title: Systematic review of studies on rotavirus disease cost-of-illness and productivity loss in Latin America and the Caribbean.
abstract: BACKGROUND
  Rotavirus is the most common cause of severe acute diarrhea among children in both developed and developing countries. Vaccination can reduce the disease burden and its incorporation into health care systems should consider future costs and benefits.
  
  
  OBJECTIVE
  To systematically review studies on costs due to rotavirus infection in Latin America and Caribbean (LAC) region, considering their methods and results.
  
  
  METHODS
  A search of relevant databases including the Cochrane Central Register of Controlled Trials, Embase, MEDLINE via PubMed, the Latin American and Caribbean Health Sciences Literature database (LILACS), and the Brazilian Thesis Databank was performed. Inclusion criteria for studies were: (a) economic evaluation or cost-of-illness studies; (b) conducted in the LAC region; (c) assess economic burden of rotavirus disease or the economic impact of rotavirus vaccination programs. Two authors independently screened the studies for eligibility.
  
  
  RESULTS
  Of 444 studies initially retrieved, 21 met the eligibility criteria and were included (14 cost-effectiveness analyses of vaccination programs and 7 cost-of-illness studies). Direct medical costs were assessed in all 21 studies, but only 10 also investigated indirect and non-medical direct costs. The most commonly observed methods for cost estimation were retrospective database analysis and hospital-based surveillance study. Only one study was a household-based survey.A wide cost range was identified (e.g., inpatient care US$79.91 to US$858.40 and outpatient care US$13.06 to US$64.10), depending on the methods, study perspective, and type of costs included.
  
  
  CONCLUSIONS
  Rotavirus-associated costs were assessed in 21 studies across the Latin America and Caribbean region. The majority of studies were made alongside economic evaluations of vaccination programs. Methods are broadly different among studies but administrative databases seem to be the most employed source of data.
authors.affiliation: Internal Medicine Department, State University of Rio de Janeiro, Rio de Janeiro, Brazil. mlibertad@gmail.com
authors.forename: Maíra Libertad Soligo
authors.initials: ML
authors.lastname: Takemoto
authors.forename: Luciana
authors.initials: L
authors.lastname: Bahia
authors.forename: Cristiana M
authors.initials: CM
authors.lastname: Toscano
authors.forename: Denizar Vianna
authors.initials: DV
authors.lastname: Araujo
mesh_terms: D017691:Caribbean Region / Q000453:epidemiology; D002675:Child, Preschool; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D003967:Diarrhea / Q000453:epidemiology / Q000821:virology; D004526:Efficiency; D017048:Health Care Costs; D006801:Humans; D017589:Immunization Programs / Q000191:economics*; D007843:Latin America / Q000453:epidemiology; D012400:Rotavirus Infections / Q000191:economics* / Q000453:epidemiology; D022243:Rotavirus Vaccines / Q000191:economics
chemical_list: D022243:Rotavirus Vaccines