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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...

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Autores principales: Mbaga, Mwajabu, Msuya, David, Mboma, Lazaro, Jani, Bhavin, Michael, Fausta, Kamugisha, Christopher, Said, Said Ali, Saleh, Abdulhamid, Mwenda, Jason Mathiu, Cortese, Margaret
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The African Field Epidemiology Network 2021
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.
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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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