title: Risk Factors for Varicella Susceptibility Among Refugees to Toronto, Canada.
abstract: Several outbreaks of varicella have occurred among refugees. We aimed to estimate the prevalence of varicella susceptibility among refugees, and identify risk factors for varicella susceptibility. All refugees rostered at Crossroads Clinic in Toronto, Canada in 2011-2014 were included in our study. Varicella serology was assessed at the initial visit. Refugees' age, sex, education, time since arrival, and climate and population density of birth country were abstracted from the chart. Multivariate logistic regression was used to identify risk factors for varicella susceptibility. 1063 refugees were rostered at Crossroads Clinic during the study; 7.9 % (95 % CI 6.1, 9.7) were susceptible to varicella. Tropical climate (OR 3.20, 95 % CI 1.53, 6.69) and younger age (ORper year of age0.92, 95 % CI 0.88-0.96) were associated with increased varicella susceptibility. These risk factors for varicella susceptibility should be taken into account to maximize the cost-effectiveness of varicella prevention strategies among refugees.
authors.affiliation: Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th floor, Toronto, ON, M5T 3M7, Canada. genevieve.cadieux@mail.utoronto.ca.
authors.forename: Geneviève
authors.identifier: 0000-0002-7163-4030
authors.initials: G
authors.lastname: Cadieux
authors.affiliation: Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Redditt
authors.affiliation: Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada.
authors.forename: Daniela
authors.initials: D
authors.lastname: Graziano
authors.affiliation: Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada.|Crossroads Clinic, Women's College Hospital, Toronto, ON, Canada.
authors.forename: Meb
authors.initials: M
authors.lastname: Rashid
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D002170:Canada / Q000453:epidemiology; D002644:Chickenpox / Q000208:ethnology*; D002648:Child; D002675:Child, Preschool; D002980:Climate; D004522:Educational Status; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D044469:Racial Groups; D012036:Refugees / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D013997:Time Factors; D055815:Young Adult
keywords: Chickenpox; Immunity; Refugees; Screening; Varicella