Four‐country surveillance of intestinal intussusception and diarrhoea in children

Awasthi, Sanjay; Agarwal, Gaurav; Mishra, Vikas; Nag, Vijay Laxmi; Sayed, Hesham Fathey El; Cunha, Antonio Jose Ledo da; Madeiro, Alvaro; Jain, Dipty; Macharia, William; Ndung'u, James Muturi; Awasthi, Saumya; Wakhlu, Ashish

doi:10.1111/j.1440-1754.2008.01434.x

Cited by 17 publications

(19 citation statements)

References 18 publications

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“…In our study, nearly 50% of children with recurrence of intussusception were younger than one year at the first episode and it decreased to 7.9% in older children. 71% of recurrences developed within 6 months of the initial onset, thus it can be concluded that intussusception is more common in the first year of life and the recurrence of intussusception decreases after the toddler period, that is consistent with some other studies ( 10 , 25 , 33 , 35 , 36 ). There were controversies about seasonal variation of the occurrence of intussusception.…”

Section: Discussionsupporting

confidence: 88%

Pediatric Intussusception in Northern Iran: Comparison of Recurrent With Non-Recurrent Cases

et al. 2016

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Background:Intussusception represents as the invagination of a part of the intestine into itself and is the most common cause of intestinal obstruction in infants and children between 6 months to 3-years-old. Objectives:The objective of this study was to determine the recurrence rate and predisposing factors of recurrent intussusception.Patients and Methods:The medical records of children aged less than 13-years-old with confirmed intussusception who underwent reduction at a tertiary academic care in northern Iran (Mazandran), from 2001 to 2013 were reviewed. Data were extracted and recurrence rate was determined. The two groups were compared by chi square, Fisher, Mann-Whitney and t-test. Diagnosed cases of intussusception consisted of 237 children. Results:Average age of the patients was 19.57 ± 19.43 months with a peak of 3 to 30 months. Male to female ratio was 1.65 and this increased by aging. Recurrence rate was 16% (38 cases). 87 (36.7%) underwent surgery. These were mainly children under one year old. In 71% (40) of episodes recurrence occurred 1 to 7 times within 6 months. The recurrence occurred in 29 (23.5%) children in whom a first reduction was achieved with barium enema (BE) and 5 (5.7%) children who had an operative reduction (P < 0.001) in the first episode. Pathological leading points (PLPs) were observed in 5 cases; 2.6% in recurrence group versus 2% in non-recurrence group (P = 0.91). Three patients had intestinal polyp, 2 patient’s lymphoma and Mackle’s diverticulum. Age (P = 0.77) and sex (P = 0.38) showed no difference between the two groups. PLPs were observed in 1.4% of children aged 3 months to 5 years. This was 13.3%, in older children (P = 0.02).Conclusions:The recurrence of intussusception was related to the method of treatment in the first episode and it was 5-fold higher in children with BE than in operative reduction. Recurrent intussusceptions were not associated with PLPs, they were more idiopathic.

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Section: Discussionsupporting

confidence: 88%

Pediatric Intussusception in Northern Iran: Comparison of Recurrent With Non-Recurrent Cases

et al. 2016

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“…There is considerable documentation of a marked diversity in seasonality of not only rotavirus but also of the rotavirus strains in circulation because of the variation in humidity and temperature across the country. The majority of rotavirus diarrhoea cases have been reported to occur between 6 and 12 months of age [22], but in developing countries rotavirus diarrhoea has been reported to be prevalent in younger children [23,24], data that are corroborated by our study: 79.7% of rotavirus-positive cases were found to be <1 year old and 58.2% cases were <7 months old. A meta-analysis of three observational studies in developing countries has shown that breast-fed children <6 months old are 6.1 times less likely to die of diarrhoea than infants who are not breast fed [25].…”

Section: Discussionsupporting

confidence: 86%

Genomic diversity of group A rotavirus strains in patients aged 1–36 months admitted for acute watery diarrhoea in northern India: a hospital-based study

