Healthcare Facilities and Medical Tourism Across the World: A Bibliometric Analysis.

This study aimed to review the literature on healthcare facilities and medical tourism from a range of nations that have established medical tourism sectors and assess the effect of healthcare facilities on medical tourism. A bibliometric study of the Scopus database was carried out by using the search terms '(Facility AND of AND healthcare) AND TITLE-ABS-KEY (health AND tourism) AND medical tourism' for the years 2012-2022. A qualitative evaluation of the literature was then performed to find and locate 92 articles. VOSviewer and NVivo 12 Plus were employed for data analysis. The findings indicated that the following trending subject keywords were used during the period in question: health (rate 1.97), medicine (rate 1.91), tourism (rate 1.70), care (rate 0.83), facilities (rate 0.64) and healthcare (rate 0.61). Furthermore, this research identified four distinct clusters: i) medical tourism, ii) healthcare quality, iii) healthcare system and iv) health services. The study found that healthcare facilities, as actors that have a role in the development of medical tourism, have not been sufficiently explored, even though there is evidence that they play a role in the growth of the sector. This result is in line with Heung's argument, which makes the same point.

A retrospective comparison of the biceps femoris long head muscle structure in athletes with and without hamstring strain injury history.

INTRODUCTION: Hamstring strain injuries (HSI) and re-injuries are endemic in high-speed running sports. The biceps femoris long head (BFlh) is the most frequently injured muscle among the hamstrings. Structural parameters of the hamstring muscle are stated to be susceptible to strain injuries at this location. This retrospective study targeted comparing the BFlh's structural parameters between previously injured and uninjured athletes. METHODS: Nineteen male athletes with previous BFlh strain injury history and nineteen athletes without former lower extremity injury history were included in this study. Fascicle length, mid-muscle belly and distal musculotendinous (MTJ) passive stiffnesses of the biceps femoris long head (BFlh) were examined via b-mode panoramic ultrasound scanning and ultrasound-based shear-wave elastography. Parameter comparisons of both legs within and between athletes with and without injury history were performed. RESULTS: Comparison of the BFlh fascicle length between the injured leg of the injured group and the legs of the controls revealed a trend to shorter fascicle lengths in the injured leg (p = 0.067, d = -0.62). However, the mid-muscle belly passive stiffness of the BFlh was significantly higher in the injured legs (p = 0.009, d = 0.7) compared with the controls. Additionally, the distal MTJ stiffness was much higher in the previously injured legs compared with controls (p < 0.001, d = 1.6). CONCLUSIONS: Outcomes support the importance of BFlh properties related to stiffness, and fascicle length for injury susceptibility in athletes. Future prospective studies should determine whether the higher stiffness in the injured athletes is a cause or consequence of the HSI. Physical therapy and rehabilitation programmes after HSI should focus on BFlh muscle properties i.e., elasticity and fascicle length for reducing re-injury and increasing sports performance.

Etlingera hemisphaerica Alters One-Dimensional Profile of Serum Proteins Due to Mercury Chloride in Rats (Rattus norvegicus).

<b>Background and Objective:</b> Several previous studies have shown that leaf ethanolic extract of <i>Etlingera hemisphaerica</i> (LE3H) has the potential to reduce the toxicity and teratogenicity effects of mercury. This study aimed to describe the effects of LE3H on the protein profile of <i>Rattus norvegicus</i> serum due to treatment with HgCl₂. <b>Materials and Methods:</b> Four groups of male rats, K1 was injected intraperitoneally (IP) HgCl₂ (5 mg kg¹ b.wt.), K2 was injected IP HgCl₂ (5 mg kg¹ b.wt.) and after 24 hrs it was gavage LE3H (0.27 mg g¹ b.wt.) every day for seven days, K3 was injected IP HgCl₂ (5 mg kg¹ b.wt.), after 24 hrs was gavage LE3H (0.55 mg g¹ b.wt.) every day for seven days. The K0 as control, received double-distilled water. On the ninth day, the experimental animals were killed via CD and blood was drawn from the heart to obtain serum. Serum samples were measured for protein content using the Lowry and serum was separated using the One-Dimensional Sodium dodecyl Sulfate-Polyacrylamide gel Electrophoresis (1D SDS-PAGE) technique. <b>Results:</b> The electropherograms showed four bands, 264.77, 219.53, 98.57 and 37.29 kDa, whose intensity significantly increased due to HgCl₂ treatment and then decreased to close to the control condition with LE3H administration. The results also revealed four bands, 31.95, 28, 06, 26, 29 and 15.09 kDa, whose intensity decreased significantly due to HgCl₂ treatment and then increased to close to the control condition by LE3H administration. <b>Conclusion:</b> The LE3H change profile of the eight blood serum protein bands due to HgCl₂ approximates the control condition in <i>R. norvegicus</i>.

