Epidemiology and Management of Intussusception Among Children Aged Under 2 Years in Gujarat, India

Some rotavirus vaccines are associated with an increased risk of intussusception (IS) in children. This study investigated the epidemiology of IS in children aged under 2 y in Gujarat, India.

Hospital-based surveillance of IS cases was conducted from July 2019 to December 2022 at four hospitals in Gujarat. Children aged under 2 y who met the level 1 Brighton criteria were enrolled. Data were collected on their sociodemographic and clinical characteristics, clinical management, feeding patterns, and immunization history.

Overall, 213 children with IS were enrolled. Their median age was 8 (interquartile range, 6-13) mo and 62.9% were boys. No seasonal variation in the incidence of IS was observed. The most common presenting complaints were vomiting (82.6%), abdominal pain (76.1%), and bloody stools (53%). Most cases (56.3%) were managed via radiological reduction; 21.6% underwent exploratory laparotomy and intra-operative reduction; 10.3% underwent bowel resection; and 11.7% were treated using mixed modalities. Children admitted more than 48 h after the onset were significantly more likely to require surgical intervention (33% vs. 17.9%, p = 0.002) and have hospital stays > 5 d (59% vs. 35.2%, p < 0.001). In total, 13 of 169 children with documented rotavirus vaccination had received a dose of rotavirus vaccine within 21 d of the onset of symptoms.

Ongoing surveillance is needed to establish whether vaccination with the oral pentavalent rotavirus vaccine, ROTASIIL, is associated with an increased risk of IS. Early case detection and referral, and increased use of safe and non-surgical methods of treatment need to be encouraged.