Risk Factors Associated With Increased Mortality From Intussusception in African Infants

Area of Science:

• Pediatric Surgery
• Gastroenterology
• Global Health

Background:

• Intussusception is the primary cause of intestinal obstruction in infants.
• Mortality and morbidity rates for intussusception are disproportionately higher in Africa compared to global averages.
• The underlying risk and protective factors contributing to these disparities remain underexplored.

Purpose of the Study:

• To investigate the demographic, clinical, and socioeconomic factors associated with mortality and the need for intestinal resection in infants with intussusception.
• To identify specific risk and protective factors influencing outcomes in sub-Saharan African infants.

Main Methods:

• A hospital-based surveillance study was conducted across seven sub-Saharan African nations from February 2012 to December 2016.
• 1017 infants under one year of age diagnosed with intussusception were enrolled.
• Multivariable logistic regression analysis was employed to examine associations between various factors and outcomes (death or intestinal resection).

Main Results:

• The study enrolled 1017 infants, with a 13% mortality rate and 48% requiring intestinal resection.
• Factors associated with increased mortality included female sex, prolonged symptom duration before presentation, and undergoing intestinal resection.
• Protective factors against intestinal resection included diagnosis via ultrasound or enema and having an employed household member.

Conclusions:

• Delayed hospital presentation and female sex are significant risk factors for death in infants with intussusception.
• Higher socioeconomic status and access to radiological diagnostic tools were associated with a reduced likelihood of requiring intestinal resection.
• Enhanced awareness, timely diagnosis, and improved management strategies for intussusception are crucial in resource-limited sub-Saharan African settings to mitigate severe outcomes.