Is particulate or non-particulate steroid the determinant of periarticular injection efficacy for controlling postoperative TKR pain? Network meta-analysis.

Purpose: Combining steroids for a periarticular injection (PAI) regiment has resulted in better pain control for postoperative TKR pain. Despite the available evidence, the most effective type of steroid for PAI still needs to be established. Network meta-analysis is conducted to analyze whether there is any difference in the effect of particulate compared to non-particulate periarticular steroid injection on post-TKR patients for pain control based on published literature. Method: This study is conducted following the PRISMA guideline. In general, studies assessing the efficacy of periarticular injection analgesia added with either particulate (Triamcinolone, methylprednisolone, or prednisolone) or non-particulate (dexamethasone or betamethasone) steroid compared to the same regiment were analyzed. Results: Ten studies were finally included from the 108 identified papers through database searching. VAS reduction on POD1 is found to be similar in particulate (0,91; CI95%: 0,45-1,37) compared to non-particulate (0,81; CI95%: 0,34-1,28) (Fig. 2). The difference becomes wider and favors non-particulate POD3. Subgroup analysis based on each steroid type was conducted. A stark difference can be observed for each pair of steroids (particulate and non-particulate), resulting in a similar cumulative effect of particulate and non-particulate steroids and inconsistent result on POD1 compared to POD3. Conclusion: From the available evidence, we concluded that particulate or non-particulate steroid does not significantly affect post-TKR pain management. Instead, the specific type of steroid contributes more to postoperative VAS reduction. Levels of evidence: Level III.

Prevention of Pneumonia due to Ventilator in Critical Patients with U Shape Oral Hygiene Model: A Systematic Review.

In critical patients, generally, microorganisms originating from nasal cause Ventilator-Associated Pneumonia (VAP). This systematic review was aimed to identify the toothbrush U shape model usage, in potentially decrease the prevalence of ventilator-associated pneumonia among patients in intensive care units. Search strategy identified 15 potentially eligible articles, were 7 RCTs, 4 Meta-analysis, and 4 Observational studies. A total of 15 studies demonstrated the use of toothbrushing and chlorhexidine in mechanically ventilator patients in preventing VAP. Ten studies found positive association between toothbrushing and the use of chlorhexidine in preventing VAP. However, there were 5 studies that did not reveal an additional decrease of VAP incidence either of CHX and only toothbrushing or combination thereof. We cautiously assumed that toothbrushing and chlorhexidine might reduce VAP but the implementation of brushing should be taken into reconsideration in the terms of maintaining it.

Fine-tuning mesoporous silica properties by a dual-template ratio as TiO2 support for dye photodegradation booster.

Titanium dioxide (TiO2) has been integrated into the surface of mesoporous silica (SMG) synthesized via the hydrothermal approach and a dual template CTAB-Gelatin. XRD, nitrogen adsorption, FTIR, SEM-EDX, and UV-Vis DR spectroscopy were performed to evaluate a 1 wt% TiO2/SMG material. After titania incorporation, the addition of gelatin during the synthesis of SMG increases the pore volume to 0.76 cc/g. The expansion of the silica pores is caused by the development of TiO2 crystal grains on the mesoporous silica-gelatin. An increase in the gelatin-CTAB to mesoporous silica weight ratio modifies the surface area, pore size, and particle size without compromising the meso-structure. In this research, the TiO2/SMG composite demonstrated much greater photodegradability for methylene blue (MB) than the TiO2/mesoporous silica sample without gelatin. The experimental results indicate that the photocatalytic activity of methylene blue from SMG titania/silica samples is reliant on the adsorption ability of the composite and the photocatalytic activity of titania, with optimal activity from samples with the highest surface area and pore volume, which directly increase the Ti: Si ratio and decrease the photodegradability of the composite when the ratio is too high or too low.

