title: Economic burden of rotavirus disease in children under 5 years in Kazakhstan.
abstract: BACKGROUND
  We aimed to estimate the societal costs of rotavirus cases among children less than 5 years in Kazakhstan, an upper-middle income country in Central Asia.
  
  
  METHODS
  Data on medical, non-medical and indirect costs were collected for 190 patients less than 5 years, hospitalized with severe diarrhea in 2009 in two pediatric hospitals. Data on resource use for moderate and mild diarrhea cases were obtained from published sources. A probabilistic sensitivity analysis was performed to explore uncertainty in cost estimates.
  
  
  RESULTS
  Approximately 4,000 severe, 30,700 moderate, and 122,900 mild rotavirus cases were estimated annually in children <5 years old. The mean societal cost of a severe, moderate and mild rotavirus case was estimated at US$ 454, 82, and 21, respectively. The total annual cost of rotavirus disease was $37.53 million or on average $107.36 for a child under 5 years old in Kazakhstan. Ninety-four percent of total costs (35.13 million) are indirect costs (productivity losses) from fatal cases and parents' job absenteeism, while direct medical costs account for 2.04 million (5.4%), and direct non-medical for 0.46 million (1.2%).
  
  
  CONCLUSIONS
  Rotavirus-associated diarrhea represents a significant economic burden in Kazakhstan, largely due to indirect costs. The costs of rotavirus infections should be considered when planning further preventive actions, including the introduction of rotavirus vaccination.
authors.affiliation: University of Oslo, Reference Laboratory of Ministry of Health of Republic of Uzbekistan, 7A Muradova str., Tashkent 100190, Uzbekistan. renatlatip@gmail.com
authors.forename: Renat
authors.initials: R
authors.lastname: Latipov
authors.forename: Aynagul
authors.initials: A
authors.lastname: Kuatbaeva
authors.forename: Olga
authors.initials: O
authors.lastname: Kristiansen
authors.forename: Saltanat
authors.initials: S
authors.lastname: Aubakirova
authors.forename: Ulbosin
authors.initials: U
authors.lastname: Akhanaeva
authors.forename: Ivar Sønbø
authors.initials: IS
authors.lastname: Kristiansen
authors.forename: Elmira
authors.initials: E
authors.lastname: Flem
mesh_terms: D002675:Child, Preschool; D003967:Diarrhea / Q000191:economics / Q000453:epidemiology; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007623:Kazakhstan / Q000453:epidemiology; D008297:Male; D012400:Rotavirus Infections / Q000191:economics* / Q000453:epidemiology*