Prevalence of Intussusception after Rotavirus Vaccination: A Hospital Based Study from Odisha, India SC09-SC12
Dr. Nirmal Kumar Mohakud,
Associate Professor, Department of Paediatrics, KIMS, KIIT, Patia, Bhubaneswar-751024, Odisha, India.
Introduction: Intussusception is a common cause of bowel obstruction in children and results in significant morbidity and mortality. Most recent evidence shows a slight increase in risk of intussusception after rotavirus vaccination. Following introduction of Rotavac®, an indigenous oral rotavirus vaccine, there is a need of continuous surveillance for intussusception.
Aim: To examine epidemiology of intussusception in children aged <5 years admitted in hospital and the risk of onset of the disease during vaccination.
Materials and Methods: A hospital based surveillance was conducted during period of September 2016-June 2018 to assess intussusception. In the case-control study, a total of 13 hospital admitted cases aged <5 years with intussusception according to Brighton level 1 criteria and 8 controls were included. Plasma VP6 level for presence of Rotavirus and hemi nested PCR for measuring VP7 and VP4 gene levels in cases and controls were performed. Age, sex and locality matched controls were considered for comparison.
Results: The frequency of intussuception was 0.67% and 0.93% for children <5 years and <2 years of age, respectively. The median age of onset was 11.33+7.12 months in patients <2 years of age. Rotavirus was not detected in stool samples of cases, however, only one control (12.5%) was positive for the pathogen. Fifteen (88%) children with intussusception were managed conservatively and 2 cases (12%) required surgery, without mortality.
Conclusion: Prevalence of intussuception among hospitalised children, aged <5 years, was 0.67%. In this study, we had observed the absence of rotavirus association among the cases of intussusception, either due to rotavirus vaccination or natural rotavirus infection. The study provides baseline information for epidemiology of childhood intussusception in children of Odisha during post rotavirus vaccination programme implemented by Government of India.