P2-456 Evaluating burden of rotavirus-associated mortality in the Eastern Mediterranean Region; a crucial step for informed decision-making on implementation of rotavirus vaccine

Abstract

Introduction: Rotavirus-attributed diarrhea is a major cause of death in young children. The World Health Organization-Eastern Mediterranean Region, with a population over 590 millions, is a diverse area in terms of socioeconomic status and health indicators. This study aimed to evaluate burden of rotavirus-associated mortality to encourage implementation of rotavirus vaccine in the region. Materials and methods: Based on rotavirus-associated mortality in prevaccination era, the effect of rotavirus vaccine to avert children deaths was calculated. Results: More than 11% of the global rotavirus deaths was estimated to occur in Eastern Mediterranean Region, claiming more than 61,000 children less than five years of age in 2004. Pakistan and Afghanistan, each with more than 15,000 deaths per year, were the countries with the highest number of rotavirus-associated mortality; follow by Iraq, Somalia, Sudan, Yemen, Egypt and Morocco. On the other hand, each of Bahrain, Kuwait and Qatar with less than 10 deaths per year were the countries with the lowest number of rotavirus-associated mortality. When the coverage of currently used vaccines was applied to a rotavirus vaccine, a minimum of 24,100 and maximum of 43,300 deaths would be averted with vaccine efficacy of 50% to 90%, respectively. Discussion: Rotavirusassociated mortality and morbidity varies considerably in the region. While in some countries reducing rotavirus-associated mortality is a great concern, in others reducing rotavirus-attributed morbidity is the main benefit of rotavirus immunization. Implementing comprehensive strategies to facilitate usage of rotavirus vaccine in the region is encouraging.