Rotavirus gastroenteritis in uzbekistan: implications for vaccine policy in central Asia.

ABSTRACT

BACKGROUND: To determine the value of rotavirus vaccines in Central Asia, we conducted surveillance of rotavirus in Uzbekistan, the country with the largest birth cohort in the region. Uzbekistan is eligible for international funds to introduce new vaccines. METHODS: We screened stool samples for rotavirus that were collected from children aged <5 years with gastroenteritis in 2 hospitals during 2005-2006. Using surveillance information and other data, we estimated national numbers of rotavirus-associated events per year. RESULTS: Of 3537 enrolled children, 1046 (30%) had rotavirus detected in stool specimens. Children aged <2 years accounted for 841 (80%) of all rotavirus infections. The G1P[8] genotype was identified in 27 (52%) of 52 typed samples collected in 2005. Rotavirus is estimated to cause 1174-1857 deaths and 6394-6558 hospitalizations among children aged <5 years annually. The cumulative risk of hospitalization for rotavirus by age 5 years is 1 in 94-96 children, and the risk of rotavirus-related death is 1 in 330-524 children. CONCLUSIONS: One-third of all hospitalizations for gastroenteritis and almost 5% of all deaths among children aged <5 years in Uzbekistan may be attributable to rotavirus. Introduction of rotavirus vaccines into the national immunization program at the current subsidized prices could be cost-effective.