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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Retrospective surveillance of intussusception in South Africa, 1998-2003
Journal of Infectious Diseases, Volume 202, No. SUPPL. 1, Year 2010
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Description
Background. Intussusception is a common gastrointestinal emergency in children and appears to have a somewhat different clinical spectrum in developing countries. Its etiology is still unclear, but a link to infective agents and viruses has been highlighted. This study aimed to assess the clinical spectrum and prevalence of intussusception in children from the diverse South African population. Methods. Retrospective data were obtained from 9 participating pediatric referral units on the occurrence of intussusception in South African children (<14 years old) during a 6-year period (1998-2003). Results were correlated with national population statistics. Intussusception was anatomically classified into ileoileal, ileocolic, and colocolic types. The clinical features, management, outcome, and possible causes were examined. Results. We reviewed the occurrence and clinical spectrum of intussusception in 423 children (age, 0-14 years) presenting with acute intussusception to 9 pediatric surgical centers. The mean duration of symptoms was 1.5 days, but a delayed presentation was common (median delay, 2.3 days). Intussusception occurred throughout the year, with a peak in the summer months. The majority of patients (89%) were <2 years old, and 78% presented at age 3-18 months of age. Crude population estimates indicate an occurrence of 1 case per 3123 population <2 years old. Only 11% of patients presented after 2 years of age, and the age at presentation was significantly lower (P<.05) in black African patients. All ethnic groups were affected. In P < .05 84% of patients, intussusception occurred at the ileocolic region junction, in 7% it was ileoileal, and in 9% it was colocolic. Colocolic intussusception appeared more common in black African patients, and associated pathologic conditions (polyps and Burkitt's lymphoma) occurred mainly in older children. Surgical intervention was required in 81% of patients and involved resection of gangrenous bowel in 40%. Conclusion. Intussusception appears to be a relatively frequent occurrence in children in South Africa. Although the clinical spectrum appears to vary, there is an apparent link to intestinal infection, which requires further investigation. A collaborative approach is required to ascertain the relationship of intussusception to preventable infections and to improve its diagnosis and management. © 2010 by the Infectious Diseases Society of America.
Authors & Co-Authors
Moore, Samuel W.
South Africa, Stellenbosch
Stellenbosch University
Kirsten, Mari
South Africa, Pretoria
Kalafong Hospital
Muller, Elmi W.
South Africa, Pretoria
Kalafong Hospital
Numanoglu, Alp
South Africa, Cape Town
University of Cape Town
Chitnis, Milind
United Kingdom, London
Frere Hospital
Le Grange, E.
South Africa, Bloemfontein
University of the Free State
Banieghbal, Behrouz
South Africa, Johannesburg
University of the Witwatersrand
Hadley, Grenville Peter
South Africa, Durban
University of Kwazulu-natal
Statistics
Citations: 33
Authors: 8
Affiliations: 7
Identifiers
Doi:
10.1086/653563
ISSN:
00221899
Research Areas
Health System And Policy
Maternal And Child Health
Study Design
Randomised Control Trial
Cross Sectional Study
Cohort Study
Study Locations
South Africa