title: Incidence, characteristics, and economic burden of rotavirus gastroenteritis associated with hospitalization of israeli children <5 years of age, 2007-2008.
abstract: BACKGROUND
  Limited data exist on the epidemiology and burden of rotavirus gastroenteritis in Israel. Objectives. Our objective was to examine the incidence, characteristics, and economic burden of rotavirus gastroenteritis associated with hospitalization of children <5 years of age in Israel.
  
  
  METHODS
  A prospective study was initiated in pediatric wards at 3 hospitals in northern Israel. Presence of rotavirus in stool specimens was detected by immunochromatography, and G and P genotypes were determined by reverse-transcriptase polymerase chain reaction. Demographic data, clinical manifestations, and expenditures related to a child's illness were studied using parental interviews.
  
  
  RESULTS
  From November 2007 through October 2008, 472 children hospitalized with gastroenteritis were enrolled in the study. Rotavirus gastroenteritis was diagnosed in 39.1% of children, with a peak identification rate during November 2007-January 2008 (62.5%-71.0%). Most cases of rotavirus gastroenteritis (87.2%) occurred in children <2 years of age. In infections with 1 rotavirus genotype, G1P[8] was the most frequently detected (49.1%), followed by G1P[4] (11.1%) and G9P[8] (9.3%). Mixed rotavirus isolates were identified in 28.9% of the children. The estimated incidence of primary hospitalizations for rotavirus gastroenteritis among children aged 0-5 years was 5.7 hospitalizations per 1000 children per year (95% confidence interval, 5.1-6.3 hospitalizations per 1000 children per year), resulting in an estimate of 4099 annual national hospitalizations (95% confidence interval, 3668-4531 hospitalizations per year). This figure represents approximately 6.5% of the total annual hospitalizations among Israeli children <5 years of age. The annual calculated cost of hospitalizations for rotavirus gastroenteritis was US $7,680,444, including US $4,578,489 (59.6%) in direct costs to the health care system and US $3,101,955 in overall household costs.
  
  
  CONCLUSIONS
  Our findings are important for decision making regarding implementation and evaluation of a routine immunization program against rotavirus gastroenteritis.
authors.affiliation: Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Khitam
authors.initials: K
authors.lastname: Muhsen
authors.forename: Lester
authors.initials: L
authors.lastname: Shulman
authors.forename: Uri
authors.initials: U
authors.lastname: Rubinstein
authors.forename: Eias
authors.initials: E
authors.lastname: Kasem
authors.forename: Adi
authors.initials: A
authors.lastname: Kremer
authors.forename: Sophy
authors.initials: S
authors.lastname: Goren
authors.forename: Ilana
authors.initials: I
authors.lastname: Zilberstein
authors.forename: Gabby
authors.initials: G
authors.lastname: Chodick
authors.forename: Moshe
authors.initials: M
authors.lastname: Ephros
authors.forename: Dani
authors.initials: D
authors.lastname: Cohen
mesh_terms: D002675:Child, Preschool; D017281:Cost of Illness; D005260:Female; D005759:Gastroenteritis / Q000191:economics / Q000453:epidemiology* / Q000821:virology; D005838:Genotype; D005102:Health Expenditures; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007557:Israel / Q000453:epidemiology; D008297:Male; D011446:Prospective Studies; D011634:Public Health; D012401:Rotavirus / Q000145:classification / Q000235:genetics; D012400:Rotavirus Infections / Q000191:economics / Q000453:epidemiology* / Q000821:virology; D013997:Time Factors