AABSTRACT Data on the economic burden of rotavirus infection in Tunisia are needed to inform the decision to
include rotavirus in routine childhood immunizations. This study aimed to describe the epidemiological profile
of rotavirus disease in central-east Tunisia and to estimate its hospital cost. In the first stage – the prospective
collection of epidemiological data – we enrolled all patients < 5 years old who were hospitalized for acute
diarrhoea at 5 university paediatric departments in central-east Tunisia during the period 2009–2011. Rotavirus was
responsible for 65 (23.3%) of the 279 cases enrolled. In the second stage, cost data were collected retrospectively
using an activity-based costing method from the medical records of the children who were positively diagnosed
with rotavirus. The average cost of care per child was TD 433 (SD 134). This is a significant economic burden in
Tunisia, where a safe and effective vaccine is available but not yet introduced to the immunization schedule.