Epidemiology of intussusception before and after rotavirus vaccine introduction in Fiji

Abstract

In 2012, Fiji introduced rotavirus vaccine (Rotarix, GSK) into the national immunisation schedule. We describe the intussusception epidemiology prior to rotavirus vaccine, temporal association of intussusception cases to administration of rotavirus vaccine, and estimate the additional number of intussusception cases that may be associated with rotavirus vaccine. A retrospective review of intussusception cases for children aged <24 months old was undertaken between January 2007 and October 2012 pre-vaccine. All admissions and deaths with a discharge diagnosis of intussusception, bowel obstruction, paralytic ileus, or intussusception ICD10-AM codes were extracted from national databases and hospital records. Nationwide active intussusception surveillance was established for three years post-vaccine (2013–2015). There were 24 definite intussusception cases in the pre-rotavirus vaccine period, 96% were confirmed by surgery. The median age was 6.5 months. The incidence rate was 22.2 (95% CI: 13.9–33.7) per 100,000 infants. There were no deaths. Active surveillance identified 25 definite intussusception cases, 96% of which were among children who were age-eligible for rotavirus vaccine. None were potentially vaccine related. We estimated one to five additional cases of intussusception every five years. The incidence of intussusception pre-rotavirus vaccine in Fiji is low. Intussusception associated with rotavirus vaccine is likely a rare event in Fiji.

Evaluating the efficacy of point-of-use water filtration units in Fiji

“…Furthermore, a 2009 study in Fiji’s largest hospital found that 39% of children under the age of 5 who were admitted for diarrhea tested positively for rotavirus [8]. Beginning in 2012, one major prevention initiative that Fiji has taken to counteract this problem is vaccination of children for the fecal-oral pathogen rotavirus [3, 9]. As the country moves forward in the prevention of diarrhea with vaccination against rotavirus, the country of Fiji can continue to make other adjustments to lessen the burden of diarrhea caused by non-viral agents.…”

Severity of Rotavirus-Vaccine-Associated Intussusception: Prospective Hospital-Based Surveillance, Australia, 2007–2018

“…In high-income countries with good access to health care, the main impact of RV programs has been on hospitalization for gastroenteritis, whereas impacts on mortality were observed in lowand middle-income countries. 4,[21][22][23][24] In Australia, a 71% decline in rotavirus-coded, and a 38% decline in non-rotavirus coded, acute gastroenteritis hospitalizations in children <5 years of age was documented following implementation of the national rotavirus immunization program, 25 as well as a reduction in presentations with febrile seizures of 36%. 26 Estimates suggest that in countries with significant rotavirus-related mortality, the benefits of RV exceed risks by more than 100-fold, if the risk of IS was similar to low mortality settings, 27 which is likely an underestimate as IS is uncommon in many such populations.…”

A gyermekkori invaginatio modern értelmezése és kezelése

“…Fejlett nyugati országokban 30-70 eset jut 100 000 csecsemőre, míg ázsiai országokban -például Japánban vagy Vietnamban -lényegesen gyakoribb (185-302/ 100 000 csecsemő). A mortalitás a fejlett országokban 1% alatt van, míg fejlődő országokban a 9%-ot is elérheti [4].…”