Hydrothermal effect of gunningite use Pluronic F127-Gelatin as template and the ibuprofen adsorption performance.

The gunningite has been successfully synthesized using Pluronic F127 and gelatin as template via hydrothermal at 100-200 °C for 12-48 h. By scanning electron microscopy, nitrogen adsorption-desorption, and X-ray diffraction, changes in structure, pore size, and morphology due to ibuprofen adsorption were investigated in gunningite. Various hydrothermal (temperature and time) parameters had an influence on the percentage elimination (%) of ibuprofens. Gunningite's specific surface area intensifies from 14.60 to 24.03 m2/g as the longer hydrothermal time. In batch adsorption studies, the resulting sample was conducted to isotherm and kinetic analysis to evaluate the distribution of ibuprofen between the liquid and solid phases. Pseudo-first-order kinetics with an adsorption capacity range of 27-34.5 mg g-1 were the best fit for the observed data. Consequently, gunningite may be considered a viable adsorbent for the large-scale treatment of water contaminated with ibuprofen and related anti-inflammatory medicines.

Burnout status of healthcare workers in the world during the peak period of the COVID-19 pandemic.

During the COVID-19 pandemic, healthcare workers have a high workload and have been exposed to various psychosocial stressors. This study aimed to evaluate health workers during the COVID-19 pandemic in the world. The method used in this research is qualitative with a literature review approach. The data sources in this study were taken from the Scopus database using the keywords "health workers," "burnout," AND "coronavirus" from the time range of 2020 to April 25, 2022. From the determination of the time range, 150 documents emerged. This study revealed that the Pearson correlation between total burnout scale scores on healthcare workers, professionals, exhaustion, mental, stress, personal, depression, symptoms, emergency, system, job, and impact indicated that overall burnout scores were associated with depression and anxiety. Stress symptoms had correlation values ranging from 0.84 to 0.73. Job burnout had a significant relationship with exhaustion at 0.89; depression r = 0.73), impacting a score of 0.66. At the same time, the fulfillment of professional and interpersonal disengagement showed a Pearson correlation between the total burnout scale scores on health workers, professionals, exhaustion, mental, stress, personal, depression, symptoms, emergency, system, job, and impact. Overall, the participants in health care workers worldwide experienced high levels of psychological distress. We also found that health workers dealing with COVID-19 pandemic patients were more likely to experience depression, stress, and burnout than health staff who were not personally involved in medical work. Furthermore, this study will be a follow-up study using the Work Ability Index (WAI) to measure work ability and work satisfaction.

Nutrition-Related Mobile Application for Daily Dietary Self-Monitoring.

Nutrition apps for mobile devices such as smartphones are becoming more widely available. They can help ease the arduous chore of documenting intake for nutritional assessment and self-monitoring. This allows people to control food intake, support their participation in physical activities, and promote a healthy lifestyle. However, there remains a lack of research regarding systematic analysis mapping studies in this area. The objective of this study is to identify dietary self-monitoring implementation strategies on a mobile application. This study analyzed 205 journals from the Scopus database using the descriptive-analytic method. The records used in this exploration study were those released between 2007 and 2021 that were collected based on the keywords "dietary self-monitoring," or "nutrition application," or "nutrition apps," and "calorie application." Data analysis was conducted using the VOSviewer and NVivo software analytical tools. The results show that research studies on dietary self-monitoring increased in 2017. Results also indicated that the country that contributed the most to this topic was China. The study on mobile applications for dietary self-monitoring revealed seven clusters of dominant themes: attitude to improved dietary behaviors, parameters for disease diagnosis, noncommunicable diseases, methods, nutrition algorithms, mobile health applications, and body mass index. This study also analyzed research trends by year. The current research trends are about dietary self-monitoring using a mobile application that can upgrade people's lifestyles, enable real-time meal recording and the convenience of automatically calculating the calorie content of foods consumed, and potentially improve the delivery of health behavior modification interventions to large groups of people. The researchers summarized the recent advances in dietary self-monitoring research to shed light on their research frontier, trends, and hot topics through bibliometric analysis and network visualization. These findings may provide valuable guidance for future research and perspectives in this rapidly developing field.

The effect of gelatin as pore expander in green synthesis mesoporous silica for methylene blue adsorption.

