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. 2020 Jan;70(1):20-24.
doi: 10.1097/MPG.0000000000002487.

Risk Factors Associated With Increased Mortality From Intussusception in African Infants

Talia Pindyck  1   2 , Umesh Parashar  2 , Jason M Mwenda  3 , Amezene Tadesse  4 , George Armah  5 , Richard Omore  6 , Bagrey Ngwira  7 , Bhavin Jani  8 , Evans M Mpabalwani  9 , Bothwell Mbuwayesango  10 , Jacqueline Tate  2 ; African Intussusception Surveillance Network
Affiliations

Risk Factors Associated With Increased Mortality From Intussusception in African Infants

Talia Pindyck et al. J Pediatr Gastroenterol Nutr. 2020 Jan.

Abstract

Objectives: Morbidity and mortality from intussusception, the leading cause of bowel obstruction in infants, is higher in Africa than in other regions of the world, but the reasons have not been well examined. We sought to identify risk and protective factors associated with death or intestinal resection following intussusception.

Methods: Infants with intussusception from 7 sub-Saharan African countries (Ethiopia, Ghana, Kenya, Malawi, Tanzania, Zambia, and Zimbabwe) were enrolled through active, hospital-based surveillance from February 2012 to December 2016. We examined demographic, clinical, and socioeconomic factors associated with death or intestinal resection following intussusception, using multivariable logistic regression.

Results: A total of 1017 infants <1 year of age with intussusception were enrolled. Overall, 13% of children (133/1017) died during the hospitalization, and 48% (467/966) required intestinal resection. In multivariable analyses, female sex [odds ratio (OR) 1.8, 95% confidence interval (CI) 1.2-3.3], longer duration of symptoms before presentation (OR 1.1; 95% CI 1.0-1.2), and undergoing intestinal resection (OR 3.4; 95% CI 1.9-6.1) were associated with death after intussusception. Diagnosis by ultrasound or enema (OR 0.4; 95% CI 0.3-0.7), and employment of a household member (OR 0.7; 95% CI 0.4-1.0) were protective against intestinal resection.

Conclusions: Delays in hospital presentation and female sex were significantly associated with death, whereas higher socioeconomic status and availability of radiologic diagnosis reduced likelihood of undergoing resection. Efforts should be intensified to improve the awareness, diagnosis, and management of intussusception in sub-Saharan African countries to reduce morbidity and mortality from intussusception in these resource-limited settings.

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Conflict of interest statement

Conflicts of interest: None

Figures

Figure 1:
Figure 1:
Distribution of infants by age in weeks
See this image and copyright information in PMC

References

    1. WHO. Acute intussusception in infants and children : incidence, clinical representation and management : a global perspective. (World Health Organization, Geneva, 2002)
    1. Waseem M, Rosenberg HK. Intussusception. Pediatric emergency care, 24(11), 793–800 (2008). - PubMed
    1. Stringer MD, Pablot SM, Brereton RJ . Pediatric Intussusception. Br J Surg, 79, 867–876 (1992). - PubMed
    1. Jiang J, Jiang B, Parashar U, Nguyen T, Bines J, Patel MM. Childhood intussusception: a literature review. PLoS One, 8(7), e68482 (2013). - PMC - PubMed
    1. Mpabalwani EM, Mwenda JM, Tate JE, Parashar UD. Review of Naturally Occurring Intussusception in Young Children in the WHO African Region prior to the Era of Rotavirus Vaccine Utilization in the Expanded Programme of Immunization. Journal of tropical pediatrics, 63(3), 221–228 (2017). - PubMed

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