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