Mesoporous silica NSG had been synthesized while employing gelatin as a natural template to successfully increase the particle size and expand the pore diameter of NSG. All silica samples exhibited a similar XRD pattern with a broad peak centred at 2θ = 22.9°, as the characteristic of amorphous silica. FTIR results showed that the reduction of Si-O-Si symmetric stretching vibrations at 1075 cm-1 was due to the use of a high percentage of gelatin. Moreover, TEM analysis displayed the mesoporous channels in the form of a honeycomb structure with a diameter of ± 6 nm. Gelatin enhanced the surface area of silica from 467 to 510 m2/g, the pore volume from 0.64 to 0.72 cc/g and expanded the pore diameter from 3.5 nm to 6.0 nm. The expansion of the ordered mesopores with the increase of P123: gelatin ratios was elucidated by the pore size distribution. The adsorption capacity of methylene blue (MB) was improved on mesoporous silica with an expanded pore dimension to give 168 mg/g adsorption capacity within 70 min.

Fast Removal of Methylene Blue via Adsorption-Photodegradation on TiO2/SBA-15 Synthesized by Slow Calcination.

TiO2/SBA-15 photocatalysts were successfully prepared by impregnating low loading titania to SBA-15 via slow calcination. The photocatalyst is efficient for fast methylene blue removal via adsorption and photodegradation methods. The impregnation of low TiO2 loading via slow calcination enhanced TiO2 dispersion that preserved the SBA-15 porosity and uniform morphology. High interfacial interaction of TiO2/SBA-15 improves TiO2 photoresponse by narrowing the bandgap, resulting in a stronger redox ability. The methylene blue removal on 10%TiO2/SBA-15 followed the pseudo-second-order kinetic model that reached 67% removal efficiency in 90 min. The synergy between adsorption and photodegradation is responsible for the fast methylene blue removal. These results indicate the importance of maintaining the adsorption capacity in SBA-15 after impregnation with TiO2 for efficient adsorption-photodegradation processes, which can be achieved by controlling the deposition of TiO2 on SBA-15. A low titania loading further reduced the cost of photocatalysts, thus becoming a potential material for environmental pollution treatment.

Current Prospects for Plastic Waste Treatment.

The excessive amount of global plastic produced over the past century, together with poor waste management, has raised concerns about environmental sustainability. Plastic recycling has become a practical approach for diminishing plastic waste and maintaining sustainability among plastic waste management methods. Chemical and mechanical recycling are the typical approaches to recycling plastic waste, with a simple process, low cost, environmentally friendly process, and potential profitability. Several plastic materials, such as polypropylene, polystyrene, polyvinyl chloride, high-density polyethylene, low-density polyethylene, and polyurethanes, can be recycled with chemical and mechanical recycling approaches. Nevertheless, due to plastic waste's varying physical and chemical properties, plastic waste separation becomes a challenge. Hence, a reliable and effective plastic waste separation technology is critical for increasing plastic waste's value and recycling rate. Integrating recycling and plastic waste separation technologies would be an efficient method for reducing the accumulation of environmental contaminants produced by plastic waste, especially in industrial uses. This review addresses recent advances in plastic waste recycling technology, mainly with chemical recycling. The article also discusses the current recycling technology for various plastic materials.

Controlling the Size and Porosity of Sodalite Nanoparticles from Indonesian Kaolin for Pb2+ Removal.

Mesoporous sodalite nanoparticles were directly synthesized from Indonesian kaolin with the addition of CTABr as a mesopore template. The studies highlighted the importance of aging time (3-12 h) and temperature (50-80 °C) on increasing surface area and mesoporosity of sodalite. Indonesian kaolin was used without pre-treatment and transformed to sodalite following the initial molar composition of 10 Na2O: 2 SiO2: Al2O3: 128 H2O. Characterization data revealed the formation of high surface area sodalite with mesoporosity at increasing aging temperatures and times. The presence of CTABr as templates produced sodalites nanoparticles with smaller aggregates than the non-template sodalite. The sodalite sample obtained at 80 °C of crystallization temperature for 9 h (S80H9) displayed the highest mesopore volume (0.07612 cm3/g) and the highest adsorption capacity of Pb2+ (212.24 mg/g). Pb2+ was suggested to adsorb via ion exchange with the Na+ counter cation and physical adsorption.

Green Synthesis of Hexagonal Hematite (α-Fe2O3) Flakes Using Pluronic F127-Gelatin Template for Adsorption and Photodegradation of Ibuprofen.

