Gomez Jorge A, Sordo Maria E, Gentile Angela
Viral Gastroenteritis Laboratory, National Institute of Infectious Diseases, Heath Ministry, Buenos Aires, Argentina.
Pediatr Infect Dis J. 2002 Sep;21(9):843-50. doi: 10.1097/00006454-200209000-00012.
Information on the burden of diarrheal diseases and rotavirus diarrheal diseases would help define strategies for management and prevention and clarify the potential benefits of candidate vaccines. This report of our study of the epidemiology of rotavirus diseases in Argentina analyzes the burden of rotavirus diarrhea, based on those studies and national statistics of diarrhea-associated medical visits, hospital discharges and deaths.
Information of diarrhea-associated medical visits, hospital discharges and deaths were provided by the Argentine Health Ministry. Estimation of rotavirus disease burden was performed using the percentage of rotavirus identification from previous reports.
The incidence of diarrhea-associated medical visits (1999) was 14 times greater for ages 0 to 4 years than for ages of > or =5 years. Diarrhea-associated hospital discharges (0 to 4 years of age) decreased between 1981 and 1995 from 1.3 per 100 to 0.9 per 100 person-years) and diarrheal deaths (<2 years of age) decreased by a factor of 4 between 1985 and 1999 (64.7 per 100 000 to 16.1 per 100 000 person-years). Frequency of diarrheal deaths, hospital discharges and medical visits were highest in some of the northern Argentine provinces (26.2, 14.7 and 5.9 times greater, respectively, than in the lower risk areas of the country). We estimated that 1 in 2 children born in 1995 visited a public hospital, 1 in 12 required hospitalization, 1 in 1599 died of diarrheal diseases before their fifth year of life; 1 in 6, 1 in 35 and 1 in 4169 of those, respectively, died as a result of rotavirus diarrhea before their third year of life.
The number of preventable diarrhea-associated and rotavirus-associated hospitalizations and deaths in Argentina is significant. The lack of rotavirus diagnostic capability in Argentine hospitals has resulted in underestimation of the disease burden of this virus. A rotavirus vaccine would have the potential to avoid thousands of hospitalizations and dozens of deaths, especially in the poor high risk Argentine provinces.
腹泻病和轮状病毒腹泻病负担的相关信息有助于确定管理和预防策略，并阐明候选疫苗的潜在益处。本项关于阿根廷轮状病毒疾病流行病学的研究报告，基于腹泻相关就诊、住院和死亡的研究及国家统计数据，分析了轮状病毒腹泻的负担。
腹泻相关就诊、住院和死亡信息由阿根廷卫生部提供。利用既往报告中轮状病毒鉴定的百分比来估算轮状病毒疾病负担。
1999年，0至4岁儿童腹泻相关就诊发生率比5岁及以上儿童高14倍。1981年至1995年期间，0至4岁儿童腹泻相关住院率从每100人年1.3例降至每100人年0.9例，1985年至1999年期间，2岁以下儿童腹泻死亡人数下降了4倍（从每10万人64.7例降至每10万人16.1例）。阿根廷北部一些省份的腹泻死亡、住院和就诊频率最高（分别比该国低风险地区高26.2倍、14.7倍和5.9倍）。我们估计，1995年出生的儿童中，每2人中有1人会去公立医院就诊，每12人中有1人需要住院治疗，每1599人中有1人在5岁前死于腹泻病；其中，每6人中有1人、每35人中有1人、每4169人中有1人分别在3岁前死于轮状病毒腹泻。
阿根廷可预防的腹泻相关及轮状病毒相关住院和死亡人数众多。阿根廷医院缺乏轮状病毒诊断能力，导致对该病毒疾病负担的低估。轮状病毒疫苗有可能避免数千例住院和数十例死亡，尤其是在阿根廷贫困的高风险省份。
