Disease burden of rotavirus infection and its complications among children under 14 years old with acute gastroenteritis in China: a multicentre and retrospective study

OBJECTIVES: This study aimed to assess the positivity rate, disease burden, and complications of rotavirus gastroenteritis (RVGE) among Chinese children under 14 years of age presenting with acute gastroenteritis (AGE). METHODS: A multicentre, observational, and retrospective study was conducted at 11 centres across China (July 2013 - June 2023). Data on RVGE prevalence, direct medical costs, and complications were analyzed, with projections of direct economic burden for 2025 - 2034. RESULTS: Out of 505,987 AGE visits, the rotavirus positivity rate was 15.70%, peaked at 26.41% in the 12-month period from July 2016 to June 2017, and the annual positivity rate declined by 19.63% between 2017 and 2023. Among 7,113 RVGE cases, 28.57% of inpatients had recorded complications, and the estimated rate of recorded complications among all RVGE patients was 8.29%, most commonly recorded complications being myocardial damage, dehydration, respiratory infection, convulsion, and metabolic acidosis. The median cost of RVGE was CNY 272.80 (USD 40.68) for outpatients and CNY 5336.60 (USD 795.69) for inpatients, respectively. Projected economic burden is estimated to decrease from CNY 8.55 billion (USD 1.21 billion) in 2025 to CNY 3.96 billion (USD 559 million) in 2034. CONCLUSIONS: RVGE was associated with high complication rates. The decrease in rotavirus prevalence since 2018, highlighting the public health value of a series of preventive measures during this period, including vaccination.