title: Estimates of the burden of rotavirus disease in Malaysia.
abstract: BACKGROUND
  Accurate national estimates of the disease burden associated with rotavirus diarrhea are essential when considering implementation of a rotavirus vaccination program. We sought to estimate rotavirus disease-associated morbidity and mortality in Malaysia, using available sources of information.
  
  
  METHODS
  We analyzed national data from the Ministry of Health (Kuala Lumpur, Malaysia) to derive rates of hospitalization, clinic visits, and deaths related to acute gastroenteritis (AG) among children <5 years of age. The number of events attributable to rotavirus infection was estimated by multiplying age-stratified rates of detection of rotavirus from 2 hospital surveillance sites by national data.
  
  
  RESULTS
  In 1999 and 2000, an average of 13,936 children (1 in 187 children) were hospitalized annually for AG. Surveillance of visits to outpatient clinics for AG identified an average of 60,342 such visits/year between 1998 and 2000. The AG-associated mortality rate was 2.5 deaths/100,000 children. On the basis of the finding that 50% of children were hospitalized for rotavirus diarrhea, we estimated that 1 in 61 children will be hospitalized for rotavirus disease and that 1 in 37 children will seek treatment as an outpatient.
  
  
  CONCLUSIONS
  Among Malaysian children, there is a significant burden associated with AG- and rotavirus disease-related hospitalizations and outpatient visits, and this burden potentially could be prevented by the use of rotavirus vaccines.
authors.affiliation: Respiratory and Enteric Virus Branch, Division of Viral and Rickettsial Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. rglass@cdc.gov
authors.forename: Vincent P
authors.initials: VP
authors.lastname: Hsu
authors.forename: Hasan Bin
authors.initials: HB
authors.lastname: Abdul Rahman
authors.forename: Swee Lan
authors.initials: SL
authors.lastname: Wong
authors.forename: Lailanor H J
authors.initials: LH
authors.lastname: Ibrahim
authors.forename: Ahmad Faudzi H J
authors.initials: AF
authors.lastname: Yusoff
authors.forename: Lee Gaik
authors.initials: LG
authors.lastname: Chan
authors.forename: Umesh
authors.initials: U
authors.lastname: Parashar
authors.forename: Roger I
authors.initials: RI
authors.lastname: Glass
authors.forename: Joseph
authors.initials: J
authors.lastname: Bresee
mesh_terms: D002675:Child, Preschool; D003967:Diarrhea / Q000453:epidemiology / Q000401:mortality / Q000821:virology; D005260:Female; D006761:Hospitals; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008296:Malaysia / Q000453:epidemiology; D008297:Male; D010045:Outpatients; D012401:Rotavirus / Q000302:isolation & purification; D012400:Rotavirus Infections / Q000453:epidemiology* / Q000401:mortality; D018571:Sentinel Surveillance