title: Burden of Childhood Rotavirus Disease in the Outpatient Setting of the Russian Federation.
abstract: BACKGROUND
  This is a prospective, multicentered study conducted in 9 large urban areas in Russia, in order to determine the burden of rotavirus gastroenteritis in children <5 years of age and the genotypes circulating during 1 rotavirus season.
  
  
  METHODS
  From November 2012 to May 2013, surveillance was conducted in Moscow, Saint-Petersburg, Vologda, Krasnodar, Krasnoyarsk, Novosibirsk, Yaroslavl, Khanty-Mansiysk and Vladivostok. Children <5 years of age presenting at outpatient clinics with acute gastroenteritis (AGE) of less than 72 hours duration were enrolled in the study. Stool samples were tested for rotavirus and positive samples were P- and G-typed. Clinical symptoms were captured by physicians and parents on Day 1. Symptom severity was analyzed by Vesikari scoring system. The direct expenses of parents caused by AGE were obtained from questionnaires provided to parents by phone.
  
  
  RESULTS
  A total of 501 were children enrolled. Stool samples were analyzed for 487 (97%) children, and 151 (31%) of those were rotavirus positive. Rotavirus gastroenteritis was associated with more severe clinical course (Vesikari score 11.4 ± 2.2) versus non-rotavirus gastroenteritis (Vesikari score 9 ± 3). The identified serotypes were G4P[8] 38.9%, G1P[8] 34.2%, G3P[8] 6%, G9P[8] 6%, G2P[4] 2% and G4P[4] 0.7%. The mean overall expenses of parents caused by rotavirus and non-rotavirus gastroenteritis were 143.7 USD and 128.8 USD, respectively.
  
  
  CONCLUSIONS
  Rotavirus accounted for 31% of all AGE-related outpatient visits. The major rotavirus genotypes were G1P[8] and G4P[8]. Rotavirus gastroenteritis was associated with significantly more severe clinical symptoms than non-rotavirus gastroenteritis. The average costs of rotavirus cases for parents of children were elevated against the same indications for non-rotavirus. These findings underscore the need for a safe and effective rotavirus vaccine in Russia.
authors.affiliation: From the *Scientific Research Institute of Children's Infections, Saint-Petersburg 197002, Russian Federation; †Merck & Co., Inc., West Point, Pennsylvania; ‡Central Research Institute of Epidemiology, Moscow, Russian Federation; §Russian National Research Medical Institute by N.I.Pirogov, Department of Outpatient and Emergency Pediatrics, Moscow, Russian Federation; and ¶Institute of Chemical Biology and Fundamental Medicine, Novosibirsk 630090, Russian Federation.
authors.forename: Yury V
authors.initials: YV
authors.lastname: Lobzin
authors.forename: Susanna M
authors.initials: SM
authors.lastname: Kharit
authors.forename: Michelle G
authors.initials: MG
authors.lastname: Goveia
authors.forename: Megan A
authors.initials: MA
authors.lastname: O'Brian
authors.forename: Alexander T
authors.initials: AT
authors.lastname: Podkolzin
authors.forename: Boris M
authors.initials: BM
authors.lastname: Blokhin
authors.forename: Maria K
authors.initials: MK
authors.lastname: Bekhtereva
authors.forename: Alla V
authors.initials: AV
authors.lastname: Rudakova
authors.forename: Nina V
authors.initials: NV
authors.lastname: Tikunova
mesh_terms: D002675:Child, Preschool; D005243:Feces / Q000821:virology; D005260:Female; D005759:Gastroenteritis / Q000453:epidemiology* / Q000821:virology; D005838:Genotype; D005102:Health Expenditures; D006801:Humans; D007223:Infant; D008297:Male; D010045:Outpatients; D011446:Prospective Studies; D012401:Rotavirus / Q000145:classification* / Q000235:genetics* / Q000302:isolation & purification; D012400:Rotavirus Infections / Q000453:epidemiology* / Q000821:virology; D012426:Russia / Q000453:epidemiology; D012720:Severity of Illness Index; D012800:Siberia / Q000453:epidemiology; D011795:Surveys and Questionnaires