Department of Paediatrics & Child Health, Aga Khan University, Karachi, Pakistan.
Department of Pediatric Surgery, Aga Khan University, Karachi, Pakistan.
Vaccine. 2018 Dec 14;36(51):7775-7779. doi: 10.1016/j.vaccine.2017.06.073. Epub 2017 Jul 11.
Rotavirus vaccination introduction in routine immunization is under consideration in Pakistan. Data on the baseline epidemiology of intussusception will inform surveillance strategies for intussusception after rotavirus vaccine introduction in Pakistan. We describe the epidemiology of intussusception-associated hospitalizations among children <2years of age in Karachi, Pakistan.
We conducted a retrospective chart review for July 01, 2012 through June 30, 2015 at the National Institute of Child Health (NICH) and Aga Khan University Hospital (AKUH) Karachi. At AKUH, the International Classification of Disease, ninth revision, code 560.0 for intussusception was used to retrieve intussusception case records. At NICH, daily Operation Theater, Emergency Room, and surgical daycare log sheets and surgical ward census sheets were used to identify cases. Records of children who fulfilled eligibility criteria and the Brighton Collaboration level one case definition of intussusception were selected for data analysis. We used structured case report forms to extract data for the descriptive analysis.
We identified 158 cases of confirmed intussusception; 30 cases (19%) were from AKUH. More than half (53%) of the cases occurred in children aged 6-12months, followed by 35% among those aged <6months. Two-thirds (106/158) of the cases were male. The most common presenting complaints were vomiting and bloody stool. At NICH, almost all (93%) were managed surgically, while at AKUH, ∼57% of the cases were managed with enemas. Three deaths occurred, all from NICH. Cases occurred without any seasonality. At NICH, 4% (128/3618) of surgical admissions among children aged <2years were attributed to intussusception, while that for AKUH was 2% (30/1702).
In this chart review, intussusception predominantly affected children 0-6months of age and occurred more commonly in males. This information on the baseline epidemiology of intussusception will inform post-vaccine introduction adverse event monitoring related to intussusception in Pakistan.
轮状病毒疫苗接种正被考虑纳入巴基斯坦常规免疫接种计划。有关肠套叠的基线流行病学数据将为轮状病毒疫苗在巴基斯坦引入后的肠套叠监测策略提供信息。本研究描述了卡拉奇（巴基斯坦）＜2 岁儿童肠套叠相关住院的流行病学。
我们对 2012 年 7 月 1 日至 2015 年 6 月 30 日期间在国家儿童健康研究所（NICH）和阿迦汗大学医院（AKUH）卡拉奇进行了回顾性病历审查。在 AKUH，国际疾病分类，第九版，代码 560.0 用于检索肠套叠病例记录。在 NICH，每天的手术室、急诊室和手术日间护理日志表以及外科病房登记册用于识别病例。选择符合入选标准和布莱顿合作组织一级肠套叠病例定义的儿童记录进行数据分析。我们使用结构化病例报告表提取描述性分析数据。
我们共确定了 158 例确诊的肠套叠病例；30 例（19%）来自 AKUH。超过一半（53%）的病例发生在 6-12 月龄儿童中，其次是＜6 月龄儿童（35%）。三分之二（106/158）的病例为男性。最常见的首发症状为呕吐和血便。在 NICH，几乎所有（93%）病例均接受了手术治疗，而在 AKUH，约 57%的病例接受了灌肠治疗。3 例死亡病例均来自 NICH。病例发生无任何季节性。在 NICH，＜2 岁儿童的外科住院病例中，4%（128/3618）归因于肠套叠，而 AKUH 为 2%（30/1702）。
在本次病历回顾中，肠套叠主要影响 0-6 月龄儿童，且更常见于男性。这些有关肠套叠的基线流行病学信息将为巴基斯坦轮状病毒疫苗引入后的肠套叠相关不良事件监测提供信息。
