Elsevier

Vaccine

Volume 32, Issue 30, 24 June 2014, Pages 3740-3751
Vaccine

Review
Economic and psychosocial Impact of rotavirus infection in Spain: A literature review

https://doi.org/10.1016/j.vaccine.2014.04.058Get rights and content

Highlights

Abstract

Severe rotavirus gastroenteritis is common in children under 5 years of age. A literature review was performed to investigate the economic and psychosocial impact of rotavirus infection in children in this age group. We retrieved 56 articles on the economic burden of the disease in Europe, 18 of them reported data from Spain; 8 articles were retrieved analysing its psychosocial impact. In Spain, rotavirus is responsible for 14% to 30% of all cases of gastroenteritis, and a quarter of these require hospitalisation. It is also associated with high use of health care resources (emergency and primary care visits). Rotavirus gastroenteritis costs the Spanish national health system EUR 28 million a year and causes productivity loss in two-thirds of parents (mean of 4 days). Taking into account these costs, it was estimated that implementing universal vaccination could prevent 76% to 95% of hospital admissions due to rotavirus gastroenteritis, as well as reduce emergency and paediatric visits, nosocomial infections, and days missed from work (77% reduction). Rotavirus gastroenteritis also has a considerable psychosocial impact on the family, although it is difficult to compare results due to the diversity of study designs and the low specificity of the measurement tools used. It also causes high stress among parents, adding to their workload and adversely affecting their quality of life.

Introduction

Rotavirus is the leading cause of gastroenteritis in children, and is believed to be the most common cause of severe diarrhoea in children under 5 years of age worldwide [1]. The epidemiological burden of rotavirus infection is high in developed countries. In Spain, for instance, the estimated annual incidence of emergency department visits due to rotavirus gastroenteritis is 17 to 19 cases per 1000 children, while that of hospitalisations is 2.5 to 6.5 cases [2], [3]. Rotavirus is also a major cause of nosocomial infection, with an estimated cumulative incidence of 7 cases per 100 hospitalised infants [2].

Rotavirus infection can be asymptomatic or result in gastroenteritis, which can cause severe dehydration and even shock in some cases. Treatment is symptomatic and consists of preventing dehydration.

In cases of severe dehydration, which particularly affects children under 2 years, parents may have difficulties ensuring adequate hydration. These difficulties – added to the burden of caring for a sick child – can cause considerable anxiety [4].

Rotavirus gastroenteritis has a major family and social impact, mostly related to productivity losses associated with parental absence from work. Furthermore, the high utilisation of health care resources associated with the disease places a considerable burden on national health care systems.

A literature search was undertaken to investigate the economic and psychosocial impact of rotavirus infection from the perspective of the health care system and society in Spain.

Section snippets

Economic impact

We performed a comprehensive literature review to identify publications reporting data on the burden and cost of rotavirus gastroenteritis in children under 5 years of age or the results of pharmacoeconomic analyses of the administration of available rotavirus vaccines. Using the Ovid platform, we searched the MEDLINE, Embase, Evidence-Based Medicine Reviews, and EconLit databases. We also searched the Spanish Medical Index (IME) database, the European Network of Health Economics Evaluation

Economic impact

The literature search retrieved 340 articles (Fig. 1), of which 56 were selected for full-text scrutiny. Of these, 5 were not considered to be relevant. Nineteen articles reported data for Spain (Table 1).

Of the 56 articles selected, 23 reported results from observational studies (12 retrospective, 9 prospective, and 2 cross-sectional). Seventeen articles presented results from a cost-effectiveness analysis of the implementation of a rotavirus vaccination programme. Of these, 4 analysed the

Discussion

The findings of this review indicate that rotavirus infection in children under 5 years of age is a major burden for the health care system and for society, and that it also has a considerable psychosocial impact on the families of affected children.

The percentage of children with acute rotavirus gastroenteritis requiring hospitalisation in Spain [6], [7] is similar to that in other European countries [10], [32], [33], [34]. Fewer children, however, are seen by health care professionals in

Conclusions

Rotavirus gastroenteritis is a major burden for health care systems and society and also has a considerable psychosocial impact on the families of affected children.

Recent cost-effectiveness studies of rotavirus vaccination in Spain indicate that universal vaccination is a cost-effective alternative for the Spanish public health system.

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