Incidence and Epidemiology of Intussusception among Infants in Ho Chi Minh City, Vietnam.
OBJECTIVE
To evaluate rates of intussusception hospitalization among infants in Vietnam before the introduction of rotavirus vaccine.


METHODS
Between 2009 and 2011, we identified intussusception hospitalizations among infants using the International Statistical Classification of Diseases and Related Health Problems, 10th Revision, Clinical Modification code K56.1 at 2 large pediatric hospitals in Ho Chi Minh City, Vietnam that treat most of the intussusception cases in the city. We reviewed all medical records to confirm a Brighton level 1 case definition for intussusception.


RESULTS
We identified a total of 869 intussusception cases in Ho Chi Minh City during the 3-year study period, for an annual rate of 296 per 100,000 infants. The mean age of intussusception was ∼ 37 weeks (8.6 months), with <2% of the cases occurring before age 15 weeks. Cases of intussusception were observed year-round in these hospitals with no evident seasonal pattern. Ultrasonography was used to diagnose most cases (97%), and reduction was performed by air enema in >95% of the cases, with only 1% of cases at 1 hospital and 5% at the other hospital requiring surgical intervention. Ultrasound diagnosis was confirmed by an independent radiologist in 94% of a randomly selected group of intussusception cases at 1 of the 2 hospitals. No mortality was reported.


CONCLUSIONS
Vietnam has a substantially higher rate of intussusception in children aged >15 weeks compared with most other regions of the world. Most of our cases were diagnosed by ultrasound, and only a small proportion required surgical intervention with no fatalities, suggesting that the higher rates may be related in part to better and earlier detection of intussusception.
National Institute of Hygiene and Epidemiology, Hanoi, Vietnam.
Nguyen
N
Van Trang
Department of Network Coordination, Children's Hospital 1, Ho Chi Minh City, Vietnam.
Nhan Thanh
NT
Le Nguyen
Department of Network Coordination, Children's Hospital 1, Ho Chi Minh City, Vietnam.
Hieu Trung
HT
Dao
Department of Network Coordination, Children's Hospital 2, Ho Chi Minh City, Vietnam.
Viet Lu
VL
Ho
Department of Network Coordination, Children's Hospital 2, Ho Chi Minh City, Vietnam.
Dieu Thi
DT
Tran
Department of Radiology, Children's Healthcare of Atlanta, Atlanta, GA.
Jonathan
J
Loewen
National Center for Immunizations and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA.
James
J
Jiang
National Center for Immunizations and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA.
Baoming
B
Jiang
National Center for Immunizations and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA.
Umesh
U
Parashar
National Institute of Hygiene and Epidemiology, Hanoi, Vietnam.
Anh Duc
AD
Dang
National Center for Immunizations and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA. Electronic address: mpatel@cdc.gov.
Manish M
MM
Patel
D002675:Child, Preschool; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007223:Infant; D007443:Intussusception / Q000000981:diagnostic imaging / Q000453:epidemiology*; D008297:Male; D012189:Retrospective Studies; D014463:Ultrasonography; D014505:Urban Population; D014744:Vietnam / Q000453:epidemiology