Four-country surveillance of intestinal intussusception and diarrhoea in children.
OBJECTIVE
Establishment of baseline epidemiology of intussusception in developing countries has become a necessity with the possibility of reintroduction of rotavirus vaccine. The current study assessed the seasonal trend in cases admitted with intussusceptions and dehydrating acute watery diarrhoea in children aged 2 months to 10 years.


METHODS
In a prospective surveillance study, teaching and research hospital sites in India (Lucknow and Nagpur), Brazil (Fortazela), Egypt (Ismailia) and Kenya (Nairobi) established a surveillance where a network of hospitals with surgical facilities catered to a reference population of about 1-2 million for reporting of intussusception. One large hospital per site also recruited admitted cases of acute watery diarrhoea.


RESULTS
From April 2004 to March 2006, 173 and 2346 cases of intussusception and diarrhoea, respectively, were recruited. Cases of intussusception had no apparent seasonality. Most cases of intussusception (61.3%) (107/173) were in the < or =1 year age group, with males comprising 68.8% (119/173) of all cases. Hospital mortality of intussusception was 4.2% (4/96). Cases of diarrhoea peaked in March, with 56.6% (1328/2346) of admitted cases being males. Majority (83.1%) of cases of diarrhoea had received antibiotics, and the hospital mortality was 0.8% (18/2280).


CONCLUSIONS
Intussusception in the four participating countries exhibited no seasonal trend. We found that it is feasible to establish a surveillance network for intussusception in developing countries. Future efforts must define population base before the introduction of rotavirus vaccine and continue for some years thereafter.
Awasthi
Shally
S
Department of Paediatrics, King George Medical University, Lucknow, India. sawasthi@sancharnet.in
Agarwal
Girdhar G
GG
Mishra
Vikas
V
Nag
Vijay Laxmi
VL
El Sayed
Hesham Fathey
HF
da Cunha
Antonio Jose Ledo
AJ
Madeiro
Alvaro
A
Jain
Dipty
D
Macharia
William M
WM
Ndung'u
James
J
Awasthi
Saumya
S
Wakhlu
Ashish
A
D002675:Child, Preschool; D003906:Developing Countries; D003967:Diarrhea / Q000453:epidemiology* / Q000517:prevention & control; D005260:Female; D006801:Humans; D016233:Immunotherapy, Active; D007223:Infant; D007443:Intussusception / Q000453:epidemiology* / Q000517:prevention & control; D008297:Male; D011159:Population Surveillance; D011446:Prospective Studies; D012401:Rotavirus / Q000276:immunology / Q000302:isolation & purification; D012621:Seasons