Study On Disease Burden Of Rotavirus Diarrhea Among Children Under Five Years Old In Beijng And Gansu

Objectives:1.To understand the epidemiological characteristics and pathogenic form of rotavirus among children under five years old in the outpatient and inpatient with diarrhea and provide scientific basis for prevent and control strategies to rotavirus diarrhea;2. To explore the epidemiological characteristics of rotavirus with severe and mild diarrhea and the degree of effect to children’s health on severe rotavirus diarrhea, provide basic information for the development of rotavirus vaccine;3.To estimate lastest rotavirus diarrhea of economic burden on children under5years old in outpatient and inpatient denpartment, and establish disease burden evaluation methods of rotavirus diarrhea;4.To deduce rotavirus diarrhea mortality formulas of children under5years old and estimate the numbers of rotavirus deaths under5years age.Methods:The individual cases information and faecal specimens were collected from children under5years old who were outpatient and inpatient with diarrhea in five sentinel hospitals in Beijing and Gansu province between July2012and February2013for rotavirus diarrhea epidemic characteristic analysis, and were combined with China Statistical Yearbook and the National Child Mortality Surveillance System for estimating rotavirus diarrhea mortality under5years age. All faecal specimens were used to detect rotavirus using Enzyme-linked immunosorbant assay (ELISA).Collected data were analysed by SPSS17.0.Results:A total of1278diarrhea cases with faecal specimens were collected from children under5years old and rotavirus positive rate of32%. The peak season of rotavirus diarrhea was winter, with the highest incidence months from October to December, accounting for64.3%. Most patients were children under2years old, accounting for93.64%. All of diarrhea children under5years old, including outpatient cases587with rotavirus positive rate of25.21%, inpatient cases691with rotavirus positive rate of37.77%. The rotavirus positive rate of male children in outpatient and inpatient was24.38%and37.64%respectively; the rotavirus positive rate of female children in outpatient and inpatient was26.58%and37.98%respectively. Diarrhea cases under5years old in rural were556, and696cases in urban, so rotavirus positive rates were36.87%and27.87%respectively. The rotavirus positive rate of male children in rural and urban was36.31%and27.59%respectively; the rotavirus positive rate of female children in rural and urban was37.80%and28.35%respectively; Water diarrhea was significantly character for rotavirus diarrhea in Beijing and Gansu provinces, accounted for46.34%and85.29%, respectively. Severe diarrhea cases were276with Vesikari Scale score≥11, accounting for21.6%of all cases. Rotavirus positive rate of severe diarrhea was47.1%. Mild diarrhea cases were1002with Vesikari Scale score<11. Rotavirus positive rate of mild diarrhea was27.84%. Living in rural areas was independently associated with the development of severe rotavirus diarrhea (OR=3.759).In this study, average direct cost of per outpatient and per inpatient with rotavirus diarrhea were￥441.49and￥288.91respectively, including average direct medical costs of per outpatient and per inpatient with rotovirus diarrhea￥353.99and￥150.54respectively, average direct non-medical costs of per outpatient and per inpatient with rotovirus diarrhea were￥87.50and￥138.38respectively. The average losing of working time of per outpatient and per inpatient with rotovirus diarrhea were3days and6days respectively, and average cost on losing of working time of per outpatient and per inpatient were￥343.56and￥.687.12respectively. Average direct cost of per outpatient and per inpatient RV severe diarrhea￥854.46and2803.95respectively, and average cost on losing of working time of per outpatient and per inpatient were￥343.56and￥801.64respectively.Total economic burden of outpatient with rotabirus diarrhea of children under5years old were￥4.28billion, and those of inpatient were￥163million. Rotavirus diarrhea mortality under5years age was about0.88/100000and the numbers of rotavirus deaths was680.Conclusion:Rotavirus was an important pathogen of children under2years old with diarrhea, and epidemic season of rotavirus diarrhea was winter.The rotavirus positive rate of inpatients with diarrhea high than outpatient, children with diarrhea in rural highet than those in urban,and severe diarrhea high than mild diarrhea. Vesikari Scale score and proportion of severe diarrhea with rotavirus positive children higher than rotavirus negative ones. Living in rural areas was independently associated with the development of severe rotavirus diarrhea.In china, rotavirus diarrhea mortality under5years age was about0.88/100000and total economic burden over￥4billion.So comprehensive measures should be taken to effectively control the incidence of rotavirus diarrhea,to prevent effect on the health of children as well as alleviate huge economic burden.