Disease burden and related medical costs of rotavirus infections in Taiwan.
BACKGROUND
The disease burden and associated medical costs of rotavirus infections in inpatient and outpatient sectors in Taiwan were examined in anticipation of the availability of new rotavirus vaccines.


METHODS
The yearly national case number and medical costs for all for inpatients and outpatients with acute gastroenteritis (AGE) were extracted from the Bureau of National Health Insurance database in Taiwan according to ICD-9-CM codes. A retrospective study was also performed using records of children with AGE seen at three hospitals in Taiwan in 2001 to identify laboratory confirmed rotavirus infection cases. The annual incidence and related medical costs of AGE due to rotavirus infection were then estimated.


RESULTS
Children <5 years old comprised 83.6% of inpatient and 62.0% of outpatient pediatric AGE cases in Taiwan in 2001. Rotavirus was the most common agent detected among AGE patients in this age group in the three hospitals, and was detected in 32.9% (221/672) of inpatient and 24% (23/96) of outpatient stool specimens tested for microbial etiologies. An estimated 277,400 to 624,892 cases of rotavirus infections sought medical care in Taiwan in 2001, equaling one in 2 to 5 children <5 years old required medical care due to rotavirus infection. The incidence of hospitalization due to rotavirus infections was 1,528-1,997/100,000 for children <5 years old. The total associated medical costs due to rotavirus infection were estimated at US $10-16 millions in Taiwan in 2001. Although the per-capita medical cost of rotavirus infection was lower in Taiwan than in the United States or Hong Kong, the personal economic burden was similar among the three places when normalized for gross national incomes per capita.


CONCLUSIONS
Infections caused by rotavirus constitute an important human and economic burden among young children in Taiwan. A safe and effective vaccine is urgently needed.
Lu
Chun-Yi
CY
Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan. chunyi@ha.mc.ntu.edu.tw <chunyi@ha.mc.ntu.edu.tw>
Lauderdale
Tsai-Ling
TL
Fang
Yin-Hua
YH
Wang
Chung-Yi
CY
Ho
Yu-Huai
YH
Hung
Che-Lun
CL
Chang
Luan-Yin
LY
Lee
Chin-Yun
CY
Huang
Li-Min
LM
D000293:Adolescent; D002648:Child; D002673:Child, Hospitalized; D002675:Child, Preschool; D017281:Cost of Illness; D005759:Gastroenteritis / Q000821:virology*; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D007223:Infant; D007297:Inpatients; D010045:Outpatients; D012189:Retrospective Studies; D012401:Rotavirus / Q000302:isolation & purification / Q000472:pathogenicity; D012400:Rotavirus Infections / Q000191:economics* / Q000453:epidemiology* / Q000517:prevention & control; D022243:Rotavirus Vaccines; D013624:Taiwan / Q000453:epidemiology
D022243:Rotavirus Vaccines