Rotavirus disease burden and impact and cost-effectiveness of a rotavirus vaccination program in kenya.
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.
Tate
Jacqueline E
JE
Centers for Disease Control and Prevention, Atlanta,GA 30333, USA. jqt8@cdc.gov
Rheingans
Richard D
RD
O'Reilly
Ciara E
CE
Obonyo
Benson
B
Burton
Deron C
DC
Tornheim
Jeffrey A
JA
Adazu
Kubaje
K
Jaron
Peter
P
Ochieng
Benjamin
B
Kerin
Tara
T
Calhoun
Lisa
L
Hamel
Mary
M
Laserson
Kayla
K
Breiman
Robert F
RF
Feikin
Daniel R
DR
Mintz
Eric D
ED
Widdowson
Marc-Alain
MA
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
D022243:Rotavirus Vaccines