University of Zambia, School of Medicine, Department of Paediatrics & Child Health, Lusaka, Zambia.
University Teaching Hospitals, Children´s Hospital, Lusaka, Zambia.
Pan Afr Med J. 2021 Jul 28;39(Suppl 1):6. doi: 10.11604/pamj.supp.2021.39.1.26671. eCollection 2021.
recipients of monovalent rotavirus vaccine have a low risk of developing intussusception (IS) in high- to medium-high-income countries. In sub-Saharan Africa, Zambia included, this risk of IS has not been assessed. Two-dose monovalent rotavirus vaccine, introduced in Zambia in 2012 in the capital of Lusaka, and rolled out countrywide in 2013, is administered at 6 and 10 weeks of age with no catch-up dose. Active IS surveillance monitoring in children < 2 years has been ongoing in Zambia since July 2009 and additional retrospective review was conducted from 2007- June 2009.
retrospective review (January 2007-June 2009) and prospective (July 2009-December 2018) IS surveillance was conducted at nine hospitals and four large paediatric hospital departments in Zambia, respectively. Demographic and clinical data were collected from medical folder abstraction and supplemented by parental interview during prospective surveillance.
a total of 248 children < 2 years with IS were identified; 57.3% were male. Most cases with IS were infants (85.5%). IS admissions remained stable during the surveillance period with no seasonality pattern although an increase in cases occurred between August and October, hot dry season. The median time from symptom onset to presentation for treatment was 2 days and 63.6% (154/242) of IS diagnoses were made during surgery. The bowel resection rate was 46.6%. A high CFR of 23.3% was observed.
the number of intussusception cases in Zambia was relatively small and remained stable over the 12-year study period. However, a high CFR was observed among cases.
在高收入和中高收入国家，接种单价轮状病毒疫苗的受种者发生肠套叠（IS）的风险较低。在撒哈拉以南非洲，包括赞比亚在内，尚未评估这种 IS 风险。2012 年，单价轮状病毒疫苗在赞比亚首都卢萨卡引入，2013 年在全国范围内推广，该疫苗在 6 周和 10 周龄时接种，没有补种剂量。自 2009 年 7 月以来，赞比亚一直在对<2 岁儿童进行主动 IS 监测，并且从 2007 年 6 月至 2009 年进行了额外的回顾性审查。
分别在赞比亚的 9 家医院和 4 家大型儿科医院部门进行了回顾性审查（2007 年 1 月至 2009 年 6 月）和前瞻性（2009 年 7 月至 2018 年 12 月）IS 监测。从病历摘录中收集人口统计学和临床数据，并在前瞻性监测期间通过家长访谈进行补充。
共发现<2 岁肠套叠患儿 248 例，其中男性占 57.3%。大多数 IS 病例为婴儿（85.5%）。尽管在 8 月至 10 月，即炎热干燥的季节，病例数有所增加，但 IS 入院人数在监测期间保持稳定，没有季节性模式。从症状出现到接受治疗的中位时间为 2 天，242 例 IS 诊断中有 63.6%（154 例）是在手术中做出的。肠切除术率为 46.6%。观察到较高的病死率（CFR）为 23.3%。
在 12 年的研究期间，赞比亚肠套叠病例数量相对较少且保持稳定。然而，观察到病死率较高。
