Prospective evaluation of indirect costs due to acute rotavirus gastroenteritis in Spain: the ROTACOST study.

BACKGROUND: The effect of rotavirus in developed countries is mainly economic. This study aimed to assess the indirect costs induced by rotavirus acute gastroenteritis (RVAGE) in Spain. METHODS: A prospective observational study was conducted from October 2008 to June 2009. It included 682 children up to 5 years of age with acute gastroenteritis (AGE) who attended primary care (n = 18) and emergency room/hospital settings (n = 10), covering the regions of Galicia and Asturias (North-west Spain). All non-medical expenses incurred throughout the episode were recorded in detail using personal interviews and telephone contact. RESULTS: Among the 682 enrolled children, 207 (30.4%) were rotavirus positive and 170 (25%) had received at least one dose of rotavirus vaccine. The mean (standard deviation) indirect cost caused by an episode of AGE was estimated at 135.17 (182.70) Euros. Costs were 1.74-fold higher when AGE was caused by rotavirus compared with other etiologies: 192.7 (219.8) Euros vs. 111.6 (163.5) Euros (p < .001). The costs for absenteeism were the most substantial with a mean of 91.41 (134.76) Euros per family, resulting in a loss of 2.45 (3.17) days of work. In RVAGE patients, the absenteeism cost was 120.4 (154) Euros compared with 75.8 (123) for the other etiologies (p = .002), because of loss of 3.5 (3.6) vs 1.9 (2.9) days of work (p < .001). Meals costs were 2-fold-higher (48.5 (55) vs 24.3 (46) Euros, p < .001) and travel costs were 2.6-fold-higher (32 (92) vs 12.5 (21.1) Euros, p = .005) in RVAGE patients compared with those with other etiologies. There were no differences between RVAGE and other etiologies groups regarding costs of hiring of caregivers or purchase of material. Patients with RVAGE were admitted to hospital more frequently than those with other etiologies (47.8% vs 14%, p < .001). CONCLUSIONS: Rotavirus generates a significant indirect economic burden. Our data should be considered in the decision-making process of the eventual inclusion of rotavirus vaccine in the national immunization schedule of well developed countries.

Prevalencia de síntomas de asma en los niños y adolescentes de la Comunidad Autónoma de Galicia (España) y sus variaciones geográficas / Prevalence and Geographic Variations in Asthma Symptoms in Children and Adolescents in Galicia (Spain)

Objetivos: Determinar la prevalencia y variaciones geográficas de síntomas relacionados con asma enniños y adolescentes gallegos.Población y métodos: Estudio transversal según la metodología ISAAC (Internacional Study of Asthmaand Allergies in Childhood) mediante cuestionario escrito distribuido en el medio escolar. Se incluyeron10.371 niños de 6-7 años y 10.372 adolescentes de 13-14 años de todas las Áreas Sanitarias de Galicia. Seanalizaron las variaciones geográficas mediante un modelo de regresión logística.Resultados: Las sibilancias en los últimos 12 meses oscilaron en los pequeños, del 11,4 (Santiago) al 15,7%(Vigo) y en los adolescentes del 8,8 (Ourense) al 18,8% (Vigo). Según el género se observó una mayorfrecuencia en varones de 6-7 años (p < 0,001) y con tendencia a la significación estadística en las chicasde 13-14 años (p = 0,08). El riesgo (Odds ratio [OR]) de sibilancias en los últimos 12 meses, en el área demayor prevalencia con respecto a la de menor, fue 1,45 (intervalo de confianza [IC] del 95%: 1,12-1,88)en niños y 2,39 (IC 95%: 1,82-3,13) en adolescentes. La prevalencia de asma estimada para Galicia fue de13,6% en niños y 12,2% en adolescentes.Conclusiones: La prevalencia de sibilancias en los últimos 12 meses en las diferentes áreas gallegas essensiblemente superior al resto de ciudades españolas participantes en el ISAAC en los pequeños, siendomuy similar en los adolescentes, salvo en Vigo donde es sensiblemente superior. Encontramos un patróngeográficomuydefinido en los adolescentes, siendo mayores las prevalencias en la costa que en el interior(AU)