Hematite (α-Fe2O3) with uniform hexagonal flake morphology has been successfully synthesized using a combination of gelatin as natural template with F127 via hydrothermal method. The resulting hematite was investigated as adsorbent and photocatalyst for removal of ibuprofen as pharmaceutical waste. Hexagonal flake-like hematite was obtained following calcination at 500 °C with the average size was measured at 1-3 µm. Increasing the calcination temperature to 700 °C transformed the uniform hexagonal structure into cubic shape morphology. Hematite also showed high thermal stability with increasing the calcination temperatures; however, the surface area was reduced from 47 m2/g to 9 m2/g. FTIR analysis further confirmed the formation Fe-O-Fe bonds, and the main constituent elements of Fe and O were observed in EDX analysis for all samples. α-Fe2O3 samples have an average adsorption capacity of 55-25.5 mg/g at 12-22% of removal efficiency when used as adsorbent for ibuprofen. The adsorption capacity was reduced as the calcination temperatures increased due to the reduction of available surface area of the hexagonal flakes after transforming into cubes. Photocatalytic degradation of ibuprofen using hematite flakes achieved 50% removal efficiency; meanwhile, combination of adsorption and photocatalytic degradation further removed 80% of ibuprofen in water/hexane mixtures.

Quantitative structure-activity relationship (QSAR) and molecular docking of xanthone derivatives as anti-tuberculosis agents.

Quantitative structure-activity relationship (QSAR) and molecular docking approach were carried out to design novel anti-tuberculosis agents based on xanthone derivatives. QSAR designed new compounds were calculated by Austin Model 1 (AM1) methods and analysis of multi-linear regression (MLR). The result showed that the best model as follows: Log IC50 = 3.113 + 11.627 qC1 + 15.955 qC4 + 11.702 qC9, this result has appropriate some statistical parameters (PRESS = 2.11, r2 = 0.730, SEE = 0. 3545, R = 0.6827, FCal/FTab = 4.68), and being used to design a potential anti-tuberculosis drugs with substituted amide, sulfoxide, and carboxylate group xanthone scaffold by a number of their inhibitory concentration (IC50). The mechanism action of sulfonamide substituted on the xanthone scaffold as anti-tuberculosis was carried out using molecular docking. Docking inhibition studies were carried out on MTB C171Q receptor (4C6X.pdb) as KasA inhibitors using by the discovery studio. Based on the binding interaction showed, the sulfonamide substituted xanthone has potential being the anti-tuberculosis drugs by KasA inhibitor for target drug activity.

Inactivation of Extended-spectrum ß-lactamase (ESBL)-producing Escherichia coli by UVA-LED irradiation system.

The prevalence of extended-spectrum ß-lactamase (ESBL)-producing Escherichia coli is increasing rapidly and spreading worldwide, particularly in Asia, compared to other regions. In the last ten years, in our hospital, in particular, there has been a < 30% increase. To prevent the spread of ESBL in hospitals and the community, the ultraviolet (UV) A-light-emitting diode (LED) irradiation device was used to inactivate ESBL-E. coli in human livestock and the environment. ESBL-E. coli and E. coli bacterial samples were collected from patients at Tokushima University Hospital (Tokushima City, Japan). The UVA-LED irradiation system had 365 nm single wavelength, and the current of the circuit was set to 0.23 or 0.50 A consistently. Results demonstrated that UVA-LED was useful for the inactivation of ESBL-E. coli and E. coli. The minimum energy dosage required to inactivate ESBL-E. coli and E. coli was 40.76 J/cm2 (45 min) in the first type of UVA-LED and 38.85 J/cm2 (5 min) in the second type. There were no significant differences between ESBL-E. coli and E. coli. The inactivation of ESBL-E. coli was dependent on energy. These findings suggest that UVA-LED with 365 nm single wavelength could be useful for surface decontamination in healthcare facilities. J. Med. Invest. 67 : 163-169, February, 2020.

Size tunable mesoporous carbon microspheres using Pluronic F127 and gelatin as co-template for removal of ibuprofen.

