Health-related quality of life of the parents of children hospitalized due to acute rotavirus infection: a cross-sectional study in Latvia.

BACKGROUND: Rotavirus is the leading cause of severe diarrhea in young children and infants worldwide, representing a heavy public health burden. Limited information is available regarding the impact of rotavirus gastroenteritis on the quality of life of affected children and their families. The objectives of study were to estimate the impact of rotavirus infection on health-related quality of life (HRQL), to assess the social and emotional effects on the families of affected children. METHODS: This study enrolled all (n = 527) RotaStrip®-positive (with further PCR detection) cases (0-18 years of age) hospitalized from April 2013 to December 2015 and their caregivers. A questionnaire comprising clinical (filled-in by the medical staff) and social (filled by the caregivers) sections was completed per child. RESULTS: Main indicators of emotional burden reported by caregivers were compassion (reported as severe/very severe by 91.1% of parents), worry (85.2%), stress/anxiety (68.0%). Regarding social burden, 79.3% of caregivers reported the need to introduce changes into their daily routine due to rotavirus infection of their child. Regarding economic burden, 55.1% of parents needed to take days off work because of their child's sickness, and 76.1% of parents reported additional expenditures in the family's budget. Objective measures of their child's health status were not associated with HRQL of the family, as were the parent's subjective evaluation of their child's health and some sociodemographic factors. Parents were significantly more worried if their child was tearful (p = 0.006) or irritable (p < 0.001). Parents were more stressful/anxious if their child had a fever (p = 0.003), was tearful (p < 0.001), or was irritable (p < 0.001). Changes in parents' daily routines were more often reported if the child had a fever (p = 0.02) or insufficient fluid intake (p = 0.04). CONCLUSION: Objective health status of the child did not influence the emotional, social or economic burden, whereas the parents' subjective perception of the child's health status and sociodemographic characteristics, were influential. A better understanding of how acute episodes affect the child and family, will help to ease parental fears and advise parents on the characteristics of rotavirus infection and the optimal care of an infected child.

Health related quality of life impact from rotavirus diarrhea on children and their family caregivers in Thailand.

BACKGROUND: Rotavirus diarrhea is a major health problem among young children worldwide with potential negative impacts on health-related quality of life (HRQoL). This study assessed the impact of rotavirus diarrhea on HRQoL of children and their caregivers. METHODS: We performed a cross-sectional study among 460 hospitalized children with diarrhea aged under 5 years and their family caregivers at three hospitals in Phetchabun province, Thailand during May 2013 and February 2014. The severity of diarrhea was assessed using the Vesikari severity scoring system while the HRQoL was assessed using the EQ-5D-3L. RESULTS: The mean EQ-5D utility of children with all-causes diarrhea was 0.604. The utility of the rotavirus diarrhea group was significantly lower than that of the non-rotavirus diarrhea group (0.593 vs. 0.612; p-value = 0.040). The family caregiver's utility was 0.964 at baseline and significantly decreased to 0.620 (p-value = 0.041) when their children were hospitalized with diarrhea. In multiple regression analyses, severity but not rotavirus infection had significant negative impacts on the utility of both the children and their caregivers. CONCLUSION: Diarrhea, either caused by rotavirus or non-rotavirus infection, resulted in substantial negative impacts on the quality of life of both the children and their caregivers.

Quality of life impacts from rotavirus gastroenteritis on children and their families in the UK.

AIMS: Rotavirus vaccines (RV) are safe and effective but demand significant investment of healthcare resource. In countries with low mortality due to rotavirus, a key component to assessing cost-effectiveness is quantifying the Health Related Quality of Life (HRQoL) lost due to rotavirus acute gastroenteritis (RVAGE). METHODS: Families with children less than six years old with gastroenteritis were recruited from attendees to Bristol Children's Hospital Emergency Department. Stools were tested for viral causes of gastroenteritis. Children's HRQoL was assessed at presentation using Health Utilities Index 2 (HUI2) with visual analogue scale (VAS). The effect of the child's illness on the HRQoL of up to two adult carers was assessed using EQ-5D-5L. Families completed a daily symptom diary to assess time to recovery and within-family transmission. RESULTS: 127 families consented to take part, 84(65%) had rotavirus as the cause of illness. At the time of attendance, mean paediatric HRQoL with RVAGE was 0.74(HUI2) and 0.42(VAS). Primary/secondary carer's HRQoL was 0.68/0.80 (EQ5D) or 0.70/0.79 (VAS). The mean number of QALYs lost due to RVAGE was 3.1-3.5 per thousand children and 7.7-8.7 per thousand family units. In 52% of RVAGE families at least one other member developed a secondary case of gastroenteritis. For working parents, 69% missed work, for a mean of 2.8 days (95% CI 2.3-3.4). CONCLUSIONS: We have found the HRQoL loss associated with RVAGE in children and their carers to be significantly higher than estimates used for all RV medical attendances in UK cost-effectiveness calculations.

