Background: Rotavirus is the most common cause of gastroenteritis resulting in death from diarrhoea in children ? 5 years of age in developing countries, hence decreasing the incidence of Rotavirus diarrhoea is an important public health goal in these countries. One of the main goals of Cochrane reviews is to facilitate evidence-based health policy decisions; this is particularly relevant regarding investments in public health strategies in developing countries, where resources are often limited.
Objectives: Since March 2006 the Brazilian Ministry of Health has supplied the Rotarix® rotavirus vaccine free of charge to three million children aged ? 6 months. Government officials expect that the resulting reduction in the incidence of Rotavirus diarrhoea will prevent 850 deaths/year in infants up to age one, reduce the number of deaths/year in children under five years old by 34%, and will reduce the number of hospitalisations/year from gastroenteritis by 42%.
Methods: We compared the results of a recently updated Cochrane review on rotavirus vaccines, with these projected decreases in deaths and hospitalisations made by the Brazilian Ministry of Health.
Results: To date, the updated Cochrane review includes nine trials which randomised about 70,000 children to receive Rotarix® or placebo. Although the data from the updated review, soon to be published in the Cochrane Library, indicates that the use of Rotarix® reduces the number of rotavirus infections requiring hospitalisation, data is scarce on mortality and, currently, there is no evidence that providing rotavirus vaccine to all children will reduce mortality in babies or children ? 5 years of age.
Interpretation: Because systematic reviews summarise the best available evidence from all studies on the topic, they can be utilised as an important tool facilitating evidence-based policy decisions. This is particularly important when making decisions regarding investments in public health and health promotion in developing, as well as developed countries.