Ardern-Holmes S L, Lennon D, Pinnock R, Nicholson R, Graham D, Teele D, Schousboe M, Gillies M, Hollis B, Clarkin A M, Lindeman J, Stewart J
Community Paediatrics, School of Medicine, Faculty of Health Sciences, University of Auckland, New Zealand.
Pediatr Infect Dis J. 1999 Jul;18(7):614-9. doi: 10.1097/00006454-199907000-00009.
Rotavirus illness is associated with significant morbidity and mortality worldwide. We have examined trends in diarrheal disease in New Zealand children to determine the disease burden attributable to rotavirus and to estimate the proportion of hospitalizations preventable by vaccination.
Hospital admissions data and laboratory records for 1994 to 1996, were obtained for children 0 to 4 years at four sites (serving -60% of the New Zealand population). Rotavirus disease burden was estimated using combined admissions and laboratory data. Severity of disease was estimated in a sample of 150 hospitalizations for rotavirus diarrhea, and the proportion of vaccine-preventable admissions was extrapolated. Mortality attributed to diarrheal causes was determined from national records for 1974 to 1993.
Between 1994 and 1996, 4436 children <5 years of age were hospitalized with diarrhea (1047/100000 children per year). Admissions associated with rotavirus were estimated at 1522 to 1535 (315 to 362/100000 annually). Infants between 6 and 17 months were most commonly affected (42% of all cases). More male children than female children were hospitalized (P < 0.001) and mean length of stay was calculated as 1.51 days (SD 2.35). Disease severity scoring revealed that 61.3 and 38.0% of admissions reviewed were severe and very severe, respectively. Deaths from diarrheal causes numbered 138 among children 0 to 4 years old for the 20-year period 1974 to 1993, with 18 deaths occurring between 1984 and 1993 (10 years).
Current vaccines control severe disease, suggesting that 72% of cases reviewed would be eligible for prevention. A full cost effectiveness analysis is required to demonstrate anticipated benefits of vaccination.
轮状病毒疾病在全球范围内导致了显著的发病率和死亡率。我们研究了新西兰儿童腹泻病的趋势，以确定轮状病毒所致的疾病负担，并估计通过疫苗接种可预防的住院比例。
获取了1994年至1996年四个地点（覆盖新西兰60%人口）0至4岁儿童的住院数据和实验室记录。使用综合的住院和实验室数据估计轮状病毒疾病负担。在150例轮状病毒腹泻住院病例样本中评估疾病严重程度，并推断可通过疫苗预防的住院比例。从1974年至1993年的国家记录中确定腹泻病因导致的死亡率。
1994年至1996年期间，4436名5岁以下儿童因腹泻住院（每年每100000名儿童中有1047例）。与轮状病毒相关的住院病例估计为1522至1535例（每年每100000名中有315至362例）。6至17个月大的婴儿受影响最为常见（占所有病例的42%）。住院的男性儿童多于女性儿童（P<0.001），平均住院时间计算为1.51天（标准差2.35）。疾病严重程度评分显示，所审查的住院病例中分别有61.3%和38.0%为重度和极重度。在1974年至1993年的20年期间，0至4岁儿童中因腹泻病因死亡的有138例，其中1984年至1993年（10年）有18例死亡。
目前的疫苗可控制严重疾病，这表明所审查病例中有72%可通过疫苗预防。需要进行全面的成本效益分析以证明疫苗接种的预期益处。
