Socioeconomic impact of Rotavirus diarrhea in Vellore, India

Overall Aim: To estimate the full cost of rotavirus-associated and all-cause diarrhea in Vellore, India.

Background and Significance: As the leading cause of severe acute gastroenteritis in children, Rotavirus causes 100,000 deaths/year in India. Immunization may prevent rotavirus-associated morbidity and mortality. No economic analysis has been performed for rotavirus based on local costing data in India. Estimating the total cost of rotavirus-associated and all-cause diarrhea in India will provide a valuable baseline against which the cost-effectiveness of the rotavirus vaccine may be measured.

Methods: Parents of young children from Vellore visiting clinics, emergency rooms, or hospitalized with acute diarrhea completed a questionnaire detailing their healthcare utilization patterns, medical and non-medical expenditures, and lost income due to their child's illness. For each subject, fecal samples were screened for rotavirus and medical records examined. Unit costs were estimated for inpatient and outpatient resource consumption per episode, stratified by facility type. The full cost of rotavirus-associated and all-cause diarrhea per episode was estimated from the perspective of the patient and healthcare system.

Results: Preliminary analyses showed an average household family unit spent 17.4% of its yearly income on each diarrheal episode resulting in a hospitalization (median = 5.6%). Rotavirus diarrhea was more expensive per episode than all-cause diarrhea (2070 Rs vs. 3725 Rs), a difference attributable to rotavirus diarrhea's higher rate of hospitalization over other types of diarrhea. Therefore, rotavirus vaccination could provide significant economic savings for both the Indian healthcare system and individual Indian families by reducing the number of diarrheal hospitalizations.