The burden of rotavirus diarrhea : Estimating the cumulative incidence among children less than 3 years of age

轮状病毒是世界范围内婴幼儿急性腹泻的最重要病原体。现在已有有效的轮状病毒疫苗，并在100多个国家获得许可和使用。然而，为了确定每个国家轮状病毒疫苗的必要性，必须估计轮状病毒腹泻的负担，并了解儿科医生和护理人员对此类轮状病毒疫苗的看法。因此，本研究首先通过从托儿所儿童的照顾者那里获得信息来确定因轮状病毒住院病例的发生率。轮状病毒住院最常见于6至11个月的儿童，据估计，每30名儿童中就有1名在3岁时因轮状病毒腹泻住院。其次，询问儿科医生和3岁儿童的照顾者是否有必要和愿意支付疫苗费用。超过90%的儿科医生对轮状病毒疫苗的引入表示欢迎，其中57%的人表示轮状病毒疫苗应纳入儿童免疫计划。有趣的是，那些孩子寻求轮状病毒腹泻医疗干预的父母比那些孩子没有这种经历的父母对疫苗的必要性表现出更明确的态度。然而，父母支付轮状病毒疫苗费用的意愿很低，有人认为，除非将疫苗纳入国家的常规免疫计划，否则疫苗对减少轮状病毒腹泻住院人数的影响很小。

Rotavirus is a single most important etiological agent of acute diarrhea in infants and young children worldwide. Effective rotavirus vaccines are now available, and are licensed and used in more than 100 countries. However, to determine the necessity of rotavirus vaccines in each country, it is essential to estimate the burden of rotavirus diarrhea and to understand the perception of pediatricians and caregivers for such rotavirus vaccines. Thus, this study was undertaken, firstly, to determine the incidence of hospitalization cases due to rotavirus by obtaining information from the caregivers of children in nurseries. Rotavirus hospitalization occurred most frequently in children aged between 6 and 11 months, and it was estimated that one in 30 children got hospitalized due to rotavirus diarrhea by the age of 3 years. Secondly, pediatricians and caregivers of 3-year-old children were asked about the necessity and their willingness to pay for the vaccine. More than 90% of pediatricians welcomed the introduction of rotavirus vaccines into the country and 57% of them said that rotavirus vaccine should be incorporated into the childhood immunization schedule. Interestingly, those parents whose children sought medical intervention against rotavirus diarrhea showed significantly clearer attitudes regarding the necessity of the vaccine than those parents whose children did not have such experience. However, the willingness of the parents to pay for rotavirus vaccine is minimal and it was suggested that, unless the vaccine is incorporated into the routine immunization schedule of the country, there will be little impact of the vaccine on the reduction of the number of hospitalization due to rotavirus diarrhea.