Rotaviruses and Noroviruses as Etiological Agents of Acute Intestinal Diseases of Ukrainian Children.

(1) Background: Rotavirus and norovirus infections are the primary viral causes of childhood diarrhea. In Ukraine, the diarrhea-linked infant mortality rate is low, but the number of children infected is quite high. This study examined the rates of rotavirus and norovirus infections throughout Ukraine. (2) Methods: Fecal samples for children admitted to hospitals in six Ukrainian cities (Kyiv, Lviv, Sumy, Odesa, Kharkiv, and Uman) were tested for the presence of rotavirus and norovirus. (3) Results: The overall rate of hospitalized children suffering from diarrhea with confirmed presence of rotavirus or norovirus in fecal samples was significant (20.67% and 27.94%, respectively). Samples obtained from children from Lviv had significantly higher rates of the viruses, and Kyiv and Uman had significantly lower rotavirus or norovirus detection levels than expected. (4) Conclusion: Childhood diarrhea impacts Ukraine significantly. The economic and societal effects of the failure to address this public health issue are indicated by the hospitalization rate of children with preventable illnesses. The geographical disparities in Ukraine for child hospitalizations caused by rotavirus and norovirus infections could result from environmental (sanitary factors or water purity issues) or social factors. Further research is needed to completely characterize infant viral infections in Ukraine.

A cost minimization analysis of α2b-interferon supplementation in complex pharmacotherapy of rotavirus infection in newborns.

Rotavirus is one of the most important causative agents of gastroenteritis in both infants and children worldwide, resulting in high mortality and morbidity, mainly in low-income, developing countries. Respective analysis of medical records of newborns hospitalized with acute gastroenteritis showed that the use of α2b-interferon in complex pharmacotherapy was characterized by faster reverse development of clinical manifestations of the disease than in patients who did not receive interferon. In our study, we also aimed to estimate the effectiveness of α2b-interferon supplementation in combination pharmacotherapy of newborns with suspected rotavirus infection. Achievement of this goal was possible with the construction of a decision tree model and determination of decision rules for inclusion of α2b-interferon supplementation into the complex pharmacotherapy. The input parameters of the model were hospitalization days of patients stratified by such signs as the presence or absence of rotavirus infection, as well as the additional inclusion of α2b-interferon supplementation in complex pharmacotherapy. The criterion for prediction and decision-making was global retrospective rotavirus prevalence. The feature of the simulation was that the costs were expressed as relative to each other, which allowed unifying the proposed methodology. Retrospective analysis of the clinical database of Ukrainian newborns with acute diarrhea has proved that the decision of α2b-interferon supplementation as additional treatment could be cost-saving under 7.4 times its lower price.

Pharmacoeconomic and epidemiological bases of optimal rotavirus vaccine supply for Ukrainian population.

OBJECTIVE: Introduction: Several studies has shown that rotaviruses play a leading role in the structure of acute intestinal infections (AII) of viral etiology in children. In the National vaccination calendar of Ukraine, vaccination against rotavirus infection (RVI) is classified as recommended, with the expected goal of reducing the number of severe RVI cases among under five-year-old children. Nevertheless, despite the positive epidemiological and clinical effects of vaccination against RVI, it remains unclear how appropriate the introduction of rotavirus vaccines is in terms of potential costs and benefits, as well as determining the optimal level of subsidy required to cover part of the costs of voluntary vaccination of the population. The aim: Study of optimal subsidy level of rotavirus vaccine in Ukraine using epidemiological and pharmacoeconomic modeling. PATIENTS AND METHODS: Materials and methods: The retrospective epidemiological data of the monthly RVI incidence in Ukraine as well as the population number from 2010 to 2016 formed the information basis for determining the transmission parameter of the viral agent. The scenario of RVI epidemic process as an acute intestinal infection from the point of view of mathematical epidemiology is best described by developed mathematical model. Cost-benefit of rotavirus vaccination was studied with the use of developed pharmacoeconomic criteria. RESULTS: Results and conclusions: Prediction of possible implications of RVI vaccination and finding optimal level of vaccine supply involves a comprehensive study of the epidemic process peculiarities of this infection with development of an adequate epidemiological model. We have proposed a model of RVI epidemiological process in Ukraine, determining its main parameters with the use of available retrospective data of anual number of RVI cases for the period from 2010 to 2016. The developed model was used as an analytical tool for analyzing influence of different levels of vaccine supply on vaccination cost-benefit. The results of research showed that the use of epidemiological modeling in pharmacoeconomic analysis of rotavirus vaccination made it possible to determine analytically optimal level of vaccination subsidy level.