title: Baseline burden of rotavirus disease in Sudan to monitor the impact of vaccination.
abstract: BACKGROUND
  In 2011, Sudan became the first low-income country in Africa to introduce a rotavirus vaccine. Prevaccine baseline data on rotavirus disease burden are crucial for monitoring the impact of this new vaccine program.
  
  
  METHODS
  We conducted active, hospital-based surveillance for rotavirus disease at 8 regional public hospitals in Sudan using a standard protocol recommended by the World Health Organization for 2 full years immediately preceding vaccine introduction. Cases were children <5 years hospitalized with gastroenteritis, defined as acute onset of 3 or more loose stools or 2 or more episodes of vomiting in a 24-hour period. Stool specimens from cases were tested for rotavirus using a commercially available assay.
  
  
  RESULTS
  From June 2009 to May 2011, rotavirus was detected in 3985 (36%) of 10,953 children hospitalized for gastroenteritis, with detection rates ranging from 25% to 48% at the 8 hospitals. Approximately 61% of the rotavirus hospitalizations occurred before 1 year of age and most (91%) occurred before 2 years of age. Rotavirus was detected year-round in Sudan with peaks during March to May and November to December. Applying rotavirus prevalence to national estimates of diarrhea events, we calculated 9800 deaths, 22,800 hospitalizations and 55,400 outpatient visits related to rotavirus per year among children <5 years of age in Sudan.
  
  
  CONCLUSIONS
  The high burden of rotavirus disease in Sudan indicates that the recently implemented vaccination program should substantially improve child health in Sudan. This nationwide rotavirus surveillance system will be an important platform for assessing the benefits and value of rotavirus vaccine in a developing country setting.
authors.affiliation: From the *Ministry of Health, Khartoum, Sudan; †World Health Organization, Regional Office for the Eastern Mediterranean, Cairo, Egypt; and ‡Centers for Diseases Control and Prevention, Atlanta, GA.
authors.forename: Amani
authors.initials: A
authors.lastname: Mustafa
authors.forename: Alia
authors.initials: A
authors.lastname: Makki
authors.forename: Omer
authors.initials: O
authors.lastname: Siddig
authors.forename: Salah
authors.initials: S
authors.lastname: Haithami
authors.forename: Nadia
authors.initials: N
authors.lastname: Teleb
authors.forename: Tarak
authors.initials: T
authors.lastname: Trivedi
authors.forename: Umesh
authors.initials: U
authors.lastname: Parashar
authors.forename: Manish
authors.initials: M
authors.lastname: Patel
mesh_terms: D002675:Child, Preschool; D017281:Cost of Illness; D003967:Diarrhea / Q000453:epidemiology / Q000821:virology; D005260:Female; D005759:Gastroenteritis / Q000453:epidemiology* / Q000517:prevention & control / Q000821:virology; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D008297:Male; D015995:Prevalence; D062486:Public Health Surveillance; D012400:Rotavirus Infections / Q000453:epidemiology* / Q000401:mortality / Q000517:prevention & control; D022243:Rotavirus Vaccines / Q000008:administration & dosage; D013397:Sudan
chemical_list: D022243:Rotavirus Vaccines