Affiliations: Department of Parasitology, Faculty of Medicine,
University of Kelaniya, Ragama, Sri Lanka | Department of Pediatrics, Faculty of Medicine,
University of Kelaniya, Ragama, Sri Lanka | Division of Infectious Diseases, Department of Social
and Environmental Medicine, Institute of Scientific Research, Faculty of
Medicine, Oita University, Oita, Japan | Department of Community Medicine, Faculty of Medicine,
University of Kelaniya, Ragama, Sri Lanka | Division of Molecular Epidemiology, Department of
Molecular Microbiology and Immunology, Nagasaki University, Nagasaki,
Japan
Note: [] Correspondence: Nilmini Chandrasena, MD, Department of
Parasitology, Faculty of Medicine, University of Kelaniya, PO Box 6, Talagolla
Road, Ragama, Sri Lanka. E-mail: [email protected]
Abstract: The objective of this study was to determine the morbidity and
associated costs of rotavirus infection in Sri Lanka in anticipation of
rotavirus vaccines. From April 2005 to October 2006 stool samples of 606
children (335 males) mean age 27.3 ± 31.53 months (range
1–144 months) admitted with gastroenteritis to the pediatric units of the
Colombo North teaching Hospital were screened for rotavirus antigens by
enzyme-immunoassay (EIA) (Rotaclone®.
Severity of gastroenteritis was assessed by the Vesikari scoring system. Using
an interviewer administered questionnaire the average expense incurred
per-episode of rotavirus gastroenteritis was determined among randomly selected
rotavirus cases (n=45). Cost of universal rotavirus
vaccination was assessed assuming a cost of US$ 7 per vaccine dose for a
two-dose regime (World Bank cost-effectiveness standard for low-income
countries). One hundred and sixteen (19.1% had group A rotavirus antigens.
The prevalence of rotavirus infection among the 0–4 years age group was
20.8%. The mean severity score was 12.8 and 11 in rotavirus positive and
non-rotavirus diarrheas, respectively (P < 0.001). Nausea,
vomiting and severe dehydration were significantly associated with rotavirus.
The average cost of an episode of rotavirus gastroenteritis hospitalization was
Rs. 3626 (US$ 33). The estimated annual expenditure of universal rotavirus
vaccination in Sri Lanka was US$ 5 million. Cost saved through averting
rotavirus hospitalizations per year was US$ 0.26 million. Deaths averted
were eight per year. Rotaviruses constitute an important health and economic
burden in Sri Lanka. Vaccine safety, efficacy and affordability are
requirements for implementation of universal rotavirus vaccination.
Keywords: Rotavirus, Sri Lanka, Vesikari score, cost analysis, vaccination
