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Epidemiology of intussusception among infants in Ethiopia, 2013-2016
Amezene Tadesse1, Fasil Teshager2, Goitom Weldegebriel3
1Department of Surgery, Addis Ababa University, Addis Ababa, Ethiopia.
Insights
Intussusception in Ethiopian infants is common, with delayed presentation significantly increasing mortality. Improved management strategies are crucial to reduce deaths from this bowel obstruction.
Area of Science:
- Pediatrics
- Gastroenterology
- Epidemiology
Background:
- Intussusception, a bowel obstruction, lacks extensive epidemiological data in sub-Saharan Africa.
- This study focuses on the sociodemographic and clinical aspects of pediatric intussusception in Ethiopia.
Purpose of the Study:
- To describe the characteristics of intussusception in children under 12 months in Ethiopia.
- To identify factors associated with mortality in pediatric intussusception cases.
Main Methods:
- Active surveillance of intussusception cases in children < 12 months across six Ethiopian hospitals.
- Comparison of clinical and demographic data between survivors and non-survivors using statistical tests.
Main Results:
- 164 children < 12 months with intussusception were enrolled; 62% were male, median age 6 months.
- Surgery reduced intussusception in 90% of cases; 13% of all cases resulted in death.
- Deceased children presented significantly later to healthcare facilities (median 3 days vs. 2 days).
Conclusions:
- High mortality rates and delayed presentation underscore the need for improved intussusception management in Ethiopia.
- Lack of non-surgical options at some facilities contributes to poor outcomes.
Introduction:
intussusception is a condition in which one segment of the bowel prolapses into another causing obstruction. Information on the epidemiology of intussusception in sub-Saharan Africa is limited. We describe the sociodemographic and clinical characteristics of children with intussusception in Ethiopia.
Methods:
active surveillance for children < 12 months of age with intussusception was conducted at six sentinel hospitals in Ethiopia. Limited socio-economic and clinical data were collected from enrolled children. Characteristics among children who died and children who survived were compared using the Wilcoxon rank sum test for continuous variables and Chi-square tests for categorical variables.
Results:
total of 164 children < 12 months of age with intussusception were enrolled; 62% were male. The median age at symptom onset was 6 months with only 12 (7%) of cases occurring in the first 3 months of life. Intussusception was reduced by surgery in 90% of cases and 10% were reduced by enema; 13% of cases died. Compared to survivors, children who died had a significantly longer time to presentation to the first health care facility and to the treating health care facility (median 3 days versus 2 days, p = 0.02, respectively).
Conclusion:
the high mortality rate, late presentation of intussusception cases, and lack of modalities for non-surgical management at some facilities highlight the need for better management of intussusception cases in Ethiopia.
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