Family impact of Rotavirus Gastroenteritis in Taiwan and Vietnam: an Ethnographic Study.

BACKGROUND: Prior to the introduction of rotavirus vaccines, rotavirus was the leading cause of severe gastroenteritis in infants and young children, and it continues to be the leading cause in countries without vaccination programs. Rotavirus gastroenteritis results in substantial economic burden and has a pronounced effect on the family of those who are ill. Both in Taiwan and in Vietnam, rotavirus illness is viewed as a priority disease. This study assessed, in Taiwan and Vietnam, the impact of rotavirus gastroenteritis on the family among a group of parents whose children had recently been hospitalized for this illness. METHODS: In the first half of 2013, parents of children who had been hospitalized due to rotavirus infection were recruited from hospitals in Taiwan (n = 12) and Vietnam (n = 22), and participated in focus group sessions or in-depth ethnographic interviews. RESULTS: In both countries, the results point to a substantial burden on the parents concerning emotions and logistics of daily tasks, and to considerable disruptions of the family routine. Taiwanese parents reported satisfaction with the health care system, a great deal of effort to suppress emotions, a fair amount of knowledge about rotavirus, and little extra costs related to the illness. On the other hand, parents in Vietnam expressed concern about the emotional well-being of and the health care treatments for their children, were less knowledgeable regarding rotavirus infection, and experienced a substantial financial burden due to indirect costs that were related to accessing treatment. CONCLUSIONS: Families in Taiwan and Vietnam suffer from a considerable economic and emotional burden related to rotavirus gastroenteritis. One way to substantially reduce this burden is to provide universal and affordable rotavirus vaccination to susceptible children, especially since cost-effectiveness studies have demonstrated that universal vaccination would be safe and efficacious against severe rotavirus gastroenteritis in these countries.

Economic and psychosocial impact of rotavirus infection in Spain: a literature review.

Severe rotavirus gastroenteritis is common in children under 5 years of age. A literature review was performed to investigate the economic and psychosocial impact of rotavirus infection in children in this age group. We retrieved 56 articles on the economic burden of the disease in Europe, 18 of them reported data from Spain; 8 articles were retrieved analysing its psychosocial impact. In Spain, rotavirus is responsible for 14% to 30% of all cases of gastroenteritis, and a quarter of these require hospitalisation. It is also associated with high use of health care resources (emergency and primary care visits). Rotavirus gastroenteritis costs the Spanish national health system EUR 28 million a year and causes productivity loss in two-thirds of parents (mean of 4 days). Taking into account these costs, it was estimated that implementing universal vaccination could prevent 76% to 95% of hospital admissions due to rotavirus gastroenteritis, as well as reduce emergency and paediatric visits, nosocomial infections, and days missed from work (77% reduction). Rotavirus gastroenteritis also has a considerable psychosocial impact on the family, although it is difficult to compare results due to the diversity of study designs and the low specificity of the measurement tools used. It also causes high stress among parents, adding to their workload and adversely affecting their quality of life.

The impact of childhood acute rotavirus gastroenteritis on the parents' quality of life: prospective observational study in European primary care medical practices.

BACKGROUND: Rotavirus (RV) is the commonest cause of acute gastroenteritis in infants and young children worldwide. A Quality of Life study was conducted in primary care in three European countries as part of a larger epidemiological study (SPRIK) to investigate the impact of paediatric rotavirus gastroenteritis (RVGE) on affected children and their parents. METHODS: A self-administered questionnaire was linguistically validated in Spanish, Italian and Polish. The questionnaire was included in an observational multicentre prospective study of 302 children aged <5 years presenting to a general practitioner or paediatrician for RVGE at centres in Spain, Italy or Poland. RV infection was confirmed by polymerase chain reaction (PCR) testing (n = 264). The questionnaire was validated and used to assess the emotional impact of paediatric RVGE on the parents. RESULTS: Questionnaire responses showed that acute RVGE in a child adversely affects the parents' daily life as well as the child. Parents of children with RVGE experience worry, distress and impact on their daily activities. RVGE of greater clinical severity (assessed by the Vesikari scale) was associated with higher parental worries due to symptoms and greater changes in the child's behaviour, and a trend to higher impact on parents' daily activities and higher parental distress, together with a higher score on the symptom severity scale of the questionnaire. CONCLUSIONS: Parents of a child with acute RVGE presenting to primary care experience worry, distress and disruptions to daily life as a result of the child's illness. Prevention of this disease through prophylactic vaccination will improve the daily lives of parents and children.

