title: Epidemiology and burden of rotavirus disease in Central Asia.
abstract: BACKGROUND
  Rotavirus infection is the most common cause of severe gastroenteritis in children worldwide. New rotavirus vaccines are not currently used in the five countries that make up the Central Asian region. Three of these countries, Kazakhstan, Uzbekistan, and Kyrgyzstan, have a combined total population of 48 million and an estimated 1 million annual births.
  
  
  METHODS
  We conducted prospective hospital-based surveillance for rotavirus diarrhea in three Central Asian countries (Kazakhstan, Uzbekistan, and Kyrgyzstan) during 2005-2009 to estimate the burden of rotavirus. We calculated the proportion of rotavirus among children aged <5 years hospitalized with acute diarrhea and estimated numbers of rotavirus-associated deaths, hospitalizations, outpatient visits, and home care episodes.
  
  
  RESULTS
  Of 20 780 children hospitalized with diarrhea and enrolled in the study, 26% (95% confidence interval (CI) 25-27) were positive for rotavirus antigen by ELISA. On an annual basis, 4007 (2.6 per 1000 child-years) rotavirus hospitalizations occur in Kazakhstan, 5491 (2.1 per 1000 child-years) in Uzbekistan, and 3883 (6.8 per 1000 child-years) in Kyrgyzstan. Rotavirus is also estimated to cause 68 (0.04 per 1000 child-years) deaths in children aged <5 years in Kazakhstan, 662 (0.25 per 1000 child-years) in Uzbekistan, and 156 (0.27 per 1000 child-years) in Kyrgyzstan.
  
  
  CONCLUSIONS
  This study presents an epidemiological picture of rotavirus disease in Central Asia and illustrates a substantial rotavirus burden, which is preventable with rotavirus vaccination.
authors.affiliation: National Reference Laboratory of Uzbekistan, 7A, Yangishahar str., Yunusabad-3, Tashkent 100194, Uzbekistan. renatlatip@gmail.com
authors.forename: Renat
authors.initials: R
authors.lastname: Latipov
authors.forename: Elmira
authors.initials: E
authors.lastname: Utegenova
authors.forename: Aynagul
authors.initials: A
authors.lastname: Kuatbayeva
authors.forename: Kaliya
authors.initials: K
authors.lastname: Kasymbekova
authors.forename: Sabyrjan
authors.initials: S
authors.lastname: Abdykarimov
authors.forename: Rivojiddin
authors.initials: R
authors.lastname: Juraev
authors.forename: Umid
authors.initials: U
authors.lastname: Ismailov
authors.forename: Elmira
authors.initials: E
authors.lastname: Flem
mesh_terms: D001209:Asia, Central / Q000453:epidemiology; D002675:Child, Preschool; D003967:Diarrhea / Q000453:epidemiology* / Q000821:virology; D005260:Female; D005759:Gastroenteritis / Q000453:epidemiology* / Q000503:physiopathology / Q000517:prevention & control / Q000821:virology; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007623:Kazakhstan / Q000453:epidemiology; D007707:Kyrgyzstan / Q000453:epidemiology; D008297:Male; D012401:Rotavirus / Q000276:immunology / Q000302:isolation & purification*; D012400:Rotavirus Infections / Q000453:epidemiology* / Q000503:physiopathology / Q000517:prevention & control / Q000821:virology; D018571:Sentinel Surveillance; D014610:Uzbekistan / Q000453:epidemiology