Potential cost-effectiveness of a rotavirus immunization program in rural China.
BACKGROUND
To assess the incidence and economic burden of rotavirus diarrhea and the potential cost-effectiveness of a rotavirus immunization program in rural Zhengding County in Hebei Province, China.


METHODS
Population-based surveillance was conducted during the peak season for diarrhea among children who were <5 years of age in Zhengding County from 14 October 2004 through 19 January 2005. The cost of illness was measured from the perspectives of both patient and society. A decision-analytic model was applied to the cost-effectiveness analysis using real data derived from surveillance and from a cost-of-illness study.


RESULTS
During the surveillance period, 500 episodes of diarrhea were registered. Of these 500 episodes, 125 (25%) occurred in patients who were positive for rotavirus. Of these 125 episodes, 63 (50%) occurred in patients who were hospitalized. The overall incidence rate of rotavirus infection was 61.4 cases per 1000 children per year during the 14-week epidemic season. For a Chinese cohort of 5000 newborns, a universal rotavirus immunization program would prevent 1764 cases of rotavirus diarrhea, averting 882 hospitalizations of patients <or=5 years of age. At 2004 prices, the net savings due to the immunization program would be US$14,112 from a societal perspective and US$34,751 from a patient perspective.


CONCLUSIONS
Rotavirus was a leading cause of severe diarrhea among children <5 years of age and an economic burden for farmers in rural Zhengding County. Rotavirus vaccination should be considered as a potential cost-effective measure against rotavirus infection in China.
Wang
Xuan-Yi
XY
Institutes of Biomedical Sciences, School of Public Health, Fudan University, Shanghai, China.
Riewpaiboon
Arthorn
A
von Seidlein
Lorenz
L
Chen
Xing-Bao
XB
Kilgore
Paul E
PE
Ma
Jing-Chen
JC
Qi
Sun-Xiang
SX
Zhang
Zhi-Yong
ZY
Hao
Zhi-Yong
ZY
Chen
Ji-Chao
JC
Xu
Zhi-Yi
ZY
D002675:Child, Preschool; D002681:China; D003362:Cost-Benefit Analysis; D003967:Diarrhea / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control / Q000821:virology; D005260:Female; D006801:Humans; D017589:Immunization Programs / Q000191:economics*; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012400:Rotavirus Infections / Q000191:economics* / Q000453:epidemiology / Q000517:prevention & control*; D022243:Rotavirus Vaccines / Q000191:economics* / Q000276:immunology*; D012424:Rural Population
D022243:Rotavirus Vaccines