Health-related quality of life lost to rotavirus-associated gastroenteritis in children and their parents: a Canadian prospective study.

We estimated the impact of rotavirus-associated gastroenteritis (RGE) on health-related quality of life of children and parents as background for economic evaluation of rotavirus vaccines. A total of 186 new cases of RGE in children <36 months old were recruited from physician and pediatric clinics and followed up for 2 weeks. Our results show that RGE impacts the health-related quality of life of children and parents adversely.

[Survey about the perception of the gastroenteritis and the infection due to rotavirus by the mothers in France]. / Enquête sur la perception de la gastro-entérite et de l'infection à Rotavirus par les mères en France.

AIM: To describe the perception of the acute gastroenteritis (AGE) and the interest for the vaccination of the AGE due to Rotavirus. MATERIAL AND METHODS: Observational investigation realized by phone by the IPSOS institute, with 1002 French women of 18 years and more, constituting a representative national sample, having at least a child below 2 years, between 7 and January 31st, 2008. RESULTS: AGE is mainly considered by the mothers questioned as a grave pathology (43.1%) or very grave (51.3%) for the children below 2 years. This perception is bound to the symptoms and to the complications known for the disease. For the questioned mothers, the AGE comes along very often or often with diarrheas (97.2%), vomits (94.3%) or dehydration (94%). Hospitalizations are also perceived as frequent. The quasi-totality of the questioned women (98.3%) considers finally that it is about a very contagious disease (75.4%) or rather contagious (22.8%). The AGE at the child below 2 years provoke very frequently a medical consultation (91.8%), during which some solutions of oral rehydration are prescribed in six cases on 10 (62%). The questioned mothers are for the greater part favorable (86.3%) to a drinkable vaccine to prevent the AGE due to Rotavirus, and 88.1% say that they would intend to protect their child with this vaccine. CONCLUSION: The questioned mothers know the potential gravity of the AGE and a very wide majority of them (86.3%) declare themselves favorable to the prevention of the AGE at Rotavirus by the vaccination.

Comparison between two severity scoring scales commonly used in the evaluation of rotavirus gastroenteritis in children.

INTRODUCTION: Two severity scales, the Vesikari 20-point scale, and the Clark 24-point scale, were recently used to evaluate rotavirus vaccines. Each was used to evaluate a different vaccine. However, the two scales differ and have not been previously compared using the same patients. OBJECTIVE: To compare the Vesikari 20-point and the Clark 24-point diarrhoea severity scales. RESULTS: 987 gastroenteritis episodes in children < 3 years old were evaluated. Of these, 30.7% were rotavirus-positive. Of the 987 studied episodes, 755 (76%) were defined as severe by the Vesikari scale, vs. only 262 (27%) by the Clark scale (P < 0.001). All episodes defined as severe by the Clark's scale were also severe by the Vesikari scale. In contrast, only 262 (35%) of the Vesikari severe cases, were defined as severe by the Clark scale, while 475 (63%) and 18 (2%) were defined as moderate and mild, respectively by the Clark scale. By both methods, mean scores were slightly higher among Jewish than among Bedouin children, among females than among males, among hospitalised than among non-hospitalised children, and markedly higher in the 6-3 months old than in other age groups. The mean scores were also higher in the rotavirus-positive samples than in the rotavirus-negative samples by both scales. Transforming the Vesikari 2-category scale into a 3-category scale by further subdividing the severe category into two parts, improved the correlation between the two systems. However, still 155/344 (45%) found in the upper Vesikari severity score (> or = 16) were classified as only "moderate" by the Clark severity scale. CONCLUSION: The two evaluation scales differ largely in their definition of severe cases. This may affect the ability to compare the effectiveness of various vaccines if studies do not use the same severity of scales.