[Show abstract][Hide abstract] ABSTRACT: This study assessed the family and heath system's costs due to diarrhoea in children <2 years old, before/after the introduction of a rotavirus vaccine in Brazil in 2006. Information on diarrhoea health care costs and morbidity were obtained from the primary health care system, the National Public Health database (2004-2008) and care-givers. Diarrhoea ambulatory consultations and hospitalizations had a declining trend during the entire period, with additional steeper reductions after vaccine introduction. The vaccine thus is associated with reduced diarrhoea consultations and hospitalization costs and families' out-of-pocket expenses. Despite these gains, the overall health system's costs have increased.
[Show abstract][Hide abstract] ABSTRACT: Rotavirus vaccines were introduced in Brazil in 2006; we evaluated their effects in the state of Sergipe, Brazil.
We performed a cross-sectional survey of children with diarrhea attending emergency services in Aracaju, Brazil, between October 2006 and April 2008 and a cluster sampling survey to assess vaccination coverage. Vaccine efficacy was assessed using the screening method. Diarrhea consultation and hospitalization data (2003-2007) were obtained from state and national surveillance systems.
Rotavirus was detected in 59 of 534 stool samples (11%) from children attending emergency services. The number of rotavirus-positive samples decreased from 18 of 74 (24%) in 2006 to 31 of 321 (9.5%) in 2007 and 10 of 136 (7.4%) in 2008 (P < .01). Diarrhea severity was greater in children with rotavirus (P < .01) but decreased over time (P < .001). Of the rotaviruses detected, 56 of 59 (95%) were PG2 genotype, 1 was PG-non-typeable (NT), 1 was P[NT]G2, and 1 was P[NT]GNT. Diarrhea consultations decreased from 3020 in 2004 to 604 in 2007; reductions were greatest among children under 5 years old. Diarrhea hospitalizations decreased from 2121 in 2003 to 1176 in 2007. Vaccine coverage was 90.3%. Vaccines were highly effective against the strain PG1; efficacy against PG2 genotype was 89% (95% confidence interval: 0.87-0.92) in Aracaju and 95% in Sergipe.
Since vaccines were introduced in 2006, there has been an overall reduction in diarrhea consultations and hospitalizations in northeast Brazil, with the greatest reductions in young children. This might have resulted from vaccination and improved sanitation. Although a single rotavirus genotype (PG2) was recovered, vaccine efficacy was high against this genotype.