Incidence of intussusception in Singaporean children aged less than 2 years: a hospital-based prospective study

Kong Boo Phua,Anette Jacobsen,Harvey Teo,Bee-Wah Lee,Seng Hock Quak,Kusuma Gopala,Yanfang Liu,Kumaran Vadivelu-Pechai

doi:10.1186/1471-2431-13-161

Abstract

BackgroundContinuous surveillance for intussusception (IS) is important for monitoring the safety of second-generation rotavirus vaccines. The present study aimed to assess the incidence of IS in Singaporean children aged < 2 years.MethodsThis was a prospective, hospital-based, multi-center surveillance conducted in seven hospitals - two public hospitals and five private medical centers between May 2002 and June 2010 in Singapore. Diagnosis of IS (definite, probable, possible, suspected) was based on the case definition developed by the Brighton Collaboration. Children < 2 years of age who were diagnosed with IS were enrolled in this study. Incidence of IS was calculated per 100,000 child-year with its 95% confidence interval.ResultsOf the 178 children enrolled, 167 children with definite IS cases were considered for final analyses; 11 were excluded (six diagnosed as probable IS and four diagnosed as suspected IS; one child’s parents withdrew consent). Mean age of children with definite IS was 11.6 ± 6 months; 67.7% were males. The overall incidence of IS was 28.9 (95% CI: 23.0–34.8) and 26.1 (95% CI: 22.2–30.0) per 100,000 child-year in children < 1 year and < 2 years of age, respectively. The majority of IS cases (20 [12.0%]) were reported in children aged 6 months. Most children (98.2% [164/167]) recovered, two (1.2%) children recovered with sequelae and one (0.6%) child died of septic shock.ConclusionsThe incidence of IS remained low and stable in Singaporean children aged < 2 years during the study period (May 2002 to June 2010).Trial registrationNCT01177839

Highlights

Continuous surveillance for intussusception (IS) is important for monitoring the safety of secondgeneration rotavirus vaccines
This study aimed to determine the incidence of IS in Singaporean children aged < 2 years through a prospective hospital-based surveillance conducted between 2002 and 2010
The IS incidence values observed in Singapore in the present study and the one conducted previously were lower than that observed in Taiwan (77.0 and 93.5 per 100,000 child-year in children < 1 and < 2 years of age, respectively) [22] and Germany (60.4 and 51.5 per 100,000 child-year in children < 1 and < 2 years of age, respectively) [23]

Summary

Introduction

Continuous surveillance for intussusception (IS) is important for monitoring the safety of secondgeneration rotavirus vaccines. The present study aimed to assess the incidence of IS in Singaporean children aged < 2 years. Intussusception (IS) is one of the most frequent causes of abdominal surgical emergencies in young children [1]. It occurs when one segment of bowel invaginates into the distal bowel, resulting in venous congestion and bowel wall edema [2]. Air/hydrostatic enema is used for the treatment of IS, in addition to surgical reduction of IS [3]. In a study by Robinson CG, et al, it was demonstrated that rotavirus infection resulted in the thickening of distal ileal wall and mesenteric lymphadenopathy, suggesting a plausible mechanism of rotavirusinduced IS [5]. Previous reports indicate no association between IS and rotavirus infection [6,7,8]

Objectives

Methods

Results

Discussion

Conclusion