Aiming to understand the potential health benefits of rotavirus vaccination and also to develop a national representative data on rotavirus burden and strains in India, the Indian Council of Medical Research (ICMR) will soon embark on task force projects on burden of rotavirus diarrhoea in India under the Indian Rotavirus Surveillance Network.

The ICMR's initiative in this direction stems from the fact that the diarrhoeal diseases represent a major health problem in developing countries with wide diversity of bacterial and viral infections. Recently, the ICMR had completed a task force study on hospital based rotavirus strain surveillance network, involving four laboratories and ten hospitals in seven different regions of India which has shown that rotavirus was found in 39 per cent of children below 5 years of age presenting with acute gastroenteritis and requiring hospitalization for rehydration.

Among the enteric viruses, rotaviruses remain the leading cause of diarrhoeal disease in young children in the world. Every year, an estimated 5,27,000 young children die from severe diarrhoea caused by rotavirus infection, most of them occurring in developing countries in South Asia and sub-Saharan Africa.

Senior officials in the ICMR said that since rotavirus vaccines are now in the market and will be used widely in the private sector in India, there is need to have nationally representative data on rotavirus burden and strains in India to understand the potential health benefits of rotavirus vaccination.

For this purpose, the ICMR proposes to strengthen the existing surveillance sites and expand the network by identifying new hospital sites with each regional laboratory in India in different geographical area, in states reporting high infant mortality rates or inhabited by marginalized society.

The task force projects will focus on: studies to assess the proportion of diarrhoea cases/deaths attributable to rotavirus among children below 5 years of age in associated hospitals and community sites; studies on determination of the age and seasonal distribution of rotavirus-associated diarrhoea including monitoring of trends; studies on characterization of (G serotyping and P genotyping) strains of rotavirus currently circulating in different geographical areas and strain diversity and trend including the strains newly emerged or unusual strains specially attributed to Zoonotic infections/not identified/typed by standard techniques; and studies on proportion of age dependent children admitted to hospital due to intussusceptions.

The projects will also focus on field efficacy studies to assess the expected impact of existing rotavirus vaccine on disease and to estimate the cost-effectiveness of a rotavirus vaccine; studies on estimation of the economic burden of rotavirus gastroenteritis by standardized costing studies and the estimation of disease burden at different levels of health care; studies in IgA seroconversion assays, antigenemia, and viraemia studies at the regional laboratories? Health care utilization survey for community? Community vs. OPD vs. hospitalization comparison; studies on estimation of economic burden due to proportion of the population that sought care at primary, secondary, and tertiary level facilities due to rotavirus gastroenteritis; and studies to assess the impact of breast feeding/zinc supplement and improved sanitation on the morbidity and mortality of rotavirus diarrhoea.

ICMR has already invited concept proposals from scientists of various recognized research institutions (governmental and recognized non-governmental) and medical colleges.