Kowalzik Frank, Zepp Fred, Hoffmann Isabell, Binder Harald, Lautz Dagmar, van Ewijk Reyn, Knuf Markus, Tenenbaum Tobias, Laass Martin, Reuter Thorsten, Schulze-Rath Renate, Marron Manuela
From the *Pediatric Department and †Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University, Mainz, Germany; ‡Johannes Gutenberg University Mainz, Faculty of Economics, Mainz, Germany; §Klinikum der Landeshauptstadt Wiesbaden HSK, Dr Horst Schmidt Kliniken, Wiesbaden, Germany; ¶Pediatric Infectious Diseases, Department of Pediatrics, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; ‖Pediatric Department, University Hospital Carl Gustav Carus, Dresden, Germany; **Sanofi Pasteur MSD GmbH, Leimen, Germany; and ††Institute for Community Medicine, University Medicine of the Ernst-Moritz-Arndt University, Greifswald, Germany.
Pediatr Infect Dis J. 2016 Jan;35(1):97-103. doi: 10.1097/INF.0000000000000939.
Representative, population-based epidemiologic data for gastroenteritis caused by rotavirus (RV) are rare. RV vaccines were first licensed in Europe in 2006 and recommended in 5 western federal states in 2008 or thereafter. This study establishes a baseline for assessing the impact of vaccination and delineates the RV disease burden in Germany today.
Nationwide data obtained from hospitals for children 0 to 10 years of age and transferred to the Federal Statistical Office were analyzed retrospectively. Acute gastroenteritis cases because of RV were identified by the International Classification of Diseases code (ICD-10) combined with the referring diagnosis-related group code. Coding quality was validated by random sampling the patient records (n=1003). Crude and age-standardized rates per 100,000 person-years were calculated. The rate ratios of seasonal effects and recommended immunization adjusted for year, federal state and age were estimated using Poisson regression.
Between 2005 and 2010, 5,843,730 children were hospitalized; 520,606 cases were hospitalized because of acute gastroenteritis. RV caused 152,636 of these cases or an age-standardized rate of 302 hospitalizations per 100,000 person-years. Rates were slightly higher in boys than girls, decreased with age, and differed by federal state, year and season. Rate ratios decreased in those western federal states that recommended immunization and were inversely associated with vaccine doses sold.
With an average of 25,440 children hospitalized yearly, RV infection has a great impact on the German healthcare system. Our findings indicate that RV immunization will lead to a decline in in-patient treatment and associated costs.
基于人群的轮状病毒（RV）引起的胃肠炎代表性流行病学数据很少。RV疫苗于2006年在欧洲首次获得许可，并于2008年或之后在5个西部联邦州被推荐使用。本研究为评估疫苗接种的影响建立了基线，并描绘了当今德国RV疾病负担情况。
对从0至10岁儿童医院获取并传输至联邦统计局的全国性数据进行回顾性分析。因RV导致的急性胃肠炎病例通过国际疾病分类代码（ICD-10）结合相关诊断相关分组代码来识别。通过对患者记录进行随机抽样（n = 1003）来验证编码质量。计算每1十万人口年的粗发病率和年龄标准化发病率。使用泊松回归估计经年份、联邦州和年龄调整后的季节效应和推荐免疫接种的发病率比值。
2005年至2010年期间，5843730名儿童住院；520606例因急性胃肠炎住院。其中152636例由RV引起，年龄标准化发病率为每1十万人口年302例住院。男孩的发病率略高于女孩，随年龄降低，且因联邦州、年份和季节而异。在推荐免疫接种的西部联邦州，发病率比值下降，且与疫苗销售量呈负相关。
RV感染平均每年导致25440名儿童住院，对德国医疗保健系统有很大影响。我们的研究结果表明，RV免疫接种将导致住院治疗及相关费用下降。
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