Department of Paediatrics, Medical School of Lome, Togo, West Africa.
Ministry of Health, Togo.
Pan Afr Med J. 2021 Jul 29;39(Suppl 1):7. doi: 10.11604/pamj.supp.2021.39.1.21343. eCollection 2021.
intussusception is the leading cause of bowel obstruction in infants and young children. We describe the epidemiology and diagnostic and treatment characteristics of intussusception among Togolese infants over a 4-year period.
we implemented active surveillance among infants younger than 1 year of age admitted with intussusception from 2015 to 2018 at Sylvanus Olympio Teaching Hospital and in 2018 at Campus Teaching Hospital. Brighton Collaboration Level 1 case definition criteria were used to confirm the diagnosis of intussusception.
during four years, 41 cases of intussusception, with an annual range of 8 to 14 cases (median: 10) were reported; and the highest number of cases (89%) was enrolled at Sylvanus Olympio teaching hospital. Intussusception was uncommon in the first 2 months of life, peaked from 5 to 7 months old (63%), with male predominance (63%), and showed no significant seasonality. One third of cases (34%) were transferred to the sentinel surveillance site from another health facility; and the median delay in seeking care was 4 days (range: 0-11) with ≥ 48-hour delay in 59% of cases. Clinical symptoms, ultrasound and surgery were combined to diagnose intussusception in all the cases (100%). The treatment was exclusively surgical, and intestinal resection was common (28/41, 68%). A high case fatality rate (23%) was observed and the average length of hospital stay was 10 days (range: 1-23).
active surveillance for intussusception in Togo has highlighted exclusive use of surgical therapy; often associated to an intestinal resection with a very high case fatality rate.
肠套叠是婴儿和幼儿肠梗阻的主要原因。我们描述了 4 年来多哥婴儿肠套叠的流行病学和诊断及治疗特征。
我们在 2015 年至 2018 年期间在西尔万·奥林匹奥教学医院和 2018 年在校区教学医院对患有肠套叠的 1 岁以下婴儿进行了主动监测。使用布莱顿合作组织一级病例定义标准来确认肠套叠的诊断。
四年间，共报告了 41 例肠套叠病例，每年的病例数在 8 至 14 例之间（中位数：10 例）；89%的病例数最多在西尔万·奥林匹奥教学医院登记。肠套叠在生命的头 2 个月很少见，从 5 至 7 个月大（63%）时达到高峰，男性居多（63%），且无明显季节性。三分之一的病例（34%）从另一家医疗机构转至哨点监测点；寻求治疗的中位延迟时间为 4 天（范围：0-11），59%的病例延迟时间超过 48 小时。所有病例均结合临床症状、超声和手术诊断为肠套叠（100%）。治疗完全是手术，肠切除术很常见（41 例中有 28 例，占 68%）。观察到较高的病死率（23%），平均住院时间为 10 天（范围：1-23）。
多哥对肠套叠的主动监测突出了手术治疗的排他性；肠切除术常伴有很高的病死率。
