Temporal trends in hospitalization for rotavirus gastroenteritis: A nationwide study in Italy, 2005-2012

Abstract

AGE severity is linked to etiology, and Rotavirus (RV) accounts for most of severe cases. In 2009 the World Health Organization recommended RV vaccination for all children. Worldwide a number of Countries implemented RV vaccination in their pediatric immunisation programmes, but only a limited number in Europe. This study was designed to estimate the proportion of RVGE among children aged <6 y who were diagnosed with AGE and admitted to hospitals in Italy during the years 2005-2012. A total of 334,982 hospital discharge forms were collected, being 79,344 hospitalizations associated with RV. The average hospitalization rate (HR) was 146/100,000 children for RVGE in primary diagnosis (PD) and 150/100,000 children for RVGE in secondary diagnosis (SD). Since 2008 the RVGE hospitalization figures and rates (HRs) in SD exceed those in PD. The majority of RVGE hospitalizations (33.67%) were reported among children aged ≤ 2 years. Despite some limitations due to the hospital discharge database (HDD) synthetic contents and low potential for clinical interpretation, the analysis of national HDD, including PD and SD, documents that RV still represents a consistent cause of pediatric hospitalizations in Italy.

Keywords: children; diagnosis; frequency; gastroenteritis; hospitalization rates; rotavirus; vaccine.

Figure 1.

(A) Number of RVGE hospitalizations (code ICD9CM 008.61) in primary (PD) and secondary diagnosis (SD) among children <6 y of age in 2005–2012. Number of RVPD hospitalizations trend-test: β-coefficient = −253; p<0.014; number of RVSD hospitalizations trend-test: β-coefficient =163; p = 0 .184; total number of RV hospitalizations trend-test: β-coefficient =−89; p = 0 .630. RVPD: RVGE hospitalizations in primary diagnosis; RVSD: RVGE hospitalizations in secondary diagnosis; % RVPD: percentage of RVGE hospitalizations in primary diagnosis; % RVSD: percentage of RVGE hopistalizations in secondary diagnosis. (B) Hospitalization rates per 100,000 of RVGE PD and SD among children <6 y of age in 2005-2012. Hospitalization rates per 100,000 of RVGE PD trend-test: β-coefficient=-8.21; p=0.010; hospitalization rates per 100,000 of RVGE SD trend-test: β-coefficient=4 .40; p=0.209. Total HRRV trend-test: β coefficient = −3.80; p = 0.487. RVHRPD: hospitalization rates for RVGE gastroenteritis in primary diagnosis; RVHRSD: hospitalization rates for RVGE gastroenteritis in secondary diagnosis; RVHRTotal: hospitalization rates for RVGE gastroenteritis in any diagnosis (PD and SD).

Figure 2.

Number (N) and frequency (%) of other diseases in PD in RVGE SD cases.