Thesis title: EPIDEMIOLOGY AND CHARACTERISTICS OF VARICELLA (CHICKENPOX), IN PEDIATRIC AGE GROUPS
Abstract
Introduction: Varicella (chickenpox) remains a widespread childhood disease that can
lead to serious complications requiring hospitalization. Despite its generally benign nature
in immunocompetent children, the lack of universal varicella vaccination in Albania
sustains endemic transmission and recurrent outbreaks. Understanding the epidemiological
and clinical patterns of hospitalized cases is essential for guiding prevention and treatment
strategies.
Aim: To evaluate the hospitalization burden, epidemiological characteristics, and clinical
complications of varicella among pediatric patients hospitalized at the University Hospital
Center “Mother Teresa” from 2022 to 2024.
Methods: A retrospective observational study was conducted on 252 children admitted
with varicella between 2022 and 2024. Data on demographic variables, clinical findings,
laboratory results, complications, treatment, and outcomes were extracted from medical
records. Complications were classified by system involvement. Descriptive statistics, cross
tabulations, and multivariate logistic regression were used to identify predictors of
complications and prolonged hospital stay.
Results: Of the 252 hospitalized children, 65.5% developed at least one complication.
Only 32.9% of children were discharged with a diagnosis of uncomplicated varicella, a
significant drop compared to 82.2% on admission. The most common complications on
discharge were: skin and soft tissue infections (18.7%), respiratory complications (30.9%),
and neurological complications (4.4%) including cerebellar ataxia and encephalitis.
Hospitalizations peaked during spring (32.1%) and winter (27%). The median hospital stay
was 5 days and was significantly longer among patients with complications (p < 0.001).
Early initiation of acyclovir treatment within 72 hours was associated with a shorter
hospital stay (mean 5.3 vs. 6.5 days, p = 0.022). Multivariate logistic regression identified
age under five years, presence of comorbidities, and admission during autumn or winter as
independent predictors of complications. Children aged <1 year had an odds ratio (OR) of
2.97 (95% CI: 1.14–7.77; p = 0.026), and those aged 1–4 years had an OR = 3.18
(95% CI: 1.60–6.32; p = 0.001) compared with 5–9-year-olds. Children with comorbidities
had more than twice the odds of developing complications (OR = 2.20; 95% CI: 1.13
4.30; p = 0.021). Hospitalization during autumn and winter also increased the risk
(OR = 2.19 and OR = 2.26, respectively).
Conclusion: Varicella remains a significant cause of pediatric hospitalization in Albania,
with more than half of admitted children developing complications. Younger age,
comorbidities, and seasonal factors independently increased the risk of severe disease.
These findings strongly support the introduction of varicella vaccination into the national
immunization program, also emphasize the need for timely antiviral treatment and
improved early risk stratification to reduce complications and healthcare burden.