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

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

Prospective surveillance for intussusception in Indian children aged under two years at nineteen tertiary care hospitals

“…There were significant variations in the clinical features among the children across the regions, which may be due to the interval for presentation or clinical practices followed at the hospitals (Table 2 ). Death was observed in 1.7% cases, which was comparable to reports from India (1.0%) and other countries from Asia (0.25–6.0%), Latin America (1.0–5.0%), but lower than the African countries (2.0–25.0%) [ 17 , 18 , 24 , 28 , 29 , 31 – 33 ]. Level 1 BCCD was met by 89.1% of the cases, similar to other reports from India [ 5 , 7 , 14 ].…”

“…The regional variation in the classical triad appeared to parallel with the interval between illness onset and hospitalization. Ultrasound was the commonest (95.3%) mode of diagnosis, as reported (72.0-100%) from India and other countries [15,18,[28][29][30]. Ileocolic was the most common location, similar to reports (68.0-79.0%) from India and globally [3,7,8,14].…”

Intussusception and Monovalent Rotavirus Vaccination in Singapore: Self-Controlled Case Series and Risk-Benefit Study

“…Compared with our 86 cases, a multicenter island-wide prospective study from 2002-2010 identified 93 infants <12 months of age with the same level 1 intussusception criteria. 24 Although selection bias was possible in our study, this was unlikely because there were no significant differences in baseline demographics and characteristics between cases with intussusception with history of rotavirus vaccine vs those without rotavirus vaccination. Furthermore, the use of SCCS allowed us to control for fixed confounding variables such as genetics, socioeconomic status, sex, individual frailty, and severity of underlying disease.…”

“…23 Mortality because of intussusception is very low with a 2-year hospital-based prospective study of intussusception in children <2 years reporting only 1 death (0.6%) from septic shock. 24 In this study, we aimed to investigate the association between RV1 and intussusception over the 7 years since the availability of the vaccine in Singapore and perform a risk:benefit analysis to explore the potential impact of a wider RV1 vaccination program.…”

Relationship between Pentavalent Rotavirus Vaccine and Intussusception: A Retrospective Study at a Single Center in Korea

“…The trend of the incidence rate of IS in children below 12 months of age in our hospital showed a decreasing pattern, from 142 cases to 15 cases per 100000 children during the observation period. This is quite low compared with 47 cases in United States,13 81 cases in Australia,30 28.9 in Singapore,31 19.70–47.83 in Thailand,32 and 38 in Switzerland 33. There is one report from Jeonbuk Province in Korea showing 236 cases per 100000 children below 12 months of age,22 although nationwide data are needed to fully understand and interpret the results of this study.…”