title: Burden of rotavirus gastroenteritis in the Middle Eastern and North African pediatric population.
abstract: BACKGROUND
  Rotavirus gastroenteritis (RVGE) is the most common cause of severe childhood diarrhea worldwide. Objectives were to estimate the burden of RVGE among children less than five years old in the Middle East (Bahrain, Iran, Iraq, Israel, Jordan, Kuwait, Oman, Qatar, Saudi Arabia, Syria, UAE, Yemen), North Africa (Algeria, Egypt, Libya, Morocco, Tunisia) and Turkey.
  
  
  METHODS
  A comprehensive literature search was conducted in major databases on the epidemiology and burden of rotavirus among children less than five years old between 1999 and 2009. Data from each country was extracted and compared.
  
  
  RESULTS
  The search identified 43 studies. RVGE was identified in 16-61% of all cases of acute gastroenteritis, with a peak in the winter. RVGE-related hospitalization rates ranged from 14% to 45%, compared to 14%-28% for non-RVGE. Annually, RVGE caused up to 112 fatalities per 100,000 in certain countries in the region. Hospitalization costs ranged from $1.8 to $4.6 million annually, depending on the country. The most recent literature available showed that G1P[8] was the most prevalent genotype combination in 8 countries (range 23%-56%). G2P[4] was most prevalent in 4 countries (26%-48%). G9P[8] and G4P[8] were also frequently detected.
  
  
  CONCLUSIONS
  RVGE is a common disease associated with significant morbidity, mortality, and economic burden. Given the variety and diverse rotavirus types in the region, use of a vaccine with broad and consistent serotype coverage would be important to help decrease the burden of RVGE in the Middle East and North Africa.
authors.affiliation: BioMedCom Consultants inc,, 1405 TransCanada Highway, Suite 310, Montreal, Quebec H9P 2V9, Canada. hanane_khoury@biomedcom.org
authors.forename: Hanane
authors.initials: H
authors.lastname: Khoury
authors.forename: Isla
authors.initials: I
authors.lastname: Ogilvie
authors.forename: Antoine C
authors.initials: AC
authors.lastname: El Khoury
authors.forename: Yinghui
authors.initials: Y
authors.lastname: Duan
authors.forename: Mireille M
authors.initials: MM
authors.lastname: Goetghebeur
mesh_terms: D000352:Africa, Northern / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D017281:Cost of Illness; D005260:Female; D005759:Gastroenteritis / Q000191:economics* / Q000453:epidemiology / Q000821:virology; D006801:Humans; D007223:Infant; D008297:Male; D008877:Middle East / Q000453:epidemiology; D010372:Pediatrics / Q000191:economics*; D012401:Rotavirus / Q000145:classification / Q000235:genetics / Q000302:isolation & purification; D012400:Rotavirus Infections / Q000191:economics* / Q000453:epidemiology / Q000821:virology