TY - JOUR
T1 - Rotavirus disease burden and impact and cost-effectiveness of a rotavirus vaccination program in kenya
AU - Tate, Jacqueline E
AU - Rheingans, Richard D
AU - O'Reilly, Ciara E
AU - Obonyo, Benson
AU - Burton, Deron C
AU - Tornheim, Jeffrey A
AU - Adazu, Kubaje
AU - Jaron, Peter
AU - Ochieng, Benjamin
AU - Kerin, Tara
AU - Calhoun, Lisa
AU - Hamel, Mary
AU - Laserson, Kayla
AU - Breiman, Robert F
AU - Feikin, Daniel R
AU - Mintz, Eric D
AU - Widdowson, Marc-Alain
PY - 2009
Y1 - 2009
N2 - BACKGROUND: The projected impact and cost-effectiveness of rotavirus vaccination are important for supporting rotavirus vaccine introduction in Africa, where limited health intervention funds are available.METHODS: Hospital records, health utilization surveys, verbal autopsy data, and surveillance data on diarrheal disease were used to determine rotavirus-specific rates of hospitalization, clinic visits, and deaths due to diarrhea among children <5 years of age in Nyanza Province, Kenya. Rates were extrapolated nationally with use of province-specific data on diarrheal illness. Direct medical costs were estimated using record review and World Health Organization estimates. Household costs were collected through parental interviews. The impact of vaccination on health burden and on the cost-effectiveness per disability-adjusted life-year and lives saved were calculated.RESULTS: Annually in Kenya, rotavirus infection causes 19% of hospitalizations and 16% of clinic visits for diarrhea among children <5 years of age and causes 4471 deaths, 8781 hospitalizations, and 1,443,883 clinic visits. Nationally, rotavirus disease costs the health care system $10.8 million annually. Routine vaccination with a 2-dose rotavirus vaccination series would avert 2467 deaths (55%), 5724 hospitalizations (65%), and 852,589 clinic visits (59%) and would save 58 disability-adjusted life-years per 1000 children annually. At $3 per series, a program would cost $2.1 million in medical costs annually; the break-even price is $2.07 per series.CONCLUSIONS: A rotavirus vaccination program would reduce the substantial burden of rotavirus disease and the economic burden in Kenya.
AB - BACKGROUND: The projected impact and cost-effectiveness of rotavirus vaccination are important for supporting rotavirus vaccine introduction in Africa, where limited health intervention funds are available.METHODS: Hospital records, health utilization surveys, verbal autopsy data, and surveillance data on diarrheal disease were used to determine rotavirus-specific rates of hospitalization, clinic visits, and deaths due to diarrhea among children <5 years of age in Nyanza Province, Kenya. Rates were extrapolated nationally with use of province-specific data on diarrheal illness. Direct medical costs were estimated using record review and World Health Organization estimates. Household costs were collected through parental interviews. The impact of vaccination on health burden and on the cost-effectiveness per disability-adjusted life-year and lives saved were calculated.RESULTS: Annually in Kenya, rotavirus infection causes 19% of hospitalizations and 16% of clinic visits for diarrhea among children <5 years of age and causes 4471 deaths, 8781 hospitalizations, and 1,443,883 clinic visits. Nationally, rotavirus disease costs the health care system $10.8 million annually. Routine vaccination with a 2-dose rotavirus vaccination series would avert 2467 deaths (55%), 5724 hospitalizations (65%), and 852,589 clinic visits (59%) and would save 58 disability-adjusted life-years per 1000 children annually. At $3 per series, a program would cost $2.1 million in medical costs annually; the break-even price is $2.07 per series.CONCLUSIONS: A rotavirus vaccination program would reduce the substantial burden of rotavirus disease and the economic burden in Kenya.
KW - Cost of Illness
KW - Cost-Benefit Analysis
KW - Health Care Costs
KW - Hospitalization/statistics & numerical data
KW - Humans
KW - Immunization Programs
KW - Kenya
KW - Rotavirus Infections/economics
KW - Rotavirus Vaccines/economics
KW - Vaccination
KW - World Health Organization
U2 - 10.1086/605058
DO - 10.1086/605058
M3 - A1: Web of Science-article
C2 - 19817618
SN - 0022-1899
VL - 200 Suppl 1
SP - S76-S84
JO - Journal of Infectious Diseases
JF - Journal of Infectious Diseases
ER -