title: Rotavirus disease burden and impact and cost-effectiveness of a rotavirus vaccination program in kenya.
abstract: BACKGROUND
  The projected impact and cost-effectiveness of rotavirus vaccination are important for supporting rotavirus vaccine introduction in Africa, where limited health intervention funds are available.
  
  
  METHODS
  Hospital records, health utilization surveys, verbal autopsy data, and surveillance data on diarrheal disease were used to determine rotavirus-specific rates of hospitalization, clinic visits, and deaths due to diarrhea among children <5 years of age in Nyanza Province, Kenya. Rates were extrapolated nationally with use of province-specific data on diarrheal illness. Direct medical costs were estimated using record review and World Health Organization estimates. Household costs were collected through parental interviews. The impact of vaccination on health burden and on the cost-effectiveness per disability-adjusted life-year and lives saved were calculated.
  
  
  RESULTS
  Annually in Kenya, rotavirus infection causes 19% of hospitalizations and 16% of clinic visits for diarrhea among children <5 years of age and causes 4471 deaths, 8781 hospitalizations, and 1,443,883 clinic visits. Nationally, rotavirus disease costs the health care system $10.8 million annually. Routine vaccination with a 2-dose rotavirus vaccination series would avert 2467 deaths (55%), 5724 hospitalizations (65%), and 852,589 clinic visits (59%) and would save 58 disability-adjusted life-years per 1000 children annually. At $3 per series, a program would cost $2.1 million in medical costs annually; the break-even price is $2.07 per series.
  
  
  CONCLUSIONS
  A rotavirus vaccination program would reduce the substantial burden of rotavirus disease and the economic burden in Kenya.
authors.affiliation: Centers for Disease Control and Prevention, Atlanta,GA 30333, USA. jqt8@cdc.gov
authors.forename: Jacqueline E
authors.initials: JE
authors.lastname: Tate
authors.forename: Richard D
authors.initials: RD
authors.lastname: Rheingans
authors.forename: Ciara E
authors.initials: CE
authors.lastname: O'Reilly
authors.forename: Benson
authors.initials: B
authors.lastname: Obonyo
authors.forename: Deron C
authors.initials: DC
authors.lastname: Burton
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Tornheim
authors.forename: Kubaje
authors.initials: K
authors.lastname: Adazu
authors.forename: Peter
authors.initials: P
authors.lastname: Jaron
authors.forename: Benjamin
authors.initials: B
authors.lastname: Ochieng
authors.forename: Tara
authors.initials: T
authors.lastname: Kerin
authors.forename: Lisa
authors.initials: L
authors.lastname: Calhoun
authors.forename: Mary
authors.initials: M
authors.lastname: Hamel
authors.forename: Kayla
authors.initials: K
authors.lastname: Laserson
authors.forename: Robert F
authors.initials: RF
authors.lastname: Breiman
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Feikin
authors.forename: Eric D
authors.initials: ED
authors.lastname: Mintz
authors.forename: Marc-Alain
authors.initials: MA
authors.lastname: Widdowson
mesh_terms: D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D017048:Health Care Costs; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D017589:Immunization Programs; D007630:Kenya; D012400:Rotavirus Infections / Q000191:economics*; D022243:Rotavirus Vaccines / Q000191:economics; D014611:Vaccination; D014944:World Health Organization
chemical_list: D022243:Rotavirus Vaccines