Objectives: To determine the prevalence and geographic variations of the symptoms associated withasthma in Galician children and adolescents.Population and methods: A cross-sectional epidemiological study following ISAAC (International Studyof Asthma and Allergies in Childhood) methodology, and using a written questionnaire distributed inschools. The study sample included 10,371 6-7 year-old children and 10,372 13-14 year-old adolescents,all of them from Galician Health Areas. A logistic regression model was used to analyse geographic variations. Results: In the 6-7 year-old group, wheezing in the last 12 months varied from 11.4% (Santiago) to 15.7%(Vigo) and in the adolescents varied from 8.8% (Ourense) to 18.8% (Vigo). The distribution by gender showeda predominant significance in 6-7 year-old males (P < .001), and near to be statistically significant in 13-14year-old females (P = .08). The risk (odds ratio [OR]) of wheezing in the last 12 months in the area withhighest prevalence in comparison with the area of lowest prevalence was 1.45 (95% Confidence Interval[CI], 1.12-1.88) for children and 2.39 (95% CI, 1.82-3.13) for adolescents. The estimated prevalence of asthmain the Autonomous Community of Galicia was 13.6% in younger children and 12.2% in adolescents.Conclusions: The prevalence of wheezing in the last 12 months in the different areas of Galicia is considerablyhigher than the rest of Spanish ISAAC cities in the 6-7 years group and very similar in the 13-14 yearsgroup, except in Vigo where it is considerably higher. We found a clearly defined geographic pattern inthe adolescent group, with higher prevalences in coastal areas than in the interior(AU)

Effectiveness of rotavirus vaccination in Spain.

With the aim of determining rotavirus vaccine effectiveness (RVVE) in Spain, from Oct-2008/Jun-2009, 467 consecutive children below 2 years old with acute gastroenteritis (AGE) were recruited using a pediatric research network (ReGALIP-www.regalip.org) that includes primary, emergency and hospital care settings. Of 467 enrolled children, 32.3% were rotavirus positive and 35.0% had received at least one dose of any rotavirus vaccine. RRVE to prevent any episode of rotavirus AGE was 91.5% (95% CI: 83.7%-95.6%). RVVE to prevent hospitalization by rotavirus AGE was 95.6% (85.6-98.6%). No differences in RVVE were found regarding the vaccine used. Rotavirus vaccines have showed an outstanding effectiveness in Spain.

Prevalence and geographic variations in asthma symptoms in children and adolescents in Galicia (Spain).

OBJECTIVES: To determine the prevalence and geographic variations of the symptoms associated with asthma in Galician children and adolescents. POPULATION AND METHODS: A cross-sectional epidemiological study following ISAAC (International Study of Asthma and Allergies in Childhood) methodology, and using a written questionnaire distributed in schools. The study sample included 10,371 6-7 year-old children and 10,372 13-14 year-old adolescents, all of them from Galician Health Areas. A logistic regression model was used to analyse geographic variations. RESULTS: In the 6-7 year-old group, wheezing in the last 12 months varied from 11.4% (Santiago) to 15.7% (Vigo) and in the adolescents varied from 8.8% (Ourense) to 18.8% (Vigo). The distribution by gender showed a predominant significance in 6-7 year-old males (P<.001), and near to be statistically significant in 13-14 year-old females (P=.08). The risk (odds ratio [OR]) of wheezing in the last 12 months in the area with highest prevalence in comparison with the area of lowest prevalence was 1.45 (95% Confidence Interval [CI], 1.12-1.88) for children and 2.39 (95% CI, 1.82-3.13) for adolescents. The estimated prevalence of asthma in the Autonomous Community of Galicia was 13.6% in younger children and 12.2% in adolescents. CONCLUSIONS: The prevalence of wheezing in the last 12 months in the different areas of Galicia is considerably higher than the rest of Spanish ISAAC cities in the 6-7 years group and very similar in the 13-14 years group, except in Vigo where it is considerably higher. We found a clearly defined geographic pattern in the adolescent group, with higher prevalences in coastal areas than in the interior.