Hospitalisation of children aged 0-59 months with rotavirus gastro-enteritis before the introduction of routine vaccination (Sicily 2003-2012).

Background: Recent evidence demonstrates that rotavirus vaccination is the best strategy for reducing rotavirus gastro-enteritis (RVGE) in young children. Aims: This study describes the epidemiology of RVGE hospitalisation of Sicilian children before universal rotavirus vaccination was introduced into the regional immunisation programme in January 2013. Methods: An observational study was undertaken by analyzing data obtained from the Regional Hospital Discharge database, including hospitalisation from 2003 to 2012 of subjects aged 0-59 months who lived in Sicily. Children discharged with the rotavirus-specific ICD-9-CM code of 008·61 on first or any diagnosis stage were considered to be RVGE cases. Results: From 2003 to 2012, 9317 children (median age 19 months, M/F ratio 1·19) were hospitalised with a diagnosis of RVGE. During the study period, annual rates of hospitalisation were between 2·64 and 4·68 cases/1000 children (mean 3·74 cases). Incidence rates were higher in children aged 6-11 months (8·85/1,000 children/year), decreasing significantly with age (P<0·001). RVGE hospitalisation peaked during winter and spring with a statistically significant downward trend throughout summer and autumn. Conclusion: During the study period, the cumulative risk of hospitalisation with RVGE was determined to be about one in 54 Sicilian children in the 1st 5 years of life. Although the present study cannot be considered a proper pharmaco-economic evaluation, the findings suggest that in Sicily the health and economic burden of RVGE hospitalisation strongly supports the introduction of rotavirus vaccination into the regional immunisation programme as a probably cost-saving intervention.