Global Burden

Global Rotavirus Deaths

Rotavirus kills about 200,000 children each year and hospitalizes hundreds of thousands more 1, 2. Prior to vaccine introduction, almost every child was infected with rotavirus before age 5, regardless of where they lived.

Figure: Global Number of Deaths from Rotavirus 1

 

Figure: Global Mortality Rates from Rotavirus1

Global Hospitalization Rates

Figure: Global diarrhea hospitalizations for children under 53, 4

ROTA Council Recommendation

Countries that have introduced rotavirus vaccines or plan to introduce are encouraged to collect high-quality data on rotavirus disease burden and rotavirus-related hospitalizations to evaluate vaccine impact.

Figure: Percentage of diarrheal disease hospitalizations in children <5 caused by rotavirus in WHO surveillance countries5

  • Uganda 32%
  • Guinnea-Bissau 42%
  • Democratic Republic of Congo 54%
  • Mauritius 54%
  • Pakistan 21%
  • Oman 55%
  • Afghanistan 55%
  • Sri Lanka 30%
  • Nepal 32%
  • Myanmar 52%
  • Indonesia 52%
  • Lao People’s Democratic Republic 58%
  • Vietnam 61%
  • Cambodia 50%
  • Mongolia 40%
  • China 40%
  • Fiji 35%
  • Papua New Guinea 47%

The Economic Burden

Studies have shown that the global cost of rotavirus infections – including both outpatient visits and hospitalizations—exceeds $200 million each year.

Cost for Families and Households

The cost of hospitalizing a child for several days can be devastating to families, but even parents able to treat children in outpatient facilities can lose many hours of work. Costs to families typically include treatment, transportation, and missed wages.

  • In Brazil, parents lost about 20 hours of work due to outpatient facility treatment for a child with rotavirus diarrhea 6.
  • In Uganda, inpatient admission for one episode of severe rotavirus diarrhea costs 10% of the average family’s monthly income7.
  • In Bangladesh, treating just one episode of rotavirus diarrhea can amount to nearly 85% of the average family’s monthly income8.
  • In Malaysia, rotavirus hospitalization costs more than one-quarter of the average monthly income9.

Cost for Countries and Health Systems

Rotavirus infections incur major direct hospitalization and out-patient costs to healthcare systems. Infections further cause major indirect costs to societies related to productivity losses, transportation, and accommodation during treatment.

  • In India, a 2014 study estimated that rotavirus hospitalizations cost about US$73 million each year, while outpatient treatments cost about US$80 millon10.
  • For one cohort of children born in Iran, rotavirus infections over a 5-year period costs US $12 million from the healthcare perspective and US$32 million from the societal perspective11.
  • In Malaysia, rotavirus disease is estimated to cost US$34 million to the healthcare providers and US$50 million to society, including losses in productivity12.
  • In Senegal, rotavirus disease is responsible for an estimated US$19 million in government healthcare service costs, and more than US$28 million in societal health service costs13.

 

1.Tate, J.E., et al., Global, Regional, and National Estimates of Rotavirus Mortality in Children <5 Years of Age, 2000-2013. Clin Infect Dis, 2016. 62 Suppl 2: p. S96-s105.

2.Parashar, U.D., et al., Global illness and deaths caused by rotavirus disease in children. Emerg Infect Dis, 2003. 9(5): p. 565-72.

3.Lanata, C.F., et al., Global causes of diarrheal disease mortality in children <5 years of age: a systematic review. PLoS One, 2013. 8(9): p. e72788.

4.Parashar, U.D., et al., Rotavirus and severe childhood diarrhea. Emerg Infect Dis, 2006. 12(2): p. 304-6.

5.WHO, Global Rotavirus Information and Surveillance Bulletin. 2011.

6.Constenla, D.O., et al., Economic impact of a rotavirus vaccine in Brazil. J Health Popul Nutr, 2008. 26(4): p. 388-96.

7.Sigei, C.O., J.; Mvundura, M.; Madrid, Y.; Clark, AD., Cost-effectiveness of rotavirus vaccination in Kenya and Uganda. Vaccine, 2015. 33(Supplement 1): p. A109-A118.

8.icddr, b., Preliminary analysis from “The economic burden of rotavirus infection resulting in hospitalization among children <5 years of age in selected hospitals of Bangladesh”. icddr,b Protocol# 14009.

9.Chai, P.L., WS, Out-of-pocket costs associated with rotavirus gastroenteritis requiring hospitalization in Malaysia. Vaccine. 2009;27(5):F112-F115. Vaccine, 2009. 27(5): p. F112-F115.

10.John, J., et al., Rotavirus gastroenteritis in India, 2011-2013: revised estimates of disease burden and potential impact of vaccines. Vaccine, 2014. 32 Suppl 1: p. A5-9.

11.Mousavi Jarrahi, Y., et al., The cost effectiveness of rotavirus vaccination in Iran. Hum Vaccin Immunother, 2016. 12(3): p. 794-800.

12.Loganathan, T., et al., The Hidden Health and Economic Burden of Rotavirus Gastroenteritis in Malaysia: An Estimation Using Multiple Data Sources. Pediatr Infect Dis J, 2016. 35(6): p. 601-6.

13.Diop, A., et al., Estimated impact and cost-effectiveness of rotavirus vaccination in Senegal: A country-led analysis. Vaccine, 2015. 33 Suppl 1: p. A119-25.