Systematic review of studies on rotavirus disease cost-of-illness and productivity loss in Latin America and the Caribbean

• We systematically review rotavirus cost-of-illness studies in Latin America/Caribbean.
• We included 21 out of 444 identified studies.
• The majority of studies were cost-effectiveness analysis of vaccination programs.
• Methods for cost estimation significantly varied across studies.
• A wide range of unit costs was identified.

BackgroundRotavirus is the most common cause of severe acute diarrhea among children in both developed and developing countries. Vaccination can reduce the disease burden and its incorporation into health care systems should consider future costs and benefits.ObjectivesTo systematically review studies on costs due to rotavirus infection in Latin America and Caribbean (LAC) region, considering their methods and results.MethodsA search of relevant databases including the Cochrane Central Register of Controlled Trials, Embase, MEDLINE via PubMed, the Latin American and Caribbean Health Sciences Literature database (LILACS), and the Brazilian Thesis Databank was performed. Inclusion criteria for studies were: (a) economic evaluation or cost-of-illness studies; (b) conducted in the LAC region; (c) assess economic burden of rotavirus disease or the economic impact of rotavirus vaccination programs. Two authors independently screened the studies for eligibility.ResultsOf 444 studies initially retrieved, 21 met the eligibility criteria and were included (14 cost-effectiveness analyses of vaccination programs and 7 cost-of-illness studies). Direct medical costs were assessed in all 21 studies, but only 10 also investigated indirect and non-medical direct costs. The most commonly observed methods for cost estimation were retrospective database analysis and hospital-based surveillance study. Only one study was a household-based survey.A wide cost range was identified (e.g., inpatient care US$79.91 to US$858.40 and outpatient care US$13.06 to US$64.10), depending on the methods, study perspective, and type of costs included.ConclusionRotavirus-associated costs were assessed in 21 studies across the Latin America and Caribbean region. The majority of studies were made alongside economic evaluations of vaccination programs. Methods are broadly different among studies but administrative databases seem to be the most employed source of data.