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. 2020 Oct 7;38(43):6849-6857.
doi: 10.1016/j.vaccine.2020.04.059. Epub 2020 Jun 15.

Intussusception in children aged under two years in India: Retrospective surveillance at nineteen tertiary care hospitals

Manoja Kumar Das  1 , Narendra Kumar Arora  2 , Bini Gupta  3 , Apoorva Sharan  4 , K Kameswari  5 , P Padmalatha  6 , G Rajendra Prasad  7 , Jimmy Shad  8 , J Shyamala  9 , S Harish Kumar  10 , Yoga Nagender  11 , K Sharmila  12 , Rashmi Shad  13 , Saurabh Garge  14 , Lalit Bharadia  15 , Atul Gupta  16 , Jayanta K Goswami  17 , Kaushik Lahiri  18 , Lalit Sankhe  19 , Sushant Mane  20 , Yogini Prasad Patwari  21 , M K Ajayakumar  22 , A Santhosh Kumar  23 , Rachita Sarangi  24 , Bikasha Bihary Tripathy  25 , S S G Mohapatra  26 , Subrat Kumar Sahoo  27 , Vijayendra Kumar  28 , Rakesh Kumar  29 , Suman Sarkar  30 , Ruchirendu Sarkar  31 , Nihar Ranjan Sarkar  32 , Ashish Wakhlu  33 , Simmi K Ratan  34 , Anand P Dubey  35 , Neelam Mohan  36 , Meera Luthra  37 , Bhadresh R Vyas  38 , Harsh Trivedi  39 , John Mathai  40 , Cenita J Sam  41 , K Jothilakshmi  42 , Pavai Arunachalam  43 , Javeed Iqbal Bhat  44 , Gowhar Mufti  45 , Bashir Ahmad Charoo  46 , Pradeep K Jena  47 , Sanjib K Debbarma  48 , Sunil K Ghosh  49 , Mahesh K Aggarwal  50 , Pradeep Haldar  51 , Patrick L F Zuber  52 , Christine Maure  53 , Jan Bonhoeffer  54 , Arindam Ray  55
Affiliations

Intussusception in children aged under two years in India: Retrospective surveillance at nineteen tertiary care hospitals

Manoja Kumar Das et al. Vaccine. .

Abstract

Objective: Intussusception has been linked with rotavirus vaccine (RVV) as a rare adverse reaction. In view of limited background data on intussusception in India and in preparation for RVV introduction, a surveillance network was established to document the epidemiology of intussusception cases in Indian children.

Methods: Intussusception in children 2-23 months were documented at 19 nationally representative sentinel hospitals through a retrospective surveillance for 69 months (July 2010 to March 2016). For each case clinical, hospital course, treatment and outcome data were collected.

Results: Among the 1588 intussusception cases, 54.5% were from South India and 66.3% were boys. The median age was 8 months (IQR 6, 12) with 34.6% aged 2-6 months. Seasonal variation with higher cases were documented during March-June period. The most common symptoms and signs were vomiting (63.4%), bloody stool (49.1%), abdominal pain (46.9%) and excessive crying (42.8%). The classical triad (vomiting, abdominal pain, and blood in stools) was observed in 25.6% cases. 96.4% cases were diagnosed by ultrasound with ileocolic location as the commonest (85.3%). Management was done by reduction (50.8%) and surgery (41.1%) and only 1% of the patients' died. 91.1% cases met Brighton criteria level 1 and 3.3% Level 2. Between 2010 and 2015, the case load and case ratio increased across all regions.

Conclusion: Intussusception cases have occurred in children across all parts of the country, with low case fatality in the settings studied. The progressive rise cases could indicate an increasing awareness and availability of diagnostic facilities.

Keywords: Children; Epidemiology; India; Intussusception; Retrospective surveillance.

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Conflict of interest statement

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Age distribution of children aged 2–23 months with intussusception in India (region wise and pooled).
Fig. 2
Fig. 2
Calendar monthly distribution of intussusception case load and case ratio in children aged 2–23 months in India (pooled).
Fig. 3
Fig. 3
Trend of intussusception case load in children aged 2–23 months in India during 2010–2016 (region wise and pooled).
Fig. 4
Fig. 4
Trend of intussusception case ratio in children aged 2–23 months in India during 2010–2016 (region wise and pooled).
See this image and copyright information in PMC

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