title: Rotavirus mortality in India: estimates based on a nationally representative survey of diarrhoeal deaths.
abstract: OBJECTIVE
  To estimate the number of rotavirus-associated deaths among Indian children younger than five years.
  
  
  METHODS
  We surveyed more than 23 000 child deaths from a nationally representative survey of 1.1 million Indian households during 2001-2003. Diarrhoeal deaths were characterized by region, age and sex and were combined with the proportion of deaths attributable to rotavirus, as determined by hospital microbiologic data collected by the Indian Rotavirus Strain Surveillance Network from December 2005 to November 2007. Rotavirus vaccine efficacy data from clinical trials in developing countries were used to estimate the number of deaths preventable by a national vaccination programme. Data were analysed using Stata SE version 10.
  
  
  RESULTS
  Rotavirus caused an estimated 113 000 deaths (99% confidence interval, CI: 86 000-155 000); 50% (54 700) and 75% (85 400) occurred before one and two years of age, respectively. One child in 242 died from rotavirus infection before five years of age. Rotavirus-associated mortality rates overall, among girls and among boys were 4.14 (99% CI: 3.14-5.68), 4.89 (99% CI: 3.75-6.79) and 3.45 (99% CI: 2.58-4.66) deaths per 1000 live births, respectively. Rates were highest in Bihar, Uttar Pradesh and Madhya Pradesh, which together accounted for > 50% of deaths (64 400) nationally. Rotavirus vaccine could prevent 41 000-48 000 deaths among children aged 3-59 months.
  
  
  CONCLUSIONS
  The burden of rotavirus-associated mortality is high among Indian children, highlighting the potential benefits of rotavirus vaccination.
authors.affiliation: Division of Infectious Diseases, Hospital for Sick Children, University of Toronto, 555 University Ave, Toronto, ON M5G1X8, Canada.
authors.forename: Shaun K
authors.initials: SK
authors.lastname: Morris
authors.forename: Shally
authors.initials: S
authors.lastname: Awasthi
authors.forename: Ajay
authors.initials: A
authors.lastname: Khera
authors.forename: Diego G
authors.initials: DG
authors.lastname: Bassani
authors.forename: Gagandeep
authors.initials: G
authors.lastname: Kang
authors.forename: Umesh D
authors.initials: UD
authors.lastname: Parashar
authors.forename: Rajesh
authors.initials: R
authors.lastname: Kumar
authors.forename: Anita
authors.initials: A
authors.lastname: Shet
authors.forename: Roger I
authors.initials: RI
authors.lastname: Glass
authors.forename: Prabhat
authors.initials: P
authors.lastname: Jha
mesh_terms: D002675:Child, Preschool; D003967:Diarrhea / Q000276:immunology / Q000401:mortality* / Q000517:prevention & control / Q000821:virology; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011159:Population Surveillance; D012400:Rotavirus Infections / Q000276:immunology / Q000401:mortality* / Q000517:prevention & control; D022243:Rotavirus Vaccines / Q000008:administration & dosage / Q000276:immunology*
chemical_list: D022243:Rotavirus Vaccines