Intussusception hospitalizations before rotavirus vaccine introduction: Retrospective data from two referral hospitals in Tamil Nadu, India

Rajan Srinivasan,C.P Girish Kumar,Sridevi A Naaraayan,Susan Jehangir,Jeromie W.V Thangaraj,S Venkatasubramanian,Gagandeep Kang

doi:10.1016/j.vaccine.2017.11.043

Abstract

BackgroundThe indigenous oral rotavirus vaccine Rotavac® was introduced into the public immunization system in India in 2016 and will be expanded in phases. This data will describe the epidemiology of intussusception in India in absence of rotavirus vaccination and will help in setting up or designing a safety monitoring system. MethodsMedical records of intussusception cases between 2013 and 2016 in two major referral hospitals in Tamil Nadu, India were reviewed, and data on clinical presentation and management and outcome were collated. ResultsA total of 284 cases of intussusception were diagnosed and managed at the two centers of which 280/284 could be classified as level 1 by the Brighton criteria. Median age at presentation was 8 months (Inter Quartile Range, IQR 6–17.2) with a male to female ratio of 2.1:1. Over half (57.7%) required surgical intervention while the rest underwent non-surgical or conservative management. ConclusionsRetrospective data from referral hospitals is sufficient to classify cases of intussusception by the Brighton criteria. These baseline data will be useful for monitoring when rotavirus vaccination is introduced.

Highlights

The World Health Organization recommends introduction of rotavirus vaccine in national immunization programmes (NIPs) of countries with high under -five mortality due to acute gastroenteritis
We describe pre-vaccine epidemiology and characteristics of intussusception among children less than 5 years between 2013 and 2016 in two major referral hospitals, one private non-for-profit hospital and the other the major government pediatric referral hospital in the state of Tamil Nadu, southern India
While pre-licensure studies of RotavacÒ rotavirus vaccine have not shown an increased risk of intussusception, it is important that children receiving RotavacÒ are monitored for risk of intussusception [9]

Summary

Introduction

The World Health Organization recommends introduction of rotavirus vaccine in national immunization programmes (NIPs) of countries with high under -five mortality due to acute gastroenteritis. India introduced an indigenous rotavirus vaccine RotavacÒ into the NIP in 2016 with a plan for phased expansion to the whole country [2] This was following documentation of high burden of rotavirus associated gastroenteritis as an important cause of hospitalizations among young children in India [3,4]. The indigenous oral rotavirus vaccine RotavacÒ was introduced into the public immunization system in India in 2016 and will be expanded in phases This data will describe the epidemiology of intussusception in India in absence of rotavirus vaccination and will help in setting up or designing a safety monitoring system. Conclusions: Retrospective data from referral hospitals is sufficient to classify cases of intussusception by the Brighton criteria These baseline data will be useful for monitoring when rotavirus vaccination is introduced.

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