Rotavirus gastroenteritis in India, 2011-2013: Revised estimates of disease burden and potential impact of vaccines
Rotavirus gastroenteritis in India, 2011-2013: Revised estimates of disease burden and potential impact of vaccines
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DOI：
10.1016/j.vaccine.2014.03.004
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发表时间：
2014-08-11
期刊：
影响因子：
5.5
通讯作者：
Kang, Gagandeep
中科院分区：
文献类型：
--
作者：
John, Jacob;Sarkar, Rajiv;Kang, Gagandeep
虽然口服补液的使用和获得医疗保健的机会有所改善，使儿童生存率取得了令人印象深刻的进展，但疟疾仍然是印度儿童死亡的第二大原因。病原体特异性疾病发病率虽然是决定疫苗等具体公共卫生干预措施是否有用的关键，但在卫生服务条件不佳的发展中国家，本研究结合了五组婴儿的疾病负担，随访了婴儿的腹泻发病率，并采用了印度轮状病毒监测网络的全国代表性数据，轮状病毒相关事件发生率与联合国儿童基金会印度出生率和死亡率估计数的关系。这些估计虽然受到缺乏全国代表性人群研究数据的限制，但使用的方法与世界卫生组织儿童健康流行病学参考小组采用的方法一致。我们估计，印度每年发生1137万例轮状病毒胃肠炎，需要327万次门诊就诊和872，000次住院治疗，当医疗服务不受限制时，导致需要卢比。103.7亿美元，每年直接成本。据估计，每年发生78，000例轮状病毒相关死亡，其中59，000例发生在生命的前2年。在国家免疫规划中引入与Rotavac效力相似的轮状病毒疫苗将导致印度每年减少686，277次门诊就诊，减少291，756次住院治疗，减少26，985例死亡，假设疫苗没有间接影响。(C)2014由Elsevier Ltd.出版
While improvements in oral rehydration use and access to healthcare have contributed to impressive gains in child survival, diarrheal diseases remain the second most important cause of child mortality in India. Pathogen specific disease rates, while key to deciding on the utility of specific public health interventions such as vaccines, are extremely difficult to obtain in developing country settings with less than optimal health access, diagnostic services and information systems.This study combined disease burden within five cohorts of infants followed up for diarrheal morbidity with data from the nationally representative Indian Rotavirus Surveillance Network and applies rates of rotavirus related events to UNICEF birth and mortality estimates for India. These estimates, while limited by the lack of data from nationally representative population based studies, use methods consistent with those employed by the World Health Organization Child Health Epidemiology Reference Group.We estimate that 11.37 million episodes of rotavirus gastroenteritis occur each year in India, requiring 3.27 million outpatient visits and 872,000 inpatient admissions when health access is unconstrained, resulting in a need for Rs. 10.37 billion each year in direct costs. An estimated 78,000 rotavirus-associated deaths occur annually of which 59,000 occur in the first 2 years of life. Introduction of a rotavirus vaccine of similar efficacy to the Rotavac in the national immunization program would result in 686,277 fewer outpatient visits, 291,756 fewer hospitalizations and 26,985 fewer deaths each year in India, assuming no indirect effects for the vaccine. (C) 2014 Published by Elsevier Ltd.