Size tunable mesoporous carbon microspheres, MCMs were obtained using Pluronic F127 and gelatin in co-templating method via hydrothermal and pyrolysis treatments. The presence of gelatin increased the mechanical strength of Pluronic F127 which can sustain the uniform microspherical structure of carbon following pyrolysis at 950 °C. The diameter of MCMs were controlled by variation of weight ratios between Pluronic F127 to gelatin from 1:0.01 to 1:1. MCMs exhibited inter-particulate mesoporous structure with high thermal stability (<500 °C). The MCMs were used as adsorbent for removal of ibuprofen and the kinetic studies using linear regression analysis revealed the adsorption fits pseudo second-order kinetic. The rate of adsorption and the amount of adsorbed ibuprofen were correlated well with the surface area and the crystallite size of MCMs. The efficiencies of ibuprofen adsorption on MCMs were also investigated when ibuprofen was dissolved at different concentration of water and hexane mixtures, the effect temperature variation and the amount MCMs to the volume of ibuprofen solution.

A case report of generalized tetanus in a 42-year-old man with dental infection.

Background In the post-vaccination era, as it is today, generalized tetanus is a rare diagnosis, although mortality and morbidity continue to increase significantly throughout the world. Infection occurs when the Clostridium tetani spores are introduced into wounds, skin lesions and infections. The symptoms often begin with stiffness or spasms in the jaw muscles; they are called trismus or "lockjaw" and/or then spread to the neck and abdominal muscles. Case presentation This is a report of a 42-year-old man who was referred to the hospital with dysphagia, rigidity and trismus. He was diagnosed with generalized tetanus with a Philips score of 15. The patient was admitted to the isolation unit, received treatment that included procaine penicillin, metronidazole, diazepam, human tetanus immunoglobulin (TIG) and anti-tetanus serum (ATS). Treatment was considered according to the guidelines of the World Health Organization, and also, the drug dose has no adverse event reaction during the treatment. Conclusion The therapeutic response is related to the identification and appropriate treatment, especially in hospitalized patients with inadequate immunization so that patients recover soon.

Charge Injection and Electrical Response in Low-Temperature SnO2-Based Efficient Perovskite Solar Cells.

Defining low-temperature engineering protocols for efficient planar perovskite solar cell (PSC) preparation is important for fabrication simplification and low-cost production. In the present work, we have defined a low-temperature (123 °C) protocol for the preparation from a solution of SnO2 layers which are efficient for an application as an electron transporting layer (ETL) in PSCs. Thin, conformal, and transparent layers have been obtained. The related PSCs have shown best devices with a power conversion efficiency of 18.22% and low-hysteresis J- V curves (a hysteresis index of 6.7%). Charge injection has been thoroughly studied by photoluminescence decay measurements. The decay curves followed a biexponential function. The injection of holes into the spiro-OMeTAD layer was found very fast and is a no-limiting step. On the other side, the charge injection into the oxide ETLs depends on its structure and on the oxide. The time constant for the low-temperature SnO2 layers is close to that of the mesoporous benchmark layers with a fast (surface) and a slow (bulk) component at 11 and 129 ns with relative contributions calculated at 13% and 87%, respectively. The phenomena occurring at a longer time scale have been investigated by impedance spectroscopy. The SnO2 cell spectra showed no intermediate-frequency inductive loop. The very low frequency part of the spectra was characterized by the beginning of an arc of a circle at the origin of a very large resistance over a large applied potential range. This resistance, along with an intermediate-frequency resistance, has been assigned to a recombination resistance and explains the very large  Voc achievable with SnO2 PSCs. The existence of a capacitance at the intermediate frequency with a noticeable low value at about 0.2 mF·cm-2 is linked with the low hysteresis of the devices.

Economic evaluation of a routine rotavirus vaccination programme in Indonesia.

An economic evaluation was undertaken to assess the potential for introducing rotavirus vaccine into Indonesia's National Immunization Program. For a projected birth cohort of 4.2 million children was followed until 5 years of age, a routine rotavirus vaccination programme could potentially avert 488,547 cases of diarrhoea treated in outpatient hospital facilities, 176,375 hospitalizations, and 8148 deaths. Assuming a cost of US$ 14 per vaccine course, the incremental cost-effectiveness ratio would equal US$ 120.46 per disability adjusted life years averted, making routine vaccination highly cost-effective given Indonesia's Gross National Income per capita of US$ 1560. At a cost per vaccine course of US$ 3.79 (societal perspective) or US$ 2.70 (health-care system perspective), routine rotavirus vaccination could be potentially cost-saving in Indonesia.