Childhood intussusception in Uzbekistan: Analysis of retrospective surveillance data

We retrospectively reviewed intussusception cases in children <2 years of age treated during 2004-2008 at 15 hospitals in the Bukhara region of Uzbekistan. Demographic and clinical data as well as information on diagnostic and treatment practices were obtained from hospital records. We categorized cases using the Brighton collaboration clinical case definition and calculated the national incidence rate.Over a 5-year study period, 67 confirmed cases were identified, of which 67% were boys. The median age was 12 months, and no seasonal trend in the distribution of cases was observed. The diagnostic methods used included abdominal radiography (87%) and ultrasonography (57%). Intussusception reduction by air enema was successful in 33 (49%) patients and 34 (50%) cases underwent surgery. A total of 4 deaths occurred, including 3 deaths in infants aged 0-6 months. The median length of hospital stay was 7.3 (range 0-37) days. The incidence of intussusception is estimated at 23 (95% CI 13.6-32.4) cases per 100,000 child-years, corresponding to approximately 237 cases annually.This is the first study to estimate the incidence of childhood intussusception prior to the introduction of the rotavirus vaccination in Uzbekistan. A prospective surveillance system using a standardized case definition is needed in order to better examine the occurrence of intussusception in developing countries.Intussusception (IS) is the most common cause of bowel obstruction in young children, which involves an invagination of a proximal segment of the intestine into a distal segment. Intussusception is characterized by a sudden onset of abdominal pain, vomiting, rectal bleeding, and the presence of a palpable abdominal mass [1]. The condition is diagnosed by ultrasonography, radiology or surgery, and is usually treated by using air or hydrostatic reduction enema under radiologic or ultrasound guidance. However, surgery may be required in some cases, and approximately 10% of patients with IS underg