北京市5岁以下儿童轮状病毒腹泻经济负担研究

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目的了解北京市5岁以下儿童轮状病毒(Rotavirus,RV)腹泻经济负担,为RV免疫规划提供建议。方法在2012年7月到2013年7月,在北京市3家儿童专科医院采集门诊和输液患儿的粪便标本,采用酶联免疫吸附试验(Enzyme-linked Immunosorbent Assay,ELISA)检测粪便标本中的RV抗原,对阳性患儿调查患病的直接费用和间接费用,综合评价北京市RV腹泻的经济负担。结果分别采集门诊和输液患儿的粪便标本678份、476份,RV阳性者分别为131份(19.3%)、137份(28.8%)。RV阳性患儿中,1岁及以下者在门诊和输液患儿中分别占86.3%和94.9%。RV阳性患儿中59名(22.0%)接种了口服轮状病毒减毒活疫苗(Oral Rotavirus Attenuated Live Vaccine,ORV),首剂次接种年龄中位数为1.7岁。输液患儿平均经济负担中位数高于门诊患儿,分别为737.8元和559.4元。估算北京市每年5岁以下儿童RV腹泻经济负担为55 186 462元。结论北京市RV腹泻经济负担较高,晚于感染年龄接种RV疫苗可能降低其预防RV腹泻的作用,建议根据流行特征细化现有的ORV接种程序。 Objective To understand the economic burden of rotavirus (RV) diarrhea in children under 5 years old in Beijing and provide advice on RV immunization planning. Methods From July 2012 to July 2013, stool samples of outpatients and infants were collected from three children’s special hospitals in Beijing. Enzyme-linked immunosorbent assay (ELISA) was used to detect stool samples RV antigen, the prevalence of positive children investigated the direct costs and indirect costs, comprehensive evaluation of Beijing’s economic burden of RV diarrhea. Results A total of 678 and 476 stool specimens from outpatients and infants were collected, and 131 (19.3%) and 137 (28.8%) were positive for RV. RV-positive children, 1-year-old children and infants in the out-patient and infusion accounted for 86.3% and 94.9%. Oral Rotavirus Attenuated Live Vaccine (ORV) was inoculated to 59 (22.0%) of RV-positive children with a median age of 1.7 years. The median economic burden of infants with children was higher than that of outpatients with 737.8 yuan and 559.4 yuan respectively. It is estimated that the economic burden of RV diarrhea in children under 5 years old in Beijing is 55,186,462 yuan per year. Conclusions The high economic burden of RV diarrhea in Beijing may reduce its preventive effect on RV diarrhea by inoculating the RV vaccine later than the age of infection. It is suggested that the current ORV vaccination program should be refined according to epidemiological characteristics.
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