Global illness and deaths caused by rotavirus disease in children

Abstract

To estimate the global illness and deaths caused by rotavirus disease, we reviewed studies published from 1986 to 2000 on deaths caused by diarrhea and on rotavirus infections in children. We assessed rotavirus-associated illness in three clinical settings (mild cases requiring home care alone, moderate cases requiring a clinic visit, and severe cases requiring hospitalization) and death rates in countries in different World Bank income groups. Each year, rotavirus causes approximately 111 million episodes of gastroenteritis requiring only home care, 25 million clinic visits, 2 million hospitalizations, and 352,000-592,000 deaths (median, 440,000 deaths) in children <5 years of age. By age 5, nearly every child will have an episode of rotavirus gastroenteritis, 1 in 5 will visit a clinic, 1 in 65 will be hospitalized, and approximately 1 in 293 will die. Children in the poorest countries account for 82% of rotavirus deaths. The tremendous incidence of rotavirus disease underscores the urgent need for interventions, such as vaccines, particularly to prevent childhood deaths in developing nations.

Figure 1

A. Percentage of deaths in children <5 years that are attributable to diarrhea for countries in different World Bank Income Groups, by gross national product (GNP) per capita of the country. B. Percentage of diarrhea hospitalization attributable to rotavirus for countries in different World Bank income groups, by GNP per capita of the country. IQR, interquartile range.

Figure 2

Estimated global distribution of 440,000 annual deaths in children caused by rotavirus diarrhea.

Figure 3

Estimated global prevalence of rotavirus disease.