Center for Reproductive Health

SURVEILLANCE TO ESTIMATE DISEASE BURDEN, COST OF CHILD CARE UTILIZATION, COST-BENEFIT AND COST-EFFECTIVENESS EVALUATIONS OF IMMUNIZATION PROGRAMS FOR ROTAVIRUS DIARRHEA IN INDONESIA: EXPANDED SURVEILLANCE

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By Siswanto Agus Wilopo, Paul Kilgore, Soewarta Kosen, Yati Soenarto, Muchamad Syururi, Aminah, Cahyono, Maria Ulfa and Abu Tholib
Rotavirus (RV) is one of the most common causes of acute dehydrating diarrhea in young children in developed and developing countries1 2. In 2006, RV was estimated to cause 610,000 deaths annually in children younger than 5 years of age. For this age group, RV is also responsible for 2.4 million hospitalizations, 24 million clinic visits, and 114 million episodes of gastroenteritis requiring home care3. By age 5, nearly every child will have an episode of RV gastroenteritis, 1 in 5 will visit a clinic for treatment, 1 in 65 will be hospitalized, and about 1 in 293 will die. RV mortality occurs primarily in the poorest countries where 82 percent of RV deaths occur.
In Indonesia, diarrheal diseases continue to be a significant of public health problem for three reasons. First, the prevalence of diarrhea morbidity did not change significantly in recent decades. Second, it continues to be a third-order cause of death among children <5 years old , and third, RV diarrhea is a significant cause of pediatric hospitalizations 7-12. This hospitalization causes an economic burden, which results a significant impact to the poor families in Indonesia. However, precise estimates of RV-related morbidity are difficult to obtain from routine hospital data because stool samples from children with diarrhea are not routinely tested. Only limited data are available for laboratory-confirmed cases of RV associated
gastroenteritis. It is because a specific diagnosis of RV infection is rarely done at a
hospital on cost grounds and because diagnosis does not alter treatment or outcome. No national reporting system is established, underlining the need for RV surveillance in Indonesia.
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