one emergency department (5.3% of dermatology cases) in Singapore, and 3% of admissions at another hospital in Singapore. Pain was the most common symptom associated with HZ, reported in 74.21-100% of patients. HZ complications were reported in 10.2-21.2% of patients, and the proportions with postherpetic neuralgia and HZ ophthalmicus were 6.3-50% and 4.98-28.57%, respectively. Additionally, there is a lack of comprehensive, up-to-date HZ economic data, with only six studies identified for the Philippines, Singapore, and Thailand.

Conclusions: Overall, there are limited data reporting incidence and prevalence of HZ in Southeast Asia at a national level. High rates of complications, symptoms, and abundance of case reports suggest substantial healthcare resource utilization for patients with HZ and highlight the need for further research in Southeast Asia assessing the societal impact.

Keywords: Herpes zoster; Indonesia; Malaysia; Philippines; Shingles; Singapore; Southeast Asia; Thailand; Varicella zoster virus; Vietnam.

Publication types

Review