Close to one lakh children below the age of five years died of diarrhoea attributable to rotavirus infection in 2008, accounting for 22 per cent of the total deaths reported globally, reports the latest edition of the Lancet Infection Diseases magazine.

Diarrhoea related with the rotavirus infection resulted in 453,000 deaths worldwide in 2008 among children younger than five years—37 per cent of deaths attributable to diarrhoea with five countries accounting for more than half of all deaths attributable to such infection: Democratic Republic of the Congo, Ethiopia, India, Nigeria and Pakistan. Introduction of effective and available rotavirus vaccines in other countries, mostly middle-income or poorer, could substantially reduce worldwide deaths attributable to diarrhoea, the paper has suggested.

In this new study, Dr. Jacqueline E. Tate and Dr. Umesh D. Parashar, Centre for Disease Control and Prevention, Atlanta, US, and colleagues did a systematic review and meta-analysis of studies with at least 100 children younger than five years who had been admitted to hospital with diarrhoea. They also included data from countries that participated in the WHO-coordinated Global Rotavirus Surveillance Network. Studies were classified into one of five groups on the basis of region and the level of child mortality in the country in which the study was done.

Estimate of deaths

The authors note that their estimate of deaths due to rotavirus-related diarrhoea in 2008 is somewhat lower than the previous estimate of 527 000 deaths in 2004, saying the difference is largely because of an overall decrease in diarrhoea-related deaths in children younger than 5 years from 1·8 million in 2003 to 1·2 million in 2008. “However,” they add, “we do not know what proportion of this decrease is due to a true decline in diarrhoea-related mortality and what proportion is due to a change in the methods used to estimate the number of diarrhoea-related deaths.”

Meanwhile, Save the Children, a non-government organization working for children, said efficacy trials were still on in India on the rotaviral vaccines and till these trials are over there is little data to prove the efficacy or otherwise of these new vaccines. Secondly and critically, these patented vaccines are so far being produced by a handful of private pharmaceutical companies and are hugely expensive. Introducing these vaccines in the public health system will involve huge resources. When the government is unable to raise the resources for critical primary health care, including routine immunization, it would appear inappropriate if the government were to invest additional resources on newer vaccines.