title: Childhood intussusception: a literature review.
abstract: BACKGROUND
  Postlicensure data has identified a causal link between rotavirus vaccines and intussusception in some settings. As rotavirus vaccines are introduced globally, monitoring intussusception will be crucial for ensuring safety of the vaccine programs.
  
  
  METHODS
  To obtain updated information on background rates and clinical management of intussusception, we reviewed studies of intussusception in children <18 years of age published since 2002. We assessed the incidence of intussusception by month of life among children <1 year of age, seasonality, method of diagnosis, treatment, and case-fatality.
  
  
  RESULTS
  We identified 82 studies from North America, Asia, Europe, Oceania, Africa, Eastern Mediterranean, and Central & South America that reported a total of 44,454 intussusception events. The mean incidence of intussusception was 74 per 100,000 (range: 9-328) among children <1 year of age, with peak incidence among infants 5-7 months of age. No seasonal patterns were observed. A radiographic modality was used to diagnose intussusception in over 95% of the cases in all regions except Africa where clinical findings or surgery were used in 65% of the cases. Surgical rates were substantially higher in Africa (77%) and Central and South America (86%) compared to other regions (13-29%). Case-fatality also was higher in Africa (9%) compared to other regions (<1%). The primary limitation of this review relates to the heterogeneity in intussusception surveillance across different regions.
  
  
  CONCLUSIONS
  This review of the intussusception literature from the past decade provides pertinent information that should facilitate implementation of intussusception surveillance for monitoring the postlicensure safety of rotavirus vaccines.
authors.affiliation: National Center for Immunizations and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
authors.forename: James
authors.initials: J
authors.lastname: Jiang
authors.forename: Baoming
authors.initials: B
authors.lastname: Jiang
authors.forename: Umesh
authors.initials: U
authors.lastname: Parashar
authors.forename: Trang
authors.initials: T
authors.lastname: Nguyen
authors.forename: Julie
authors.initials: J
authors.lastname: Bines
authors.forename: Manish M
authors.initials: MM
authors.lastname: Patel
mesh_terms: D002648:Child; D062665:Epidemiological Monitoring; D006801:Humans; D038622:Internationality; D007443:Intussusception / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy
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