Mishra

Awasthi

Nag

et al. 2010

Clinical Microbiology and Infection

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The diversity and capacity of human rotaviruses for rapid evolution and genetic reassortment suggests that rotavirus vaccine should be designed to provide heterotypic protection. The objective of the present study was to provide information on the circulating genotypes of rotavirus and allied baseline epidemiology in Lucknow, India. In a cross-sectional study, the prevalence of rotavirus G-P types was studied in patients aged 1-36 months with acute watery diarrhoea. Various sociodemographic, environmental and clinical factors were assessed as potential predictors of rotavirus infection; 412 patients with acute watery diarrhoea were recruited into the study from September 2004 to April 2008 and rotavirus was identified in 19.2% (79/412) cases using ELISA and PAGE. The genotypes identified were G1 (38.0%), G2 (15.2%), G3 (16.5%), G9 (10.9%), G4 (5.1%) and mixed G types (10.1%). The most common G-P combinations were G1P[8], G3P[6], G1P[6] and G2P[8]. Rotavirus diarrhoea was found to occur throughout the year with a single peak in winter months (November-January). Rotavirus diarrhoea was found to be associated with children not currently breast fed (adjusted OR 2.2, 95% CI 1.3-3.7, p 0.004), children < or =7 months of age (adjusted OR 1.1, 95% CI 1.0-1.1, p 0.002) and children with severe dehydration (adjusted OR 1.8, 95% CI 1.1-3.0, p 0.03) using multivariate logistic regression. A high degree of strain diversity of rotavirus G and P types was detected. Rotavirus was found to be associated with dehydrating diarrhoea, particularly in children aged 0-7 months, placing them at increased risk of mortality.

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“…We reviewed 2757 abstracts to identify a total of 113 potential full-text articles and 1 meeting abstract, from which 82 studies met the inclusion criteria for our analysis (Figure 1; Table 1) [11]–[91]. We excluded 31 articles due to non-English language (n = 8), duplicate data (n = 14), non-epidemiology study or review (6), included in previous review (2), or age <1 excluded (1).…”

Section: Resultsmentioning

confidence: 99%

Childhood Intussusception: A Literature Review

et al. 2013

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BackgroundPostlicensure data has identified a causal link between rotavirus vaccines and intussusception in some settings. As rotavirus vaccines are introduced globally, monitoring intussusception will be crucial for ensuring safety of the vaccine programs.MethodsTo obtain updated information on background rates and clinical management of intussusception, we reviewed studies of intussusception in children <18 years of age published since 2002. We assessed the incidence of intussusception by month of life among children <1 year of age, seasonality, method of diagnosis, treatment, and case-fatality.FindingsWe identified 82 studies from North America, Asia, Europe, Oceania, Africa, Eastern Mediterranean, and Central & South America that reported a total of 44,454 intussusception events. The mean incidence of intussusception was 74 per 100,000 (range: 9–328) among children <1 year of age, with peak incidence among infants 5–7 months of age. No seasonal patterns were observed. A radiographic modality was used to diagnose intussusception in over 95% of the cases in all regions except Africa where clinical findings or surgery were used in 65% of the cases. Surgical rates were substantially higher in Africa (77%) and Central and South America (86%) compared to other regions (13–29%). Case-fatality also was higher in Africa (9%) compared to other regions (<1%). The primary limitation of this review relates to the heterogeneity in intussusception surveillance across different regions.ConclusionThis review of the intussusception literature from the past decade provides pertinent information that should facilitate implementation of intussusception surveillance for monitoring the postlicensure safety of rotavirus vaccines.

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Four‐country surveillance of intestinal intussusception and diarrhoea in children

Cited by 17 publications

References 18 publications

Pediatric Intussusception in Northern Iran: Comparison of Recurrent With Non-Recurrent Cases

Pediatric Intussusception in Northern Iran: Comparison of Recurrent With Non-Recurrent Cases

Genomic diversity of group A rotavirus strains in patients aged 1–36 months admitted for acute watery diarrhoea in northern India: a hospital-based study

Childhood Intussusception: A Literature Review

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