The need for rotavirus vaccine

One third of the causes of diarrhea in children aged under five years in Thimphu is due to the prevalence of rotavirus, and yet the rotavirus vaccine is not available in the country.

Rotavirus infects the children below five years of age and it is the leading cause of the acute diarrhea in children. According to the World Health Organization, about 0.43mn children die annually from rotavirus.

“The rotavirus vaccine is commercially available to prevent severe rotavirus infection, but it has not been introduced in the national immunization program of Bhutan because many policy makers and health care providers do not recognize the burden of rotavirus infection,” the report states.

To address this need, first of its kind, public health laboratory (PHL), Department of Public Health carried out a study, “A Prospective Hospital-based Surveillance to Estimate Rotavirus Disease Burden in Bhutanese Children 5 Years of Age.”

The study found the estimate of burden of rotavirus diarrhea among children less than five years old being attended in the Department of Pediatrics, Jigme Dorji Wangchuck National Referral Hospital, Thimphu.

Thw Chief Laboratory Officer, PHL, Sonam Wangchuk, said the study looks into the possibility of the introduction of rotavirus. He added in other countries, depending upon the burden, they use such vaccines. To introduce the vaccine in Bhutan, he said there is a burden but cost, in terms of cost of procuring the vaccine with present treatment and management, is to be taken into consideration. The report does not study the cost, he pointed out.

The study saw 284 children hospitalized in the pediatric ward, and 2220 in the dehydration treatment unit (DTU) with diarrhea among children residing in Thimphu during the three years of study starting from 2010.

It found out that the most common strain of Group A rotavirus was detected in 32.5% and 18.8% of the stool samples were rotavirus-positive while majority of about 90.8% was detected in children aged under two years.

Report estimates that the annual incidence of hospitalization due to rotavirus diarrhea was 2.4/1000 in the ward and10.8/1000 in the DTU. It also found that the rotavirus was predominant, 90.8% in children aged below two years.

Winter-spring season saw a higher infection rate of rotavirus and it states that in December to April is the rotavirus season in Bhutan.

The annual incidences reported were similar to that reported from other South Asian countries. In the Philippines, the prevalence of rotavirus diarrhea in hospitalized children was 31%, similar to that in Bhutan. South Asian countries, like India, Pakistan, and the Philippines have already started the rotavirus vaccine.

The study will also give way to generate evidence that will contribute to policy discussions by the health ministry on its diarrheal disease control program, and the introduction of rotavirus vaccination in the country.

At present, the rotavirus vaccine is neither a part of the routine immunization program nor it is available in the private market.

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