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在扩大免疫规划中使用轮状病毒疫苗之前,对世卫组织非洲区域幼儿自然发生的肠套叠情况的回顾。

Review of Naturally Occurring Intussusception in Young Children in the WHO African Region prior to the Era of Rotavirus Vaccine Utilization in the Expanded Programme of Immunization.

作者信息

Mpabalwani Evans M, Mwenda Jason M, Tate Jacqueline E, Parashar Umesh D

机构信息

Department of Paediatrics & Child Health, University Teaching Hospital, Lusaka, Zambia.

WHO Regional office for Africa (WHO/AFRO), Brazzaville, Republic of Congo.

出版信息

J Trop Pediatr. 2017 Jun 1;63(3):221-228. doi: 10.1093/tropej/fmw069.

Abstract

Rotavirus vaccines, Rotarix and RotaTeq, are increasingly being introduced in national immunization programmes in Africa to prevent severe dehydrating acute gastroenteritis. A low-level risk of intussusception has been associated with rotavirus vaccines. We reviewed published data on intussusception in children <2 years of age in Africa. PubMed electronic database search was used to retrieve papers published on intussusception. The search was further refined to identify surveillance reports and case series conducted from 1980 to 2014, with at least 25 cases. The initial search identified 34 studies, and the refined search yielded 16. Intussusception occurred naturally in infants 2-4 months and peaked around 5-8 months of age. Delayed presentation was common and required surgical intervention in 87% (1008 of 1158) of cases with a high CFR, 10-33.7%. In African children, intussusception has been reported infrequently at a young age when the first dose of rotavirus vaccine is administered.

摘要

轮状病毒疫苗Rotarix和RotaTeq越来越多地被引入非洲国家的免疫规划中,以预防严重脱水的急性肠胃炎。轮状病毒疫苗与肠套叠的低风险相关。我们回顾了非洲2岁以下儿童肠套叠的已发表数据。使用PubMed电子数据库搜索来检索关于肠套叠的已发表论文。进一步细化搜索以确定1980年至2014年进行的监测报告和病例系列,病例数至少为25例。最初的搜索识别出34项研究,细化搜索得到16项。肠套叠自然发生于2 - 4个月的婴儿,在5 - 8个月左右达到高峰。就诊延迟很常见,1158例病例中有87%(1008例)需要手术干预,病死率较高,为10% - 33.7%。在非洲儿童中,在接种第一剂轮状病毒疫苗的幼年时,肠套叠的报告较少。

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