Review of Naturally Occurring Intussusception in Young Children in the WHO African Region Prior to the Era of Rotavirus Vaccine Utilisation in the Expanded Programme of Immunisation
Abstract
Background: Intussusception is a rare form of bowel obstruction in which one portion of the bowel invaginates into a distal portion. Currently available rotavirus vaccines, Rotarix and RotaTeq, are increasingly being introduced in national immunisation programmes in Africa to prevent severe dehydrating acute gastroenteritis. A low level risk of intussusception has been associated with rotavirus vaccines in some countries. We reviewed published data on intussusception in children below 2 years of age in the countries of the WHO African Region prior to widespread use of rotavirus vaccines in the national immunization programs. Methods: PubMed electronic database search was used to retrieve papers published on intussusception in Africa. The search was further refined to identify surveillance reports and case series conducted from 1980 to 2014; those that reported at least 25 intussusception cases among children <2 years of age were included in the analysis. Results: The initial search identified 34 studies from 1980 to 2014, and the refined search yielded 16 studies that met inclusion criteria. Intussusception occurred naturally in young African infants beginning at 2–4 months of age and peaked around 5–8 months of age. Surgical intervention was required in 87% (1008/1158) of cases. Delayed presentation resulting in advanced disease was common with a high case fatality rate ranging from 10% to 33.7%. Conclusion: In African children, intussusception has been reported…
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