Family impact of Rotavirus Gastroenteritis in Taiwan and Vietnam: an Ethnographic Study

Abstract

BackgroundPrior to the introduction of rotavirus vaccines, rotavirus was the leading cause of severe gastroenteritis in infants and young children, and it continues to be the leading cause in countries without vaccination programs. Rotavirus gastroenteritis results in substantial economic burden and has a pronounced effect on the family of those who are ill. Both in Taiwan and in Vietnam, rotavirus illness is viewed as a priority disease. This study assessed, in Taiwan and Vietnam, the impact of rotavirus gastroenteritis on the family among a group of parents whose children had recently been hospitalized for this illness.MethodsIn the first half of 2013, parents of children who had been hospitalized due to rotavirus infection were recruited from hospitals in Taiwan (n = 12) and Vietnam (n = 22), and participated in focus group sessions or in-depth ethnographic interviews.ResultsIn both countries, the results point to a substantial burden on the parents concerning emotions and logistics of daily tasks, and to considerable disruptions of the family routine. Taiwanese parents reported satisfaction with the health care system, a great deal of effort to suppress emotions, a fair amount of knowledge about rotavirus, and little extra costs related to the illness. On the other hand, parents in Vietnam expressed concern about the emotional well-being of and the health care treatments for their children, were less knowledgeable regarding rotavirus infection, and experienced a substantial financial burden due to indirect costs that were related to accessing treatment.ConclusionsFamilies in Taiwan and Vietnam suffer from a considerable economic and emotional burden related to rotavirus gastroenteritis. One way to substantially reduce this burden is to provide universal and affordable rotavirus vaccination to susceptible children, especially since cost-effectiveness studies have demonstrated that universal vaccination would be safe and efficacious against severe rotavirus gastroenteritis in these countries.

Burden of rotavirus gastroenteritis on caregivers: Findings from a systematic literature review

“… 25 Household transmission was discussed in several of the identified studies, again reinforcing the additional burden of caring for, and sharing a household with, RVGE patients. 10 , 11 , 15 , 17 …”

“… 16 Higher levels of anxiety and parental distress were also reported in hospital settings, with parents particularly concerned by the severity of symptoms and the effect these had on their child. 9 , 10 , 13 , 15 , 17 , 19 Laizane et al reported that in a sample of children hospitalized with RVGE, parents were negatively affected; of note, their emotional (feelings of distress, exhaustion and helplessness), social (disruption of schedules and restrictions on daily life), and economic (lost working days and increased expenditure on nappies) burden was affected, regardless of the severity of the health status of their child. 13 Parents in Vietnam had little knowledge of RVGE, and so were particularly worried about preventing the disease in the future.…”

“… 13 Parents in Vietnam had little knowledge of RVGE, and so were particularly worried about preventing the disease in the future. 15 …”

Health-related quality of life of the parents of children hospitalized due to acute rotavirus infection: a cross-sectional study in Latvia

“…In our study and other studies, parents experienced lost work days [ 5 , 20 ] and additional expenditures. [ 17 , 21 ].…”

“…Tearfulness and irritability are usually not associated with the image of a healthy child in Latvia, and these symptoms can provoke more intense levels of parental distress, worry and anxiety. Cultural factors regarding the impact of rotavirus gastroenteritis on families were analyzed in an ethnographic study in Taiwan and Vietnam [ 21 ]; another study also compared the emotional reactions of Spanish, Italian and Polish parents due to childhood acute rotavirus gastroenteritis. To help parents manage their child’s health needs during an acute illness and their own perceptions and reactions toward their child’s symptoms, sufficient parental health education is required [ 24 ].…”