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Intussusception among infants in Tanzania: findings from prospective hospital-based surveillance, 2013-2016
INTRODUCTION: intussusception surveillance was initiated in Tanzania in 2013 after monovalent rotavirus vaccine was introduced, as part of the 7-country African evaluation to assess whether the vaccine was associated with an increased risk of intussusception. An increased risk from vaccine was not i...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The African Field Epidemiology Network
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8437428/ https://www.ncbi.nlm.nih.gov/pubmed/34548896 http://dx.doi.org/10.11604/pamj.supp.2021.39.1.21358 |
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author | Mbaga, Mwajabu Msuya, David Mboma, Lazaro Jani, Bhavin Michael, Fausta Kamugisha, Christopher Said, Said Ali Saleh, Abdulhamid Mwenda, Jason Mathiu Cortese, Margaret |
author_facet | Mbaga, Mwajabu Msuya, David Mboma, Lazaro Jani, Bhavin Michael, Fausta Kamugisha, Christopher Said, Said Ali Saleh, Abdulhamid Mwenda, Jason Mathiu Cortese, Margaret |
author_sort | Mbaga, Mwajabu |
collection | PubMed |
description | INTRODUCTION: intussusception surveillance was initiated in Tanzania in 2013 after monovalent rotavirus vaccine was introduced, as part of the 7-country African evaluation to assess whether the vaccine was associated with an increased risk of intussusception. An increased risk from vaccine was not identified. Published data on intussusception in Tanzanian infants are limited. METHODS: prospective intussusception surveillance was conducted at 7 referral hospitals during 2013-2016 to identify all infants with intussusception meeting Brighton Level 1 criteria. Demographic, household and clinical data were collected by hospital clinicians and analyzed. RESULTS: a total of 207 intussusception cases were identified. The median age of cases was 5.8 months and nearly three-quarters were aged 4-7 months. Median number of days from symptom onset to admission at treatment hospital was 3 (IQR 2-5). Seventy-eight percent (152/195) of cases had been admitted at another hospital before transfer to the treating hospital. Enema reduction was not available; all infants were treated surgically and 55% (114/207) had intestinal resection. The overall case-fatality rate was 30% (62/206). Compared with infants who survived, those who died had longer duration of symptoms before admission to treatment hospital (median 4 vs 3 days; p < 0.01), higher rate of intestinal resection (81% [60/82] vs 44% [64/144], p < 0.001), and from families with lower incomes (i.e., less likely to own a television [p < 0.01] and refrigerator [p < 0.05). CONCLUSION: Tanzanian infants who develop intussusception have a high case-fatality rate. Raising the index of suspicion among healthcare providers, allocating resources to allow wider availability of abdominal ultrasound for earlier diagnosis, and training teams in ultrasound-guided enema reduction techniques used in other African countries could reduce the fatality rate. |
format | Online Article Text |
id | pubmed-8437428 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | The African Field Epidemiology Network |
record_format | MEDLINE/PubMed |
spelling | pubmed-84374282021-09-20 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 Mathiu Cortese, Margaret Pan Afr Med J Research INTRODUCTION: intussusception surveillance was initiated in Tanzania in 2013 after monovalent rotavirus vaccine was introduced, as part of the 7-country African evaluation to assess whether the vaccine was associated with an increased risk of intussusception. An increased risk from vaccine was not identified. Published data on intussusception in Tanzanian infants are limited. METHODS: prospective intussusception surveillance was conducted at 7 referral hospitals during 2013-2016 to identify all infants with intussusception meeting Brighton Level 1 criteria. Demographic, household and clinical data were collected by hospital clinicians and analyzed. RESULTS: a total of 207 intussusception cases were identified. The median age of cases was 5.8 months and nearly three-quarters were aged 4-7 months. Median number of days from symptom onset to admission at treatment hospital was 3 (IQR 2-5). Seventy-eight percent (152/195) of cases had been admitted at another hospital before transfer to the treating hospital. Enema reduction was not available; all infants were treated surgically and 55% (114/207) had intestinal resection. The overall case-fatality rate was 30% (62/206). Compared with infants who survived, those who died had longer duration of symptoms before admission to treatment hospital (median 4 vs 3 days; p < 0.01), higher rate of intestinal resection (81% [60/82] vs 44% [64/144], p < 0.001), and from families with lower incomes (i.e., less likely to own a television [p < 0.01] and refrigerator [p < 0.05). CONCLUSION: Tanzanian infants who develop intussusception have a high case-fatality rate. Raising the index of suspicion among healthcare providers, allocating resources to allow wider availability of abdominal ultrasound for earlier diagnosis, and training teams in ultrasound-guided enema reduction techniques used in other African countries could reduce the fatality rate. The African Field Epidemiology Network 2021-07-28 /pmc/articles/PMC8437428/ /pubmed/34548896 http://dx.doi.org/10.11604/pamj.supp.2021.39.1.21358 Text en ©Mwajabu Mbaga et al. https://creativecommons.org/licenses/by/4.0/The Pan African Medical Journal (ISSN: 1937-8688). This is an Open Access article distributed under the terms of the Creative Commons Attribution International 4.0 License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Mbaga, Mwajabu Msuya, David Mboma, Lazaro Jani, Bhavin Michael, Fausta Kamugisha, Christopher Said, Said Ali Saleh, Abdulhamid Mwenda, Jason Mathiu Cortese, Margaret Intussusception among infants in Tanzania: findings from prospective hospital-based surveillance, 2013-2016 |
title | Intussusception among infants in Tanzania: findings from prospective hospital-based surveillance, 2013-2016 |
title_full | Intussusception among infants in Tanzania: findings from prospective hospital-based surveillance, 2013-2016 |
title_fullStr | Intussusception among infants in Tanzania: findings from prospective hospital-based surveillance, 2013-2016 |
title_full_unstemmed | Intussusception among infants in Tanzania: findings from prospective hospital-based surveillance, 2013-2016 |
title_short | Intussusception among infants in Tanzania: findings from prospective hospital-based surveillance, 2013-2016 |
title_sort | intussusception among infants in tanzania: findings from prospective hospital-based surveillance, 2013-2016 |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8437428/ https://www.ncbi.nlm.nih.gov/pubmed/34548896 http://dx.doi.org/10.11604/pamj.supp.2021.39.1.21358 |
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