title: The impact of rotavirus vaccination on emergency department visits and hospital admissions for acute diarrhea in children under 5 years.
abstract: Acute diarrheal disease is the second cause of death in children under 5 years. In Brazil, from 2003 to 2009, acute diarrhea was responsible for nearly 100,000 hospital admissions per year and 4% of the deaths in children under 5 years. Rotavirus is the leading cause of severe acute diarrhea worldwide. In 2006, the rotavirus monovalent vaccine (RV1) was added to the Brazilian National Immunization Program.
  To analyze the impact of the RV1 on emergency department (ED) visits and hospital admissions for acute diarrhea.
  A retrospective ecologic study at the University Hospital, University of São Paulo. The study analyzed the pre-vaccine (2003-2005) and the post-vaccine (2007-2009) periods. We screened the main diagnosis of all ED attendances and hospital admissions of children under 5 years in an electronic registry system database and calculated the rates of ED visits and hospital admissions. The reduction rate was analyzed according to the following formula: reduction (%) = (1 - odds ratio) x 100.
  The rates of ED visits for acute diarrhea was 85.8 and 80.9 per 1,000 total ED visits in the pre and post vaccination periods, respectively, resulting in 6% reduction (95CI 4 to 9%, p<0.001). The rates of hospital admissions for acute diarrhea was 40.8 per 1,000 in the pre-vaccine period and dropped to 24.9 per 1,000 hospitalizations, resulting in 40% reduction (95CI 22 to 54%, p<0.001).
  The introduction of the RV1 vaccine resulted in 6% reduction in the ED visits and 40% reduction in hospital admissions for acute diarrhea.
authors.affiliation: MSc in Pediatrics, Hospital Universitário, Universidade de São Paulo (HU-USP), São Paulo, SP, Brazil.
authors.forename: Rodrigo Locatelli Pedro
authors.initials: RL
authors.lastname: Paulo
authors.affiliation: MSc in Pediatrics, São Paulo, SP, Brazil.
authors.forename: André Broggin Dutra
authors.initials: AB
authors.lastname: Rodrigues
authors.affiliation: PhD in Pediatrics, HU-USP, São Paulo, SP, Brazil.
authors.forename: Beatriz Marcondes
authors.initials: BM
authors.lastname: Machado
authors.affiliation: PhD in Pediatrics, HU-USP, São Paulo, SP, Brazil.
authors.forename: Alfredo Elias
authors.initials: AE
authors.lastname: Gilio
mesh_terms: D000208:Acute Disease; D001938:Brazil / Q000453:epidemiology; D002675:Child, Preschool; D003967:Diarrhea / Q000453:epidemiology / Q000517:prevention & control / Q000821:virology*; D004636:Emergency Service, Hospital; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D017589:Immunization Programs; D007223:Infant; D012189:Retrospective Studies; D012400:Rotavirus Infections / Q000453:epidemiology / Q000517:prevention & control*; D022243:Rotavirus Vaccines / Q000008:administration & dosage*; D012621:Seasons
chemical_list: D022243:Rotavirus Vaccines