Intussusception among infants in Tanzania: findings from prospective hospital-based surveillance, 2013-2016

Mbaga, Mwajabu; Msuya, David; Mboma, Lazaro; Jani, Bhavin; Michael, Fausta; Kamugisha, Christopher; Said, Said Ali; Saleh, Abdulhamid; Mwenda, Jason M.; Cortese, Margaret M.

doi:10.11604/pamj.supp.2021.39.1.21358

Cited by 3 publications

(9 citation statements)

References 20 publications

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“…In this study, the distribution of male and female patients was similar to the literature 3,4,6,7,9–11,14–19 . In their study in the United States, Otero et al 15 reported a similar age to our study, with a mean of 3.2 years, and 88.5% of the patients were aged younger than 5 years.…”

Section: Discussionsupporting

confidence: 89%

“…In this study, the distribution of male and female patients was similar to the literature. 3,4,6,7,[9][10][11][14][15][16][17][18][19] In their study in the United States, Otero et al 15 reported a similar age to our study, with a mean of 3.2 years, and 88.5% of the patients were aged younger than 5 years. Sun et al 20 reported that 42% of their patients were aged between 3 and 4 years with a mean age of 3.86 years and also mentioned that most of their patients were admitted within 24 hours of symptom onset.…”

Section: Discussionsupporting

confidence: 73%

“…The average or median time from symptom onset to admission to a health center is 3-4 days. 3,5,10,11,18 We found much earlier admissions to our center: 80% of patients were admitted and diagnosed within less than 24 hours. Bloody stool, which is an indication of impaired intestinal circulation, was less frequent in our study, 10%-43% 15%-54% 13%-59% 5%-43% 7%-67% 9%-50% 0%-9.3% perhaps because of shorter symptom duration and earlier diagnosis.…”

Section: Discussionmentioning

confidence: 89%

“…It has been reported that a longer symptom duration and late diagnosis increases operative treatment needs, complications, morbidity, and mortality. [1][2][3][4][5][10][11][12]18,19 Mortality rates are 4%-34% in African counties 10,11,18 but less than 1% in most developed countries (like ours), where the symptom duration is shorter and the diagnosis is earlier (Table 4). 1,5 Diagnosing patients quickly after symptom onset seems possible with 24/7 access to USG in the health care system.…”

Section: Discussionmentioning

confidence: 97%

“…Most authors have reported a younger age at diagnosis than in our study. 3,4,6,7,[9][10][11][12][16][17][18][19]21,22 This could be due to the age limitation of most studies; many studies included cases only under a certain age, such as younger than 2 years 3,4,6,7,12,21 or younger than 5 years 10,11 (Table 4). Another explanation for this difference could be the early detection of intussusception, which could also involve intussusceptions that may have resolved spontaneously and would not cause symptoms if not diagnosed using USG.…”

Section: Discussionmentioning

confidence: 99%

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Comparison of Clinical Features of Intussusception in Terms of Age and Duration of Symptoms

Acer-Demir,

Güney,

Fakioğlu

et al. 2023

Pediatr Emer Care

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Objectives Intussusception is one of the most common surgical emergencies in children. We aimed to analyze the current clinical characteristics of intussusception. Methods We retrospectively reviewed 209 children diagnosed with intussusception, who were admitted to our hospital between January 2009 and August 2022. We grouped the patients according to symptom duration (before and after 12 hours and before and after 24 hours) and age (younger and older than 1 year, and younger and older than 2 years). Results The median age at admission was 31 months (2–204 months). The median symptom duration was 12 hours (1–420 hours). Most patients (91.4%) were admitted due to abdominal pain, irritability, and/or vomiting. The most common symptoms were vomiting (70.8%) and abdominal pain (60.6%). The classical triad of symptoms was seen in 9 cases (4.3%). In patients aged younger than 1 year, bloody stool, abnormal abdominal radiography findings, and a longer intussusceptum segment were more frequent. In patients aged younger than 2 years, abdominal pain, fever, and defense on physical examination were less frequent, and irritability, bloody stool, and recurrence were more frequent. Patients aged younger than 2 years had a longer intussusceptum segment and less lymphadenopathy based on ultrasonography (USG). The patients admitted more than 12 hours after symptom onset had more diarrhea, fever, abnormal x-ray, peritoneal fluid on USG, and recurrences, and less vomiting. After the symptoms had lasted for 24 hours, fever, mass palpation, and abnormal abdominal radiography findings were more frequent. Conclusions We recommend performing abdominal USG, especially in young children admitted to the emergency department with complaints of abdominal pain and/or vomiting, to rule out intussusception. In countries that have reported a high mortality rate from intussusception, we advise precautions such as increasing the availability of USG in emergency departments and educating the population to seek early medical assistance.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 73%

Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Comparison of Clinical Features of Intussusception in Terms of Age and Duration of Symptoms

Acer-Demir,

Güney,

Fakioğlu

et al. 2023

Pediatr Emer Care

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Clinical presentation and management outcome of pediatric intussusception at Wolaita Sodo University Comprehensive Specialized Hospital: a retrospective cross-sectional study

Zewde,

Bugie,

Daniel

et al. 2024

J Int Med Res

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Objective To assess the pattern of clinical presentations and factors associated with the management outcome of pediatric intussusception among children treated at Wolaita Sodo University Comprehensive Specialized Hospital, Ethiopia. Methods This retrospective cross-sectional study included the medical records of 103 children treated for intussusception from 2018 to 2020. The data collected were analyzed using SPSS 25.0 (IBM Corp., Armonk, NY, USA). Results In total, 84 (81.6%) patients were released with a favorable outcome. Ileocolic intussusception was a positive predictor, with a nine-fold higher likelihood of a favorable outcome than other types of intussusception [adjusted odds ratio (AOR), 9.16; 95% confidence interval (CI), 2.39–21.2]. Additionally, a favorable outcome was three times more likely in patients who did than did not undergo manual reduction (AOR, 3.08; 95% CI, 3.05–5.48). Patients aged <1 year were 96% less likely to have a positive outcome than those aged >4 years (AOR, 0.04; 95% CI, 0.03–0.57). Conclusion Most patients were discharged with favorable outcomes. Having ileocolic intussusception and undergoing manual reduction were associated with significantly more favorable outcomes of pediatric intussusception. Therefore, nonsurgical management such as hydrostatic enema and pneumatic reduction is recommended to reduce hospital discharge of patients with unfavorable outcomes.

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Temporal Validation of Chiang Mai University Intussusception Failed Reduction Score (CMUI)

Khorana

Sayuen

Chanaturakarnnon

et al. 2022

IJERPH

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This study aimed to validate the “Chiang Mai University Intussusception Failed Score (CMUI)” for intussusception non-operative reduction. Both a 2-year retrospective and a 5-year prospective consecutive review of patients with intussusception were conducted. Data were collected from January 2013 to December 2020. Related retrospective data of a developmental set from two centers from January 2006 to December 2012 were used. Ten prespecified prognostic factors for failed reduction were collected and from these a predictive score was calculated. The actual results of non-operative reduction were collected and set as a reference standard. Altogether, 195 episodes of intussusception were found. Twenty-two patients were excluded due to contraindications; therefore, a total of 173 episodes were included in the validation dataset. The development data set comprised 170 episodes. We found that no statistical significance was found from comparing the areas under the ROC of two datasets (p-value = 0.31), while specificity of the validation set was 93.8% (88.1–97.3). This temporal validation showed a high specificity and a high affinity for prediction of failed reduction as the development dataset despite being in an era of a higher successful reduction rate. The intensive reduction protocols might be introduced among patients with high-risk scores.

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Intussusception among infants in Tanzania: findings from prospective hospital-based surveillance, 2013-2016

Cited by 3 publications

References 20 publications

Comparison of Clinical Features of Intussusception in Terms of Age and Duration of Symptoms

Comparison of Clinical Features of Intussusception in Terms of Age and Duration of Symptoms

Clinical presentation and management outcome of pediatric intussusception at Wolaita Sodo University Comprehensive Specialized Hospital: a retrospective cross-sectional study

Temporal Validation of Chiang Mai University Intussusception Failed Reduction Score (CMUI)

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