Burden of community-acquired and nosocomial rotavirus gastroenteritis in the pediatric population of Western Europe: a scoping review

Abstract

Background Rotavirus affects 95% of children worldwide by age 5 years and is the leading cause of severe dehydrating diarrhea. The objective of this review was to estimate the burden of rotavirus gastroenteritis (RVGE) in the Western European pediatric population. Methods A comprehensive literature search (1999-2010) was conducted in PubMed and other sources (CDC; WHO, others). Data on the epidemiology and burden of RVGE among children < 5 years-old in Western Europe --including hospital-acquired disease--were extracted. Results 76 studies from 16 countries were identified. The mean percentage of acute gastroenteritis (AGE) cases caused by rotavirus ranged from 25.3%-63.5% in children < 5 years of age, peaking during winter. Incidence rates of RVGE ranged from 1.33-4.96 cases/100 person- years. Hospitalization rates for RVGE ranged from 7% to 81% among infected children, depending on the country. Nosocomial RVGE accounted for 47%-69% of all hospital-acquired AGE and prolonged hospital stays by 4-12 days. Each year, RVGE incurred $0.54- $53.6 million in direct medical costs and $1.7-$22.4 million in indirect costs in the 16 countries studied. Full serotyping data was available for 8 countries. G1P[8], G2P[4], G9P[8], and G3P[8] were the most prevalent serotypes (cumulative frequency: 57.2%- 98.7%). Serotype distribution in nosocomial RVGE was similar. Conclusions This review confirms that RVGE is a common disease associated with significant morbidity and costs across Western Europe. A vaccine protecting against multiple serotypes may decrease the epidemiological and cost burden of RVGE in Western Europe.

Decline in rotavirus hospitalizations following the first three years of vaccination in Castile-La Mancha, Spain

“…In Europe, rotavirus represents 14% to 54% of all admissions for AGE in this group. 4,6,21 This variability constitutes a limitation when making comparisons and is most likely due to differences in study design, coding methods, access to health care, disease management, data sources, coverage and representativeness of surveillance systems, and the years and geographic areas included. Moreover, rotavirus possesses significant genetic diversity that can cause changes in its antigenicity and pathogenic ability.…”

“…2 In fact, hospitalization costs due to rotavirus account for more than half the expenses caused by all AGE cases in children under 5. 3 Indeed, the incidence of hospitalizations due to rotavirus for this age group in Europe ranges from 30 to 1,190 per 10 5 children per year (100-310 per 10 5 in Spain), 4 with an estimated cost of 1,525-2,101 euros per admission. 5 The disease costs the Spanish national health system EUR 28 million a year.…”

Improvement in hospital Quality of Care (QoC) after the introduction of rotavirus vaccination: An evaluation study in Belgium

“…24,25 Overcrowding as indicated by excess BDOR has been associated with increased hospital infections and patient mortality, [26][27][28] and exposure to BDOR of >10% in excess of the recommended limit of 85% for >6 months has been associated with antidepressant treatment in hospital staff. 29 Overcrowding typically occurs in the winter, when influenza, RSV, pneumococcal disease and rotavirus all circulate together, and can be exacerbated by rapid pathogen spread within the hospital causing high rates of nosocomial infection.…”

Universal rotavirus vaccination program in Sicily: Reduction in health burden and cost despite low vaccination coverage

“…3 Moreover, RV infection accounted for a large number of nosocomial infections in neonatal intensive care and pediatric units, especially during the late winter and early spring of temperate regions. 4 , 5 , 6 Rotavirus vaccination represents the most effective strategy for reducing rotavirus gastroenteritis (RVGE) among children and the introduction of RV vaccines in immunization schedules is strongly recommended by international health authorities. 7 , 8 …”